I have been a victim of diagnostic overshadowing by a primary care physician.  I’ve been dealing with major depressive disorder, recurrent, severe and anorexia for twenty-five years -- practically my entire adult life.  However, I work full-time and I’m a published writer.  At the time I saw this PCP, I was on hefty doses of Cymbalta (an antidepressant) and Abilify (an antipsychotic which can also be used to boost the effects of an ...

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The days of using your insurance to see the family doctor are numbered. As more patients join the practice and I hear each new patient’s story, I become more impressed with the benefits of direct primary care for both the patient and the physician. Recently, a 63-year-old female, who we’ll call Martha, came in for a visit. Martha is an out of work chef who, due to financial hardship, hasn't had health ...

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Medical errors happen every day. Few make the headlines, but when they do, almost everyone who chimes in to comment offers the same type of solution for avoiding them. Three of the most common are guidelines, decision support and checklists. From my vantage point as a primary care physician I agree that checklists, in particular, can enhance clinical accuracy, but some of the lists I have to work with in today’s ...

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Years later, I now wonder if I overstepped my boundaries. Nancy was a pleasure to have as a patient.  A physician assistant in her early twenties, we often chatted amiably during visits.  Our conversations randomly ambled between personal and professional topics.  She recently married and was looking forward to having children.  Her gynecologic history was complicated and after a period of months of unsuccessful attempts to get pregnant, she visited a ...

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Just yesterday I was searching for a local surgeon, and on one website he had 2 out of 5 stars.  Hardly anyone was recommending him.  Yet prominently featured on another site he had 4.7 out of 5 stars.  Both sites had a good number of reviews.  What’s going on?  Is one site cherry picking the reviews?  Is someone falsifying reviews on one of the sites?  Which reviews can I trust? ...

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After reading a book about conducting good business, you’ll likely review the concept of adequately meeting demands for clients or consumers. Whether a company is thriving due to lower pricing or higher quality, in the world of business, the golden rule is provide value or go bankrupt.

One industry has seemingly remained immune from this concept, however. In the past few decades, especially, health care has unequivocally failed in ...

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Health reform: Great for patients, but this doctor lost his job As an employed physician specialist working in an underserved community, I am thrilled with the Affordable Care Act (ACA). I was initially a skeptic of the program because of the cost to taxpayers, but I have since witnessed first hand the tremendous benefits. People with limited resources and real problems can now get help without suffering financial harm. Those with chronic ...

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One of the major reasons that health care providers resist implementing an electronic medical record (EMR) system is the belief that using it will decrease provider productivity, reducing the number of patients they can see and therefore reducing practice revenue. However, an EMR that is designed around a streamlined workflow can enable providers to work faster and more efficiently. Having an EHR and vendor that can give you ongoing visibility and ...

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Want to know why residents dont chose primary care? Read this. I just got a taste of improved access, and I gotta tell you, it sapped my energy. It reminds me of the old standup comic one-liner, "I just flew in from Vegas, and boy, are my arms tired." Today was the department of medicine housestaff picnic (pretty much a guarantee to cause the weather to change from clear skies to rain), and so ...

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Assimilating independent physician practices: Is resistance futile? Fans of Star Trek: The Next Generation will recall that the most disturbing aliens encountered by the Federation were the Borg, a part-cyber, part human collective race that functioned as an integrated and cyber-connected whole that existed only for the good of the collective, rather than as distinct individuals with their own thoughts and personalities -- much like honey bees work together as ...

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