Originally published in MedPage Today by Charles Bankhead, MedPage Today Staff Writer The physician workforce in the U.S. is growing smaller and younger, according to data from the Census Bureau, but conflicting estimates make it difficult to determine just how many doctors are out there -- and how many the nation will need. The census survey showed 67,000 fewer physicians than estimates based ...

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I would like to introduce you a remarkable article by Edward J. Volpintesta, MD, a 65-year old solo primary care doctor in Bethel, Connecticut. Dr. Volpintesta is a veritable writing machine and has been published in The Wall Street Journal, the New York Times, medical journals, and other publications. His articles cry for a deeper understanding of primary care dilemmas. In the October issue of Connecticut Medicine, Dr. Volpintesta hits the ...

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Of the myriad of proposals meant to change the health care system, including switching to electronic records, paying for performance, and adhering to evidence-based standards, very little attention is being paid to how they will be implemented, and the unintended consequences that may arise. Annie Brewster, an urgent care provider in Boston, outlines this in a nice commentary: "Reform should make my job more, not less, satisfying. Of course, doctors should ...

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After a painful, summer-long labor, Senate Finance eventually had to be induced before it gave birth to a health reform bill of its own. But give birth it finally did, and the products of its conception now stand alongside the offspring of 4 other proud Congressional committees. But please! Save the silver spoons and bunting! None of the quintuplets does enough to assure there will be enough PCPs out there to ...

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I think by now there is not a person in the US who cannot quote at least approximately how much we spend annually on healthcare. Fewer people appreciate that nearly 1/3 of this $2.2 trillion bill is eaten by hospitalizations, amounting to about $680 billion. Although the data in the diagram below represent a single year, the overall distribution of expenses is remarkably constant over time.
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Does anyone realize that the chaos of modern American health-care is not a tragedy, but a triumph? We’re so busy trying to fix what isn’t broken and ignoring what is, so busy casting stones and casting doubts that we are blind to what we have. I have practiced medicine in this labyrinth for 16 years. I am an emergency physician. I practice in what may be considered the ‘epicenter’ of modern ...

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by Bruce Douglas, MD I've been practicing my health care specialty for sixty years and have enjoyed almost every minute of it. The minutes I have not enjoyed all have to do with "money." Financial transactions in doctors' offices are the root of most evils in the relationship between doctor and patient. Along with that evil goes an additional detraction from good, humane health care called the fee-for-service system, which ...

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If you want to get insights into the problems of our health care system, look at a mural by Washington DC resident Regina Holliday. regina holliday mural Holliday is a 37-year old mother of two and an art teacher. Last summer, her husband, Fred, died from kidney cancer at the age of 39. The Hollidays' experience is a case study in ...

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by Daniel A. Graubert, MD Medicine has changed so dramatically since I graduated medical school in the 1980's, that it is hardly recognizable. Certainly, there has been an enormous growth in knowledge which is often beneficial, but has often led us down the wrong path. For example, when advanced imaging techniques such as CT scans and MRIs became available, we were able to see the inside of large numbers of patients ...

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As Bob Dylan sang so long ago, The Times They Are A-Changin’. Some like change; some do not. Consider these change scenarios: * One of the important scenes of change for health care providers is the national debate on health care coverage currently playing out in Washington D.C. Some are very vocal in their support. The media covers many of the vocal opponents. Certainly some sort of change will come out of ...

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