"Great health always starts with primary care"

Well said.

Procedures and turf wars

Not surprisingly, it’s about the money.

Getting defibrillated at Nordstroms

Hospitalist Bob Wachter comments on the recent NEJM study:

. . . the study once again highlights the perpetual neglect of the med-surg patient. Even though such patients make up the biggest cohort in virtually every hospital, the fact that they are heterogeneous, often scattered around the building, bring in relatively low reimbursements, are in a comparatively low tech environment, and lack powerful advocates (namely, surgeons and proceduralists) means that …

Read more…

Dealing with surgeons

Are they really that much harder to deal with. The Happy Hospitalist with a story:

The reason why we don’t call you, most likely is because you complain, you bitch, and you obstruct my ability to care for patients. You may be the best damn surgeon in the world, but if you can’t get a long with people in a respectful, civilized way, you will never get a call …

Read more…


A circumcision is reimbursed $800.

Contrast that to an office visit where diabetes, hypertension, smoking cessation and high cholesterol is addressed – probably less than 100 bucks. Somethings wrong here.

"Doctors aren’t greedy. America is."

Find out why. Another on-the-money post from this great blog.

The VA: Behind the scenes

“A system hell bent on creating obstructionist care at every step of the way.”


A better appreciation of what we do. (via The Happy Hospitalist)

The patient handoff

And why doctors stink at it.


The WSJ’s Ben Brewer is having second thoughts.

Volume. Volume. Volume.

It’s no secret why medical students avoid primary care like the plague…

The public devalues primary care

As indicated by this recent survey. Well, don’t complain when you get what you pay for:

Unfortunately, only 50% felt that a primary care physician should make at least $180,000. This pales in comparison to most other specialties and is the reason for the death of primary care.

1/3 believed that the primary care physician was only worth $140,000 a year. Again, an unreasonable expectation when specialties offer …

Read more…

Good news for hospitalists

A recent NEJM study support their use:

“Even though the differences in length of stay we observed may on first blush appear as small, if you multiply those by the many thousands of admissions to hospitalist care each year, the effect can really be quite large,” lead author Dr. Peter Lindenauer of Baystate Medical Center in Springfield said in an interview. “This benefit did not come at the expense of …

Read more…

Medicine is not an exact science

Despite what some patients and lawyers say, the only guarantee in medicine is that nothing is guaranteed. Nothing is ever 100%, and this is not communicated clearly enough by many physicians.

Balance billing

Something that can help solve the primary care crisis. (via The Happy Hospitalist)

Ask for a hospitalist

You’ll be thankful if, God forbid, there’s ever a Code Blue situation.

The Medicare donut hole

Some are calling it brilliant.

The frequent flyers

This pretty much sums it up.

Gamesmanship and quality

When P4P becomes widespread, the games maximize quality reporting will only begin.

29 chest x-rays, 9 CT scans

All for one patient in one year. No wonder the system is going bankrupt.


✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories