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Latest Posts

Why We Need Private-Practice Primary Care Doctors

A recent post on Kevin MD by Joseph Biundo, a rheumatologist, challenged my assertion that primary care doctors can save money:

(In reference to my claim…) That may be true in theory, but I see patients in my rheumatology office every day who have been “worked up” by primary care physicians and come in with piles of lab tests and X-ray and MRI reports, but are diagnosed in my office by a simple history and physical exam.

Prior to that, an article in the New York Times along with a post by Kevin Pho noted the fact that more solo practitioners are leaving private practice and joining hospital systems. Why are they doing this? Read more »

*This blog post was originally published at Musings of a Distractible Mind*

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*

What Primary Care Physicians Need To Know About Healthcare Reform

DrRich is obviously far more intelligent than those wayward Democrat Congresspersons, whose last-minute “yes” votes Speaker Pelosi is seducing with her winning smile, and with her double-super-hope-to-die promise that the Senate will surely agree with the reconciliation package the House has finally assembled.

Unlike Pelosi’s reluctant Blue Dogs, DrRich understands that once the House has deemed the Senate bill to have been passed, and the President signs it into law, and the confetti drops and the champagne pops and the press goes into raptures and the work begins to revise Mt.Rushmore, the odds immediately become vanishingly small that the President, the Senate, or even the 200 House Democrats who really like the new law, will actually then embark on a new, prolonged, contentious spectacle of a reconciliation fight in the Senate.

Rather, once healthcare reform becomes law, political expediency dictates that we in the teeming masses never hear another word about healthcare until after the November elections. We will be distracted by more pressing matters, from which there will be many to choose — gasoline prices, Iranian nuclear weapons, economic collapses in the PIIGs, etc.

Now, DrRich does not have the stamina to study the new law all at once as a whole. He must bite off little pieces. And the first thing he sought in embarking on his study of our new healthcare system was evidence of how the new law would rescue the Primary Care Physician (PCP). Read more »

*This blog post was originally published at The Covert Rationing Blog*

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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