As correctional health care professionals, there may be times when we are tempted to conduct ourselves in a less than professional manner simply because we can. We may be able to get away with speaking to our patients rudely, using profanity profusely, or wearing inappropriate clothing. After all, we work in jails and prisons. This culture is far from prim and proper. And, our patients are inmates. Many may tolerate misbehavior ...

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Ten years ago, I was an Emergency Medicine Resident and wanted to die. Today, I’m a general practitioner in part-time practice and am in love with life. What made the difference? I signed up for a dance class. Reports on physician burnout list the personality traits that set us up for trouble: we’re excessively conscientious, feel overly responsible, want to please everyone, and function on an extremely high level - even ...

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If the lack of time is the chief barrier to poor physician-patient communications, it logically follows that longer patient appointments are the solution. Ok, let's say that I could wave a magic wand and add 5 or even 10 more minutes to the average primary care office visit. Would more time really make a difference? Probably not. A quick examination of just some of the key drivers of physician-patient ...

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I received several requests asking me to comment on this CNN story, "Some nurses paid more than family doctors." This isn't really news, as CNRA salaries have been on a trajectory surpassing primary care physicians' for a few years now. In fact, I wrote about it back in June of 2008. According to the latest numbers, "Primary care doctors were offered an average base salary of $173,000 in ...

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Here's a novel, and incredible, use of social media in health care. A 40-year old man was admitted several days ago with a fever of unknown origin. His significant other, Laura, is live blogging his hospital stay -- hoping to solicit other medical opinions on the case, as there is no clear reason on what is causing his symptoms. Blogging at The Z Update, here's an excerpt of how he ...

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With health reform possibly passing within the next few months, attention now turns to the primary care doctor shortage. Regular readers of this blog know that there are not enough primary care doctors currently; it's frightening to think what would happen if an additional 40+ million newly insured patients start looking for care. A recent piece from Newsweek nicely encapsulates the problem. It's a good piece, elucidating the myriad of ...

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I went to my physical therapist yesterday for knee treatment and we talked about the fact that Blue Cross is cutting their reimbursement to the point that the cost of providing care will not even be covered. All I could do was lament with him and listen. One insurer even told him (the owner of the business) to just "make the sessions shorter and don't give as much care." Clearly the insurance ...

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One of the joys of practicing at an academic center is that I get to do many different things in my job. The foundation of my work is seeing my own patients in a large group (more than thirty doctors!) primary care practice. Two months a year, I take my turn rotating on the hospital inpatient services, supervising teams of residents and students who are the primary caregivers for patients with illnesses ...

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Originally published in MedPage Today by Michael Smith, MedPage Today North American Correspondent Physicians are working fewer hours than they once did, the result of a decade-long decline that coincided with lower fees for their services, a study showed. After two decades of stable hours, a steady decrease began in 1997, according to Douglas Staiger, PhD, of Dartmouth College, and colleagues. The decline coincided ...

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What if your local hospital went national? In a growing trend, big name institutions are partnering with smaller hospitals nationwide, looking to leverage their reputation. Drew Weilage, blogging at at our own system, highlights a local hospital in Ft. Lauderdale, Florida which signed a partnership agreement with Boston's Massachusetts General Hospital. Indeed, he asks, "Who wouldn’t choose, if they could, the Mayo Clinic for neurosurgery? Or the Cleveland Clinic for heart treatment? Or ...

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