Earlier this week, President Obama argued that we need to spend money now, in order to curtail the spiraling costs that Medicare and Medicaid will reap on future generations.

However, when it comes to primary care, the Congressional Budget Office is not so forward thinking: "Savings from some initiatives may not materialize because incentives to reduce costs are lacking. For example, proposals to establish a 'medical home' might ...

Read more...

Do most surgeons think mid-level providers can replace primary care physicians?

That much was implied during recent testimony by the American College of Surgeons' John Preskitt, who said, "With trauma care and surgical emergencies, there are no good substitutes or physician extenders for a well-trained general surgeon or surgical specialist."

The ACP's Bob Doherty took that to mean that there were good substitutes for primary ...

Read more...

And if so, is this the best time to start a turf war?

The ACP's Bob Doherty highlights a study from the research arm of the American Academy of Family Physicians suggesting that, "Medicare spending by general internists and subspecialists is significantly higher than for family physicians."

I haven't seen the study myself, but if this is correct, is it really the time to release a study that ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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.

Read more...

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 ...

Read more...

Most Popular

Join 150,000+ subscribers

Get the best of KevinMD in your inbox

Sign me up! It's free. 
close-link
✓ Join 150,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.