Physician

ER overuse may be a myth

Overuse of the emergency department is commonly discussed during the health care conversation. Especially with the lack of primary care access shunting patients with seemingly routine symptoms to the ER.

But is this a myth?

That’s what two emergency physicians contend in a piece from Slate.

The emergency department is functioning just fine, they say: “Just 12 percent of ER visits are not urgent. People also tend to think ER visits …

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Primary care is the loss leader of medicine

Medicare’s sustainable growth rate, or SGR, has been the bane of doctors for years now.

To encapsulate, this is the reason for Medicare’s annual threat to cut doctors’ fees by 20% or more, only to be staved off at the last minute.

Emergency physician Shadowfax has a nice take on it, explaining why it has devastated primary care:

Primary care has many fixed expenses in addition to those we bear: they pay …

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Primary care is disproportionally hurt by Medicare cuts

Doctors don’t garner much sympathy when they rail against the perpetual threat of Medicare reimbursement cuts.

In a story from CNNMoney.com, a primary care physician provides some stark reality.

In an independent solo primary care practice, employing an office staff and two nurse practitioners for instance, fixed costs add up to $60,000 per month. A 21% cut in Medicare reimbursement, assuming an average sized Medicare panel, can take away …

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Doctors need protected time away from the pager

When nurses sign out during the end of shift, it’s done so in a quiet setting.

Contrast that to medical residents — at least when I was a resident 8 years ago — where pager interruptions during sign out were the norm.

PookieMD compares the situation to the “sterile cockpit” that airline pilots enjoy: “Pilots have the sterile cockpit–a situation in which, if the plane is below 10,000 feet, only conversation …

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ED can predict heart death

Originally published in MedPage Today

by Joyce Frieden, MedPage Today News Editor

Patients with erectile dysfunction (ED) who were treated with telmisartan, ramipril, or both were at greater risk for cardiovascular events than other patients on the same medications, researchers found.

In men who reported ED at baseline, all-cause mortality during a median follow-up of four years was double that seen …

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Palliative care shows the importance of language

by Patrice Villars

The best learning experiences for me have been times when I come away questioning core assumptions about the work I/we do. As palliative care folks, we try to help people understand where they are in relation to their disease and what their hopes and goals are for care. We offer treatments and resources to match those needs through, in part, supportive communication.

What if, in our kind, well-meaning …

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CRNA salaries surpass those of primary care doctors

I received several requests asking me to comment on this CNN story, “Some nurses paid more than family doctors.”

This isn’t really news, as CNRA salaries have been on a trajectory surpassing primary care physicians’ for a few years now. In fact, I wrote about it back in June of 2008.

According to the latest numbers, “Primary care doctors were offered an average base salary of $173,000 in …

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A patient live blogs his hospital stay, looking for a cure

Here’s a novel, and incredible, use of social media in health care.

A 40-year old man was admitted several days ago with a fever of unknown origin. His significant other, Laura, is live blogging his hospital stay — hoping to solicit other medical opinions on the case, as there is no clear reason on what is causing his symptoms.

Blogging at The Z Update, here’s an excerpt of how he …

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Nurse practitioners will not solve the primary care shortage

With health reform possibly passing within the next few months, attention now turns to the primary care doctor shortage.

Regular readers of this blog know that there are not enough primary care doctors currently; it’s frightening to think what would happen if an additional 40+ million newly insured patients start looking for care.

A recent piece from Newsweek nicely encapsulates the problem. It’s a good piece, elucidating the myriad of …

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