Medicine is a very old profession. Ancient and honorable. Sadly, for the vast majority of recorded history, honor was pretty much all it had. The Hippocratean ideals of “first do no harm” and putting the patient first and all held special importance when medicine truly had nothing to offer. Make no mistake: up until the last two centuries, the vast majority of what passed as ...

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Recently, I had a discussion with a prominent academic family physician.  I had last seen him 37 years ago when he was getting ready to graduate from medical school and I was a new medical student. We had a wonderful discussion and agreed to disagree about merging primary care.   Long time readers know that I dislike the term for the tasks that outpatient internists do.  Most of the push for merger ...

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Did you know that international medical graduates account for 30% of primary care doctors in the United States? And with American medical graduates continuing to shy away from the field, that number will undoubtedly go up. But that's not necessarily a bad thing. Recent news stories, like Pauline Chen's New York Times column, have focused on a landmark study comparing patient outcomes of doctors educated in the United States versus those ...

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Not long ago, we interviewed a physician for possible partnership in our practice. After showing him around our town, some of us partners had dinner with him to discuss business. He was a quite pleasant fellow, well trained, and seemed to be a good ‘fit’ for our practice. As dessert was being served, he said he needed to get one more thing off his chest: he prays aloud in the ...

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Abraham Verghese is a professor of medicine at Stanford University, and one of the most articulate physician-writers today. He recently wrote an op-ed highlighting primary care's plight, and focuses on the scarcity of time:

The science of medicine has never been more potent - incredible advances and great benefits realized in the treatment of individual diseases - yet the public perception of us physicians is often one of a harried individual more ...

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For years now we’ve been hearing about the trials and tribulations that have evolved in the practice of primary care medicine. However, the discussion has intensified in recent months with passage of national health reform. Recent publications highlight the problems. A paper in the New England Journal of Medicine by Dr. Richard Baron entitled, What Keeps Us So Busy in Primary Care? discusses the time spent by primary care ...

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by Pepi Granat, MD Yesterday, and every day, in my office we had one or two patients we call our "Oldie Goldies". People who have been with us since 1971 when I opened my practice, 39 years ago. People whose progress, medical and personal, I’ve shared, and who share mine. We know their parents, kids and cousins either because they call us in crisis, or they’re our ongoing ...

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"An apple a day keeps the doctor away," or so goes the old adage. People who believe there’s some truth behind the saying are crunching on a great big Macintosh right now, or at least they will be once they hear about the results of a study from UC-San Diego which showed that every July, there’s a 10% spike in fatal medication errors in hospitals. The scientists behind the study suggested that ...

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Recently I had an interesting conversation with a few young doctors regarding the new health care reform that had been passed in the United States. One future specialist asked me why primary care doctors should receive more money than they have in the past. And this is an important question that I think sheds light on the suboptimal state of our current health care system. It is important to specialists because ...

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by John Trahanas She was not my patient. Actually, she was nobody’s patient, she was just a wife; she was “the family.” She was a rough, stern looking woman, and with good reason as she had weathered many difficult times. Her husband had been severely demented for many years; however, it was only in the past few months that he required such intensive inpatient care. He was not conscious or communicative, but he ...

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