Is medical training taking a turn for the worse?

We are so focused on reducing medical errors, as we should, that doctors in training have no leeway to make a mistake. Often times, giving them that space is the only way to give them the confidence to become a competent physician.

Psychiatrist Richard Friedman is noticing that more of his residents are asking him for help, for ...

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Family doctors are doing less obstetric care these days.

As reported by MedPage Today, a study shows that the number of prenatal visits seen by family physicians declined from 11.6% to 6.1% from 1994 to 2004, and perhaps of more concern, 38.6% to 12.9% in rural areas.

It's not a huge surprise, since these days, obstetricians have absorbed most of the maternity cases. One reason is ...

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Would Natasha Richardson be alive today if she had gone skiing in the United States instead?

I don't think it would have made a difference.

To recap the tragedy, Ms. Richardson died from an epidural bleed, after she fell while skiing. Her presentation was somewhat classic, with the well-described "lucid" period before she deteriorated.

According to Canada's Globe and Mail, "ambulance workers were not ...

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It's becoming apparent that the solo and private practice model of primary care is dying a slow death.

PookieMD interviewed me, as well as retainer physician Kevin Lutz, about the divergent paths that one can take after leaving private practice.

I represent the hospital-owned practice route, and here's my take:

He opines that, "primary care is the loss leader for the hospital," explaining that primary care brings business ...

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Tragic news this morning regarding actress Natasha Richardson, who reportedly, suffered a head injury during a ski lesson in Canada.

According to reports, she fell on a beginner's ski hill, and did not hit anyone or anything during the fall. There was no obvious sign of injury, and in fact, she was "was walking around and feeling fine for an hour after her accident."

Things then ...

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In a surprise, President Obama has signaled a willingness to discuss medical liability as part of the health reform process.

Good for him for standing up to the trial lawyers, a core constituency of the left.

That's a good sign, as the costs of defensive medicine brought on by the broken malpractice system, should be addressed if there is any hope of reducing health care spending.

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A study recent came out showing that specialists are providing a greater proportion of primary care services to patients.

According to the Annals of Family Medicine, "Researchers looked at more than 1 billion ambulatory visits to U.S. office-based specialists in 2002-04 and found that 46.3% of visits were for routine follow-up and preventive care of patients already known to the specialist, while referrals accounted for only ...

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Hospitalists are here to stay, for good.

MedPage Today reports on a NEJM study, not surprisingly concluding that "hospitalists now account for nearly 40% of inpatient Medicare claims for general internist services, up from less than 10% in 1995."

That's a lot.

How will it affect primary care doctors, who increasingly are confined to the office? Well, it's not a positive as you'd think.


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The work ethic instilled in most physicians may actually be a detriment to patient care.

In this piece in Slate, emergency physicians Zachary F. Meisel and Jesse M. Pines write about the culture in medicine where doctors are expected to show up for work (via RangelMD.com), no matter what their malady is: "Sick doctors have been known to do rounds while dragging IV poles and receiving fluids for ...

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Corporations are finding out what primary care doctors already know: it's hard to make money only doing office visits.

CVS has announced they are closing 90 of the 550 MinuteClinic locations until next fall's flu season.

As the WSJ Health Blog comments, "the clinics appear to be showing a pattern sort of like the dot-com bubble, in which some will go away while others survive."

That's ...

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