shutterstock_245121460 A while ago, I wrote about “The secret lives of doctors.” The post must have struck a nerve because it went viral, maybe because it helped patients to realize that doctors are human. We doctors can’t really know how human we are until we become a patient. That happened to me recently. And it wasn’t pretty. You need to know the ...

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shutterstock_209415490 You gotta hand it to our health department. They are laser focused on this one. They want 85 percent of payments made to doctors by the Centers for Medicare & Medicaid Services (CMS) to be linked to clinical quality measures within the next two years. Moreover, I suspect the health department is still giddy from Congress passing a new health care ...

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Fire-Doctor-640x399 Not all relationships work out. My prescription: If a relationship isn’t working, end it. Now. Recently an insurance plan told me they were sending a nurse to my office for a chart review that would take 3 hours. After 24 years of education, state licensure, board certification, and over 50 hours of continuing medical education each year, I’m not trusted to provide Pap ...

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It is with regret that meaningful use legislation has barreled down the path of insanity. As a primary care physician, I don’t see how 700+ pages of rules and proposals mean any bit of relevance to my clinical practice anymore. As the attrition continues regarding eligible providers, it is leading primary care physicians towards the junction point of going off the grid entirely or being enslaved by horrible EHRs forever. I ...

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shutterstock_253709923 As a primary care physician with a special interest in tackling obesity, I spend a large portion of my day pointing out the obstacles between my patients and a healthier lifestyle. In the United States, these stumbling blocks are everywhere and often cloaked in legitimacy by people or groups that hold sway over consumer confidence. Say, for instance, the placement of ...

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As a general internist who has been on the front lines of adult primary care for over twenty-five years, it is clear to me that we are living witnesses to a major and rapid transformation in medical care delivery. When Paul Starr published The Social Transformation of American Medicine in 1982, his work covered gradual changes over a 200 year period. We now live in a fast paced world where ...

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Like a lot of people, I get pretty numbed to gun violence on television. I stopped watching the local news because all they seem to show is news about shootings. The general public’s perception about gun violence is that it’s always somebody else, that the person who was shot had somehow been involved in crime. The numbness we feel to gun violence often ends for most of us when things ...

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Do you think that physicians’ advice should be based on their patients’ best interests? How about lawyers? Plumbers? Financial brokers? An advisor who has what is termed a fiduciary duty is required to use the best interest standard with his client. For example, an attorney is prohibited from recommending that his client proceed to trial, which would be beneficial financially to the lawyer, if the attorney believes that a settlement serves ...

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Humans are social creatures who naturally evaluate where they stand in relation to those around them. I have no idea how this evaluation process evolved, but at some point we noticed that some cavemen brought more food to the cave than others. The idea was born that some people are better hunters than others. We’ve been trying to decide who is “better” ever since. The origin of the word "test" comes ...

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They say that there may be children, born now, who could live to be 1,000 years old. Can you fathom that? Some humans could continue to live for what would be well more than ten current lifetimes. We aren’t there yet. But this isn’t so far out of the possible. Some medical researchers are already talking about resuscitating those who die up to five hours after death. It involves special ...

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