"I make my living off unnecessary procedures."

So will be the rallying cry of some doctors once the true impact of comparative effectiveness research (CER) is felt.

Proponents of CER have been very careful not to associate its evidence-based findings with the coverage decisions of Medicare and other health insurers.

But let's face it, that eventually has to happen. I see CER as the initial baby ...

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It's been said that hospitalists are the fastest growing specialist field in the history of medicine.

Hospitals are constantly recruiting, and the increasing demand is continually pushing salaries up. But, in the midst of the current recession, what does the future hold?

Writing in Today's Hospitalist (via Dr. RW), Erik DeLue predicts that salaries are likely to plateau, or even fall. Most hospitals ...

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One of the newer trends is doctors using social networking sites like Sermo and iMedExchange.

Likened to a "virtual doctor's lounge," physicians can ask questions and speak freely knowing their posts will not be seen by, or released to, the public.

Often times, questions about patient management are asked, and it's nice to have a quick response to queries by a variety of specialists.

In this piece ...

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Here's what happens when you give so much attention and influence to such a crude instrument.

Following quality measures can make or break a hospital's reputation, especially if they are being widely advertised. Patients often make health care choices based on whether doctors following quality measures.

However, as these measures are currently constructed, they often ignore the nuance surrounding many cases.

Emergency physician WhiteCoat cites ...

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One proposed way to control costs is to replace primary care doctors with mid-level providers, like nurse practitioners and physician assistants.

Merely bringing up this idea brings out the worst in turf battles, with most discussions devolving into nurse versus doctor cat-fights.

The ACP comes up with their vision of how nurse practitioners fit within the primary care spectrum. It wisely takes a balanced approach, but, ...

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Despite the fact that almost 100,000 patients die from medical mistakes each year, only 30 percent of those errors are ever disclosed to patients. Saying "I'm sorry" is morally and ethically proper. It re-establishes trust and empathy between doctor and patient, and makes it easier for everyone involved to learn from the incident. Hospitals that have instituted full disclosure programs have seen a decrease in the number of ...

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The fallout from California's balance billing ban is about to get much, much worse.

A patient is suing an emergency physician group for the $57 he spent last year on the balance bill he had to pay for services his insurance didn't cover.

If successful, the results for already near-bankrupt hospitals are chilling, as "hospitals and ER doctors could be on the hook for hundreds of millions of ...

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Washington DC's infamous Walter Reed Army Medical Center is set to close in 2010.

In an effort to subsidize the city's subway system, the medical center purposely limited the number of parking spots, forcing staff to use public transportation.

Combined with the fact that buildings are subject to a height restriction in DC, the campus became increasingly sprawled as it expanded, forcing staff to walk longer distances.


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I think so.

The NEJM has a perspective piece on the declining percentage of doctors who practice independently. Depending on the source, the number ranges from 29 to 61 percent.

It is becoming increasingly difficult for doctors not to be supported by a hospital or large integrated health system. With reimbursements declining, many doctors are opting for the relative security of a salary.

Furthermore, ...

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Studies show that international medical graduates (IMGs) see a disproportionally high number of Medicaid patients when compared to their American counterparts.

Like most doctors, if they had a choice, the incentives are such that they too would choose to practice in cities rather than in rural areas.

Less-restrictive visa requirements are making it harder to recruit IMGs to rural areas, and compounded by the fact that American ...

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