July 14th, 2010 by AlanDappenMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, True Stories
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The vexing problem with “truth” when it comes to healthcare is to understand its limits. Let’s start with two popular notions. The first: canaries are harbingers for detecting chemical leaks. The second: primary care specialists claim higher salaries for their work will prevent their extinction. Both claims sound plausible, but then come the conditions, the nuances, the variables and empirical testing and observation — the so called threads of truth.
Notion 1, The Canaries: In 1972 my brother passed through the military’s basic training and was Vietnam bound until a perfect score on a standardized test, his Phi Beta Kappa and a chemistry degree from college rerouted his destiny to a remote patch of the Utah desert. Instead of being a foot soldier, he gave back to his country in a chemical warfare lab. Read more »
June 16th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, True Stories
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There’s little question that the workplace environment for doctors is deteriorating. Especially in primary care, where physicians are arguably needed the most.
That’s why is so disheartening to read this Newsweek essay from pediatrician Karen Li, explaining why she left the field. Much of her piece can be attributed to the bad old days of managed care, where doctors were frustrated by the bureaucratic impediments placed before them. Read more »
*This blog post was originally published at KevinMD.com*
May 12th, 2010 by Edwin Leap, M.D. in Better Health Network, Health Policy, Opinion, True Stories
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There is discontent in the house of medicine. So many physicians struggle. They seem to wade through uncertainty every day — uncertain about diagnoses, about pain, about disposition. We find ourselves uncertain about our jobs, our futures, our finances.
The consultants we call are uncertain about their practices and whether they can remain viable in the coming years as medicine evolves into something we may find unrecognizable.
Some days, as I enter my 17th year of practice, I don’t know if I can bear to walk around our little department for 10 or 20 more years, like some gerbil on an exercise wheel. I am uncertain if I can bear the weight of more entitlements, more confabulated stories, more regulations, and manufactured drama. I wonder if I can endure decades more of circadian assaults on my brain. Read more »
*This blog post was originally published at edwinleap.com*
May 12th, 2010 by BobDoherty in Better Health Network, Health Policy, Opinion
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“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*
May 12th, 2010 by KevinMD in Better Health Network, Health Policy, Research
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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*
