Primary Care

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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Tips for doctors who negotiate reimbursement rates with insurance companies

Originally published in HCPLive.com

by Ed Rabinowitz

When it comes to negotiating fees with health plans, practices and physicians have more leverage than they realize. The problem, says John Schmitt, a managed care expert with EthosPartners Healthcare Management Group, is that practices often don’t even try. “Groups negotiate an agreement with a payor and then, for whatever reason, just fi le it away. Most medical groups do not have a good, proactive …

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How sleeping late can lead to depression in teenagers

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Later parent-set bedtimes and correspondingly shorter sleep durations appear to be related to the development of depression in adolescents, a cross-sectional analysis showed.

In addition to depression, adolescents with later bedtimes also had a greater risk of having suicidal thoughts, James Gangwisch, PhD, of Columbia University in New York City, and …

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Op-ed: Humor can be healing for both doctors and patients

A version of this op-ed, co-written with Doug Farrago, was published on October 26th, 2009 in Medscape.

It’s tough to be a doctor these days. Whether it’s listening to the difficulties of our medical colleagues as they try to best care for their patients, or engaging other health professionals about the uncertainties surrounding health reform, we’ve noticed a tense, sometimes gloomy, atmosphere among physicians.

A recent survey from the Annals of Internal …

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Can family doctors do safe first trimester abortions?

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Complications from first trimester abortions performed by family practitioners are rare, and family doctors could help address abortion provider shortages across the U.S., a new study found.

Among more than 2,500 abortions performed by family physicians, abortion was successful without complications in 96.5% of patients using medications (95% CI 95.5% …

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Should doctors be paid to e-mail their patients?

by Michael Kirsch, MD

This is a less controversial issue than patients ‘friending’ their doctors on Facebook, which I oppose. Although most physicians’ offices are not e-mailing with patients, perhaps they should. There are several obvious advantages.

* Decompress phone lines, which are suffocating nearly every medical practice in America.

* Relieve patients of the cruel and unusual punishment of languishing on ‘hold’ listening to elevator music or dead air.

* Allow office staff …

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Do patients really need their complete lab and radiology reports?

Most prefer the bottom line, sparing them the raw data.

Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.

So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):

lab-values

A doctor in Cuba becomes a nurse in the United States

When physicians in other countries come to the United States, they often become nurses or lab technicians, rather than re-taking rigorous board exams to remain doctors.

One example includes doctors from Cuba. According to this story in The New York Times, “6,000 medical professionals, many of them physicians, have left Cuba in the last six years.” Cuban doctors, who often earn $25 per month, find it significantly more …

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How soon should patients receive their test results?

And should you assume that no news is good news?

The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent.

That’s almost a quarter of abnormal test results from that center that patients were never …

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How much time do doctors spend on paperwork?

A common complaint is that doctors these days are spending more time doing clerical tasks.

Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do not need a medical degree to do these tasks.

Bob Doherty points to a study that gives some numbers to back up the claims. Primary care doctors spend about 3.5 …

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Once you hit Medicare age, good luck finding a primary care doctor

Almost 30 percent of Medicare beneficiaries have trouble finding a new primary care doctor.

Expect that number to rise dramatically in the near future, as the number of Medicare beneficiaries balloons, and the amount of primary care physicians plummets.

The whole scenario is a perfect example of how poor physician access makes medical coverage practically worthless.

Contrary to popular belief, Medicare’s paperwork requirements and …

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Nighthawks, dayhawks, and the demise of the American radiologist

More hospitals are resorting to so-called “dayhawk” radiology services to read their x-rays.

It’s modeled after the “nighthawk” model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.

Now, the phenomenon is happening during business hours as well, which according to radiologist Giles W. L. Boland, means that “some radiologists can no longer assume long-term …

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Why do I need a rectal exam, and what can doctors find with the gloved finger?

Have you ever wondered why doctors have to perform a digital rectal exam?

Well, look no further, as primary care doctor Rob Lamberts gives us the answers discerning readers demand.

Simply by looking at the rectum, which by the way, indeed “takes some getting used to,” can lead to significant diagnostic findings. Furthermore, does tight sphincter tone matter? And should you be worried about the large hands …

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