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Latest Posts

I’m Your Doctor, And I’m Worth It

Rx Vending MachineI saw the note on the patient’s chart before I opened the door: “Patient is upset that he had to come in.”

I opened the door and was greeted by a gentleman with his arms crossed tightly across his chest and a stern expression. I barely recognized him, having only seen him a handful of times over the past few years. Scrawled on the patient history sheet in the space for the reason for his visit were the words, “Because I was forced to come in.”

My stomach churned. I opened his chart and looked at his problem list, which included high blood pressure and high cholesterol –- both treated with medications. He was last in my office in November — of 2008. I blinked, looked up at his scowling face, and frowned back. ”You haven’t been in the office for over 18 months. It was really time for you to come in,” I said, trying to remain calm as I spoke.

He sat for a moment, then responded with very little emotion. “I’m doing fine. You could’ve just ordered my labs and called in my prescriptions. I don’t know why I had to be seen.” Read more »

*This blog post was originally published at Musings of a Distractible Mind*

A Doctor’s Hauntings

2:30AM: The beeper sounds. “Please call the ER x2222.” Why are they calling me? I’m not on call. A flash then a clap of thunder outside. “Your patient from a few days ago is here in the ER.”

The mind races. You remember the case clearly. No problem at all. What could be going on? You ask 20 questions, you get 20 answers. All of the bases have been covered. “Doin’ better now,” you’re told. “We’ll just admit ’em and you can see ’em in the morning.” Hesitantly you return to bed, mind racing. Read more »

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

Is A Nurse Practitioner A “Doctor?”

Nurse practitioners are demanding a wider scope of practice and even to be called “doctor” if they have a doctorate. And 28 states are considering giving them what they want, to which physician societies object.

Health policy analyst Jack Needleman (a Ph.D., so he gets to be called doctor, too), says the quality of care is the same. (He’s also an honorary fellow of the American Academy of Nursing.) AMA president-elect and internist Cecil B. Wilson, M.D., a Master of the American College of Physicians, (who is definitely called doctor) says the primary care shortage is a call for more physicians, not for fewer. Read more »

*This blog post was originally published at ACP Internist*

Do Satisfied Patients Mean Good Medical Care?

A version of this op-ed was published on March 15, 2010 in USA Today:

If you recently saw a doctor, you might subsequently receive a survey in the mail asking whether your physician was friendly, spent enough time with you, or showed the appropriate level of concern for your medical issues.

Read the rest of article here: Op-ed: Patient satisfaction doesn’t mean the best medical care

*This blog post was originally published at KevinMD.com*

When Doctors Can’t Get Health Insurance

We use a little company called Assurant to administer the employee health insurance plan for our business.  We have about 50 employees, not all of whom are on our insurance (some get theirs through a spouse), so we are in a particularly undesirable segment of the small-business market. Ironically, we have had a fair amount of difficulty in getting coverage which was affordable and sustainable. A lot of insurers wouldn’t even bid on us. Funny, right?  The doctors can’t get health care insurance!  Hysterical! So we wound up with an unusual sort of self-funded plan administered by Assurant, which was working OK.

Recently, however, a couple of our doctors wound up taking family members to the ER for various reasons — nothing serious, but common and reasonable presentations for an ER.  And Assurant denied payment for the claims.  They didn’t deny it outright, actually, just imposed a $500 “penalty for non-emergent use of the Emergency Room” on top of the usual co-pays and deductibles. Read more »

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

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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