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Physicians Are Unhappy, But Do They Have It Worse Than The Rest Of The Country?

Many physicians, and especially primary care physicians, aren’t happy campers. Why should they be? They feel disrespected, overworked, over-managed, and underpaid. They tell me they wouldn’t advise their children to go into medicine. Some feel that physicians are singularly beset upon. “Our government acts toward the medical profession in an abusive fashion. No other industry or profession is humiliated in this way,” writes RyanJo, a frequent commentator to this blog.

I can appreciate why many physicians are upset. They’ve had a decade where the Medicare SGR formula repeatedly has threatened to cut their fees, only to have Congress enact last minute reprieves that replace the cut with a small token increase that has not kept pace with their costs. Last year, Congress actually allowed the cut to go into effect and then retroactively restored it, creating havoc in physicians’ offices during the four weeks when they weren’t being paid. Like Charlie Brown and Lucy’s football, they are told each year by their members of Congress that that “this will be the year when the SGR will finally get repealed, really, for sure, we promise, this time will be different”–only to see it pulled away at the last minute.

In the meantime, they are constantly hounded to be more accountable for the care they deliver, to fill out just another form, to document their encounters, to get Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Initiatives In The Field Of Positive Health: Optimism And Stroke Risk

Way back in 1946, the chartering documents for a new agency of the UN—the World Health Organization—defined health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

We have made astounding progress in medicine and public health since the WHO charter was crafted, yet we have actualized only part of its comprehensive vision for health. What we call health care today is really just illness care. Even our disease prevention and health promotion programs focus on reducing risk factors for disease. It is the rare initiative indeed that encourages good health for its own sake. Read more »

*This blog post was originally published at Pizaazz*

Do You Think You Have OCD?

When I leave for work in the morning, I go through my precommute checklist. Train pass, check. Wallet, check. Coffee mug, check. Smart phone, check. Keys to the house, check. Only when I’m sure that I have everything I need do I open the door and head outside.

Sometimes I worry that this morning routine is becoming too much of a ritual. Is it possible that I have obsessive-compulsive disorder (OCD for short)?

Probably not. The fact that I am able to get out the door every morning means that my daily ritual isn’t interfering with my ability to function, says Dr. Jeff Szymanski, a clinical instructor in psychology at Harvard Medical School.

You have OCD when obsessions and compulsive behavior Read more »

*This blog post was originally published at Harvard Health Blog*

Organized Medicine Is Out Of Touch With How Practicing Physicians Feel About Obamacare

There is a widespread discrepancy between the opinions of organized medical group leaders in the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), and  practicing physicians.  AMA, AAFP, and ACP are part of organized medicine.

These organizations supported the healthcare reform law in 2010 and continue to support the legislation. I believe they have taken this position because they want a seat at the table as implementation of the legislation moves forward. President Obama has not paid attention to them so far and there is little evidence that he will in the future.

In March of 2010, Speaker of the House Nancy Pelosi famously said, “We have to pass the [health care] bill so that you can find out what is in it.”

Most physicians are starting to realize the implications of President Obama’s Healthcare Reform Act (ACA) (Obamacare). They are terrified about the implications for the practice of medicine.

Organized medicine is still not disenchanted with President Obama’s Healthcare Reform Act. Charles Cutler, MD, chair of the ACP Board of Governors said recently,  “The medical community recognizes that so much of the ACA is good.” Read more »

*This blog post was originally published at Repairing the Healthcare System*

Meditation: How It May Change The Brain

Meditation sounds like a great idea from the perspective of a psychiatrist: Anything that calms and focuses the mind is a good thing (and without pharmaceuticals, even better).

Personally, I tried transcendental meditation as a kid (more to do with my mother than with me) and found it to be boring. I have trouble keeping my thoughts still. They wander to what I want for dinner, and should I write about this on Shrink Rap, and will Clink and Victor ever eat crabcakes with me again, and did I remember to give my last patient informed consent, and a zillion other things. Holding my thoughts still is work.

The New York Times Well blog has an article on meditation and brain changes. In “How Meditation May Change the Brain,” Sindya N. Bhanoo writes:

The researchers report that those who meditated for about 30 minutes a day for eight weeks had measurable changes in gray-matter density in parts of the brain associated with memory, sense of self, empathy and stress. The findings will appear in the Jan. 30 issue of Psychiatry Research: Neuroimaging.

M.R.I. brain scans taken before and after the participants’ meditation regimen found increased gray matter in the hippocampus, an area important for learning and memory. The images also showed a reduction of gray matter in the amygdala, a region connected to anxiety and stress. A control group that did not practice meditation showed no such changes.

Lower stress, lower blood pressure, higher empathy. I may have to give meditation another try.

*This blog post was originally published at Shrink Rap*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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