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10 Reasons To Be A Doctor

With all the negative press, the pay cuts, and the uncertainty of healthcare reform, I am approached by people who secretly whisper in my ear, “Would you have your child go into medicine?”

On first blush I am tempted to answer, “Heck no!” given the administrative hassles, the changes in the public’s perception of our profession, the frontload of education, and the long hours involved. But those observations, while real, are superficial at best.

Drilling down with more careful analysis after a challenging weekend on call, I find it worthwhile to stop and ask myself what makes medicine special for those of us crazy enough to subject ourselves to this lifestyle. I decided to put together a list of things that were important to me and would welcome additions from others. Read more »

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

Saving Primary Care: What Will It Take?

“Bold changes are needed in how the United States delivers and pays for primary care if the key goals of national health reform are to be achieved,” according to the health policy journal Health Affairs, which has released a thematic issue devoted entirely to the crisis in primary care.

(The complete articles are available only to subscribers, but Health Affairs’ blog has a good summary.)

I have spent much of the day reading the journal — 47 articles, and a combined 300 pages of text. Here are my “take-home” messages from the articles. Read more »

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

Why Primary Care Doctors Are So Busy

There’s been a lot of commentary on a recent article from the New England Journal of Medicine, detailing the undocumented tasks that a typical primary care physician performs.

For those who haven’t read the piece, entitled, What’s Keeping Us So Busy in Primary Care? A Snapshot from One Practice, it’s available free at the NEJM website. I highly recommend it.

To summarize, primary care doctors are responsible for much more than seeing patients in the exam room. In the cited practice, which has a fairly typical makeup, physicians were responsible for an average of over 23 telephone calls and 16 e-mails per day. Many practices don’t engage their patients over e-mail, so it’s conceivable that the number of telephone calls is lower than average here. Read more »

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

How To Micro-Tweak Diagnosis And Treatment

A common problem in healthcare is the number of times that small adjustments are needed in a person’s care. Often for these little changes, a physical exam and face-to-face time have nothing to do with good medical decision making.

Yet the patient and doctor are locked in a legacy-industrialized business model that requires the patient to pay a co-pay and waste at least half of their day driving to and from the office, logging time in a waiting room, and then visiting five minutes with their practitioner for the needed medical information or advice.

Today I’d like to visit the case of a patient I’ll call “DD,” who I easily diagnosed with temporal arteritis (TA) through a 15-minute phone call after she’d spent four weeks as the healthcare system fumbled her time with delays and misdirection via several doctors without establishing a firm diagnosis. Read more »

A Helpful Guide For Discharge Planning

Medicare has a handy guide to help patients and their caregivers take control of the discharge planning process. It might be good for hospitals to have a stack of these at the ready and a plan to make sure every patient gets one:

Planning for your discharge: A checklist for patients and caregivers preparing to leave a hospital, nursing home, or other health care setting

*This blog post was originally published at ACP Hospitalist*

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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