What if some physicians actually like the way primary care is currently practiced? It's hard to believe, considering the majority of studies suggest marked dissatisfaction among primary care doctors, and an increasing prevalence of physician burnout. The ACP's Bob Doherty recently summarized an epic Health Affairs article devoted to fixing primary care. The bottom line was that better paying primary care doctors isn't enough. The whole field needs to ...

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I’ve just finished a month “on-service” as a teaching attending for a general medicine team here at GlassHospital. This means I served as the physician of record for every patient admitted to the team. You might find it interesting to know that patients admitted to the hospital’s general medicine service get assigned to their teams by random assortment. Since there are five teams, one team takes call every fifth day. ...

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A patient's grief can threaten the safety of health care providers when it crosses into rage. Emergency physician Edwin Leap illustrates some concerning instances:

In one instance, family members became angry because we did not leave the body in the ER for eight hours so that everyone could come and pay their respects. (Which I always thought was the purpose of a funeral home.) In another, a family was ...

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by Tricia Pil, MD This is the true story of a hospitalization as told from three points of view: first, the recollections of the patient (who happens to be a physician); second, events as recorded in the medical charts by doctors and nurses; and third, the version put forth by the hospital. FRIDAY Patient: It is fall 2005, and I am nine months pregnant. A healthy 33-year-old pediatrician, I am a longtime patient of ...

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Once you’ve decided that you want to explore other income opportunities, then it’s time to do some preliminary brainstorming. The goal here is to create a list of business ideas that you would find success in and be happy with. As a physician, you have a distinct advantage if your business plan involves the medical field. However, you do not need to limit yourself to this field as there are enumerable ...

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by Kristina Fiore Shorter hospital stays and lower costs were the result when surgical patients with diabetes and dysglycemia received endocrinology consults, researchers said. Adding endocrinologists to surgical care teams for patients with abnormal blood glucose readings cut total length of stay among patients in a single center by 1,342 days and saved the hospital $1.15 million, according to Arthur Chernoff, MD, of Albert Einstein Medical Center in Philadelphia. Chernoff presented his findings ...

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Will medical school loan forgiveness be enough to convince prospective doctors to forsake specialty practice as a career? I've argued previously that it may help a little, but it's unlikely to change the overall trend away from primary care. A recent article from Health Affairs compares lifetime earnings from a cardiologist versus a primary care physician. The difference is stark:

Their calculations showed that cardiologists earn a career average of more ...

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Although every day can bring surprises in a medical practice, you can develop a clinical team that can optimize the efficiencies of your operation and make it easier for you to see your patients. There are three key areas that lead to provider frustration in daily operations: preparation and anticipation; the daily dance; and being in the moment. Address these, and your days should go more smoothly. Preparation and anticipation Are your charts ...

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I have spent most of the past 2 weeks on the road – first at ACP and this week at SGIM. I have talked with many internists, but several conversations have contributed to writing this post. Each of several leaders contributed to these ideas, but I will keep them anonymous so the innocent are protected. Here are the main assumptions: 1. Internists by training excel in the care of complexity 2. Pursuing the ...

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There's been a lot of commentary on a recent article from the New England Journal of Medicine, detailing the undocumented tasks that a typical primary care physician performs. For those who haven't read the piece, entitled, What's Keeping Us So Busy in Primary Care? A Snapshot from One Practice, it's available free at the NEJM website. I highly recommend it. To summarize, primary care doctors are responsible for much more ...

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