On a recent international flight to London, a passenger required medical assistance.  I don’t know if it is the karma of London but this is the second medical emergency on a plane headed to London that I have encountered. I was only a couple rows behind the passenger and could see even before the crew announced the need for a doctor that he needed assistance.  I jumped over the woman ...

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It was 1976 and I had just started my solo practice.  I employed only a receptionist and a nurse.  My nurse was absent because of an illness and I asked my middle-aged mother to come and serve as my chaperone for the afternoon. The first patient was a young lady and I asked her to give a urine specimen and place it in the turnstile in the restroom.  My mother, wearing ...

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Since it strikes at the very core of what this blog is all about, I couldn’t pass up the opportunity to comment on Dr. Karen Sibert's recent op-ed piece in the New York Times. She argues that, especially given the current shortage of primary care doctors in this country, being part of the medical profession confers one with the moral obligation to serve and, as such, conflicting interests, such ...

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"I need you to do me a favor," my nurse asked me at the end of our day on Friday. "Sure," I answered, "what do you want?" "Please have a better week next week," she said with a pained expression. "I don’t think I can handle another one like this week." It was a bad week.  There was cancer, there was anxiety, there were family fights, there were very sick children.  It’s not that ...

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The word "holistic" has been kidnapped by practitioners of alternative medicine and marketers.  Holistic has become synonymous with "all natural" treatments and cures.  Those who kidnapped the word holistic imply that medical doctors are not holistic.  The implication is that docs treat the disease and not the person. According to the Merriam-Webster Dictionary, holistic means, "relating to or concerned with wholes or with complete systems rather than with the analysis of, treatment ...

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Turns out there is an unintended consequence of many of the current efforts to standardize the way doctor’s practice medicine.  It is called de-skilling.  De-skilling can occur when physicians and other providers try to adapt to standardized, new ways of doing things.  Examples of such standardization include clinical based care guidelines, electronic medical records (EMRs), pay for performance (P4P), patient centered medical home (PCMH) requirements and so on. Examples of ...

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With computerized health systems, physicians can place orders as easily as they can shop online at Amazon.com. Just a few clicks and your physician can purchase a panel of blood tests, futuristic imaging and diagnostic procedures that will hopefully guide their path to solving your ailments. Search. Click. Submit. Repeat. Except, unlike online shopping, physicians don’t see the price tags and they never get the bill. Doctors are the true consumers ...

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Billing is way more than billing. In a typical medical practice, more than 300 insurance cards cross the front desk every month. The variety of plans and coverage along with the complexities of coding and the difference among payers requires expertise and technology to effectively manage accounts receivable, regardless of practice size. There are two basics required to manage your billing and accounts receivable -- a practice management system and a clearinghouse. The ...

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Something huge happened at the American Medical Association House of Delegates meeting. Although the meaning of what happened will be spun throughout the blogosphere, twittersphere, and schmuckosphere, the bottom line is that the AMA just voted most commercial funding of CME out of existence. Specifically, the delegates voted to approve a report of the AMA ethics committee that calls for a near elimination of industry support for CME. The report is ...

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There is a lot of speculation about why there are fewer and fewer primary care physicians joining the workforce every year. Some have focused on the choices that medical students are making when choosing residencies. Whether due to laziness, desire to make money or the drive to be perceived as “successful” in choosing a more prestigious specialty, the new generation of physicians are being blamed for not ...

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