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Fixing Up Primary Care: Is Anyone “Home?”

love Don't live here anymore... by Robb North via Flickr

By John Henning Schumann, M.D.

The Patient Protection and Affordable Care Act (aka “Health Care Reform”) signed by President Obama in March will revolutionize primary care in the United States. By 2014 tens of millions of uninsured people will “enter” the system by being granted insurance, either through expansion of the Medicaid program or through mandated purchasing of insurance via state pools or the private market.

This alone will have a profound impact, straining the capacity of our already frayed system. Therefore, embedded in the law are funds to encourage growth and improvement in primary care: Incentives to encourage graduates to enter primary care fields (family medicine, internal medicine, and pediatrics) and practice in underserved areas (through scholarships and loan forgiveness), and money to re-format the way that primary care is practiced and paid for. Read more »

*This blog post was originally published at ACP Internist*

Defining Family Practice

Family DoctorI like Dr. Rob, the one with the “distractible mind.” And although I thoroughly agree with the stance he takes in his recent post against cholesterol screening in kids, I must take issue with his opening statement:

I have a unique vantage point when it comes to the issue universal cholesterol screening in children, when compared to most pediatricians. My unique view stems from the fact that I am also an internist who deals with those children after they grow up on KFC Double Downs.

From Dictionary.com:

“Unique: existing as the only one or as the sole example; single; solitary in type or characteristics.”

Your med-peds training allows you to follow patients from birth to death (but no obstetrics or gynecology). You can care for all organ systems and all stages of disease (but without as much training in psychiatry). Congratulations! You’ve just (re)invented family practice (except for the above shortcomings). Oh, wait — that’s already a recognized specialty with its own residency programs, boards and everything like that, forty years now.

This misuse of the word “unique” is one of my pet peeves. “Unique?” I don’t think that word means what you think it means. After twenty years in practice, I agree that there probably isn’t much difference between what Dr. Rob does and what I do. After twenty years, I’m not even sure how much relevance remains from our “training.” Still, there remains a great deal of confusion about the very real differences between family practice and med-peds residencies. Read more »

*This blog post was originally published at Musings of a Dinosaur*

The Divide Between You And Your Medical Records

You have a right to your medical record. It’s true –- the record of every test and procedure you’ve had done, any films or studies, your doctors notes — it’s all yours if you ask for it. But it’s not that simple.

If you’re sick, your “record” is likely in pieces in lots of different places. Some of it is in paper files and computers in the offices of each of your doctors, or in the clinics where you had a test or procedure. It’s in multiple computer systems in a hospital, or in a folder in a radiology department, a container in a pathology department, or the computer system of a pharmacy. Each of these places has their own policy or procedure if you want your record. There are forms you have to fill out, fees you have to pay, time you have to wait.

So while you have a “right” to your records, for practical purposes, you’re going to have a very difficult time actually getting them. (By the way, this is something our team at Best Doctors does very well.) But let’s say you actually get all of your medical records. Now what? Read more »

*This blog post was originally published at See First Blog*

An App For Baby-Related Emergencies

RN Tara Summers was inspired to make an iPhone app after a frightening episode where she saw her infant child choking. Because she was a nurse, she sprang into action and gave the Heimlich maneuver, but worried about parents (or babysitters) without the same training.

So, along with her emergency medicine physician husband, she created MedBasics — a readily-accessible information packet for the home about things to do in an emergency. Now they’re announcing an iPhone app called BabyMedBasics for emergencies when you’re not at home.

More from MedBasics

iTunes link to the iOS app…

*This blog post was originally published at Medgadget*

A Big Pay Raise For Internists?

Full-time internists average $191,864 in income, according to one recruiter’s annual salary survey. LocumTenens.com conducted its survey in the early spring of 2010 among locum tenens and permanently employed physicians. That’s up from $179,958 in 2009, the company reported. Specific breakdowns by gender, years in practice and owner/employee status are here.

That’s a 6.6 percent pay raise. We’re going to do our own salary survey right here. Let us know if you saw such an increase in the past year.

*This blog post was originally published at ACP Internist*

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