Hospitalists are here to stay, for good.

MedPage Today reports on a NEJM study, not surprisingly concluding that "hospitalists now account for nearly 40% of inpatient Medicare claims for general internist services, up from less than 10% in 1995."

That's a lot.

How will it affect primary care doctors, who increasingly are confined to the office? Well, it's not a positive as you'd think.


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The work ethic instilled in most physicians may actually be a detriment to patient care.

In this piece in Slate, emergency physicians Zachary F. Meisel and Jesse M. Pines write about the culture in medicine where doctors are expected to show up for work (via RangelMD.com), no matter what their malady is: "Sick doctors have been known to do rounds while dragging IV poles and receiving fluids for ...

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Corporations are finding out what primary care doctors already know: it's hard to make money only doing office visits.

CVS has announced they are closing 90 of the 550 MinuteClinic locations until next fall's flu season.

As the WSJ Health Blog comments, "the clinics appear to be showing a pattern sort of like the dot-com bubble, in which some will go away while others survive."

That's ...

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The movement of "health coaching" is gaining some traction in health care circles.

PookieMD explores the phenomenon, and finds that a health coach, among other duties, "help people clarify their health goals, and implement and sustain behaviors, lifestyles, and attitudes that are conducive to optimal health; guide people in their personal care and health-maintenance activities; and, assist people in reducing the negative impact made on their lives by chronic ...

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There's such a shortage of dentists in Maine that primary care doctors are the ones pulling teeth.

Not only does the state have a severe shortage of dentists, poorer patients have trouble seeing one, since few accept those without insurance or with Medicaid.

So that leaves the primary care doctors to pick up the slack and learn to pull teeth, screen for tooth decay, or lance oral ...

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What if a retired physician, Harvard-trained no less, wanted to give away medical care?

You'd think the huge demand would make it easier for him to accomplish this, but that's not the case.

When funding dried up for New York physician Lloyd Hamilton's free care clinic, he wanted to continue serving the same patients, even depriving himself of a salary. Unfortunately, it wasn't so easy, as ...

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First, Wall Street executives are vilified. Are academic physician-administrators next?

The WSJ Health Blog didn't do the profession any favors by highlighting the fact that 3 of the top 4 highest paid college employees were physicians at academic medical centers, pulling in $3 million to $4 million per year.

Needless to say, that statistic comes out at an inopportune time, only reinforcing the false public notion that ...

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Meet the obstetric version of hospitalists, known as laborists.

Faced with rising malpractice premiums, and the increasing financial pressure to see more patients in the office, more obstetrician/gynecologists are ceasing to deliver babies. In fact, according to Massachusetts' largest malpractice carrier, more than half of the OB/GYN's they cover have dropped obstetrics.

It's no wonder, as "an obstetrician-gynecologist in Massachusetts generally pays between $75,000 and $100,000 ...

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"I make my living off unnecessary procedures."

So will be the rallying cry of some doctors once the true impact of comparative effectiveness research (CER) is felt.

Proponents of CER have been very careful not to associate its evidence-based findings with the coverage decisions of Medicare and other health insurers.

But let's face it, that eventually has to happen. I see CER as the initial baby ...

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It's been said that hospitalists are the fastest growing specialist field in the history of medicine.

Hospitals are constantly recruiting, and the increasing demand is continually pushing salaries up. But, in the midst of the current recession, what does the future hold?

Writing in Today's Hospitalist (via Dr. RW), Erik DeLue predicts that salaries are likely to plateau, or even fall. Most hospitals ...

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