If a prescription isn't hand-printed, typed or electronically generated, it can't be filled:

Robertson said random samples of 6,000 prescriptions were collected throughout the state with help from the state's Board of Pharmacy. When pharmacists, physician assistants and others tested the samples, they found 24 percent to 32 percent illegible.
(via medmusings)

Maybe. Many physicians are bringing patients back for multiple visits rather than dealing with all of them during a single visit. Blame the HMOs:

People made more than 1 billion visits in 2004 to doctors' offices, emergency rooms and hospital outpatient departments, according to the report from the National Center for Health Statistics.

This is an increase of 31 percent from 10 years before, while population ...

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A doctor explains why Japan's population is declining.

It is as weird as it sounds:

Two competitors face each other in 11 alternating rounds, six of chess, five of boxing. A bout begins with chess, which is played on a board placed directly in the middle of the ring. Each round of chess lasts four minutes. After each chess round, the bell sounds, and workmen remove the chessboard for a two-minute round of boxing, the gloves go ...

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Seems like everyone is pointing fingers.

Dr. Centor writes on the possible increased reimbursement for E/M services. This single action, if it goes through, will go a long way in resuscitating primary care.

Shadowfax also writes about how emergency medicine will benefit.

Can they be finally cluing in? One can only hope.

There is no data supporting that it works.

Instead of targeting PCPs as they have, they should be making big pharma a cost-cutting focus. What HMOs and Medicare have done is virtually destroy primary care in the US:

It remains a mystery why managed care and Medicare have centered their cost reduction efforts for so long on physicians, and particularly on the least well paid physicians, while apparently willingly paying out ever more for pharmaceuticals . ...

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Joe Paduda writes:

It appears the answer lies in declining reimbursement rates. These hard-working docs are spending plenty of time (over 45 hours a week) with patients, but their reimbursement rates have not kept pace with inflation. For example, Medicare has increased fees by 13% during the study period, while the underlying inflation was 21%. And, private payers' reimbursement declined from 143% of Medicare's rate in 1997 to 123% in ...

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The BMJ has this unfortunate case:

According to the BBC, the British Medical Journal cites the case of a 15-year-old girl who was struck by lightning in a London park while talking on her phone. She suffered a burst eardrum and cardiac arrest and, a year later, "has severe physical difficulties as well as brain damage which has led to emotional and cognitive problems".

This is one plausible solution to malpractice reform that I've always supported. Dr. Charles writes more on a bill introducing health courts:

Our lawsuit culture is disgusting. Anyone who stands up to do anything of consequence in our society is at risk of being sued for it. Teachers, policemen, doctors, coaches, ministers - we're generally trying to make the world a better place, but we're all living in fear, ...

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A small, unscientific survey to be sure - but I'm not surprised by the results.

It makes it harder for hospitals to fire physicians, since this doctor is making the hospital beg for mercy:

Randall Andrada, who represented Fremont-Rideout Medical Group, declined to comment following the Wednesday's verdict. During the closing statements, he said the hospital leadership "got the message" the jury sent with Friday's award and pleaded with the jury not to award additional monetary damages.

Primary care is facing the same challenges and deterrents in Canada as well:

Dr. Brian Berger, who has a family practice in Richmond Hill, says many young doctors stay out of family medicine because it's too time-consuming. He says young doctors have other priorities, like spending time with their families or pursuing other interests.

"More doctors want to do sort of part-time family practice. A lot of people may ...

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They are trying to drive generic drug makers out of business:

It's a novel approach in the long battle between brand name drugs and their generic rivals: Merck & Co. is slashing the price of its cholesterol drug Zocor so low for one insurance plan that members will actually pay less for the original pills than for the generic.

That tactic has some consumer advocates fearing the practice will ...

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Dr. Centor outlines a fundamental reason why medical students are avoiding primary care:

Some would argue that this is really a lifestyle issue. I would argue that money drives lifestyle. Family physicians and general internists have responded to lowered reimbursement by increasing the number of patients they see each day. These increases must decrease quality of care and decrease physician satisfaction.

Shawdowfax speculates:

The most common proposal I have heard for government-funded single payor health care is something along the lines of "Medicare for all." The clear implication from this, for physicians, is that all patients would be reimbursed at the same rate. While you would think this is a good thing, I expect that many doctors would fight it tooth and nail. For a ED group that is well-managed ...

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Disturbing news coming out of China:

WHO was surprised by the report, which came not from the Chinese government but from eight scientists in a research letter in the New England Journal of Medicine.

"We will formally request the Ministry of Health to clarify this," and why it has taken more than two years to come to light, said Roy Wadia, a WHO spokesman in China.

The expert witness was shown to demonstrate "a lack of adequate subject matter knowledge", but is protected when his professional society tries to sanction him:

A Baton Rouge federal judge has issued a temporary restraining order against a national medical association, protecting a prominent local neurosurgeon who claims he is the victim of a professional smear campaign.
(via This Makes Me Sick)

Another pro-reform citation of the Studdert study:

Dr. Bret DeLone, a Harrisburg-area surgeon, disputes the association's conclusion that the system is working well. He pointed to another study, published last month in the New England Journal of Medicine, that said more than half of the money awarded in medical malpractice lawsuits went to attorneys' fees and administrative costs.

"That's where the money ends up. ... Of course ...

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