An emergency physician, like me, may be the worst possible person to discuss relationships with patients. I mean, one of the reasons I chose this specialty was that I didn’t want long-term relationships with my patients. I see, now, that God has a great sense of humor. See, the county I landed in after residency is small enough that I do know many of my patients, and I do see them ...

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Believe it or not, some element of federal tort reform is not only possible, but likely. Sounds counterintuitive? We all know that Congress has a strong majority with Democrats. We know the President is also a Democrat. We know the plaintiff’s bar strongly supports the Democratic Party. We know that Democrats have traditionally shied away from specific reforms, such as caps on pain on suffering. So, this would seem the worst ...

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Turns out, it may not matter. According to a recent study from the Archives of Surgery, when it comes to trauma surgery, the mortality rate of trauma causes handled by "novice" surgeons - those just out of residency - did not differ appreciably from those handled by more experienced doctors. As reported by ABC News (under the somewhat melodramatic headline, "In the ER, Baby-Faced Doc Is No Death Sentence"), whether the ...

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Operating is difficult enough, but imagine doing on someone's organs that were transposed on the other side. 1 in 10,000 patients have a condition known as situs inversus, where, despite the non-traditional placement of organs, patients function without clinical symptoms. In this interesting piece from MedPage Today, several surgeons are interviewed about their experiences performing procedures on such patients. For instance, when talking to a heart surgeon who knew ...

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by Derek Mazique Between “death panels,” a NICE-style cost effective analysis board, and Obama’s slowly graying hair, one conspicuously absent part of reform are reimbursement rates. Medicare and private insurance typically reimburse for expensive procedures, which ultimately rewards procedure-heavy specialists while discourage those cognitive-heavy services like primary care docs. The result? As a recent Baltimore Sun op-ed and this very blog pointed out, a combination of pay and burn-out are encouraging ...

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My latest opinion piece was published on CNN this morning. cnn Entitled, Why the doctor won't see you now, it should be familiar to regular readers of KevinMD. Here's an excerpt:

Although it is a moral imperative for every American to have access to health insurance, alleviating the shortage of primary care providers is of equal importance. The prospect of ...

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When physicians in other countries come to the United States, they often become nurses or lab technicians, rather than re-taking rigorous board exams to remain doctors. One example includes doctors from Cuba. According to this story in The New York Times, "6,000 medical professionals, many of them physicians, have left Cuba in the last six years." Cuban doctors, who often earn $25 per month, find it significantly more ...

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Fear-mongering about health care reform killing grandma really burns me: I have delivered "everything", I know what "everything" looks like. I know its dark side. I also know that these deliberate and self-serving lies will ultimately hurt not only grandma, but the rest of us too. Here is what I mean. When I was in practice I cared for critically ill patients. I loved the ICU for its complex physiology and ...

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According to a recent op-ed, Jim Hall, former chairman of the National Transportation Safety Board, says, "Because American medicine accepts error as an inevitable consequence of treatment, our hospitals, insurers and government do little to respond to unnecessary deaths. If we are to address the problem in a serious manner, we must first change this culture." But a simple solution to reduce medical errors may be elusive, says emergency physician ...

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The primary care physician (PCP) shortage has attracted a lot of attention recently, and for good reason. Individual Americans are concerned that they will not have timely access to needed medical care, and policy makers are concerned that our specialist-heavy medical system is failing, giving us expensive but disjointed, poor quality care. Many experts rightly think that a robust primary care system would give us better health care for ...

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