Ophthalmology resident Rachel K. Sobel pens an open letter to the President-elect in the Philadelphia Inquirer:

Where have all the primary-care doctors gone? Today's young doctors are buried in educational debt. They have a huge incentive to skip poorly paid primary care and choose more lucrative, procedural-based specialties. In the 1980s, the median amount of debt was $27,000 for private-medical-school students. Now that figure is $135,000. It's children who get hurt the most ...

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Stanley Feld continues the missive of advice to President-elect Obama, sharing his input. I wholeheartedly agree with his assertion that "no one asked for the opinion of practicing physicians," and that "the problems with the healthcare system are broader than economics."

His letter then takes an interesting turn, suggesting that America's problems of health care, energy independence and climate change can be traced back to food policy.

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According the Moody's, hospitals and medical centers could benefit under President-elect Obama's health reform proposal:

"The expected spending could positively affect the top-line growth of many health care providers," the rating agency added, noting that the agenda of Obama's Democratic party includes increasing research funding and providing $10 billion over five years to health care providers to build up electronic-information systems . . .

. . . "The ...

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Zealous supporters of a single payer system, such as PNHP, can be as inflexible and intolerant of alternative approaches to health reform as some socially conservative groups on the right are of abortion and gay marriage.

It will be interesting to see if they will budge in their narrow views on health reform. The ACP's Bob Doherty quotes health policy heavyweight Jacob Hacker in emphasizing that the success ...

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It's not out of the realm of possibility in the current economic climate:

If you are a health insurance executive, you are probably looking at your current broken business model, lamenting that your savior Mr. Obama is probably not going to be able to come to your rescue with the one last windfall he has promised, and observing what is happening with other "vital" American industries in similar straits. ...

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Obama's health care plan is actually the most moderate of the options coming from the left. That fact, as well as the ads he ran emphasizing that his approach wasn't a single-payer plan, scored him points with the moderates and frankly, made him the most appealing of the Democratic candidates.

Now that he's in office with Democratic majorities, will the Medicare for all, single-payer demagogues sway his ...

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Obama and health care IT

What does an Obama administration mean for health care IT? He has stated that he'll spend billions on modernizing our antiquated health record systems.

Health IT guru John Halamka predicts how he'll approach it.

topics: obama, electronic records



Congratulations to Barack Obama on his historic Presidential victory. He dominated New Hampshire, carrying my home state by over 10 points.

I voted with the nominees' health care platforms weighing heavily. Both did not offer plans that I felt would work, as I wrote previously. While reading their competing pieces in the NEJM however, Obama made the more compelling case:

There is little ...

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The answer is yes, as I wrote in my open letter to Barack Obama and John McCain.

Brian Doherty, a lobbyist who started a new blog at the ACP, takes a similar slant:

So what have the candidates said about primary care? Not too much. As ACP's comparison of the candidate's positions shows, Senator Obama's plan mentions the importance of primary care and the need to reduce ...

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The following is a reader take by Sam Solomon.

Canadians and Americans aren't so different: Tim Hortons and Dunkin' Donuts, poutine and disco fries, professional hockey and professional wrestling -- there's some truth behind that "51st state" joke. But despite our similarities, there's a glaring difference between us that we can't seem to reconcile: health insurance.

This year, in which a Canadian federal election ...

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Massachusetts is a nice lab to see the effects of an Obama health plan. The proposals are fairly similar, with the exception that Obama does not mandate individuals to obtain insurance.

One consequence is a marked rise in emergency care, due to lack of primary care access.

Now a second shows that people still can't afford health care, despite 97 percent of the state being ...

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"Obama, wake up"

Jay Parkinson warns that Obama needs to work on the primary care supply side first before opening up coverage. Look what's happening in Massachusetts. Much the same has been said here, but it bears repeating:

Massachusetts got this bright idea as well a few years back. They made being uninsured illegal and punishable by massive fines. So they added hundreds of thousands of new people to the ...

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Senator Obama has gone on record saying that health care is a right. Bad move, pandering to his base. Dr. Wes warns that this is a slippery slope that will dwarf the current housing crisis. As Hawaii learned in the example below, providing this right will almost certainly drive the country into bankruptcy:

As we consider this entitlement, we must now ask ourselves how, exactly, the government ...

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60 percent of health care workers, including doctors, don't receive their flu shots. Some hospitals are taking a hard line, requiring those who refuse shots to wear masks whenever in the hospital.

Should they be mandatory, akin to washing hands? Not everyone likes to be forced to take flu shots, as parents in New Jersey are demostrating.

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Reynolds' Pentad - fever, jaundice, RUQ pain, ...

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Hospitals and doctors are speaking out against the balance billing ban in California. Balance billing is the only mechanism that gives physicians a recourse against unilateral payment decisions made by insurance companies and the government. It has to be an essential feature of any major health reform proposal. (via the WSJ Health Blog)

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Primary care physicians can least afford to lose money. Limiting ...

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Antibiotics don't work for colds. Instead of recalling children's cold medications, this ED physician thinks the FDA should outlaw inappropriate antibiotic use and ban amoxicillin.

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What happens when an ophthalmology resident gets pink eye? Well, he's banished from the program for 2 weeks, since "a resident in ophthalmology working with pink eye is a set-up for disaster."

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Those iPod Touch ads seemed ...

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A guest post by Val Jones, MD.

On the eve of our second presidential debate, I had the chance to interview Dr. Ken Thorpe, Executive Director of the Partnership to Fight Chronic Disease (PFCD), about America's healthcare crisis. Here's what he had to say (click here to listen to the podcast):

1. I was part of a press conference call with you ...

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The following op-ed was published on October 1st, 2008 in the USA Today. Despite the fact that we can complete our taxes and perform complex financial transactions digitally over the Internet, medical records have faced an impasse preventing a transition to the digital age. Patient charts are still paper-based in most doctors' offices across the country. President Bush's goal was for every American to have an electronic medical ...

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The left-leaning NEJM

The NEJM has always been the medical journal equivalent of the NY Times.

Several early release articles are available critiquing the Presidential candidate's health reform proposals again show their stripes.

They have a somewhat balanced analysis of the Obama plan, but to have an overt Obama supporter criticizing the McCain approach is hardly impartial analysis.

As I mentioned before, I don't think ...

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I'm honored to co-guest-host this week's Grand Rounds. Without further ado, here's Dr. Val Jones.

Welcome to the historic, 5th year anniversary of Grand Rounds, the weekly summary of the best of the medical blogosphere. As the proud new co-leader of Grand Rounds, I am committed to expanding its reach, promoting the Grand Rounds "brand," and making sure contributors' voices are heard ...

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