Targeting physician salaries is a poor strategy for health care costsA recent study from Health Affairs took aim at physician salaries. Well, not exactly their salaries, but fees. It's a subtle difference, but that nuance is lost in the mainstream media narrative. According to the study, "American primary care and orthopedic physicians are paid more for each service than are their counterparts in Australia, Canada, France, Germany and the United ...

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How not to convince doctors to embrace single payerWhat would happen to physician salaries if the United States adopted a single payer system? The concept of a single payer system is a progressive ideal, and has been vociferously pursued by some left-leaning physician groups. For a variety of reasons, not least of which is the political climate in our country, I think the chances of single payer ...

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Doctors should learn personal finance during medical schoolI read somewhere in the comments here something to the effect of this: "Physicians are only good for one thing: doctoring." That would explain the general ineptitude of many physicians when it comes to skills outside medicine, such as political lobbying, or business and personal finance decisions. The New York Times has written a helpful column that's required reading for any ...

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How much physician guidance do patients want with medical decisions?As access to medical information has become more common, patients are gaining empowerment in their medical care. And rightly so. Gone are the days where medical decisions are paternalistic in nature, with the physician leading, and the patient following. Today, an ideal medical decision has input from both patient and provider. But, have we gone too far the other way? In ...

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The emotional costs of malpractice mean more to doctors than moneyEvery year, according to a recent study from the New England Journal of Medicine, a typical physician has about a 7% chance of being sued for medical malpractice. Surgeons almost certainly will face a malpractice claim sometime during their career.  Neurosurgeons, for instance, have a 19.1% chance of being sued in a given year, while that number is 18.9% ...

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Why work hour restrictions wont improve patient safetyDarshak Sanghavi recently wrote an excellent piece in the New York Times summarizing the controversy over resident work hours. The topic has been discussed here frequently, with ramifications ranging from the fact that errors arising from patient handoffs negate any benefit gained from restricting work hours, to surgeons not accumulating enough experience during their work hour-restricted training. I've ...

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Should Lipitor go OTC? A cardiologist says yes, an internist says noWith the patent for Lipitor expiring, Pfizer is considering selling an OTC version of the statin. It's generated a firestorm of debate, with doctors speculating on the impact for patients. According to Pharmalot, "an OTC version would allow Pfizer to capture some of the sales that will be lost when the Lipitor patent expires in November. In fact, Pfizer execs recently ...

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Hospitalist care is more expensive but dont blame hospitalistsHospitalists save money.  Until the patient leaves the hospital, at least. A recent study from the Annals of Internal Medicine ignited debate over the cost effectiveness of hospitalists. Looking at Medicare patients from 2001 to 2006, researchers found that "those who were followed by a primary care physician spent about half a day more at the hospital, costing ...

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Why the debt ceiling deal is a horrific outcome for physiciansIf you're a physician or hospital that relies on Medicare payments, grim times are ahead.  Yes, even worse than the scheduled 29% payment cut that's scheduled to go into effect in 2013.  Emergency physician Shadowfax calls the debt deal "a terrible deal for health care providers." Under the contentious debt ceiling agreement, significant cuts in Medicare dollars will be ...

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Advances in cancer treatment are hyped by headlinesThe following op-ed was published on June 5, 2011 in USA Today. A patient recently asked me if I had heard about the new "wonder drugs" used to treat skin cancer. Indeed, I had. In a widely reported story in early June, two novel cancer drugs were found to benefit patients with advanced melanoma, a devastating form of skin cancer. ...

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