Referencing a recent New York Times article “What Kids Wish Their Teachers Knew” got me thinking about both sides of the coin.  Physicians are human beings and sometimes this fact gets lost when a patient is angry or frustrated seeking help from the medical system.  Here is a primer on what I wish my patients knew. (This is a companion piece to "I wish my doctor ...

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Recently the New York Times published an article, "What Kids Wish Their Teachers Knew." As a pediatrician, I have spent a good part of my lifetime fighting for the health and welfare of our young people.  They are the future.  We owe our children a safe, caring, stable childhood whenever possible. Outside of a supportive family, a long-term family physician or pediatrician can be an important role model ...

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Give me technology which improves my life and that of my patients, or give me death. Medical records must be informative, efficient, and flexible; like the physicians they serve. For me, a medical record does not contain just a collection of problem lists, prescribed medications, and immunizations; it is a noteworthy account of the health care provided to another human being over a lifetime. Recently, I attended a baby shower of ...

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In 1978, the Institute of Medicine published A Manpower Policy for Primary Health Care: Report of a Study where they defined primary care as “integrated, accessible services by clinicians accountable for addressing a majority of heath care needs, developing a sustained partnership with patients, and practicing in the context of family and community.” The four main features of “good” primary care based on this definition are: 1. First-contact access for new medical ...

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Quality measures began as tools to quantify the health care process, using outcomes, patient perceptions, and organizational structures associated with the provision of high-quality health care. Overall, the goals should focus on delivery of care that is effective, safe, efficient, and equitable.  Did you notice a particular word missing?  Yes, I missed the word physician too, because they have been left out of the conversation entirely. Measuring quality health care by ...

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My thoughts settled on the Frank Sinatra song, "My Way," when asked about necessary resources for rural health care to survive. Seven years ago, my father and I changed office buildings.  We closed the office that Friday to allow three full days to get settled.  However, we ended up seeing sick patients in the parking lot (seriously), while the movers were loading up the truck. “All we need is a stethoscope, ...

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Why must we keep repeating history? NCLB significantly increased the federal role in education by holding schools accountable for the academic progress of all students. NCLB held teachers responsible for education of children; MACRA-proposed changes will hold physicians responsible for the medical progress of our patients.  The largest problem with this approach is students and patients go home each day to whatever environment in which they live.  Neither teachers nor physicians ...

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Recently, physicians in small private practices and rural areas breathed a collective sigh of relief.  There is a possibility the implementation of changes to physician reimbursement (known as MACRA) could be delayed.  Thank you, Mr. Slavitt, for listening.  I am grateful to Orrin Hatch (R-UT) and Ron Wyden (D-OR) for keeping our rural needs in mind.  We have a window of opportunity for rural health care to survive, but we ...

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Small, independent private practices are closing, increasing numbers of physicians are retiring, and fewer medical school graduates are choosing primary care.  The old-fashioned practice my father and I have built is a dying entity.  Parents say coming to see us for an appointment feels more like a visit with a friend than a medical encounter.  I am fighting for the survival of primary care practices.  MACRA proposed reimbursement will decimate ...

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This story has been on my mind for many years, but each time I have sat down to write it, the words would not fall into place. The other day, a family mentioned having their “rainbow baby” referring to a child born after a tragedy.  To me, rainbows symbolize that even after the roughest storm, things can get better.  To see a rainbow, there must be moisture, like falling rain, in ...

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