Our health care system needs more physician leaders. Physician-led accountable care organizations have been shown to improve the quality of patient care while reducing overall costs. Physicians, by their nature, tend to be goal-oriented, have the ability to gather and assimilate evidence, and make difficult decisions, but these traits do not always translate naturally into leadership skills. We are trained to make a diagnosis and map out a treatment plan ...

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Everyone deserves a chance to be healthy. Physicians, of course, focus on helping patients. Unfortunately, I often see patients’ frustrations with the health care system itself directed toward doctors. Meanwhile, doctors are under increasing pressures on multiple fronts. Yes, we’re imperfect, but making physicians the primary focus of patient anger will not solve problems we all face as humans who will, at some point, need health care. (Note: I’m using doctors ...

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We have met the enemy, and he is us. -Pogo (a comic strip character of Walt Kelly) I doubt that physicians would have supported the creation of the American Board of Medical Specialties (ABMS) in the early 1900s if they had known that eventual maintenance of certification (MOC) might be used as requirements for re-licensure. In my state of Connecticut, we already have continuing medical education requirements (CME) which consists of 50 hours ...

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It’s really quite easy to kill a doctor. Here’s a step-by-step process guaranteed to succeed at least 400 times a year: Start early. Be sure to denigrate medical students whenever possible. Even if they’ve come to the profession later in life and have accomplished all kinds of amazing things personally and professionally (which don’t count, of course, since those are other professions) they don’t know squat about medicine and you do. Make sure to emphasize ...

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During the MOC debate that JAMA sponsored, I was asked what I would do if “I were king” of MOC. As an internist, I believe in first making a diagnosis, then prescribing a treatment. So I have spent time diagnosing my needs as an internist. When I passed my boards I showed knowledge competency. But medicine changes over time. We have major advances and changes since I took my boards. Some examples follow:

Doctors have a difficult time adjusting to other cultures and because of this flaw, patients, and the medical profession suffer.  By culture, I do not mean religious or philosophical background, socio-economic difference, country of origin, nor even the silence created by language and education barriers.  I am referring to the communication and comprehension chasms that exist between different occupations and physicians. What are the core values and guiding principals of medical ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. How many of you have heard a flight attendant or pilot announce, “We know you have a choice of airlines when you fly, and we want to thank you for flying with us”? Over the years, many other industries have adopted similar statements.  Continuing medical education (CME) ...

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Most readers know that an EMR (electronic medical record) is the back-end software that runs a health care organization. EMRs have been around for a while. Recently most large hospitals and health systems have begun building out the patient-facing version of their EMR; allowing patients to communicate electronically with their doctors, refill prescriptions, schedule appointments, and view clinical information. I’ve written at length about the differences between B2B software and B2C ...

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When my husband and I stopped watching television a few months after we were married, we often didn't notice what had changed until we'd compare notes with friends.  "I miss my old hobby," a neighbor might complain, "but I just don't have the time."  And yet we'd see his head just above the back of the couch, silhouetted against his big screen TV for hours.  Not only did we regain ...

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In the past half century or so, medicine has changed the complexity of the human population as it has never been seen in the past. Think about it, there are people walking around today that fifty years ago, wouldn’t even be alive.   This evolution in medicine has not only brought about transformation in the human population, but it is also changing the approach of how clinicians need to treat these complex ...

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