Here are the top posts from this past month, based on the number of times they were viewed. 1. Apple’s iPad on medical rounds, a hands on physician review 2. Why primary care is like air traffic control 3. “I’m a patient, not a consumer” 4. Doctors hiring scribes because of electronic medical records 5. Pelvic exam etiquette that doctors need to know 6. Laugh, Sing, and Eat Like a ...

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Physician/poets such as William Carlos Williams are an honorable tradition in the history of medicine, following in the footsteps of Keats, Schiller, and Oliver Wendell Holmes (of “Chambered Nautilus” fame). Physicians have also been writers, painters, musicians, philosophers, and – at least in more recent times –photographers. Yet in 1980 the historian G.S. Rousseau expressed concern that modern physicians no longer embodied the humanist tradition of their predecessors. Now that medicine ...

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by Drew Rosielle, MD Recently, the New York Times reported of the movement in Washington State to officially do something about prescription opioid abuse, coming on the heels of course of the FDA rejecting the current risk evaluation and mitigation strategy plan as, essentially, not going far enough. The article basically discusses the discussion in Washington about what to do; no formal new plans have been ...

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The recess appointment of Dr. Donald Berwick as head of CMS has incited a furor among politicians outraged at what they claim are his advocacy for rationing and fondness for Britain's National Health Service. To support their claims, these politicians are using Berwick's own words, in a way eerily reminiscent of the recent Shirley Sherrod debacle. It started with Glenn Beck, master of the one-word quote, and then slipped over ...

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The rapidly ramifying crisis in health care may (we can pray) end all delusions. It may at least begin to weaken them by exposing them to the light, to the sobering effects of reality. The reform act has not brought us to the Promised Land. By bringing us access without capacity, fierce restrictions coupled with vague language and loopholes, mandates coupled with fines low enough to become the cheap way out, ...

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The authors call it “an in-office linguistic study” and write that it “was conducted to assess physician–patient discussions of mixed dyslipidemia.” But it’s really an Abbott marketing study for Niaspan, the company’s long-acting niacin product, and the question is: why is it published in the American Journal of Cardiology? The study involves the recorded conversations of 12 cardiologists and 12 PCPs with 45 patients with low levels of HDL. The authors ...

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This evening I went to a meeting of many of the independent physicians in our community who came together to discuss ways we can help each other to remain viable as relatively small independent practices of medicine.  Two things about the meeting really hit home for me. First is how seldom I get to meet socially with my fellow physicians in the community.  Now that many of us use hospitalists to take care ...

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The primary care-specialist pay gap is a popular target for those eager for reform. The gap is hailed independently as an example of and a cause of the lack of focus on primary care and prevention in the United States. There is no doubt that the United States treats primary care, preventative care and triage much differently than most of the rest of the developed world. The distribution of primary care ...

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I am a medical doctor.  I am also called an allopath, someone who practices “Western medicine.” We allopaths like data, proof, science, randomized, double-blind, placebo-controlled trials.  We want to know the “mechanism of action.”  We want someone to prove that yoga or medication or some procedure actually helps your depression or blood pressure or back pain and that these treatments are safe before we prescribe them.  We feel more confident about ...

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After seeing Mrs. WhiteCoat argue on the phone with Medco representatives for 20 minutes about why one of her 80+ year old patients hadn’t received her medicine despite three lost faxes to Medco, I had to write this post to let the public know what is going on with some mail order pharmacies. If you’re like most Americans, you want to try to save some money. One of the ways that ...

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