November 2nd, 2011 by KennyLinMD in Health Policy, Opinion
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Last month, my family was involved in a scary traffic accident en route to the Family Medicine Education Consortium‘s North East Region meeting. I was in the left-hand eastbound lane of the Massachusetts Turnpike when a westbound tractor trailer collided with a truck, causing the truck to cross over the grass median a few cars ahead of us. I hit the brakes and swerved to avoid the truck, but its momentum carried it forward into the left side of our car. Strapped into child safety seats in the back, both of my children were struck by shards of window glass. My five year-old son, who had been sitting behind me, eventually required twelve stitches to close a scalp laceration. Miraculously, none of the occupants of the other six damaged vehicles, including the truck driver, sustained any injuries.
Family physicians like me, and physicians in general, like to believe that the interventions we provide patients make a big difference in their eventual health outcomes. In a few cases, they do. But for most people, events largely outside of the scope of medical practice determine one’s quality and length of life, and Read more »
*This blog post was originally published at Common Sense Family Doctor*
October 16th, 2011 by ChristopherChangMD in Opinion
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Over the years, I have found that patients can be loosely grouped into 4 different types. Nothing particularly wrong with any type, but it does help me to approach patients appropriately if I can get a sense of what type they are.
The four types are:
Type A: If a surgery can “fix” or “cure” me such that I won’t have to take medications every day of my life, than let’s do it.
Type B: I will never consider surgery unless it is a life-threatening situation. If a medicine can help, why do it???
Type C: I will consider surgery only as a last resort when all else fails.
Type D: Read more »
*This blog post was originally published at Fauquier ENT Blog*
October 11th, 2011 by KennyLinMD in Health Policy
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The buzzwords of cutting-edge primary care reform – the medical home, coordination of care, electronic health records – have usually been associated with large integrated health systems such as Intermountain Healthcare, Group Health, and Kaiser Permanente. If you believe the arguments that economies of scale and financial resources give such organizations built-in advantages over the traditional small group practice, you may be inclined to believe that solo practice is going the way of the dodo. Indeed, immediate past AAFP President Roland Goertz, MD, MBA penned an editorial a few months ago, “Helping Small Practices Survive Health System Change,” that, while touting some services that the Academy offers family physicians in these practices, betrayed a decidedly pessimistic outlook on their long-term future.
Not everyone agrees, however. In the September issue of the Journal of Family Practice, Jeff Susman, MD cast solo practices as vital engines of primary care innovation: Read more »
*This blog post was originally published at Common Sense Family Doctor*
October 9th, 2011 by Shadowfax in Opinion, True Stories
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My father in law, now deceased, was a nephrologist. I met him while I was in medical school. He was a reserved guy, not prone to butt into what he saw as others’ business. So I still remember that while I was considering what sort of residency to pursue, he took a surprisingly strong stance that I should go into interventional radiology. His reasoning was simple: they have a great lifestyle, they make bags and bags and bags of money, and they get to play with all the coolest gadgets.
It was tempting, I admit. As anyone who knows me can attest, I am ALL about the gadgets. I’m not averse to bags of money either. But I never gave it much consideration, mostly because I am just not real good at radiology, though for an ER doc I do OK. (A low bar, it is true.)
I sometimes regret that decision. For example, I wrote the other day about a gentleman who presented with a ruptured abdominal aortic aneurysm. We had some heroic fun in the ER resuscitating him and getting him to the OR. After the fact, I had to wonder whether it was all in vain — Read more »
*This blog post was originally published at Movin' Meat*
October 4th, 2011 by Shadowfax in Humor
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Lest the students out there get disillusioned, it is probably a good idea to be upfront about the reality of being a doctor:
Maybe it’s not always this bad, but in the ER there is a real ring of truth to this.
From the marvelous Saturday Morning Breakfast Cereal
*This blog post was originally published at Movin' Meat*
