shutterstock_141411661 I didn’t really notice him standing in line. But how could I? Hundreds of kids came through the high school gym yesterday. His turn for the heart and lung portion of the high school sports physical had come. He said he was going to play baseball and basketball. How could he with that arm he carried so carefully? I am not ...

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shutterstock_205431067 What is it like for physicians to fail their ABMS Maintenance of Certification® (MOC) program examination? How does the largest member board of the ABMS, the American Board of Internal Medicine (ABIM), respond to doctors who fail their secure examination? As I continue to confidentially collect information from physicians who have failed their MOC examination, I thought it would be important to publish ...

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shutterstock_246706588 Imagine a surgeon removing a gallbladder miles away from where he or she actually is. Imagine when you are ill, a physician has the ability to diagnose you from your living room. Telemedicine. Telemedicine itself is not a concept that is all that new. In the 1930’s, Italy used telemedicine to communicate with ships at sea, while in the United States, NASA ...

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Practicing physicians like me rely on up scientific medical journals to keep us current on medical developments. We learn about new treatments for old diseases. New diagnostic tests are presented as alternatives to existing methods. Established treatments, which are regarded as dogma, may be shown to be less effective or less safe than originally believed. It’s a confusing intellectual morass to sort among complex and conflicting studies some of which ...

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Physicians are struggling to adapt to a sea change in the health care delivery system. Solo physician practices are disappearing, small group practices are merging to become larger, and large group practices are being acquired by hospitals and integrated delivery systems. All of this is occurring in a milieu of decreased fee-for-service reimbursement from government and private insurers, bundled payments and pay for performance, increased levels of student loan debt, ...

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Following the recession, the Obama administration sought shovel-ready projects. One unlikely shovel-wielding aggregate demand was health information technology. The Health Information Technology for Economic and Clinical Health (HITECH) Act passed in 2009 directed 5 percent of the stimulus towards digitizing medical records. Computerization of medical records doesn’t induce the images of public works as building freeways during the Great Depression does, but the freeway is a metaphor for exchange of information between ...

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One of the goals of the Affordable Care Act (a.k.a. Obamacare) was to increase access to primary care physicians. The notion is that if people have insurance it would be easier for them to get appointments with primary care physicians. This is because many physicians are unwilling to accept new patients who are uninsured. Further, a key component of the ACA was to increase physician reimbursement for Medicaid because this program ...

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A couple of years ago, my clinical practice (Dermatology Associates at Massachusetts General Hospital) began sending patients a bill when they did not show up for an appointment. Dentists do this with some frequency, but it’s unusual for a physician practice to do it. Our reasoning was that we have many folks who insist they need to be seen right away and, despite a large, busy practice (we see more ...

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The buzzwords many use in medicine today are "personalized," "individualized," or "targeted." Rather than doctors prescribing tests or treatments that work in most people but might not work for you, proponents argue, we should tailor medical interventions to unique patient characteristics, such as genomic data. (The White House's Precision Medicine Initiative is an example of this kind of thinking.) Although I am skeptical that big data-driven genetic ...

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shutterstock_118623196 I’ve been a doctor for more than 20 years, and I hate to break it to you, but it’s time I came clean: We lie. Doctors lie. Not always. Not necessarily on purpose. But we do. Sometimes the lies are to our patients. Sometimes, the lies are to our families. And sometimes the lies are to ourselves. But, nonetheless, we lie. A lot. ...

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