Business and medicine

I have long contended that some sort of business education or degree should be mandatory for every practicing physician.

Skills like running a business and the art of negotiation are just as important as clinical aptitude. The medical profession’s lack of business skills is a major reason why physicians have lost control of their profession, and why doctors have so little influence in the health care debate.

Those …

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Unintended consequences of EMTALA

Edwin Leap: “EMTALA has created the very conditions it sought to avoid. Now, with specialists unavailable, hospitals full, transfers always difficult and no lack of genuinely sick and dying patients, there’s often 1) no one to care for them and 2) no place to put or send them. EMTALA, the federal mandate to save the poor from sickness has begun to crumble at its foundations, and leave …

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My take: What makes a good medical blog?

Maria writes: “I’d like your take on what you think constitutes a ‘good’ medblog . . . I am continually surprised with what people like about medblogs. Some people like brief links, some people like critical discussions, some people like stories.

This ultimately all boils down to opinion, but I’d like to know what traits you like in medblogs.

Can you start by opining that you strongly dislike …

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Doctors with MBAs

Any physician who recognizes that good business skills is essential in medicine is ahead of the curve:

“Medical schools have done a horrible job preparing physicians to enter into private practice. They don’t give them any understanding of debits and credits, what it’s like to run a small business. They’re prepared to be clinicians, not to run their practice.”

Some sort of business training should be mandatory prior to becoming …

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Touching a patient

Victoria McEvoy: “Let’s face it, human sexuality is often the elephant in the room when doctors and patients interact. Or, I should say, perceived sexuality. What may seem like prurient interest from the patient’s point of view may be just another breast exam, pelvic, or mole check in a busy afternoon. What can be deeply mortifying for a patient does not even register on the radar of a busy …

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Is general surgery the primary care of specialties?

WSJ Health Blog: “One key driver of this trend is a move toward specialization by young docs. In 1992, 55% of surgeons did a subspecialty fellowship after finishing surgical residency; now that figure is over 70%, the authors report.

This sounds a lot like what’s happening on the medical side of the profession, as younger docs increasingly head for medical subspecialties that often pay more and give doctors …

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Lingo

Simply awesome. Funniest post I’ve read in awhile.

Prevention doesn’t save money

David Brown: “Even when prevention greatly reduces future cases of a particular illness, overall cost to the health-care system typically goes up when lots of disease-preventing strategies are put into practice. This is usually true whether treating the preventable diseases is cheap or expensive.”

(via Ezra Klein)

The baby with two faces

A rare case of facial duplication:

While she may only be 2½ weeks old, she is far more famous than any resident of this part of the country has ever been. She is famous because she was born with a condition known as facial duplication. She has one body and two faces.

Doctors do not know the extent of any damage as the family is refusing imaging scans:

But perhaps she …

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Suing to be paid for prior authorizations

Hopefully this will set a precedent:

Gary Gibson, FACP, sued MEDCO Health Solutions of Columbus North, Ltd., in Trumbull County Court to collect on the time he spent filling out two or three prescription inquiries a week, each taking between six and 10 minutes to complete. He told MEDCO in December 2005 that he would bill $150 an hour to fill them out, and when MEDCO said they would not …

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Neurosurgeon shortage

Expect more of this to happen:

As a group, specialists are getting older and less willing to work on call. Many specialists say they fear they are more likely to get sued by emergency patients than by their regular patients, who know and trust them. Even when hospitals pay doctors for working on call, specialists often make less money working emergencies than they do caring for regular patients.

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EMTALA and "social admits"

Scalpel: “‘Social’ admits to the ‘no-doc’ admitting staff are usually about as welcome as a fart in an elevator. Particularly when they are unfunded midnight weekend language-barrier system-abusing complicated social admits of questionable medical necessity.

When patients like you get admitted, you tend to be challenging for the hospitalists to discharge too, so you end up receiving much more medical care than the emergency stabilization which is mandated …

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