Bard-Parker asks: "Can the availability of fellowships leading to high-paying specialist postitions explain how IM and Pediatrics outperform FP?"
The answer is yes. Consider the following rant from an unhappy FP:

Finished FP Residency in 1992. The worst decision I ever made in my life was Family Practice! For the last 16 years or so I have have watched it continually decline in every single way. My ...

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Medicare doesn't get it
"Spending grew as doctors saw patients more frequently, did more tests and provided more in-office drugs than expected.

In addition to increasing premiums, the higher-than-expected spending on doctor services last year might hamper physician efforts to win a pay increase instead of a cut from Medicare next year."

This is a no-win situation for everyone involved. The government is blaming the physicians ...

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People who rely on their primary-care doctor to coordinate their health-care needs fare better than those who don't
"In addition, having a long-term relationship with a doctor resulted in fewer hospitalizations and other reductions in health-care costs, the researchers found."

A few days ago, I wrote about how the our leaders in primary care were out of touch with what drives medical students' career choices:

That's all well and good, but perhaps primary care needs to appeal more to the bottom-line. It has been shown that a better lifestyle is a priority in today's medical students, which is evident by more and more taking the R.O.A.D. to happiness. In ...

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Leaders in medicine are trying to figure out how to make primary care attractive to students and residents once again
"AAMC has formed a group to consider broad issues around improving chronic care, including how a change in emphasis could be one way to attract more students into primary care. This group started its work last fall and is expected to produce a proposal sometime this year, Dr. Whitcomb said.

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Man sues over "botched" testicular surgery: Another frivolous lawsuit?
"A man is suing a hospital and one of its surgeons, claiming one of his testicles was wrongly removed during surgery.

Danny Curtis claims the surgeon at Kern Medical Center did not conduct a biopsy before arranging urgent surgery to remove a testicular tumor in July 2004, according to the lawsuit filed in Kern County Superior Court."

I ...

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Bill Frist writes about a utopian future of medicine in ten years
"I would like you to meet a patient from the year 2015. He lives in a world in which years ago America's leaders made tough but wise decisions. They built on the best aspects of American health care and unleashed the creative power of the competitively driven marketplace. These changes resulted in dramatic improvements to the U.S. ...

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A few months ago, the NEJM published an article outlining The Future of Primary Care Medicine. That article drew several responses. The first states that the "ideal" primary care setting outlined in the article is not grounded in today's reality:

To the Editor: Whitcomb and Cohen and Fincher (Aug. 12 issue) call for changing the training settings for students and residents in primary care to reflect the ...

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Back pain, neck pain, and headache are common office visits I see in primary care. Today, I read an article put out by the American Chiropractic Association:

A new survey showing that nearly half of all Americans are concerned about the safety of the medical care they receive should send a strong signal to the health and insurance industries that safer non-drug, non-surgical treatments should be considered whenever ...

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Doctors should return test results faster
"In many ways, uncertainty is the worst disease in the world . . . the not-knowing can be worse than knowing the worst."
How true. Sheer volume of paperwork sometimes causes delay. As a primary care physician, I receive every single lab and X-ray test for my patients, whether they were ordered by me or not. This can number to over ...

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