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Latest Posts

A Video Poem: Medical Tests And What “Normal” Means

I’ve written a few times about Veneta Masson, a nurse practitioner who wrote in Health Affairs and the Washington Post about her decision to forego further mammograms despite the fact that she was in a higher-risk category.

Veneta is also a poet. She sent me a video animation of her poem “Reference Range,” which I’m pleased to share with you. I think the poem and the video are beautiful, touching on important issues of how meaningless numbers and scores may be, subject to misinterpretation. She writes:

I see no cause for alarm.

“Is it normal?” you ask.

Normal’s a shell game you seldom win.

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Family Physicians: Are They Paid Well Compared To Other Docs?

Here’s an interesting article, talking about stuff that’s not new to anyone who has read my blog for the last three years. The current relative value unit (RVU) system is a scam, perpetuated by a super-secretive group of subspecialists each  inflating their own worth for the benefit of themselves, at the expense of primary care.

If you don’t understand what I’m talking about, first read about RVUs explained. Then come back and read this article put out by the National Institute for Health Care Management. It’s titled “Out of Whack: Pricing Distortions in the Medicare Physician Fee Schedule.“ In his essay, Dr. Robert Berenson shows how distorted primary care specialties are paid, relative to other specialties, in an all Medicare practice with the equivalent input of hours worked. Read more »

*This blog post was originally published at The Happy Hospitalist*

Medicine And The Gender Barrier

It’s only a matter of time before female physicians outnumber men, say medical school heads who are seeing more women in their programs. Although women have broken the gender barrier in medicine, they may want to keep going into nursing, because nurse practitioner salaries grew faster than primary care physicians’ pay – nearly 5 percent compared to nearly 3 percent.

Physicians can take some comfort that their average pay is more — $191,000 compared to more than $85,000 — unless they’re women, who among all the life sciences average $13,000 less than their male counterparts in comparable positions and with similar experience. (WCSC TV, Fierce Practice Management, Academic Medicine)

*This blog post was originally published at ACP Internist*

The Insulting Term “Physician Extender”

“Physician Extender.” It sounds like the name of a male enhancement product. It’s a term often used to describe a nurse practitioner or a physician’s assistant. I hate it. It’s insulting.

A nurse practitioner is not an adjunct physician. They do not supplement the care of a physician. They provide essential advance-practice nursing services, services that include diagnosis and provision of medical care.

While some of these services overlap those of medicine, nurse practitioners are not extensions of another profession, they provide care in their own right — as educated, licensed practitioners. Sometimes the only care provider for a community is a nurse practitioner. Read more »

*This blog post was originally published at Emergiblog*

“Team Care” In The Patient-Centered “Medical Home?”

“Team care” has become a rallying cry for those who think the patient-centered medical home is bad for healthcare reform. Comments on a recent blog post in the New York Times provide a good example of this. When patients get sick, as the argument goes, they want to see their doctor — not some nurse or PA who they don’t know. I agree.

There are a whole bunch of things wrong with all the current focus on team care in the patient-centered medical home. Read more »

*This blog post was originally published at Mind The Gap*

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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