In defiance of dire predictions, children haven’t been sent to workhouses and women haven’t been chained to utensils after the GOP gained strength in the House and the Senate. And Vivek Murthy, the unabashed Obamaphile, was finally confirmed surgeon general. To be honest, I always thought the controversy surrounding Murthy’s nomination because of his stance on gun control was rather daft. Stopping doctors from pontificating over guns, such as the docs ...

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shutterstock_177270461 The insurance companies have discovered a new way to give me a headache. About a month ago, a number of providers in our practice received an email with instructions about a new task to which we had been assigned. Apparently, we were supposed to log on to some website, create an account, and fill out a SOAP note on about a dozen of ...

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Health care in the United States is often compromised by fragmentation in its delivery, limited patient access due to a shortage of primary care doctors, long wait times (even for patients who have appointments), and spiraling costs. As a result, innovative approaches to delivering health care are becoming increasingly important in America’s continued pursuit of improved outcomes and reduced cost of care. Health care delivery models such as telemedicine aim to ...

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Dr. Oz is going to love this one. At least, I think that he will. I've never actually met him. To be honest, I wouldn't have a clue as to whether he's really a good guy or not. In fact, I suspect that he's never read my book, but I did devote almost an entire chapter to him, because he intrigues me by being a physician businessman. All I can tell you ...

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Our health care system needs more physician leaders. Physician-led accountable care organizations have been shown to improve the quality of patient care while reducing overall costs. Physicians, by their nature, tend to be goal-oriented, have the ability to gather and assimilate evidence, and make difficult decisions, but these traits do not always translate naturally into leadership skills. We are trained to make a diagnosis and map out a treatment plan ...

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Everyone deserves a chance to be healthy. Physicians, of course, focus on helping patients. Unfortunately, I often see patients’ frustrations with the health care system itself directed toward doctors. Meanwhile, doctors are under increasing pressures on multiple fronts. Yes, we’re imperfect, but making physicians the primary focus of patient anger will not solve problems we all face as humans who will, at some point, need health care. (Note: I’m using doctors ...

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shutterstock_2262685 We have met the enemy, and he is us. -Pogo (a comic strip character of Walt Kelly) I doubt that physicians would have supported the creation of the American Board of Medical Specialties (ABMS) in the early 1900s if they had known that eventual maintenance of certification (MOC) might be used as requirements for re-licensure. In my state of Connecticut, we already have continuing ...

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shutterstock_156241253 It’s really quite easy to kill a doctor. Here’s a step-by-step process guaranteed to succeed at least 400 times a year: Start early. Be sure to denigrate medical students whenever possible. Even if they’ve come to the profession later in life and have accomplished all kinds of amazing things personally and professionally (which don’t count, of course, since those are other professions) they don’t know squat ...

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During the MOC debate that JAMA sponsored, I was asked what I would do if “I were king” of MOC. As an internist, I believe in first making a diagnosis, then prescribing a treatment. So I have spent time diagnosing my needs as an internist. When I passed my boards I showed knowledge competency. But medicine changes over time. We have major advances and changes since I took my boards. Some examples follow:

shutterstock_118667590 Doctors have a difficult time adjusting to other cultures and because of this flaw, patients, and the medical profession suffer.  By culture, I do not mean religious or philosophical background, socio-economic difference, country of origin, nor even the silence created by language and education barriers.  I am referring to the communication and comprehension chasms that exist between different occupations and physicians. What ...

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