I have a love-hate relationship with the no-show patient.  Like most doctors, I’m a reasonably good multitasker, adept enough at charting while emailing while waiting on hold with insurance companies and planning what to prepare for dinner when I get home. But there are days, more than I’d like to admit, when I feel like I need just a little bit more time, and I find myself compulsively refreshing my ...

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If you stay in medicine long enough, you will encounter physicians who seem to care more about the paycheck than the patient in front of them: think Dr. Farid Fata.  You may find those colleagues revolting; I know I did.  I despised these physicians and felt nauseated even to be in the same room as them.  But as time went on, I realized that almost nobody starts a career ...

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21 minutes on the phone for a pre-authorization? Watch Dr. Ryan Neuhofel try to get a CT scan "approved." Take a deep breath, and press play. Want to escape pre-auth hell? Consider attending the Direct Primary Care Summit.

Ever wonder where tissue samples go after they're taken? The College of American Pathologists shares their journey in this video.

They played Taps at my dad’s funeral. Two teenagers on trumpets. First, the girl, positioned to the back and left of the crowd. Ta-ta-dah, she starts boldly, without the unease of her youth. Each simple note pierces the dry winter air. Yes, you have our attention. Not another sound. Not even a breath by gathered friends and family. In time, the second musician’s reply from the front. Ta-da-dah. And a pause. Their ...

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Wes Fisher recently took his case against MOC to the AMA House of Delegates.  Watch how it went.

A primary care physician named Ashley Maltz recently discussed advantages and disadvantages of a cash-based practice. I appreciate her evenhanded tone: She prefers this model yet expressed concern for patients who can’t use it. In the comments section, several physicians extolled the virtues of cash-pay, but patients were mixed. It’s attractive for those who can afford it, while it worries, and maybe angers, those who can’t. I enjoy the personal and patient benefits of a mostly cash-pay psychiatric practice (I ...

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I recently saw the movie, Captain America: Civil War.  If you haven’t seen it yet (no spoilers), the United Nations decides that because of civilian fatalities during previous Avenger battles, the world would be safer if all superheroes voluntarily subjugate themselves to the authority of an organized government body. Sounds good to some of the Avengers; after all, innocent people have died, and maybe some form of supervision will minimize collateral ...

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Doctors have become a profession of whiners.  Meetings, dinners, doctor lounges and the blogosphere are flooded with physician complaints, tirade, and anger. The volume of pained voices suggests that health Armageddon is only a few moments away. It was not always so.  Medicine is a career where idealism runs rampant.  In medical school interviews, young students really do answer that they want to help their fellow man.  Nonetheless, in recent years ...

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The term, "evidence-based medicine" (EBM), provokes strong feelings from its proponents and its skeptics.  I spent a full day recently in discussions about EBM.  As the day proceeded I understood that evidence is wonderful when it fits the clinical question, but that too often the clinical question does not, and probably will not have adequate evidence. We have great evidence for some clinical questions.  We all know that ACE inhibitors decrease ...

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