SHOCKING NEWS: "Fewer American doctors are focusing on primary care, but the decline is being covered by physicians from other countries . . .
. . . Overall growth in the number of primary-care physicians "has been totally due to the number of international medical students training in America," Sanders said. 'We are increasingly dependent on international medical school graduates to meet our needs. Currently, one in four new ...
February 2008
All Stories
My take: MA and the Titanic, second opinions, airplane banter, cheap primary care
1) Boston Globe: "In Massachusetts, the coalition behind the health reform law is holding firm. The plan itself is creative and sound. Who dares call this a failure?"
My take: Sounds like the captain of the Titanic before the iceberg. More people may have health coverage, which in the Globe's view is the only marker for success. Costs continue to spiral to unsustainable levels, and there ...
Primary care is damn cheap, and can solve our health care woes
Ben Brewer: "It makes sense to me that there be fair payment for primary care services that require a lot of what is now largely uncompensated work beyond an office visit. The cost would be peanuts, and the benefits of improved care could be enormous. What's missing in the debate over our nation's health-care crisis is that primary care is cheap. Cheaper than your cellphone bill. Cheaper than a ...
Five patients in the ED
And not an emergent complaint in sight.
Severed carotid
Shadowfax comments on the hockey player who had his carotid artery repaired. Scary stuff.
Arbitration is an answer
Patients are asked to give up their right to a jury trial in favor of arbitration. Lawyers are up in arms over this, but think about it. A malpractice trial is long and laborious, and at the end of it all, patients are often not appropriately compensated for medical errors.
Arbitration would be a more streamlined process, and allow patients to be compensated more quickly.
Canada’s single-payer: "They think it needs to be torn to the ground and built back up"
Looks like the grass isn't greener on the other side:
More than two-thirds of Canadians think the health-care system needs major repairs or a complete overhaul, says a national poll that regularly gauges public attitudes on health.
The survey also found that most professionals who provide health care agree with the sentiment.
Sixty-nine per cent of nurses felt the system needed significant change, while 62 per cent of ...
My take: Carrot > stick, the pandering NEJM, retail clinics
1) Merrill Goozner notes that when it comes to wellness programs, employees respond better to the carrot than the stick.
My take: The same goes for physicians. Instead of cutting reimbursements, why not reward them instead? P4P is a step in this direction, but the carrot is not nearly big enough.
2) The NEJM recently ran a left-pandering op-ed by the American Prospect's Robert Kuttner.
Orgasms
Got your attention. Now read what the LA Times has to say about it:
How, for example, can they explain the fact that some men and women who are paralyzed and numb below the waist are able to have orgasms?
How to explain the "orgasmic auras" that can descend at the onset of epileptic seizures -- sensations so pleasurable they prompt some patients to refuse antiseizure medication?
Does Eric Dane have skin cancer?
Grey's Anatomy fans, tune in to the dermatologist at Skinema to find out.
When patients won’t take personal responsibility
And until they do, don't expect rising health costs to subside. Take a look at the backlash to tough wellness programs:
The conflicts playing out as employers try to contain skyrocketing medical costs mirror tensions in society's views about privacy, personal responsibility and shared risk. They reflect growing intolerance for smokers and the obese. And they signal an erosion of a belief that once stood at the bedrock ...
The vigorous comber
ER Stories: "Somehow this guy lacerated his scalp with the comb. Not just a small cut but he literally opened up a giant flap that was between 4 and 5 inches long! It was gushing blood when the EMT's arrived, who stanuched the flow with about 10 Kerlix's. It required a deep layer of sutures and about 15 more in the skin to properly close it."
Garbage in, garbage out
Why public reporting of physician quality is next to useless.
When doctors cherry pick
In-demand Canadian GPs get to call the shots on who they accept as patients.
Starting physician salaries
Why are there such a primary care shortage? It's a no-brainer:
Nearly half of all physicians come out of medical school with more than $175,000 in debt from student loans. That adds an immediate burden on new doctors who are trying to establish practices, particularly in a rural setting such as northern New York.
"When they are deciding what kind of specialty to turn to, they are going ...
"Was it the DNR that killed her?"
Scott Haig talks the issues of operating on a 99-year old's hip fracture.
Update:
Christian Sinclair comments further.
The internet disconnect
Doctors and patients view the importance of the internet's role in health information differently:
Even for their patients, let alone for themselves, few physicians view the Internet/Websites as extremely or very important in learning about medications/diseases.
In actuality, however, for the majority of patients the Internet/Websites play a critical role in learning about medications/diseases.
Something about Merck’s web sites
They are most-trafficked by doctors.
How much money should doctors make?
Edwin Leap tries to tackle this controversial question.
Remember, any answer needs to take into account the following factors:
i) American medical school debt
ii) malpractice insurance
iii) higher salaries of other professions in the United States relative to other countries
Expanding coverage without access
John Washburn: "Access to primary care would vanish. Even today, you will probably find it difficult to get an appointment with your family doctor within the next few days. But then flood the system with all of these unnecessary government-funded visits, and be ready to wait one or two MONTHS for an appointment. As for those who are sick and need to be seen right now, well they will ...
Kevin Pho, MD
-
Why Priscilla Chan may become the country’s most influential doctor
Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from...
-
Confused about prostate cancer screening? Make a shared decision
In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men. Case closed, right? Hardly. The prostate...
-
When it comes to doctors and social media, hospitals fail miserably
When it comes to medicine and social media, much of the attention is negative. Doctors losing their hospital privileges because of Facebook....
-
Warren Buffett’s prostate cancer choices aren’t right for every man
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
Physician
-
Why test recalls should not be considered cheating
I was appalled recently by the coverage of radiology “test recalls” by CNN, amplified by Dr. Gary Becker of the American Board...
-
Why physicians are susceptible to hardball tactics
I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the...
-
How we deliver bad news is critical to how families deal with grief
As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during...
-
His father’s suffering had already been too great
He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I...
Patient
-
How death can be a beautiful experience
I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law...
-
What meaningful encouragement can be given to someone who is dying?
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
-
Health care journalists have tendencies similar to those of doctors
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
-
Adaptation can be painful, but it can also be a gift
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
Policy
-
What should America’s health care vision be?
America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the...
-
Hospitals around the world aim to remain relevant to patients
"It was the best of times, it was the worst of times ..." So begins a story called A Tale of Two...
-
Repairing the tear in health care’s safety net with social media
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
-
Look to technology to reduce health costs
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
Tech
-
When patient care becomes secondary to filling out the medical record
The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above...
-
Doctors, use Google to get more patients in less than 7 minutes
Every month, hundreds of thousands of people look for a doctor on Google. As an amazing practitioner, your site deserves to be...
-
The user interface for EHRs should be uniform
The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with...
-
EMR liability needs to go further than just the physician
This example of a disaster waiting to happen, in the form of an error-promoting CPOE, is a poster example of why the...
Social Media
-
We need to see the potential harm of social media
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
-
Why social media may not be worth it for doctors
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
-
Transparency defines social media success for doctors
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
-
How Twitter was used in a potential mass casualty scenario
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
