Physician

Will the lack of primary care doctors make universal coverage useless?

It appears that one source of agreement among health reformers is that there isn’t enough primary care doctors.

The New York Times wrote a front-page piece on this issue last month, which I had commented on.  Now, an article in the Washington Post re-iterates the same theme:

As the debate on overhauling the nation’s health-care system exploded into partisan squabbling this week, virtually everyone still agreed on one point: There are …

Read more…

Primary care doctors face burnout, and how that affects health reform

Not only are primary care physicians in short supply, there more evidence that they are burning out and leaving the field.

According to a study in the Annals of Internal Medicine, “large numbers of physicians claimed a lack of control of their work, a chaotic work pace and time constraints during patient visits,” and, “more than a quarter complained of burnout. More than 30 percent indicated they would leave the …

Read more…

Should severe birth injuries be pulled out of the court system, and can defensive medicine be good?

Two recent op-eds were recently published in The New York Times concerning medical malpractice.

With health care costs spiraling out of control, there is some grudging acceptance within both the Democratic party and mainstream media that something needs to be done to fix the American malpractice system.

The stance that the American Medical Association is taking, namely, exempting doctors from malpractice if they adhere to evidence-based clinical guidelines, is a good one. …

Read more…

Fixing malpractice is a vital part of health reform

It was gratifying to see President Obama recently acknowledge the role malpractice plays in our failing health system, as well as admitting the presence of defensive medicine.

Furthermore, The New York Times, whose editorials I’ve taken exception with in the past, wrote a reasonable opinion on the issue. As they admit, “The current medical liability system, based heavily on litigation, has a spotty record. It fails to compensate most …

Read more…

If health reformers want to emulate Canada and Europe, can we copy their malpractice systems too?

Most health reformers and progressive policy experts want our health system to be more like Canada, a single payer system, or Europe, which include hybrid public-private systems.

What most fail the mention is that in both these instances, malpractice systems (via DB’s Medical Rants) from these countries compensate patients more fairly, and do not expose the physician to the lengthy and traumatizing litigation process that they do in America.

Consider this …

Read more…

Older primary care doctors can’t retire

Just when you think the primary care shortage can’t get any worse.

Not only are there not enough primary care access to serve the almost 50 million uninsured Americans, recent numbers also show that out of 270,000 primary care doctors, almost 5,000 of them are older than the age of 75.

They simply can’t retire, mainly because of an inability to find a young doctor to take their place within the …

Read more…

Shadowfax on the KevinMD Live Q&A: Tuesday, July 14th at 10:30pm Eastern

Emergency physician Shadowfax will be my next guest on the Live Q&A.

Blogging over at Movin’ Meat, Shadowfax is the pseudonym of an emergency physician in the Pacific Northwest. His blog posts are a combination of cogent health care reform analysis and opinion, commentary from the administrative side of medicine, and fascinating ER cases.

He recently had a piece on health care reform published in The New York Times’ Room …

Read more…

Surgery’s pre-painkiller, pre-antiseptic past and its robotic future

Engineer and surgeon Catherine Mohr gives a dynamic lecture on the surgery’s history and its potential future.

width=”446″ height=”326″ data=”http://video.ted.com/assets/player/swf/EmbedPlayer.swf” type=”application/x-shockwave-flash”>

Well worth listening to.

Why removing the tax breaks for non-profit hospitals could be dangerous

It’s because of the unintended consequences, of course.

In their regular column in Slate, physicians Zachary Meisel and Jesse Pines talk about the recent attention that non-profit hospitals are garnering. The problem is this. Many are acting like for-profits, and in some cases, have been caught mistreating the uninsured and those who are on Medicaid.

So, when money is tight, you hear stories like this one a few weeks …

Read more…

Why would a doctor stop seeing patients?

It’s no secret that training a doctor takes a tremendous amount of time and money, both from the physician and the government, who subsidizes a substantial amount of the cost of training.

So, in the midst of a physician shortage, internist Toni Brayer wonders about doctors who simply decide to stop seeing patients.

After talking to a young physician who made such a decision, and instead, is starting a a pharmaceutical business, …

Read more…

ER crowding and your risk of dying from a heart attack

It’s not a secret that emergency departments are becoming more crowded by the day.

Especially if universal health coverage is enacted without appropriate primary care doctors to see the newly-insured, expect the problem only to worsen.

So, it comes as no surprise that those who wait longer, especially for symptoms that could be cardiac in nature, potentially can have worse outcomes.

As reported in MedPage Today, a study shows that, “emergency …

Read more…

Poll: Should a doctor blog his medical malpractice trial?

Emergency physician WhiteCoat has been blogging a detailed account of his recently concluded malpractice trial at Emergency Physicians Monthly.

In 2007, pediatrician known as Flea live-blogged his malpractice trial. He shared his thoughts on the defense strategy and frank, unflattering opinions of the opponent’s legal counsel. The plaintiff’s attorney discovered the blog, confronted him during cross examination, and the case was settled the next day.

In these litigious times, there’s been …

Read more…

Physician malpractice deposition observations

Emergency physician WhiteCoat continues the chronicles of his concluded malpractice trial.

A recent episode focused on the deposition at the plaintiff attorney’s office. Along the way, there are observations on whether doctors with thick foreign accents make good witnesses (according to WhiteCoat’s lawyer, “juries are not very forgiving of foreign doctors”), or if the bathrooms were bugged. Cloak and dagger stuff.

But importantly, with the deposition focused on whether WhiteCoat …

Read more…

The worst medical malpractice cases you can possibly imagine

Read it to believe it.

It’s not often that this blog links to Cracked, but here it is, The 6 Most Terrifying Medical Malpractice Cases Ever. (via WhiteCoat)

Among them is a psychiatric case where the doctor gave a patient, who unfortunately eventually committed suicide, “several thousand pages of sadomasochistic fantasies [in] an extensive effort to brainwash him into believing he was a child and that the doctor was his mother.”

But …

Read more…

Should medical errors be prosecuted criminally?

A pharmacist in Ohio is being criminally prosecuted in a medical mistake that resulted in a death of a two-year old child.

Is that going too far?

Indeed, if the criminal prosecution of this pharmacist is successful, it may lead to a dangerous precedent. Indeed, “he wasn’t drunk or impaired. He wasn’t even the one who prepared the mixture. He was inattentive and lazy and careless, and now he faces the …

Read more…

Medical tourism, malpractice, and it’s easier to sue American doctors

How are American doctors fighting medical tourism trend?

Cardiologist DrRich’s latest post details the concern the American College of Surgeons have for the burgeoning medical tourism industry, and how they are using malpractice as a reason not to travel overseas for your procedure.

“Indeed, the potential difficulty in suing foreign doctors appears to be the chief differentiator, and the primary argument in favor of good-old-American-surgery,” DrRich writes. “The surgeons, in essence, are …

Read more…

Why doesn’t medical peer review work?

Reporting bad doctors seems like a pretty simple task.

Why then, is physician peer review seemingly inept?

Bob Wachter comes up with some theories, including the fear of litigation. Although doctors who perform peer review are supposed to be legally immune, many hospitals have little faith in these protections. As Dr. Wachter concludes from an analysis of the National Practitioner Data Bank, “these protections must be unambiguously robust,” but in …

Read more…

A surgeon dumps post-op patients to hospitalists

Is it ever ok for a hospitalist to be the primary physician in post-op cases?

The answer is no, but as The Happy Hospitalist reports, it’s happening in some cases.

He details an instance where a hospitalist program is being asked by an orthopedic surgeon to provide care for his post-op cases, with the surgeon only coming in for a visit on the day of discharge.

As Dr. Happy correctly states, it’s “one …

Read more…

A doctor is sued, and blogs his malpractice trial

An emergency physician recently concluded his malpractice trial, and is blogging about it.

Sound familiar? Well, this isn’t the first time it happened. In 2007, pediatrician Flea live-blogged his malpractice trial, which wasn’t a good idea for him, and indeed, became a media circus.

Prominent emergency physician blogger WhiteCoat is diving into the same waters, albeit with a disclaimer saying that the trial has already ended, and also, …

Read more…

Physician apologies, and does saying you’re sorry mean it’s your fault?

There’s a movement afoot to make physician apologies inadmissible in court for cases of adverse patient outcomes.

Hospitalist Chris Rangel notes the absurdity of the situation, and says that expressing sympathy shouldn’t always imply causation in the first place. After all, saying sorry and expressing sympathy is the right thing to do in these difficult circumstances.

But not everyone supports such a move. For instance, Massachusetts is considering such a …

Read more…

459
pages

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories