So you want not to be decimated by a malpractice lawsuit? I understand that, and I agree. Here are eight ways to elude that destiny. Way number 1. Don't do malpractice. Way number 2. Care deeply about your patients; and let them know by your actions that you really do care. Way number 3. Communicate diligently with your patients so that you and they are on the same page and understand together what ...

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One of the simultaneously most enjoyable and exasperating aspects of being an infectious disease specialist is the large volume of “curbside” consultations we get from colleagues. For example, here’s this week’s tally — and it’s only Tuesday — done from memory and without systematically keeping track of emails, pages, phone calls, etc.:

  1. Duration of antibiotics after urosepsis, organism resistant to TMP/SMX and quinolones
  2. Need for repeat immunizations in splenectomized adults (got that one ...

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Interesting article recently from Health Affairs about the clinical equivalence between the care provided by anesthesiologists and CRNAs. The article concludes by advocating that CRNAs be given permission to practice anesthesiology without physician supervision. It's more cost effective. And there is no compromise to the quality of care delivered to patients.

We recommend CMS return to its original intention of allowing nurse anesthetists to work independently of surgeon or ...

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My wife and I were invited to dinner at the home of one of my daughter’s friends. My daughter is a graduate of the International Baccalaureate program of Murphy High and her friends tend to be interesting. This particular friend is majoring in pre-med and has parents who immigrated from Vietnam following the fall of Saigon. As is usual when one has a physician dinner guest (and perhaps when one doesn’t) ...

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Let’s say you develop some heart problem and get sent to me for an evaluation. You show up to the office, check in, get ushered into an exam room, then you wait and wait and wait. When I finally come into the room I seem terse, impatient and rushed, and you end up visiting with me for less than 5 minutes. I provide you with a diagnosis, order a couple ...

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"How many staffers should we have per doctor?" That's a question I'm asked at almost every seminar I present. Of course, like many good consultants, I almost invariably respond "it depends." One of the factors that needs to be considered is what jobs we're talking about -- clinical or front office. It's staffing in the clinical area that will do most to enhance a physician's productivity, so that's what we'll focus ...

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"You know, what Mr. HD really needs is for his mom or somebody to chain herself to him …" [the ICU team laughs] … "But seriously, he needs to be watched over, he needs to be talked to. He needs someone to give him his medications, someone to take him to his appointments, someone to take care of him. With that somebody he can live for years to come. Without ...

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Physicians used to take care of patients at their homes. Through the 1960s, patients would make a phone call and the doctor would arrive at the doorstep, black bag in hand, eager to serve. This changed in the mid to late-1960s as doctors developed group practices and as medical care expanded to include technology-based studies and specialty referrals, and thus became more hospital-centered. Prior to World War II, 40 percent of ...

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Almost every Sunday night, I walk to this one restaurant in my neighborhood for some comfort food (we’re creatures of habit aren’t we?). I pass a church on my way where an Alcoholics Anonymous meeting is held almost every night. As I walk through the crowd of smokers, I look at them and they look at me. They don’t know that I know they’re recovering addicts. And they put a smile ...

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There is a critical gap in the supply of primary care physicians in the U.S., and it should come as no surprise that our existing primary care delivery and payment models are at the heart of the issue. The traditional primary care model -- medical care provided by a physician and a small support staff, often without benefit of health information technology (HIT) -- was developed at a time when the ...

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