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On Media and Intellectual Darwinism in the Blogosphere

Last week Aaron Sorkin wrote for The Atlantic a piece in which he details his daily news feed, in What I Read. He’s not into blogs:

When I read the Times or The Wall Street Journal, I know those reporters had to have cleared a very high bar to get the jobs they have. When I read a blog piece from “BobsThoughts.com,” Bob could be the most qualified guy in the world but I have no way of knowing that because all he had to do to get his job was set up a website–something my 10-year-old daughter has been doing for 3 years. When The Times or The Journal get it wrong they have a lot of people to answer to. When Bob gets it wrong there are no immediate consequences for Bob except his wrong information is in the water supply now so there are consequences for us.

PZ Meyers, whose tagline for Pharyngula at ScienceBlogs is a bit crass for my taste, but with whom I often agree, writes On What’s Wrong With the Media:

This is the problem, that people blithely assume that because it is in the NY Times or the WSJ that it must be right — I’d rather read BobsThoughts.com because there, at least, poor lonely Bob must rely on the quality of his arguments rather than the prestige of his name and affiliation to persuade. Read more »

*This blog post was originally published at Medical Lessons*

Accountable Care Organizations (ACOs): HMOs With Lipstick?

Thousands of articles have been written about forming ACOs. Millions of dollars have been spent by hospital systems to try to form an ACO. Healthcare policy consultants have discovered a new cash cow.

Hospitals systems are wasting their money. They think the return from owning salaried physicians’ intellectual property will be more than worth the cost.

  1. Thousands of physicians have been confused by the concept of ACO.
  2. Many have felt ACOs are an attack on their freedom to practice medicine the best they can.
  3. Many have rejected the concept because they feel they will have to be salaried by hospital systems.
  4. Many physicians do not trust President Obama or Dr. Don Berwick.
  5. The Stage 2 ACO regulations are not easy to understand. They are more ominous than the stage 1 regulations.

The two core stated objectives for ACOs are:

(1) Reducing healthcare costs.

(2) Preserving and improving quality.

The stated objectives are laudable. The government regulations and controls are confusing. Read more »

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

Does Your Doctor Trust You?

Jessie GrumanMembers of the  American public are frequently surveyed about their trust in various professionals.  Doctors and nurses usually wind up near the top of the list, especially when compared to lawyers, hairdressers and politicians.  Trust in professionals is important to us: they possess expertise we lack but need, to solve problems ranging from the serious (illness) to the relatively trivial (appearance).

How much professionals trust us seems irrelevant: our reciprocity is expressed in the form of payment for services rendered or promised, our recommendations to friends and families and repeat appearances.

So I was surprised to read an article in the Annals of Family Medicine describing a new scale to measure doctors’ trust in their patients.  This scale, based on input from focus groups and validation surveys of physicians, was developed for research purposes on the grounds that trust is a “feature of the clinician-patient relationship that resonates with both patients and clinicians.” Read more »

*This blog post was originally published at CFAH PPF Blog*

The “I Get It” Moment In Direct-Pay Primary Care

After seven years, my wife has finally stopped asking me for “The Power of DocTalker” story of the day. Now when I start with the details of the latest case report justifying the model, she stops me with “I get it, I get it! Go write the case report up and post it on your website for others to ‘get it,’ too.”

Case reports center on the mission of our medical practice, with points regarding care that include quality, accessibility, convenience, affordability, empowerment, trust, and price transparency. Because our patients pay us directly for the service and don’t necessarily expect any insurance “reimbursement,” we are a very unique practice. We adhere to the points in our mission and also outperform all our local competition — i.e. medical offices that accept insurance payment for service in order to survive as a business.

To the patient, our services cost a lot less than services available via the insurance model. About 40 percent of our clientele have no insurance, and the other 60 percent have insurance yet chose to use our services because they believe it’s worth paying directly in order to assume control of their care. (As a quick aside — my favorite clients in this group are health insurance executives and CEOs of large companies, who have the best health insurance in the country.) Read more »

10 Reasons To Be A Doctor

With all the negative press, the pay cuts, and the uncertainty of healthcare reform, I am approached by people who secretly whisper in my ear, “Would you have your child go into medicine?”

On first blush I am tempted to answer, “Heck no!” given the administrative hassles, the changes in the public’s perception of our profession, the frontload of education, and the long hours involved. But those observations, while real, are superficial at best.

Drilling down with more careful analysis after a challenging weekend on call, I find it worthwhile to stop and ask myself what makes medicine special for those of us crazy enough to subject ourselves to this lifestyle. I decided to put together a list of things that were important to me and would welcome additions from others. Read more »

*This blog post was originally published at Dr. Wes*

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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