Transferring patients

It's sad that this is the easiest way to do it: "If a patient is stable - and can be driven to the other hospital by family or friends, you can gently suggest they sign out AMA and just show up over in the other ER. Then the HAVE to take care of the patient. Ola! No transfer paperwork, calls, or legal issues."

The AMA's Ethics Forum takes on the following question: "Can physician-written blogs meet legal and ethical professionalism standards?"

Maurice Bernstein: "Medical blogs, moderated with attention to civil and open discussion among the visitors and following guidelines for ethical operations, make a significant contribution to the medical education of the public and, I dare say, the profession."

Rob Lamberts: "Physician blogs should not be seen as an attempt to ...

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Your first job

Rural Doc focuses on generalists opting for rural positions, but her advice can apply to every graduating resident.

Bad news

Dr. Rob with tips on giving bad news to patients.

In the Clinic - Dr. Carol Conrad, MD, discusses the causes and treatments of cystic fibrosis
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"I've been doing this 25 years and even I've never heard of that one!"

You know it's a rare case when that's the response you get from poison control.

We need to do a better job in managing patient expectations:

Healthcare is not a commodity like a Toyota that can be turned out, day after day, in exactly the same way. Every human body is unique. At any moment, a surgeon may run into a surprise. Your cancer may be hiding in place that makes it very difficult to detect on a mammogram"”not impossible, but very difficult. And ...

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On-call

The disgusting behavior of some on-call physicians.

Heart attack and you

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(via Dr. Wes)

Loan repayment

This is one of the ways government can help with the primary care shortage.

However, as Dr. Secretwave points out, the current example of such a program is not adequate.

The $20,000 amount does not influence medical students' decisions, and the fact that this amount is taxed makes this incentive more irrelevant.

Money talks, and so far, the government is barely whispering.

This should be on a pre-medical school screening questionnaire: "If money is you main object, avoid medicine. We make decent money, but we invest so much time getting there, that from a pure financial calculation, medicine is not your best choice.

If you do not like people, and here I mean all types of people, all social classes of people, then you should avoid medicine. If ...

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Good point here. Medicare and other payers pay the same for each medical service or procedure, regardless of whether it's done by a new doctor or a 30-year veteran:

Differentiating one physician from another or one surgeon from another is very difficult. Additionally, seniority does not necessarily mean that the product or service is better.
The only way that pay increases with age is the increased efficiency that comes ...

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It's the real estate:

One strategy some physicians utilize is to buy larger space than they typically utilize. Then they rent out space to other physicians. This is an excellent strategy for those physicians who have the means to do this. In some respects it turns the physician into a real estate investor rather than just a business owner.

Weight loss camp

Outrage at kids being priced out of these expensive programs:

Several national groups are pressing for government financing or insurance reimbursement for more intensive weight loss treatment for children, including weight loss camps.
Wouldn't it be better use of funds to focus on preventing kids to be so heavy in the first place?

Hospitalist layoffs

In the midst of their boom, here's an article about an institution considering laying off hospitalists.

Hospitalist programs typically operate at a loss, with the financial gains not apparent for years to come. The benefits of these programs also do not directly impact the bottom line, but instead help with recruiting, as well as the primary care physicians affiliated with the hospital.

Cash-strapped facilities, like Cape Cod ...

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Humanness

Trust between patients and physicians are at an all-time low. Although we blame a variety of reasons - ranging from third-party payers to malpractice fears - for this, simply being nice and appearing human can do wonders for the medical profession.

The following op-ed was published on August 22nd, 2008 in the USA Today. "Why should I care if doctors get a pay cut?" my patient recently asked me. Therein lies the delicate dilemma physicians face today. While the common perception is that the medical profession is well-compensated, there are serious implications in targeting physician pay to control medical spending. Congress recently passed a bill protecting doctors from a 10.6% ...

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An abridged version of my op-ed was published in this morning's USA Today: Doctors' pay cuts save little in health costs.

It discusses whether targeting physician pay as a means to control health care spending makes sense and touches on Congress' recent passage of the Medicare bill.

For those new here, my name is Kevin Pho and I practice ...

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The story of an illegal immigrant in a coma. He is scheduled to be deported to Mexico.

Tough position for the hospital to be in. With limited resources, it is not financially viable for hospitals to foot the bill for illegal immigrants.

However, any solution is likely to cast a negative PR light on the hospital.

(via WSJ Health Blog)

And touches off a firestorm of debate on the WSJ Health Blog.

If there was a single thing he could do to lose my vote, endorsing single-payer would be it.

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