From the monthly archives:

April 2008

My take: Just say no to unnecessary tests

April 30, 2008

This is a piece that I wrote awhile back. I have used some of the article’s wording in recently published op-eds.
“Aren’t you are going to order a urine test, chest x-ray or electrocardiogram?”
The patient before me was a healthy adult I was seeing for a preventive health exam. As a primary care physician, I [...]

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Bipolar Disorder

April 30, 2008
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That’s pretty nasty

April 30, 2008

Read why.

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Health insurance is the new Green Card

April 30, 2008

WSJ Health Blog: “Seven percent of Americans said that in the past year they or someone in their household decided to tie the knot mainly so one spouse would be eligible for the other’s health coverage.”

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Relying on prayer, prosecuting the parents

April 30, 2008

Orac: “That is why I am heartened to see the Neumanns prosecuted, even though it may well be an uphill battle to obtain a conviction. So great is our deference to religion in this country that I am not at all confident that the Neumanns won’t get off scot-free and even ultimately regain custody of [...]

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Note to politicians: Balance billing is essential

April 30, 2008

The Happy Hospitalist: “My biggest problem, which I think outweighs all other issues in the health care. And that is balance billing. Payment rates by our government and followed by all third party payers have decimated cognitive medicine, the exact saviour of McCain’s proposed market system. Without balance billing, we will never have a market [...]

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Insulating your practice from Big Pharma

April 30, 2008

Concupiscent Curds: “I still fool myself sometimes thinking I’ve sterilized my practice from Big Pharma. But I haven’t and I’m not sure I could completely. I am always on guard, though, against them trying to cozy up to me. In fact, one rep came close to actually becoming a friend until I [...]

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More on doctors getting a life

April 30, 2008

Toni Brayer: “Young physicians do not want to deal with office employees or running a business. They expect a full schedule of patients to be there and an office administrator to deal with other business aspects like contracting with insurers, collecting payments and worrying about Medicare hassles.
The problem is that primary care practice and even [...]

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Doctors with MBAs

April 30, 2008

Any physician who recognizes that good business skills is essential in medicine is ahead of the curve:
“Medical schools have done a horrible job preparing physicians to enter into private practice. They don’t give them any understanding of debits and credits, what it’s like to run a small business. They’re prepared to be clinicians, not [...]

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My take: Preventive care, geriatricians, lifestyle

April 29, 2008

1) 80% of preventive care occurred outside of yearly physicals.
My take: Interesting study questioning the usefulness of a routine physical. In many cases, unnecessary tests are performed during these visits, driving up health care costs.
However, I find a routine preventive health visit helpful. It is a way to consolidate a patient’s screening status [...]

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Treatment of Eye Herpes

April 29, 2008
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Are you a Super Doctor?

April 29, 2008

And should you want to be one?
Do these lists really measure quality? I don’t think they do. If there is no vetting of who gets the surveys in the first place, then the results are really just a mish-mash of referral patterns across and between specialties. I’ve always been surprised at seeing who is on [...]

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Tobacco dependence and disease mongering

April 29, 2008

Bioethics Forum: “It is almost as if these companies had made a joint decision to cast smoking as a chronic disease in order to reposition their products as long-term maintenance medications, like methadone. Smoking cessation is painted as a goal unachievable without pharmacologic assistance. Nicotine, the addictive component in both cigarettes and nicotine replacement products, [...]

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Life of a hospitalist: "A highly paid intern"

April 29, 2008

Hospitalist medicine is similar to what internal medicine residents do in the hospital. That’s part of the appeal for newly graduated doctors who want to continue to do what they’re familiar with.
After a few years of doing this, you start to realize that there’s more to medicine than scutwork.

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"His penis was basically sitting in a small pool of old urine"

April 29, 2008

Please, urinary catheters are not meant to be home-made.

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Traffic cameras and P4P

April 29, 2008

Dr. Wes: “I saw this ticket as an extreme example of “Pay for Performance (P4P)” – just like we are implementing in healthcare. P4P is another government-mandated endeavor to assure the best quality of healthcare through the use of “absolute truths” agreed upon by a body of experts. There can be no room for negotiation, [...]

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