In response to a recent article on the topic of economic motivation theory, Michael Kirsch sent me information about a very interesting study (May 2010 issue of the British Medical Journal) done to evaluate the effects of monetary incentives on clinic, physician, and staff work performance. From 1999 to 2007,  35 medical facilities of Kaiser Permanente in NorthernCalifornia, were given financial incentives  for ensuring that their patients got regular screening for ...

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Health care is changing at lighting speed. If you don’t know this, or worse, don’t accept it you’re doomed. No. Really. It’s change or close shop. Whether you like it or not, health care reform is going to change the way we practice from now on. Many physicians are choosing to work for large group practices to buffer themselves from directly dealing with change. Mental health providers could do the same, ...

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I got a chance to fly JetBlue for the first time recently. Since I had heard so many good things about the airline, I was looking forward to experiencing the JetBlue, well, experience. I took four flights in total with them. While outbound, they lost my bag. While inbound to Chicago, my last leg was delayed about 2 hours. I then I had to wait another 80 minutes for my bag ...

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Lucian Leape MD, a public health professor at Harvard, wants to subject doctors in America to strict random and periodic drug testing to help identify those physicians who are impaired. All in the name of patient safety, of course:

"I'm very much in favor of random testing," Dr. Leape says. "We have a responsibility to identify problem doctors and bring them into treatment." And to protect patients in the process.
Ok, I ...

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Doug Farrago is a family physician in Maine, and the editor of the entertaining Placebo Journal. He uses his Placebo Journal media platform to show his audience what primary care is all about. In this video, Doug Unplugged, he gives us a little taste of that journey. Hollywood, take notice. classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="425" height="344" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
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by Shawn Vuong Recently, our class learned and practiced how to correctly 'scrub' for surgery. During this little lab activity, we were all gowned up and washing our hands when a couple of classmates asked if I was going to be a surgeon. I said I didn't really know yet, although I did find surgery pretty fascinating. With that, they told me that they thought I would make a good surgeon. due ...

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The following op-ed was published on July 18th, 2010 in USA Today. A new patient recently said he was referred to me after his last doctor had left medicine. His old doctor always looked unhappy and burned out, he noted. Burnout affects more than half of doctors, according to researchers at the University of Rochester School of Medicine. Beyond mere job dissatisfaction, these doctors are emotionally exhausted to the point ...

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by Robert Graham, MD As the nation works to reinvigorate primary care, a lot is riding on the medical home. Some see it as an answer to a fragmented health care system that is not responsive to patients’ needs for coordinated, comprehensive care. Others have invested in it as a vehicle to improve both the quality of care and control costs. While we work to address ...

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Dr. Marcus Conant, among the first AIDS specialists in San Francisco, who for decades had one of the world’s largest private practices for patients with AIDS and HIV, has left town and moved to Manhattan. He has been a physician for nearly 50 years, but like many doctors, in the past decade he has become increasingly frustrated with insurance challenges that made running a private practice unnecessarily complicated and a financial ...

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Eating right, exercising, avoiding the sun or using sunscreen, moderating alcohol consumption, abstaining from tobacco use, getting mammograms, Pap smears, colonoscopies—almost every measure we’re asked to take to safeguard our future health is difficult.  It’s a strange paradox that we have to work in some way, to expend energy, and experience discomfort of some kind in order to gain benefit in life. Wouldn’t it be nice if the most pleasurable things ...

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