Are American doctors paid too much or too little? A version of column was published in USA Today on July 2, 2014. There are some who think that I’m overpaid as a physician, and that my salary fuels rising health costs.  I can understand their point: A May 2014 survey released by the Medical Group Management Association found that internal medicine doctors like myself have a starting median annual salary of $190,000, ...

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How physicians should respond to online ratings: Lessons from the Union Street Guest House What can physicians learn from the Union Street Guest House? For those who don't know, this hotel in New York threatened to fine those who dared write a bad review.  The New York Post got wind of this, and needless to say, the fallout has been ugly. The hotel has hundreds of 1-star reviews of Yelp for its efforts. This leads to a question ...

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Why the VA scandal is a red flag for single payer advocates "I will not stand for it.” That’s what President Obama said about the deepening VA health care crisis.  It’s also a lightening rod for how partisans want to frame the ongoing health debate. Some are eager to link the VA scandal to Obamacare, and more broadly, government-run health care. Others extol the virtues of the VA, holding it as ...

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Pay me like a French doctor.  You know you want to. Whenever new physician salary data is released, reporters and policy experts often compare doctor salaries in the United States to those of other countries: most notably, France. And on cue, Vox's Sarah Kliff -- normally an excellent health care writer, by the way -- is uncharacteristically lazy in framing physician salaries through a biased lens. After presenting the data, ...

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A version of column was published in USA Today on April 2, 2014. Patients in my clinic increasingly use health apps on their mobile devices.  Many of these apps track various health metrics, such as weight or calories eaten, while others go a step further and help patients make sense of their symptoms or even suggest diagnoses.  It’s estimated that 500 million people worldwide will use a health app by 2015, with ...

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Why you need to hear from miserable doctors Is being a physician a good gig, or not? In a piece that's gone viral, internist Daniela Drake writes a strongly-worded column in the Daily Beast about how miserable it is to be a physician:

To be sure many people with good intentions are working toward solving the healthcare crisis. But the answers they’ve come up with are driving up costs and driving ...

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A version of column was published on March 5, 2014 in the New York Times’ Room for Debate blog. To remedy our fragmented health system, reformers want to consolidate health care.  President Obama, for instance, has praised integrated health systems like the Mayo Clinic as a model for national reform.  To that end, the Affordable Care Act drives more hospitals to become more Mayo-like by purchasing physician practices.  Today, about 39% ...

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Let's talk internal medicine maintenance of certification (MOC). I recertified back in 2011, and it was an onerous process capped off with a challenging exam.  Thankfully I passed, and I'm good until 2022. Since then, the American Board of Internal Medicine has made maintenance of certification a more "continuous" process, and is sparking some outcry among physicians.  Wes Fisher has multiple posts on his site ...

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A version of column was published in USA Today on January 19, 2014. Over half of physicians today use electronic medical records, thanks to the federal government spending more than $22 billion dollars incentivizing providers to transition away from paper charts.  Supporters of digital records, including President Obama, say they improve patient care and reduce health costs.  Having navigated a transition from paper charts to electronic records in my own practice, ...

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Mammograms: Breast cancer screening as an individual patient decision In a major cancer screening development, a study from the British Medical Journal found that an annual screening mammography didn't result in a mortality benefit:

Women screened annually by mammography for 5 years had had a breast cancer mortality hazard of 1.05 compared with the control group during the screening period. During follow-up for a mean of 22 years, the mammography group ...

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