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Solo Practice Vs. Integrated Health Systems: What’s Best For Primary Care Reform?

The buzzwords of cutting-edge primary care reform – the medical home, coordination of care, electronic health records – have usually been associated with large integrated health systems such as Intermountain Healthcare, Group Health, and Kaiser Permanente. If you believe the arguments that economies of scale and financial resources give such organizations built-in advantages over the traditional small group practice, you may be inclined to believe that solo practice is going the way of the dodo. Indeed, immediate past AAFP President Roland Goertz, MD, MBA penned an editorial a few months ago, “Helping Small Practices Survive Health System Change,” that, while touting some services that the Academy offers family physicians in these practices, betrayed a decidedly pessimistic outlook on their long-term future.

Not everyone agrees, however. In the September issue of the Journal of Family Practice, Jeff Susman, MD cast solo practices as vital engines of primary care innovation: Read more »

*This blog post was originally published at Common Sense Family Doctor*

The Reality Of Being A Doctor

Lest the students out there get disillusioned, it is probably a good idea to be upfront about the reality of being a doctor:


Maybe it’s not always this bad, but in the ER there is a real ring of truth to this.

From the marvelous Saturday Morning Breakfast Cereal

*This blog post was originally published at Movin' Meat*

Health Care Attorney Discusses The Use Of Disclaimers On Facebook Pages

This is the third part of a three part post addressing the legal concerns of social networking in the health care arena.

In part one, legal expert David Harlow, Esq., Health Care Attorney and Consultant at The Harlow Group, LLC in Boston, answered questions regarding “The Legal Implications for Doctors, Nurses and Hospitals Engaging in Social Media?”

In part two, Mr. Harlow answered questions related to the Pharma industry;  “Legal Concerns: What Steps can Pharma Take to Engage in Social Media?”

The third part addresses a question from a follower on Facebook about the use of disclaimers.

Q:  Barbara: A Healthin30 reader on Facebook writes:  “I’m looking for a good disclaimer to put on a couple of medical practices’ Facebook pages. The AMA social media guidelines aren’t helpful. Do you have a good boilerplate you recommend? Thanks in advance for your help!”  David, can you offer a couple suggestions?

A:  David: Read more »

*This blog post was originally published at Health in 30*

What Should People Receiving Health Care Be Called? Empowered Patient Vs. Health Care Consumer

“There is a better way – structural reforms that empower patients with greater choices and increase the role of competition in the health-care marketplace.” Rep. Paul Ryan (R-WI) August 3, 2011

The highly charged political debates about reforming American health care have provided tempting opportunities to rename the people who receive health services.  But because the impetus for this change has been prompted by cost and quality concerns of health care payers, researchers and policy experts rather than emanating from us out of our own needs, some odd words have been called into service.  Two phrases commonly used to describe us convey meanings that mischaracterize our experiences and undervalue our needs: “empowered patient” and “health care consumer.”

As one who has done serious time as a patient and who spends serious time listening to talks and reading the literature that use these words to describe us, I ask you to reconsider their use.

“Empowered patient” The fabrication of the verb “to empower” from the noun “power” was used in the civil rights and community development movements to describe a benevolent bestowal of influence on disenfranchised individuals and groups by those who had previously excluded them.  When used in relation to health care, the word perpetuates the idea that we are passive entities, waiting to be gratefully endowed by our clinician or a new policy with the right and ability to act on our own behalf.  Our “empowerment” takes place not as a result of our own will or preference, but rather because we have been given permission to act in a different way by some external agent.

This word is Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

A TV Physician Is Not Your “Doctor” Or “Coach”

A German physician wrote me about this, so while CNN may have an international reach, it’s not always with an adoring audience.

The physician was reacting to the weekend “Paging Dr. Gupta” program, which Dr. Gupta referred to once as “SG, MD.” The first thing that struck me was his introduction, in which he said:

“I’m your doctor. I’m also your coach.”

Later in the program he said:

“Think of this as your appointment. No waiting. No insurance necessary.”

I find this very troubling. He’s not my doctor. He’s not my coach. When I watch a “news” program, it’s NOT my medical appointment. It’s supposed to be news, not medical advice.

But that’s not what the German physician wrote to me about, so I kept watching (the segment in question appears about 5 minutes and 30 seconds deep, and after the 30-second commercial you have to watch to get there):

Gupta reacted to a viewer’s message on Twitter in which the tweep asked: “Does anyone know a ‘miracle’ treatment for ovarian cancer?” Read more »

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

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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