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The Primary Care Shortage: What We Can Do Today

The new healthcare reform law, which is called the Patient Protection and Affordable Care Act (PPACA), will be a huge disappointment to the millions of previously-uninsured people who finally purchase insurance policies when they try to find a doctor.

Primary care physicians are already in short supply and the most popular ones have closed practices or long waits for new patients. Imagine when 2014 hits and all of those patients come calling. Who is going to be available to treat them? Read more »

*This blog post was originally published at EverythingHealth*

The Future Of Small Practices

This blog was written from Toronto, Ontario, where ACP’s elected Board of Governors met to provide direction on the policies to be advocated by the organization.

One issue raised by many of the governors is the enormous economic pressure on smaller internal medicine practices, and what the ACP might be able to do about it. Today, most physicians work in private practices of ten or fewer. Read more »

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

How Will The Medicare Cut Affect You?

Once again, Congress is playing with fire by not enacting a permanent solution to the Medicare SGR (sustainable growth rate) physician payment cut problem.

Congress got itself tied up in knots trying to figure out a way to reverse a 21% cut in Medicare payments to doctors that went into effect yesterday. It ended up agreeing to legislation, which was signed into law late Thursday evening by President Obama, to restore payments to the pre-cut (2009) levels through the end of May.

The action, though, may have come a dollar short and day late. CMS has indicated that it had no choice but to tell carriers to begin processing claims with the 21% cut, starting yesterday. Read more »

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

Who’s Really Overcrowding The ER?

If you think the overcrowding in emergency rooms across the country is because of the uninsured, think again.

A new study in the Annals of Emergency Medicine reports that of patients who are frequent users (over 4 times a year) of emergency departments (ED), the uninsured represent only 15 percent of those frequent users.

Also, the frequent ED users were more likely than occasional users to have visited a primary care physician in the previous year.

They also found that most patients who frequently use the ED have health insurance and the majority of users (60 percent) were white. These findings contradict the widely held assumption that frequent users are minorities or illegal immigrants without insurance. Read more »

*This blog post was originally published at EverythingHealth*

In The News: Boosting Disease Prevention And Unethical TV Doctors

An article in the New York Times this week looks at a raft of new public health initiatives passed by Congress that are aimed at boosting disease prevention. Examples include requiring restaurants with at least 20 locations to include nutrition information on their menus and mandating employers with at least 50 employees to allow new mothers to express breast milk at work. In addition, Medicaid will now cover smoking cessation counseling for pregnant women and Medicare beneficiaries will be eligible for an annual physical. The initiatives are expected to eventually save money by decreasing the country’s chronic disease burden. (New York Times)

Researchers from Johns Hopkins University recently did a study applying physicians’ ethical codes to the conduct of the fictional doctors on “Grey’s Anatomy” and “House, M.D.” Perhaps to no one’s surprise, TV doctors are behaving very badly. As the abstract of the study states, both shows feature “egregious deviations from the norms of professionalism and contain exemplary depictions of professionalism to a much lesser degree.” (Philadelphia Inquirer, Journal of Medical Ethics)

*This blog post was originally published at ACP Internist*

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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