The New York Times had a front-page story about the growth of urgent care clinics nationwide. These are the places that are often referred to as “minor emergency rooms,” or “doc-in-a-box” outfits. Their value proposition is simple: You don’t need an appointment. The costs are “reasonable,” and much more transparent than usual medical care at a doctor’s office, emergency room, or hospital. Best of all: They can treat a majority of acute conditions and ...

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Most busy doctors completely forget (or ignore) the importance of integrating personal downtime and self-care into their schedules. It’s no surprise so many doctors wrestle with overwhelm. Downtime is crucial for stress management. What about you? Are you guilty of skipping your “you time?” No, I don’t mean attending a seminar, reading an article, or talking about stress reduction at a staff meeting. I mean, when is the last time you scheduled some real ...

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When it comes to preserving health and prolonging life, study after study shows that prevention is essential. From type 2 diabetes to early-stage prostate cancer, clinical trials have demonstrated that countless diseases can be avoided or even reversed through (often simple) lifestyle changes. We know the solution. Yet the challenge is reaching it. For example, tens of millions of overweight Americans are dieting at any given moment, but only a ...

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Top 10 ways to know its time to quit your job as a doctor Attention all doctors: The first three are mine. The rest are from miserable colleagues. All true. And common. If you’re a doctor and you recognize anything on this list, please quit your job. 10. You feel nauseated when you see your clinic logo; you alter your commute to avoid streets with your clinic’s billboard. 9. Discouraged by the general despair among staff, you ...

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William was doing great.  His C. Diff  was finally gone after a month taper of vancomycin.  He was stronger.  The nursing home staff reveled in how much progress was being made over such little time.  It seemed every one was ecstatic, except for, of course his family.  Every step this octogenarian took forward was accompanied by a litany of concerns and complaints from his daughter. If he was not gaining weight, ...

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For three years before I applied to medical school, I worked in post-Katrina New Orleans helping to rebuild school-based health centers. One of the main challenges, however, was how to create a sustainable safety net for at-risk youth to whom we were hoping to provide much needed health services -- key word being “sustainable.” All too often, there isn't funding to carry out primary care’s mission of improving the health of communities and ...

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Marcus Welby wont survive todayMarcus Welby wont survive today An excerpt from So Long, Marcus Welby, M.D.: How Today's Health Care Is Suffocating Independent Physicians - and How Some Changed to Thrive. A 30-ish public-relations executive representing a large, modern physician practice was shaking her head in puzzlement. Her physician client liked to talk about how his practice was not "a ...

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Part of a series. In earlier posts, I have described direct primary care (DPC) in its various forms called membership, retainer and concierge. There are some concerns with DPC. Does more doctor-patient time really mean better quality care? Does it really mean lower total costs? It seems logical that closer care means better care, fewer referrals to specialists and fewer hospitalizations. Most DPC physicians will tell you this is the case ...

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I don't like to brag, but if there is one area of my skills as a doctor about which I am proud, it would be my skill as a diagnostician.  I like to play Sherlock Holmes and figure out what's going on with people, and I think I'm pretty good at it. So I lied.  I do like to brag ... a little. In most people's mind's eye, the role of diagnostician ...

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It is clear that patient compliance with prescribed medications is critical to success in the treatment of any chronic disease process.  In addition, patient engagement and co-management of their disease has been proven to improve outcomes.  A new study from the Annals of Internal Medicine suggests that any changes in the appearance of a medication may result in a decrease in compliance; when a pill looks differently patients often simply ...

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