Do you believe that I have to mention this?  I can’t believe it either but since the advent of the EMR, this seems to be an issue; a really big issue.  Amazingly enough, you are there, as a doctor, to treat the patient and not the computer.  You would think it was the other way around with all the bogus quality indicators, meaningful use baloney and pay-for-performance nonsense being stuffed ...

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David Bornstein did a real nice job in his New York Times column, Medicine’s Search for Meaning.   He partly captures what it is like to walk in our shoes.  This is not a pity party for doctors.   It is a limited look at some of the stuff that tears us up inside.  He explains nicely the damage we have to absorb to get to the pinnacle ...

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American Medical News reported earlier this year the wonderful story of CareFirst BlueCross BlueShield, which covers patients in Maryland, Virginia and the District of Columbia.  They have come out and claimed that their patient-centered medical home program is benefiting everything it hoped to help: its own bottom line, patient care and physician pay. Am I wrong to be skeptical when an insurance company says anything?   Philosophically, I love the medical home ...

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Doctors are always at a disadvantage when it comes to administrators and lawyers.  Administrators meet all day, comparing and sharing information, and therefore have all the leverage in any contract negotiations or bureaucratic bombshell they want to drop on us docs. We are too busy treating patients to arm ourselves with the proper information (or will) to fight back.  Lawyers do the same thing.  They are out there always looking for ...

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Dr. Sanjay Gutpa has come out on the side of medical marijuana.   To him, that is a big deal.  Here is a snippet of what he said:

I apologize because I didn’t look hard enough, until now. I didn’t look far enough. I didn’t review papers from smaller labs in other countries doing some remarkable research, and I was too dismissive of the loud chorus of legitimate patients whose ...

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Patients do need the power to complain about bad doctors and, trust me, there are some bad doctors out there.  That being said, the other way for patients to get some retribution is to stop seeing that doctor.   Word of mouth will spread, like any other business, and that doctor’s business goes under. Right now, state boards allow patients to complain about anything and they have to investigate that complaint. ...

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There continues to be a push for more docs to answer patients’ emails.  And not get paid for it.  The only way this will work is in a direct pay model where doctors are paid on a monthly basis and no insurance company is involved.  American Medical News discussed how more patients not only want to email their doctors but want a quick response as well.

One reason is to apply an extra “facility fee” to patients’ bills. Another reason is that primary care docs generate a ton of money for the hospital.  A new survey was sent to hospital chief financial officers across the nation and based on data submitted by 102 facilities, it found that PCPs generate more annual revenue than specialists do. PCPs (defined in the survey as family physicians, general internists, and pediatricians) generated a ...

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As you may know, I left Maine to come to Virginia to work in an urgent care center.  It was not how I pictured myself when I trained to be a family doctor 18 years ago but the world has changed. I like my present job fine and there isn’t a bunch of suits looking over my shoulder all day.  That being said, I want to share my thoughts about the ...

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