June 23rd, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion, Research
Tags: ACP, American College Of Physicians, Annals Of Internal Medicine, Black Colleges and Universities, Dr. Wayne Riley, Family Medicine, General Medicine, Howard University, Medical Schools, Medical Students, Medical Training, Meharry Medical College, Morehouse College, New Medical Residents, NIH Support, Physician Recruitment, Primary Care Output Rankings, Primary Care Physicians, Primary Care Track Record, Private School, Public Schools, Research-Intensive Medical Schools, Social Mission Score, Technical Medicine, Underserved Communities, University of California-San Diego, University of Colorado, University of Minnesota, Unversity of Washington
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A new study published in the Annals of Internal Medicine, ACP’s flagship journal, finds that medical schools vary greatly in producing more primary care physicians and getting them into underserved communities.
– “Public schools graduate higher proportions of primary care physicians” than private schools.
– “The 3 historically black colleges and universities with medical schools (Morehouse College, Meharry Medical College, and Howard University) score at the top” in training primary care physicians who then go on to practice in underserved communities. (Click here for an interview with two recent graduates of historically black colleges and with Wayne Riley, MD, FACP, who is the president and CEO of Meharry Medical College in Nashville, Tennessee and a regent of the American College of Physicians.)
– “The level of NIH support that medical schools received was inversely associated with their output of primary care physicians and physicians practicing in underserved areas.” Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
June 23rd, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
Tags: Doctor-Patient Communication, Doctor-Patient Encounter, Encouraging Medical Students, Family Medicine, General Medicine, Internal Medicine, Less Is More In Medicine, Medicare Cut, Patient-Doctor Relationship, Primary Care, Too Much Medicine, Unnecessary Procedures
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He came in for his regular blood pressure and cholesterol check. On the review of systems sheet he circled “depression.”
“I see you circled depression,” I said after dealing with his routine problems. “What’s up?”
“I don’t think I am actually clinically depressed, but I’ve just been finding it harder to get going recently,” he responded. “I can force myself to do things, but I’ve never have had to force myself.”
“I noticed that you retired recently. Do you think that has something to do with your depression?” I asked.
“I’m not really sure. I don’t feel like it makes me depressed. I was definitely happy to stop going to work.”
I have taken care of him for many years, and know him to be a solid guy. “I have seen this in a lot in men who retire. They think it’s going to be good to rest, and it is for the first few months. But after a while, the novelty wears off and they feel directionless. They don’t want to spend the rest of their lives entertaining themselves or completing the ‘honey do’ list, but they don’t want to go back to work either.”
He looked up and me, “Yeah, I guess that sounds like me.” Read more »
*This blog post was originally published at ACP Internist*
June 23rd, 2010 by Happy Hospitalist in Better Health Network, Health Policy, Opinion
Tags: Clinical Experience, Compentent Care, Customer Service In Healthcare, Doctors of Medicine, Family Medicine, Future of American Healthcare, General Medicine, Gold Standard, Healthcare in America, Internal Medicine, M.D., Medical Boards, Medical Doctor, Medical School, Medical Training, NP, Nurse Practitioner, Patient Loads, Physician Education, Primary Care
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The future of American healthcare will not value physician education. Perhaps it’s time to abandon the medical school model and train millions of nurses instead at a fraction of the cost. This comment was left on my blog over at NP=MD:
I don’t even compare NPs and MDs. Their models differ. One is not better than the other. The schooling — minus the residency — is nearly equivalent in terms of time spent. The problem is that NPs don’t get a long enough residency. If you take a NP and a MD, both with 20 years clinical experience, the MD does not know more than the NP. Sure, he had a few extra classes 20 years ago — which he doesn’t remember — but that’s about it.
NPs aren’t trying to steal MDs’ meal tickets, they’re attempting to better serve patients. Read more »
*This blog post was originally published at The Happy Hospitalist*
June 23rd, 2010 by AlanDappenMD in Better Health Network, Opinion, Primary Care Wednesdays, True Stories
Tags: DocTalker Family Medicine, Dr. Alan Dappen, House Calls, Medicine and Religion, Primary Care Wednesdays
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A few weeks back, I had introduced a patient who was willing to let her religious beliefs stand in the way of receiving the proper medical treatment she needed to stay alive. I want to revisit with you this dying patient, who hadn’t known me or any doctor for over 30 years.
As the rest of the family, who were not as committed to a religious path, stood by her expectantly, I said to her: “I had a brother who was a true believer in the power of God and that faith could heal all things or be called God’s will. Like you, he was a competent adult in charge of his decisions. He wouldn’t listen to anyone else — not his wife, father, mother, children, brother — not even me, the doctor. He died two years ago, leaving behind 10 children and a wife who depended on him. We all believe he died unnecessarily.
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June 22nd, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, News, Opinion
Tags: Boston Celtics, Doctors' Diagnosis, Expensive Tests, Imaging Tests, Kendrick Perkins, Knee Injury, Less Is More In Medicine, Magnetic Resonance Imaging, MCL, Medical Technology, MRI, PCL, Physical Exam, Too Many Medical Tests, Too Much Testing, Torn Medial Collateral Ligament, Torn Posterior Cruciate Ligament, Unnecessary Testing, Unnecessary Treatment, X-Ray Vision
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Boston Celtics basketball player Kendrick Perkins injured his knee during the NBA Finals against the Lakers when he landed awkwardly. Unable to weightbear, he left Game 6 not to return for the following pivotal Game 7.
Based on his mechanism of injury and his physical examination, his trainer reported that he tore his medial collateral ligament (MCL) as well as the posterior cruciate ligament (PCL). More amazingly, this was done without the help of a MRI. Since Perkins was unable to play the final game, there was no urgent medical need to expedite the test, as regardless of the result his season was already done.
How do doctors know what’s wrong without X-ray vision or an imaging test? (Note that Perkins did get a X-ray, but X-rays generally don’t show ligament injuries.) Is it guessing? Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
