shutterstock_117500125 As a physician, you have endured many years of schooling, and you have received many A’s on your report cards. You have passed exams with flying colors, and you have pleased your higher-ups in the food chain. You have come so far, and you now find yourself in a rarefied position that most people only dream about. So what’s standing ...

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When I speak with colleagues about ways to provide primary care to the poor, they generally fall into one of two camps. The first camp, generally supporters of the Affordable Care Act, contends that the ACA's originally mandatory (but later ruled optional) expansion of Medicaid insurance eligibility and a temporary federally-funded increase in Medicaid fee-for-service rates to Medicare levels provided enough incentives to attract family physicians to patient-centered medical homes that ...

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Whether you like it or not health care financing is transitioning from payment for discrete services to global payment for value. Whether you agree with this trend, or comprehend its meaning, if it has one, is largely irrelevant in the short term. The government of the United States, the Chamber of Commerce, both political parties, all health care stakeholders, and even your own medical associations are fervently supporting, and actively ...

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Many of the patients that I treat have brain injuries. Whether caused by a stroke, car accident, fall, or drug overdose, their rehab course has taught me one thing: nobody likes to be forced to do things against their will. Even the most devastated brains seem to remain dimly aware of their loss of independence and buck against it. Sadly, the hospital environment is designed for staff convenience, not patient ...

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The ink hadn't yet dried on the report of the 2015 Dietary Guidelines Advisory Committee before the assaults began. I guess in this day and age, that's not much of a big, fat surprise. Despite all the over-heated rhetoric I've seen about not trusting this report because the "government" can't be trusted, this report is not from the government. While we may, indeed, need to worry about what the political authorities ...

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I remember one day a few years ago when I was talking with one of my friends about the challenges of being a doctor after a tough day at work. I had seen a large number of patients within the span of a few hours, and in addition to many of them being sick, I dealt with family members who had so many questions and who wanted to provide me ...

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Dr. Wes has written passionately against MOC: ABIM Pleads for Mercy.

But perhaps we should ask first: Why MOC at all? Contrary to years of propaganda promoted through pseudo-science and journal article citations on the ABIM’s website, might MOC have really been created because the ABIM’s consolidated fund balance dropped 43.2% from $54,009,086 on June 30. 2001 to $30,691,329 by June 30, 2013 while the Standard and Poors 500 index increased 37.7% ...

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In order to interpret the world, we tell ourselves stories.  All day long.  About everything.  That guy in the grocery store who clipped your heels with his cart?  A jerk.  The car that cut you off at that intersection? A jerk.  A little old lady stopping in the middle of the aisle at the grocery store?  Senile. It is automatic, it takes no effort, and it is completely egocentric.  It is ...

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shutterstock_195401897 Have you ever tied your shoes and found that the bow unraveled and you almost tripped over your own laces?  Learning to tie your shoes is a life skills task that you learned as a toddler unless you were trained on Velcro straps!  You performed the task of tying your shoes nearly every day of your life believing that you were ...

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I went to the retired firefighters dinner last week and had a great time, probably because I happened to land on a table full of contemporaries: men who worked at pretty much the same time I did. Inevitably, conversation turned to our memories of some of the older firefighters we had to deal with as we worked our way up the seniority ladder; "getting time on" is what it was called.  ...

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