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How To Talk To Your Doctor: 3 Simple Steps

As a practicing primary care doctor, I continue to work incredibly hard on making my bedside manner even better so that patients feel heard. The other reason is because as most doctors learned in medical school 90 percent of getting the right diagnosis comes from taking a good history from a patient.

Unfortunately with shorter doctor office visits and doctors interrupting patients within 23 seconds of starting, you need to know how to get your concerns across. While I don’t believe this is the responsibility of patients, the reality is not everyone has access to doctors with great bedside manner.

How to talk to your doctor is quite easy if you follow three simple steps. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Baby Boomers Are Bypassing Primary Care

Office-based practices are focusing increasingly on patients 45 and older, reports the Centers for Disease Control and Prevention.

In 2008, those 45 and older accounted for 57 percent of all office visits, compared to 49 percent in 1998. Prescriptions, scans and time spent with the doctor also became increasingly concentrated on those middle aged and older, according to data from the CDC’s National Center for Health Statistics.

Also, physician visits increasingly concentrated on medical and surgical specialists and less on care provided by primary care practitioners for those ages 45 and older. Furthermore, for patients ages 65 and older, the percentage of visits to primary care specialists decreased from 62 percent to 45 percent from 1978 to 2008, while the percentage of visits to physicians with a medical or surgical specialty increased from 37 percent to 55 percent. Read more »

*This blog post was originally published at ACP Internist*

Defining Family Practice

Family DoctorI like Dr. Rob, the one with the “distractible mind.” And although I thoroughly agree with the stance he takes in his recent post against cholesterol screening in kids, I must take issue with his opening statement:

I have a unique vantage point when it comes to the issue universal cholesterol screening in children, when compared to most pediatricians. My unique view stems from the fact that I am also an internist who deals with those children after they grow up on KFC Double Downs.

From Dictionary.com:

“Unique: existing as the only one or as the sole example; single; solitary in type or characteristics.”

Your med-peds training allows you to follow patients from birth to death (but no obstetrics or gynecology). You can care for all organ systems and all stages of disease (but without as much training in psychiatry). Congratulations! You’ve just (re)invented family practice (except for the above shortcomings). Oh, wait — that’s already a recognized specialty with its own residency programs, boards and everything like that, forty years now.

This misuse of the word “unique” is one of my pet peeves. “Unique?” I don’t think that word means what you think it means. After twenty years in practice, I agree that there probably isn’t much difference between what Dr. Rob does and what I do. After twenty years, I’m not even sure how much relevance remains from our “training.” Still, there remains a great deal of confusion about the very real differences between family practice and med-peds residencies. Read more »

*This blog post was originally published at Musings of a Dinosaur*

Leaving The Organization But Not The Practice Of Medicine

I confess ignorance. I know nothing about interviews with vampires. However, last week on my drive to a house call to see a sick patient, I experienced a sudden respect for author Anne Rice. I listened to a stranger completely off my radar screen being interviewed on NPR saying and making me feel the meaning of the phrase “Evil needs but one thing to grow. It is for good people to do nothing,” and reminding me that throughout history there have been numerous times where groups, organizations, and governments have acted even in ways that don’t represent our values or feel wrong minded or appear short sighted.

This statement was her simple explanation for a recent blog posting announcing she was resigning from Christianity. She remained a believer in God and in Christ, but no longer would listen to the Church tell her what to think, when and how to believe, or define truth while trying to control belief and the process. Read more »

The Divide Between You And Your Medical Records

You have a right to your medical record. It’s true –- the record of every test and procedure you’ve had done, any films or studies, your doctors notes — it’s all yours if you ask for it. But it’s not that simple.

If you’re sick, your “record” is likely in pieces in lots of different places. Some of it is in paper files and computers in the offices of each of your doctors, or in the clinics where you had a test or procedure. It’s in multiple computer systems in a hospital, or in a folder in a radiology department, a container in a pathology department, or the computer system of a pharmacy. Each of these places has their own policy or procedure if you want your record. There are forms you have to fill out, fees you have to pay, time you have to wait.

So while you have a “right” to your records, for practical purposes, you’re going to have a very difficult time actually getting them. (By the way, this is something our team at Best Doctors does very well.) But let’s say you actually get all of your medical records. Now what? Read more »

*This blog post was originally published at See First 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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