One proposed way to control costs is to replace primary care doctors with mid-level providers, like nurse practitioners and physician assistants.

Merely bringing up this idea brings out the worst in turf battles, with most discussions devolving into nurse versus doctor cat-fights.

The ACP comes up with their vision of how nurse practitioners fit within the primary care spectrum. It wisely takes a balanced approach, but, ...

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Despite the fact that almost 100,000 patients die from medical mistakes each year, only 30 percent of those errors are ever disclosed to patients. Saying "I'm sorry" is morally and ethically proper. It re-establishes trust and empathy between doctor and patient, and makes it easier for everyone involved to learn from the incident. Hospitals that have instituted full disclosure programs have seen a decrease in the number of ...

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The fallout from California's balance billing ban is about to get much, much worse.

A patient is suing an emergency physician group for the $57 he spent last year on the balance bill he had to pay for services his insurance didn't cover.

If successful, the results for already near-bankrupt hospitals are chilling, as "hospitals and ER doctors could be on the hook for hundreds of millions of ...

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Washington DC's infamous Walter Reed Army Medical Center is set to close in 2010.

In an effort to subsidize the city's subway system, the medical center purposely limited the number of parking spots, forcing staff to use public transportation.

Combined with the fact that buildings are subject to a height restriction in DC, the campus became increasingly sprawled as it expanded, forcing staff to walk longer distances.


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I think so.

The NEJM has a perspective piece on the declining percentage of doctors who practice independently. Depending on the source, the number ranges from 29 to 61 percent.

It is becoming increasingly difficult for doctors not to be supported by a hospital or large integrated health system. With reimbursements declining, many doctors are opting for the relative security of a salary.

Furthermore, ...

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Studies show that international medical graduates (IMGs) see a disproportionally high number of Medicaid patients when compared to their American counterparts.

Like most doctors, if they had a choice, the incentives are such that they too would choose to practice in cities rather than in rural areas.

Less-restrictive visa requirements are making it harder to recruit IMGs to rural areas, and compounded by the fact that American ...

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A family physician chronicles his journey from an HMO to urgent care to practicing outside of the insurance system.

Steve Simmons notes that doctors out of residency rarely have any training in the business of medicine, including the all-important skill of coding.

"I needed to learn this'skill' on the fly," observes Dr. Simmons, "using a code book to translate each medical diagnosis into a five digit number, ...

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The furor over the California octuplet case refuses to die.

Attention has recently been focused on her doctor, one Michael Kamrava. MedPage Today cites a LA Times story, shedding more light on the physician and his Beverly Hills practice.

In addition to the Suleman case, another one of his patients his currently hospitalized with quadruplets. Apparently, in reproductive medicine, any result greater than twins is ...

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And if you don't, does it really matter?

Bob Wachter discusses a recent study concluding that very few could actually name their hospitalist one month after an admission.

Ideally, "patients need to have a personal connection to their physicians, particularly at times of great need and uncertainty," writes Dr. Wachter.

I agree, but the health system has incentives geared towards giving more disjointed, fractionated care. Hospitalists ...

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Lawyers and left-leaning policy wonks often discount how pervasive defensive medicine is.

WhiteCoat, an emergency physician, is almost convinced by those who call defensive medicine a figment of the medical profession's imagination.

Then he starts his shift working in the emergency department, an experience that most lawyers and policy experts do not have by the way, and cites specific examples where he made a decision specifically to thwart ...

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