In the Clinic - Dr. Roberto Pineda, MD - Indications for the Excimer Laser
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The following op-ed was published on March 13th, 2008 in the USA Today. Crippling health care bills, long emergency room waits and the inability to find a primary care physician just scratch the surface of the problems that patients face daily. Surveys suggest that health care is a top domestic priority in the presidential election, and there is no lack of ideas on how to fix our system. ...


Blog break

I'll be away until Tuesday the 24th. I'll put up a few classic posts as well as a Reader Take on Sunday. Enjoy the weekend.

Some hope

Rather dour day of blogging stories today. Here's a more optimistic link.


Know what you're getting into: "So many of my classmates have gotten this far only to realize that they have made a very expensive mistake. I know of at least two people who now openly admit that they dislike medicine. Unfortunately, they are now more than $150,000 in debt and cannot leave the profession. They are now stuck in this job field for no other reason than economics."

CRNAs are quietly becoming a very lucrative field, without the physician hassles.

The generalist-specialist salary disparity is so great that specialist mid-levels pay (i.e. dermatology PAs) will soon overtake those of generalist physicians.

Further reason why students will shun primary care medicine.

An early-release NEJM study is getting some much-needed airplay in mainstream media. About time they caught up to what's been discussed on the medical blogs for some time now.

Here's one reason why physicians aren't implementing electronic records:

Unless electronic medical records are fully funded, the majority of independent practicing physicians do not have any incentive to make the switch.

In fact, the individual ...


As if being a PCP isn't difficult enough: "The typical primary care physician with a patient load of 3,000 souls can assume that at least 60 of these individuals (up to 150, if he/she treats a lot of patients with pain or disability) would not only like to see them dead, but would be pleased to be the instrument of their demise."

Dunking dangers

A plastic surgeon talks ring finger avulsion.


The problem of caring too much: "If you empathize with all your patients, do you risk bearing too much of a burden? Does it lead to burnout? Is that "professional distance" necessary for one's own survival -- forget about the patients.' As I see it, that is in fact the higher concern. Paradoxically, empathy needs pairing with the ability to compartmentalize, to relate one-on-one and leave it behind when ...


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(via over my med body!)

Dr. Rob reveals basic plays from the pharma playbook.

Medscape under fire

Bernard Carroll continues the criticism: "There seems to be a right hand "“ left hand problem at Medscape. Though I take Dr. Lundberg at his word about his intentions, I invite him to defend the products that actually appear under his oversight as editor-in-chief."

Edwin Leap thinks about it after meeting this patient who figured that disability was "tantamount to a career choice."

A problem when one in five young veterans are women: "When it comes to female reproductive health, contraception, pregnancy, and disorders of menstruation, the VA system is simply not equipped to handle that."

Is the field growing too fast?

"100 percent cosmo"

What separates the bat boys from the heavy hitters in plastic surgery: "If I get less and less money for the reconstructive cases, the only way to maintain or increase income is to drop reconstructive cases for cosmetic cases."

A self-inflicted wound: "The remarkably anemic response of the AMA and AAFP to the aggressively ascendant doctor-nurses, of course, merely reflects how truly weakened the position of PCPs has become. PCPs are, and have allowed themselves to become, well and truly screwed."

Taking on George Lundberg: "Like a cornered animal, Lundberg wildly lashes out all progressive forces in medicine."


Don't you hate it when bugs crawl into your ear?

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