Comments on: Poll: Top health care issues you will face in 2009 as a practicing physician

By: Karen

Karen — Mon, 19 Jan 2009 23:09:00 +0000

Consumers may never see the savings appreciated by the Pharmaceutical Companies being denied access to their toolbox of freebies because corporate America always finds a way to fritter away their resources. It will be refreshing to see their Barbie and Ken doll sales reps reach back into their cranium rather than their goodie chest for conversation starters and to explain the validity of why anyone should prescribe or consume their product.

By: Family Medicine Resident

Family Medicine Resident — Wed, 19 Nov 2008 05:11:00 +0000

I'm a big fan of your emphasis on the lack of access to primary care, but you so often forget to mention those of us who *specialize* in primary care, Family Medicine specialists. Yes, only 2% of IM residents are going into primary care. That's why we're here! We are an important component of strengthening the primary care network in this country.

Our specialty is of course plagued by lack of interest in primary care; many slots go unfilled or are filled with people who are unable to be competitive in other residencies. Interest in Family Medicine has decreased significantly over the past decade. But we're also part of the solution, don't forget us!

Perhaps some of those who went into internal medicine initially hoping to practice primary care would have been happier in Family Medicine. Unfortunately as soon as they enter the world of IM they are bombarded by specialists, hospitalists, and proceduralists and have very little primary care exposure. In my residency program, only 2 of the 8 people who specifically entered the primary care track are actually planning to do primary care. These are people who self-selected to do primary care upon graduating medical school, so something happened in those 3 years to make only 25% of them want to continue in primary care. Something is very wrong in the public view of primary care providers, but even more disturbing is how we are viewed within our own profession.

By: Anonymous

Anonymous — Mon, 17 Nov 2008 14:23:00 +0000

There are so many negatives facing a small practice in implementing EMRs includign high cost of acqusition, high ongoing costs, very hard transitions, and in my view, dubious improvement in patient outcomes. Also, the temmplates are filled with nonsense, you can’t communicate with anyone else except to print and fax, etc. Maybe the best argument is to cue the coders? I really do not think we are there yet.

By: DR. MARY JOHNSON

DR. MARY JOHNSON — Mon, 17 Nov 2008 13:25:00 +0000

You left a BIG one out Kevin . . . and that is REAL ACCOUNTABILITY for all of the people/institutions hovering over and around the practice of medicine . . . from the businessmen of medicine (i.e. hospital/practice administrators), to insurers, to the pencil-pushers in government programs, to the politicians "overseeing" those programs, to lawyers.

Doctors have been hammered for well over a decade - selectively singled out as wholly accountable for every wrong - when, in fact, so much of what we do depends upon and is affected by the actions of others.

And, when it comes to accountability in the equation of medicine, those "others" have gotten a free ride - or free license to skim off the top.

To coin a phrase, it's time for a CHANGE.

P.S. Some personal accountability for patients would be nice as well. It ain't all free - whether patients are paying for, insurers or the government.