Comments on: My take: PCP influence, stroke, ECGs/MIs, doctor shortage http://www.kevinmd.com/blog/2008/04/my-take-pcp-influence-stroke-ecgsmis.html Tue, 14 Feb 2012 23:00:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/04/my-take-pcp-influence-stroke-ecgsmis.html#comment-85089 Anonymous Fri, 18 Apr 2008 18:20:00 +0000 http://clients.emmense.com/kevinmd/2008/04/my-take-pcp-influence-stroke-ecgsmis-doctor-shortage.html#comment-85089 @ Dr Blue, and Anon 6:23 PM - "Why don't the USA make your certification rules easier and import many English GPs who are fed up of the constrints [sic] of the NHS?"<br/><br/>In fact, there IS reciprocity with the Royal Colleges and the American Board of Family Medicine. <br/><br/>http://tinyurl.com/4blv3q<br/><br/>[Links to the American Board of Family Medicine]<br/><br/>I don't know about other specialty boards, they all have their own rules. But at least for family physicians (GP's in the UK), the American Board of Family Medicine reciprocates with the College of Family Physicians of Canada, the Royal New Zealand College of General Practitioners, the Royal Australian College of General Practitioners, and the Royal College of General Practitioners of Great Britain. @ Dr Blue, and Anon 6:23 PM – “Why don’t the USA make your certification rules easier and import many English GPs who are fed up of the constrints [sic] of the NHS?”

In fact, there IS reciprocity with the Royal Colleges and the American Board of Family Medicine.

http://tinyurl.com/4blv3q

[Links to the American Board of Family Medicine]

I don’t know about other specialty boards, they all have their own rules. But at least for family physicians (GP’s in the UK), the American Board of Family Medicine reciprocates with the College of Family Physicians of Canada, the Royal New Zealand College of General Practitioners, the Royal Australian College of General Practitioners, and the Royal College of General Practitioners of Great Britain.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/04/my-take-pcp-influence-stroke-ecgsmis.html#comment-85079 Anonymous Fri, 18 Apr 2008 11:26:00 +0000 http://clients.emmense.com/kevinmd/2008/04/my-take-pcp-influence-stroke-ecgsmis-doctor-shortage.html#comment-85079 if equalizing the income disparity between general practitioners and specialists means decreasing the pay for the specialists rather than increasing the pay of the generalists, which, given the current political atmosphere, doesn't seem all too unlikely, then i wonder who will go into medicine at all. all those loans and lost years for $75-90k a year? if equalizing the income disparity between general practitioners and specialists means decreasing the pay for the specialists rather than increasing the pay of the generalists, which, given the current political atmosphere, doesn’t seem all too unlikely, then i wonder who will go into medicine at all. all those loans and lost years for $75-90k a year?

]]> By: the a&amp;e charge nursehttp://www.kevinmd.com/blog/2008/04/my-take-pcp-influence-stroke-ecgsmis.html#comment-85077 the a&amp;e charge nurse Fri, 18 Apr 2008 08:19:00 +0000 http://clients.emmense.com/kevinmd/2008/04/my-take-pcp-influence-stroke-ecgsmis-doctor-shortage.html#comment-85077 Kevin - I cannot find any reference to the exclusion of MI after a single ECG trace (in the article on the proposed triage system).<br/><br/>You may be aware that current health policies in the UK are geared toward increasing the management of chronic diseases outside of hospital (which increases the risk threshold for GPs, of course).<br/><br/>Many GPs have an ECG machine quietly gathering dust in a corner of their surgery - does this kit have ANY role to play in risk stratification ?<br/><br/>I can't help noticing your concerns about litigation but in what way does an additional investigation increase the risk of a law suite, or is this more a reflection of the American health scene ?<br/><br/>As I say an ECG cannot be used to exclude MI but may be used in the prehospital setting to determine if a patient should be delivered directly to the cath lab rather than the ED (if elevated ST segments are evident on the 12-lead). <br/><br/>This investigation may also have it's uses if it reveals Wenckbach rather than 3rd degree block, say ? Kevin – I cannot find any reference to the exclusion of MI after a single ECG trace (in the article on the proposed triage system).

You may be aware that current health policies in the UK are geared toward increasing the management of chronic diseases outside of hospital (which increases the risk threshold for GPs, of course).

Many GPs have an ECG machine quietly gathering dust in a corner of their surgery – does this kit have ANY role to play in risk stratification ?

I can’t help noticing your concerns about litigation but in what way does an additional investigation increase the risk of a law suite, or is this more a reflection of the American health scene ?

As I say an ECG cannot be used to exclude MI but may be used in the prehospital setting to determine if a patient should be delivered directly to the cath lab rather than the ED (if elevated ST segments are evident on the 12-lead).

This investigation may also have it’s uses if it reveals Wenckbach rather than 3rd degree block, say ?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/04/my-take-pcp-influence-stroke-ecgsmis.html#comment-85074 Anonymous Fri, 18 Apr 2008 01:47:00 +0000 http://clients.emmense.com/kevinmd/2008/04/my-take-pcp-influence-stroke-ecgsmis-doctor-shortage.html#comment-85074 shouldn't there be some kind of differential. My residency was much more difficult and longer than that of a family practitioner. Shouldn't some sort of disparity exist. I don't expect to make as much money as a neurosurgeon or a ct surgeon. <br/><br/>I think the differential is a bit excessive at some times, but then I do know some fp's that are making far in excess of the average, but they are working very hard and the specialists that I know that are making the average seem to be working with substantially more call.<br/><br/>Of course most of the fp's around here don't take any call, they send all of their patients to a hospitalist. shouldn’t there be some kind of differential. My residency was much more difficult and longer than that of a family practitioner. Shouldn’t some sort of disparity exist. I don’t expect to make as much money as a neurosurgeon or a ct surgeon.

I think the differential is a bit excessive at some times, but then I do know some fp’s that are making far in excess of the average, but they are working very hard and the specialists that I know that are making the average seem to be working with substantially more call.

Of course most of the fp’s around here don’t take any call, they send all of their patients to a hospitalist.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/04/my-take-pcp-influence-stroke-ecgsmis.html#comment-85060 Anonymous Thu, 17 Apr 2008 23:25:00 +0000 http://clients.emmense.com/kevinmd/2008/04/my-take-pcp-influence-stroke-ecgsmis-doctor-shortage.html#comment-85060 Kevin: If the fee and income differential is corrected, why would PCP's need or warrant loan foriveness. Aim for the first and the second will not be needed. I know you don't buy the idea that loan forgiveness will be result in enslavement but you'll figure it out when it is too late if it is ever implemented. Better to get fair reimbursement and buy you own education with it than to be state property, bought and paid for. Kevin: If the fee and income differential is corrected, why would PCP’s need or warrant loan foriveness. Aim for the first and the second will not be needed. I know you don’t buy the idea that loan forgiveness will be result in enslavement but you’ll figure it out when it is too late if it is ever implemented. Better to get fair reimbursement and buy you own education with it than to be state property, bought and paid for.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/04/my-take-pcp-influence-stroke-ecgsmis.html#comment-85059 Anonymous Thu, 17 Apr 2008 23:23:00 +0000 http://clients.emmense.com/kevinmd/2008/04/my-take-pcp-influence-stroke-ecgsmis-doctor-shortage.html#comment-85059 30% of our doctors are foreign medical graduates now and a lot of the ones who do get through the current certification process suck. We will be glad to have you but you'll have to clear the bar that is in place--not ask for it to be lowered. 30% of our doctors are foreign medical graduates now and a lot of the ones who do get through the current certification process suck. We will be glad to have you but you’ll have to clear the bar that is in place–not ask for it to be lowered.

]]> By: Dr Bluehttp://www.kevinmd.com/blog/2008/04/my-take-pcp-influence-stroke-ecgsmis.html#comment-85057 Dr Blue Thu, 17 Apr 2008 20:17:00 +0000 http://clients.emmense.com/kevinmd/2008/04/my-take-pcp-influence-stroke-ecgsmis-doctor-shortage.html#comment-85057 Why don't the USA make your certification rules easier and import many English GPs who are fed up of the constrints of the NHS? Why don’t the USA make your certification rules easier and import many English GPs who are fed up of the constrints of the NHS?

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