As time pressures increase for PCPs, expect more of this to continue. It takes less time to give an antibiotic than it is to counsel and test:

About 14 percent of U.S. children visit a health professional at least once a year for serious sore throat, and over two-thirds of these are prescribed antibiotics, according to a survey by HHS' Agency for Healthcare Research and Quality.

But the ...

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The reason being that they are not written in conversational English:

Many health directions are written at a level that''s above the average consumer, Rudd said. A simple example, she said, would be a can of baked beans at the local supermarket. A consumer may want to know the salt content before buying, but they don't see the word salt anywhere on the label.

It just doesn't fit in most patients.

Try the parents:

A 15-year-old girl and her parents recently came in for a chat with Dr. James Perrin, a Boston pediatrician, because they were concerned about the girl's grades. Previously an A student, she was slipping to B's, and the family was convinced attention deficit hyperactivity disorder was at fault -— and that a prescription for Ritalin would boost her brainpower.

After examining the girl, Perrin determined ...

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A surprise diagnosis makes for an awkward ER visit.

A study suggests that satisfied patients don't receive better care than the least satisfied.

Increased screening frequency, more sensitive diagnostic tests, or substantial decrease in tobacco use? The Cheerful Oncologist gives his take.

They made a revision in their narcotic medication policy:

The Drug Enforcement Administration yesterday overturned a two-year-old policy that many pain specialists said was limiting their ability to properly treat chronically ill patients in need of powerful, morphine-based painkillers.

While defending its efforts to aggressively investigate doctors who officials conclude are writing painkiller prescriptions for no "legitimate medical purpose," the agency agreed with the protesting experts that it ...

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So says a recent JAMA study:

Doctors often have a falsely exaggerated view of their own capabilities, a new study suggests.

In fact, physicians who were judged by outsiders to be the worst performers in a given area often gave themselves especially high marks, researchers report.

"There is a subset of clinicians who appear, either by training or personality, unable to judge themselves," said study lead researcher Dr. ...

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Concord, NH - about 30 miles from Nashua - is feeling the primary care crisis up close. Some straight talk from this local editorial:

A study of physician recruitment offers by a national health care search firm goes a long way to explaining the primary care shortage. Family practice doctors were offered an average of $145,000 per year, cardiologists $342,000, radiologists $351,000 and orthopedic surgeons $370,000. Doctors several ...

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What really happens in gross anatomy lab, typically studied during the first year of medical school.

Interesting concept, but it will never happen with the amount of pull (and money) drug companies have:

Limited-time drug licensure would furnish incentives to ensure that all new drugs are properly scrutinized. Companies would need to formulate post-marketing surveillance plans as well as promotional plans when a drug is approved. The FDA would be subject to firm deadlines in reviewing post-marketing information, because prescribers and patients would be relying ...

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"Geriatrics ain’t sexy"

Why there will be a shortage of physicians for the baby-boomer explosion:

Why are so few medical students interested in geriatrics?

"What we found was that students have an interest in prestige," says Diachun. "They're worried about debt load. And many students are interested in developing technological or procedural skills."

Sometimes, doctors can't work by the clock. There are no defined hours for patient care.

Cosmetic charting

Dr. RW writes about how P4P will lead to an increase in chart games. EMRs already gives notes added verbosity (via templates and cut/paste), leading to an increase in coding. Once P4P comes into play, expect the templates to gear towards P4P goals - at the expense of meaningful clinical information.

Mark McClellan’s legacy

Joe Paduda: "McClellan may have done more to usher in national health care than anyone else."

This scenario happens all the time. Again, patients lose:

What would you do if you're a neurosurgeon and you understand neurosurgery better than anybody sitting a jury or a trial lawyer and you know this patient desperately needs you? But you know that the outcome (from a particular procedure) is terrible. So are you going to put your practice, your livelihood, your family and everything at risk by ...

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No, just kidding. But physicians are finally wising up to an even greater threat: declining reimbursement.

Problems can arise if they are not challenged:

"The most common problem is that they don't learn to work," says Maureen Neihart, a clinical child psychologist and coauthor of the book "The Social and Emotional Development of Gifted Children." Children who earn good grades and high praise with relative ease may not learn how to try hard and to persevere when things are difficult. They can come to equate their ...

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A reason why physician dissatisfaction will continue?

The problems in medicine are even more pronounced for female physicians, so it is not surprising that female physicians report more job stress, lower perceived wellness and more burnout than men. Women now make up almost 50 percent of medical school students, and so the problem with physician dissatisfaction is likely to get worse for this reason alone.

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