There's no question that health reform needs to rebuild around primary care medicine.
Doctors give their own suggestions, including aligning generalist salaries comparable to how the UK pays GPs in their nationalized health system, which is approximately "$230,000 a year plus 25% performance bonuses."
Some other more aggressive tactics involve forming a physician union, or joining the Service Employment International Union (SEIU). One doctor has initiated ...
January 2009
All Stories
Jett Travolta’s seizure and death, was Scientology a factor?
Jett Travolta tragically passed away yesterday, after being found unconscious in his hotel room by his caretaker. There is speculation that he had a seizure and hit his head on a bathtub.
Travolta apparently had a long history of medical problems, including Kawasaki disease, which is a vasculitis that primarily affects children. It is one of the most common causes of acquired heart disease in children, and ...
What should a doctor do when he discovers another doctor’s mistake?
An interesting question.
Amy Tuteur asks this question at a dinner party, and it elicits a whole host of responses. If a patient asks directly, the answer is easy. But what if the patient doesn't ask? Is there an ethical requirement to disclose another physician's error?
My first reaction, along with Dr. Tuteur's, would be full disclosure, meaning that the patient should know everything ...
Local television news may be using pre-packaged health stories
Budget cutbacks are forcing some local television stations to use canned health segments that can be tailored to a specific local market.
The result can give "viewers the false impression that the stories were locally produced and the patients and doctors quoted in the stories could be their neighbors," and one nationally syndicated physician is ...
The economy, plastic surgery, and how it’s affecting cash only medicine
It's no secret that difficult economic times have forced many patients to put off cosmetic surgery.
No where is that more apparent than in South Korea, the Asian "mecca" of plastic surgery. Thirty percent of Korean women had cosmetic procedures done last year, and now, scores of luxury clinics either are empty or have gone out of business.
Doctors are always drawn to cosmetic procedures, since ...
How old is too old to continue breast feeding?
A woman continues to breast feed her 6-year old son.
Many find that shocking, but when you consider that "the average age of weaning around the world is 4 years old and there are no studies saying it is harmful," is it really?
While psychologists wonder whether it will impede the ability to "develop the capacity to soothe oneself, the capacity to tolerate frustration," mothers claim a ...
Is health care prohibition in our future?
One scenario envisioned by health reformists is to prohibit doctors from practicing outside a government-run system.
This is the situation in Canada, leading to single-tier health care. Opting out of Medicare and other health insurers remains the last trump card doctors have in negotiations. Removing that option would enslave physicians to the whims of government control. Most health policy wonks would like nothing more than to ...
Are doctors finding the physical exam useless and obsolete?
Many are bemoaning the deterioration of physical exam skills that the current generation of doctors are displaying.
Bob Wachter says it may not be that big a deal. "Even if we could create a new generation of expert physical examiners," he writes, "would it be worth the time and trouble?" He doubts it, saying the time spent to learn and perform a comprehensive physical has to be ...
Health journalists need to be held to a higher standard
I have been critical in the past with the health reporting in some major media publications.
The NEJM has a nice perspective piece (via Gary Schwitzer) on the issue from Susan Dentzer, editor-in-chief of Health Affairs. In today's 24/7 news cycle, health stories provide ample opportunities for "gotcha" headlines. Nothing captures the public's attention like reporting a drug scare, a botched ...
How the general surgeon shortage affects patients
General surgeons are the primary care doctors of proceduralists.
As the current generation of physicians are placing a priority on controlled hours and emphasis on lifestyle, general surgery is taking a hit.
Medical students are gravitating towards specialties like dermatology or radiology, with comparable incomes but less grueling hours, and young surgeons are specializing "in fields such as transplant surgery or plastic surgery, in which they can ...
What’s good about our health care system?
Whenever you read magazines or watch TV, the news on our health care system is never good.
Val Jones convenes a community group to talk health reform, and refreshingly, talks about the positives in our health system.
Some cited examples of what's right include customer service, accommodations for persons with disabilities, access to specialty care, and drug development for rare diseases.
Our health care system certainly ...
Why doctors are reluctant to adopt electronic records
Most of the rewards go to the insurance companies instead of benefiting the physician.
This piece by David Hamilton doesn't break any new ground, and I cited a statistic earlier this year that doctors only realize about 11 percent of each dollar saved with EMRs.
Nonetheless, it's a good overview of the obstacles facing every doctor who's on the fence about going electronic. Office costs in ...
Who loses the most with the drug company gift ban?
The makers and distributors of the promotional products of course.
It's a $19 billion industry, and the ban is going to set these companies back at least $1 billion. Pen makers for instance, often receive orders in excess of one million pens per drug.
Kevin Pho, MD
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Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
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Should Google censor anti-vaccine claims?
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
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Radiologists who cheat on their board exams: Who’s to blame?
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
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Doctors: Don’t be ashamed about going bankrupt
Are doctors really going broke? According to this piece from CNN Money, some are: "Doctors list shrinking insurance reimbursements, changing regulations, rising...
Physician
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Patients will understand an honest mistake if the doctor tells the truth
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned...
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Diagnosing an illness is an art
Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. ...
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Physicians have a natural role as advocates
As physicians, we are often called upon to be advocates for our patients. Sometimes they have no other person to turn to....
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Our society expends huge sums on futile care
Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for "feeling good", but...
Patient
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How will the Baby Boomers age and die?
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in...
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Patient engagement is the holy grail of health care
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a...
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Why do doctors delay hospice referrals?
This is a response to Deb Discenza's article requesting a one page informational sheet informing a patient about hospice or palliative care. This would...
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How touch can calm patients
So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence. The following passage really caught my attention: "Question is: are...
Policy
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Improve patient safety to improve healthcare quality
It has taken 13 years for us to revisit the issues in To Err Is Human, the 1999 landmark government report that...
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A lack of incentive for medical schools to train primary care doctors
A social media movement is happening before our eyes with action starting to take shape. The #occupyhealthcare movement has begun within to...
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What should be the stated aim of health care in America?
The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering...
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How Moneyball applies to healthcare
The storyline is familiar. An organization is challenged to achieve better results without spending more money. An executive is committed to obtaining...
Tech
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New classes of devices to diet and exercise
For many celebrities, their livelihoods depend on their physical appearance and they rely on armies of personal assistants, schedulers, stylists, trainers and...
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Repetition is the curse of the doctor-patient engagement
How many times as a doctor do you ask the same questions over and over again as part of the routine process...
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Why the prognosis of patients is difficult
Many clinical decisions in older persons are dependent on life expectancy. For example, as life expectancy declines, cancer screening is likely to...
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Innovative technologies can markedly enhance safety
“To Err Is Human” is the title of the now famous book from the Institute of Medicine on patient safety published about...
Social Media
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The Internet is where patients go for pre-visit consultations
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
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5 ways doctors can benefit from professional connections
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
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Twitter Is my third office location
The physician’s decision to first dive into social media can be stress-inducing. Issues of time management, maintaining professionalism, and determining a return...
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The impact of social media on a physician assistant
The impact of social media on medicine could arguably be compared to the impact of the industrial revolution on the human condition....
