As a family doctor, I had the privilege of sitting down at the hospital recently with Mr. M, a longstanding patient of mine, and his family. Mr. M is a college-educated engineer, struggling near the end of his life with end-stage kidney disease, dialysis, severe congestive heart failure and crippling COPD. And he was pretty down about it. In the hospital, a critical care physician, a pulmonologist, a nephrologist, and a cardiologist ...

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Part of a series. Comprehensive primary care for employees means better employee health, greater productivity, less presenteesism and lower costs for both employee and employer. That is why some companies are making health care a strategic imperative rather than just a tactic as part of human resource cost management. Some are developing full service enhanced primary care clinics on site with excellent success as described in my last ...

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Britain’s most prolific serial killer was a general practitioner (GP), Dr. Harold Shipman. He wasn’t England’s most famous murderer. That accolade goes to Jack the Ripper. The Ripper killed five women in the streets of Whitechapel. Shipman might have been responsible for over 200 deaths. Shipman’s legacy to the medical profession was not just a permanent simmering of mistrust. He triggered the introduction of revalidation, Britain’s version of maintenance of certification ...

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My life changed dramatically when I started my new practice.  The biggest change personally was a dramatic drop in my income as I built a new business using a model that is fairly new.  That's a tough thing to do with four kids, three of whom were in college last fall.  OK, that's a stupid thing to do, but my stupidity has already been well-established. Yet even if the income stayed ...

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When I was in high school, a national hardware retailer opened a new franchise down the street from the mom-and-pop hardware store that had served my neighborhood for many years. Since the new store had the advantage of larger volumes and lower costs, it seemed to be only a matter of time before it drove its smaller competitor out of business, the way that big bookstore chains and fast-food restaurants ...

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One hundred forty-nine messages. This is what I return to on my first day back from vacation. Many of them were marked with a little red arrow, indicating a high-priority phone message. Recharging with a little time off is a darn good thing, something we all need, and something which has been shown to help all of us be better at what we do. All of us, no matter what our jobs are. ...

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Around the country, doctors are leaving independent practice and joining large groups owned by health care systems. It’s a trend: the recruiting firm Merritt Hawkins predicts that if current growth continues, over 75% of newly hired physicians will be hospital employees within two years. There seem to be a number of reasons for this consolidation of physicians and hospitals into islands of care. One is the desire for larger groups to have ...

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There’s been a lot of controversy recently about workplace wellness programs: Do they save money for employers on health care costs? Can they produce measurable benefits for employee health? Do they unfairly punish people who are unable to participate? Are these programs just a ploy to shift medical costs to unhealthy employees? Recently Austin Frakt and Aaron Carroll revisited these questions in a piece for the New York Times’ Upshot column, “
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The Affordable Care Act (ACA), commonly known as Obamacare, increased the availability of FDA-approved contraception to women through cost-free coverage under the contraceptive mandate. With the exception of some religiously affiliated insurance plans and employers who are legally exempt, this mandate supports women’s access to comprehensive reproductive health care, including the most effective forms of contraception. However, an integral part of family planning was left out of the legislation: contraceptive ...

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1. Physician assistant (PA) growth will remain unprecedented. Demand is driving growth and PA program expansion.  The educational programs are charging students higher tuition costs for these coveted PA positions. PA students now acquire unparalleled debt, according to a recent Robert Graham Center report; one in four PA students owed more than $100,000. Although high student debt may impact PA graduates ability to go into fields like primary ...

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