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How Much Is A Primary Care Visit Worth To You?

How much is a primary care appointment worth? Not much, it appears.

Physicians in California decided to embark on an innovative idea, asking patients to simply pay them what they thought the visit was worth. Here’s how it worked:

On the day of the events, no insurance was accepted. Care was provided only to the uninsured, who were asked to pay what they could afford. Laboratory tests were provided at cost, and patients who needed additional services were referred to various public resources. Practices also handed out lists of generic medications available for reduced prices at large, discount pharmacies.

Physicians who accept Medicare are not allowed to include Medicare beneficiaries in any pay-what-you-can program.

Although patients did value the visit, they grossly underestimated its cost. Read more »

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

Doc Fix Blamed On Doctors

The American Medical Association will launch a multi-million-dollar ad campaign tomorrow to heighten pressure on Congress for a doc-fix bill. The American College of Physicians (ACP) reacted by calling for doctors to contact their member of Congress directly to let their voices be heard. Robert Centor, FACP, called for doctors to protest as well. (American Medical Association, American College of Physicians, DB’s Rants)

Meanwhile, a Florida medical society predicts a crisis in that senior-laden state. The society cited but did not name eight primary care doctors who’ve stopped accepting Medicare patients this year, and 12 cardiologists who left private practice for employment elsewhere because of already reduced payments. Unbelievably, business columnist Steven Pearlstein sorted through the issues around the doc fix, and concluded that it’s the docs that need fixing for paying themselves generous salaries. (Naples News, The Washington Post) Read more »

*This blog post was originally published at ACP Internist*

How To Deal With Unhappy Or Difficult Patients

There’s a nice article in the May issue of Plastic Surgery Practice that discusses how to deal with unhappy or difficult patients. No matter the area of medicine or surgery, you’re bound to have one or two of these patients over the years. It never hurts to learn or review tips in dealing with them.

In the article, Rima Bedevian interviews Julie Ann Woodward, M.D., chief of the oculoplastic and reconstructive surgery service at Duke University:

…how to successfully deal with them -– with compassion and humanity without allowing them to “run you over” or manipulate a difficult situation into a potentially litigious one.

Dr. Woodward provides a helpful checklist for doctors. Read more »

*This blog post was originally published at Suture for a Living*

Health Journalism Gems You Shouldn’t Miss

A couple of health journalism gems you shouldn’t miss just because they were published over the holiday weekend:

Natasha Singer of the New York Times had an important piece, “When Patients Meet Online, Are There Side Effects?,” about privacy concerns when social networking sites like CureTogether.com and PatientsLikeMe.com offer online communities for patients and collect members’ health data for research purposes.

John Fauber of the Milwaukee Journal-Sentinel published another in his “Side Effects” series on conflicts of interest in healthcare. This one was about doctors vouching for the drug Multaq for treating atrial fibrillation without ever having seen all of the data.

The Minneapolis Star Tribune began a “Too Much Medicine” series. Health editor Dave Hage informs that they’ve been working on this project for nearly a year with plans for a few more installments in coming months, each covering different ailments and procedures that are over-used or under-proven. (Unfortunately, I think the series is only available in the print editions.)

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

Medicare Cut Effective Today: Who Should Doctors Be Angry At?

Instead of blogging (again) about Congress’s failure to stop the 21% Medicare SGR cut, which went into effect today, I could just re-run my April 16 post. I wrote then:

“It is the failure of both political parties, over many years, to honestly deal with the SGR, including the cost of getting rid of it, which has resulted in the current ongoing SGR farce. And yet members of Congress wonder why the public holds them in such low regard.”

Blogging in DB’s Medicare Rants, Dr. Bob Centor captures the outrage felt by most physicians:

“I am mad. Every physician I know is mad. Patients should join us in expressing anger. Physicians cannot trust Congress if they cannot repair this absurdity.”

(Bob references ACP’s statement, released on Friday; click here to read it in its entirety.)

That Congress allowed politics again to get in the way of doing what is best for patients makes my blood boil. Voters can and should hold them accountable. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

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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