Physician

Private practice medicine will soon become extinct

I’ve written previously that the days of the private practice physician are numbered.

A detailed piece from the New York Times confirms the exodus.

Young doctors, who are burdened with medical school debt exceeding $150,000 are opting for the financial stability that a salary from a hospital-owned practice, or a large integrative medical center, can bring. Gone are the days where a solo practitioner can hang a shingle and …

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Healthcare workers in the ER hit hard by H1N1

by Michael Smith

Healthcare workers in a New York City emergency department had the highest rate of infection among employees of an urban hospital system during the first wave of the H1N1 pandemic flu, researchers said.

In a single-institution study using medical and administrative records, the adult emergency department had an H1N1 infection rate of 28.8% during April, May, and June of 2009, according to Robert Bristow, MD, and colleagues at New …

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Emergency departments are frequently used by young adults

by Kristina Fiore

Twenty-somethings rely on emergency departments (EDs) for care far more than do other age groups, researchers have found.

In 2006, nearly a quarter of all young adult healthcare visits — 22.1% — took place at an ED, compared with 12.6% for children and adolescents and 8.3% for patients over 30.

That rate has significantly increased over a 10-year period, Robert J. Fortuna, MD, MPH, of the University of Rochester Medical …

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Op-ed: Patient satisfaction doesn’t mean the best medical care

A version of this op-ed was published on March 15th, 2010 in the USA Today.

If you recently saw a doctor, you might subsequently receive a survey in the mail asking whether your physician was friendly, spent enough time with you, or showed the appropriate level of concern for your medical issues.

Patient satisfaction surveys are being increasingly used in hospitals nationwide. Press Ganey, a leading organization measuring patient satisfaction, counts more …

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Retail clinics are starting to do more primary care

by Joyce Frieden

Retail clinics aren’t just for strep throats any more; they’ll also be managing diabetes and other chronic diseases.

“It’s a new service strategy,” Sandra Ryan, CPNP, told attendees at a meeting on retail clinics sponsored by the Convenient Care Association and the Jefferson School of Population Health.

“We’re evolving our clinic offerings,” said Ryan, chief nurse practitioner officer for Take Care Health Systems, which operates retail clinics inside Walgreens pharmacies, …

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Patient attacks on doctors and nurses are more frequent

With the attention focused, rightly, on patient safety, what about health care workers?

It’s somewhat of a hidden phenomenon, but attacks on doctors and nurses are on the rise.

Rahul Parikh writes about this in a recent Slate piece. He cites data from the Bureau of Labor Statistics, which found “health care workers are twice as likely as those in other fields to experience an injury from a violent act at …

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Aortic dissection symptoms and current treatment options

by Joseph Lombardi, MD

You probably remember the tragic death of actor John Ritter in 2003.

Recently, his family partnered with the Thoracic Aortic Disease (TAD) Coalition to shed light on the condition that took his life: aortic dissection.

In addition to TAD Coalition’s “Ritter Rules,” which focus on recognizing, treating and preventing the condition, the American Heart Association and American College of Cardiology also released new guidelines designed to prevent unnecessary …

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Physicians increase revenue with better appointment analysis

by Nikolaos I. Kakavoulis, MD

Physicians are working harder than ever to generate even a small increase in their income. Despite seeing more patients, average physicians net income between 1995 and 2003 has declined about 7% after adjusting for inflation, according to a national study from the Center for Studying Health System Change.

Why is this happening?

Now more than ever, physicians face an avalanche of complex rules, regulations, and administrative processes needed …

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A DNR order may not always be best for the patient

Doctors are often encouraged to discuss advance directives with their patients.

But sometimes, when it comes to act on a “Do not resuscitate” (DNR) order, the situation can be far from clear.

In a provocative essay from the Washington Post, emergency physician Boris Veysman discusses a case where he successfully revived a man who, unbeknown to Dr. Veysman, had a DNR order.

Despite the temporary nature of the illness, the family honored …

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ER overuse may be a myth

Overuse of the emergency department is commonly discussed during the health care conversation. Especially with the lack of primary care access shunting patients with seemingly routine symptoms to the ER.

But is this a myth?

That’s what two emergency physicians contend in a piece from Slate.

The emergency department is functioning just fine, they say: “Just 12 percent of ER visits are not urgent. People also tend to think ER visits …

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My health reform opinion in AOL News

Thanks to AOL News for publishing my latest opinion piece, Reform’s Great, But We Need More Doctors.

I discuss how health reform’s ultimate success or failure is largely dependent on whether our primary care system can accommodate the millions of newly insured patients:

… having health insurance doesn’t necessarily mean it will be easy to find a doctor. Even before reform, …

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Primary care is the loss leader of medicine

Medicare’s sustainable growth rate, or SGR, has been the bane of doctors for years now.

To encapsulate, this is the reason for Medicare’s annual threat to cut doctors’ fees by 20% or more, only to be staved off at the last minute.

Emergency physician Shadowfax has a nice take on it, explaining why it has devastated primary care:

Primary care has many fixed expenses in addition to those we bear: they pay …

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