Patients forming an opinion of your practice are doing so in a matter of seconds. And some of the latest research on first impressions, suggest that it may even be within the blink of an eye. Regardless of the length of time, first impressions are powerful and very difficult to reverse. So, if a patient has formed a bad opinion of you and your staff, during the first point of ...

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Americans spend more per capita on medical care than just about any other country and, yet they often have little to show for it. Americans have worse access to care than people in other countries, and are often less likely to receive primary care services, like preventive therapies and screening tests. Determined to address these problems, Medicare leaders have been testing out new models of primary care, hoping to find ...

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Classic rock music lovers who think they don’t like poetry, and literary purists who think they don’t like popular music, may have been equally baffled to hear that Bob Dylan is a winner of the Nobel Prize in Literature. As an unrepentant English major, I’m delighted. I can’t remember a time when Dylan’s music wasn’t a part of my growing up, from the rebelliousness of the anti-Vietnam era to ...

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A recent issue of the New England Journal of Medicine once again questions two practices that used to be almost the backbone of primary care. One article is about the low likelihood that prostate cancer detected through PSA screening will shorten a man’s life, even if he chooses just to keep an eye on it. The other article is about how repeated mammography screening mostly leads to the diagnosis of small and ...

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I recently spent an evening with a group of medical oncology fellows as part of a small panel discussing career alternatives. There were doctors who worked for pharma, academic medical centers, hospitals and a couple of us representing private practice. The questions and comments taught me more than I could contribute. I was surprised to learn not just about jobs and personal futures, but about something basic: the difficulty in ...

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Martha arrives for an appointment with her new primary care provider. She hesitantly hands over her pill boxes at the nurse’s request; it seems to take forever to enter them all into the computer. “You are taking a lot of blood pressure pills,” he comments. The doctor comes in and after a brief introduction, notes that she is taking five medications for her blood pressure. “Five?” Martha exclaims in disbelief. She hadn’t ...

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Independent physicians are at the beginning of a challenging movement as we fight to stay relevant and solvent during the transition of health care from independence to “regulation without representation.”     In 1773, British Parliament passed the Tea Act with the objective to help the struggling British East India Company survive. Opposition to the Act resulted in the return of delivered tea back to Britain.  Boston left the ships carrying tea ...

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Several years ago, I was meeting a young woman in my clinic for the first time. She was healthy but had been obese most of her adult life, even though she had tried many methods of losing weight. We spoke for a few minutes about diet and exercise, and she agreed to see the nutritionist. A few months later, she came back to check her progress. She had lost weight, about ...

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Self-entitled, self-absorbed and selfie-obsessed. These are just a few adjectives critics use to describe the millennial generation of today’s 16-to-36-year-olds, born between 1980 and 2000. Born in the early 80s, I both understand the criticism levied against my generation and simultaneously empathize with many of my peers who were raised in the digital revolution and, thus, see the world differently. The unique and, at times, bewildering views of millennials pose ...

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Recently, an African American female physician was prevented from providing help to a passenger in distress on a Delta airlines flight because she didn’t fit the flight attendant’s image of what a doctor looked like. The racial and gender issues that this event highlight are readily apparent.    As a South Asian, I have to say I’ve never been told I don’t look like a doctor on a racial basis.  If anything, ...

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