April 2008

All Stories

My take: Just say no to unnecessary tests

in Uncategorized | 20 responses

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 frequently encounter similar questions. Despite lacking studies suggesting any benefit to ordering ...

Bipolar Disorder

in Uncategorized | no responses

Bipolar Disorder
In the Clinic - Bipolar Disorder - Dr. James Potash, MD
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Relying on prayer, prosecuting the parents

in Uncategorized | 3 responses

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 their other children to have another chance to do it again."

Note to politicians: Balance billing is essential

in Uncategorized | 2 responses

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 force in health care. Without balance billing, primary care will never return. Without balance ...

Insulating your practice from Big Pharma

in Uncategorized | 5 responses

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 realized what was going on and learned that a key lesson in the education of ...

More on doctors getting a life

in Uncategorized | one response

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 some specialty practices have not been set up this way."

Practices ...

Doctors with MBAs

in Uncategorized | 2 responses

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 to run their practice."
Some sort of business training should be mandatory prior to becoming ...

Treatment of Eye Herpes

in Uncategorized | no responses

Treatment of Eye Herpes
In the Clinic - Dr. Christopher Rapuano, MD - Treatment of Eye Herpes
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Are you a Super Doctor?

in Uncategorized | no responses

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 and off Castle-Connolly's list in New York Magazine, since it seems more hit ...

Tobacco dependence and disease mongering

in Uncategorized | no responses

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, is portrayed as harmless in medicinal form, as is buproprion (which can cause seizures) and ...

Traffic cameras and P4P

in Uncategorized | no responses

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, no original thought involved. Follow the rules and you will get paid.:

The cost of giving patients time

in Uncategorized | 2 responses

Burnout:

"Medicine has ceased being a pleasant job, except for the patients. If you're not made to be a doctor and willing to put up with all of this for the joy and gratification of a job well needed and well done, it just isn't worth the trouble. So many doctors just quit. They get a more defined job. They get a salaried job."

A Changing Mole

in Uncategorized | no responses

A Changing Mole
If I Had - A Changing Mole - Dr. Nanette Liegeois, MD, Ph.D
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