This is a simple plan that would empower patients, improve the lot of primary care physicians and likely hold down medical costs while improving quality in the health care system. I would first like to present the plan, then elaborate on how it could accomplish the above objectives. The first part of the plan would set aside a portion of each person’s health care dollars (i.e., insurance premiums) and place it ...

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We hear a lot about the death of the independent physician practice. But perhaps the more important discussion is about the death of practicing medicine independently. That is, the days when individual physician groups could operate their businesses and treat patients independently and without regard to the surrounding network of other physicians, nursing facilities, health networks, social workers, case managers, and other support is over. It doesn’t matter whether the physician ...

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You may find this story hard to believe, but it's true. A 75-year-old non-smoking man with no serious medical problems and a relatively low-risk family history (father, a life-long smoker, died of a stroke at age 76) has been undergoing routine physical examinations by his primary care physician in Florida every 6 months for several years. The visits include a full battery of laboratory studies, nearly all of which have been completely ...

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Drop doctorspeak and get real with patients If you’re a doctor, I bet you speak doctorly. You act doctorly. And dress doctorly. And spend your days in clinic with other doctorly doctors. But life is what happens while you’re busy staring at computerized flow sheets, algorithms, and billing codes. Real life happens outside of man-made medical institutions. Patients live in the real world. And I always wanted be a real ...

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Are patient portals a gateway or barrier to patient centered care and communication?A guest column by the American College of Physicians, exclusive to KevinMD.com. Patient portals. They have great potential, but is it being met? And are we losing something in return? I ask myself these questions now that my practice offers a patient portal linked to our electronic health record (EHR). I did not expect to feel that way, ...

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After 12 years of blogging, I wonder if I should have titled my blog “unintended consequences.” So many rants focus on the unintended consequences that follow from health care policies. The aphorism (falsely attributed to Samuel Johnson) states, “The road to hell is paved with good intentions.” Too often our policy makers, be they bureaucrats in government, insurance company managers or guideline creators, think like a chess beginner. They see the ...

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Today I had a very special experience, one which many of my patients have faced: I was treated like a nobody while at the hospital. Yay me. I went to visit a patient who was admitted over the weekend to see what was going on.  She was a bit upset about the confusion of the hospitalist service and how orders apparently didn't get written for her care by the admitting physician. ...

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As Americans, we love to associate with groups. More than that -- we love to plant ourselves in a group, stand firmly in our decision, and then adamantly refuse to budge or to see the other party’s perspective. Pro-life. Pro-choice. Democrat. Republican. Pro-Obamacare. Anti-Obamacare. I suppose for all of us, myself included, it is easy to identify with our group of choice when we are sitting at home watching or reading our ...

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The doctor who has to do the laundryThe doctor who has to do the laundry An excerpt from So Long, Marcus Welby, M.D.: How Today's Health Care Is Suffocating Independent Physicians - and How Some Changed to Thrive. Ripley Hollister has been president of his county's medical society in Colorado Springs, Colo., and a director of the Colorado Medical Society. He has been a unit commander ...

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7 ways patients can help reduce medication errors I just got off the phone with a very upset patient who had just discovered that her pharmacy had been giving her the wrong medication for the past 5 months, substituting a similarly spelled antibiotic for her rheumatoid arthritis med. She was tipped off when she realized how bad she had been feeling of late and decided to check the expiration ...

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