A stunt to be sure, and it doesn't hurt that he's a millionaire.

The Physician Executive: "Many of US doctors feel that primary care is the choice of students with no other choice. Even Canada's social conscience cannot mask the prejudice entirely. I was once recruited by a cardiovascular surgeon who said I was too good to settle for family practice. It is a nearly universal phenomenon in a world where progressively greater expertise gets more respect than being a generalist."

Medical relatives

The Happy Hospitalist: "Sometimes I'm surprised, incredibly surprised, even by doctor families that are so blinded of the reality, they can't see the forest from the trees. The patients who are clearly so ill, that aggressive intervention is the worst possible course of action."

Unintended consequences, indeed: "A few years ago, as we tried to improve patient satisfaction, we changed the way that patients order their hospital food. The program was called "At Your Request" and let patients call up to order their meals from a menu of options "“ at essentially anytime they wanted to eat. (From a practical standpoint, this works a lot like room service: you call and order your ...


#1 Dinosaur launches a verbal assault on pharmacists.

I'm waiting for The Angry Pharamcist to retort.

When words gets out that a physician doesn't give out unnecessary pain medications: "My honest reaction was to swell with pride!"

How palliative care is not emphasized during medical education nor is valued by Medicare:

"When a three-person palliative care team made up of a doctor, a nurse and a psychologist spends 90 minutes in a meeting with a family, Medicare would probably pay $130 to $140"”for all three people . . though it would be hard to say that one of us is practicing more sophisticated medicine."

The chilling effect is well stated here:

The practice of medicine is a calling and as such, my colleagues and I have endured more unfair revenue cuts than most businesses would have endured. Yet, a medical practice is also a small business, and there are limits to how much we can endure. We are now at the point where further cuts are not survivable. Just like any small business, ...


Nailing anatomy

Medical students have more sex.

There's a reason why universal electronic records are nothing but a pipe dream:

The high cost of EMRs, combined with a small return on investment, is a main reason why physicians have been slow to adopt systems . . . While some EMR functions, such as billing and transcribing notes, financially benefit physicians, most of the return on investment accrues to health plans.

In the Clinic - Dr. Chris Simpson, MD Discusses Cardiac Device Therapy
classid='clsid:D27CDB6E-AE6D-11cf-96B8-444553540000' codebase='http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=7,0,0,0' WIDTH='380' HEIGHT='240' id='play_continuous_flvs'>

The following is a reader take by an anonymous primary care physician.

I am a primary care physician who is less than a decade removed from residency, and at a recent medical staff meeting, I witnessed the beginning of the end of primary care in this rural Midwestern town.

I work in a town of about 50,000 people roughly an hour outside of a major Midwestern ...


WSJ: "Almost overnight, the flow of lawsuits began to dry up and businesses started to trickle in. Federal Express invested $1 billion in a new facility in the state. Toyota chose Mississippi over about a dozen other states for a new $1.2 billion, 2,000-worker auto plant. The auto maker has stipulated that the company would pull up stakes if the tort reforms were overturned by the legislature or activist ...


Ten out of Ten: "But the problem with too many people is if they're not ignorant, then they just can't see past the boundaries of their own skin to the greater good."

DrRich takes a contrarian view:

The threat of malpractice litigation, as wasteful and counterproductive as it is, provides at least some degree of balance in the doctor-patient encounter, and gives doctors (even those whose professional pride has been successfully eroded by all the many efforts aimed at doing just that) a good reason to always ask themselves, "Is this action I'm about to take the action that THIS patient really ...


"Increasing requirements for doctors to take call as a condition of practice."

Yeah, that's going to go over real well.

It sometimes means accepting the risk of being sued. #1 Dinosaur says to deal with it.

Edwin Leap: "EMTALA has created the very conditions it sought to avoid. Now, with specialists unavailable, hospitals full, transfers always difficult and no lack of genuinely sick and dying patients, there's often 1) no one to care for them and 2) no place to put or send them. EMTALA, the federal mandate to save the poor from sickness has begun to crumble at its foundations, and leave ...


"All physicians have access to neat, clean ways to commit suicide."

The Happy Hospitalist continues his excellent analysis on payment for the medical home. Is the situation as dire as he initially thought?

retired doc is still skeptical however.

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