July 12th, 2011 by admin in Health Tips
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Feeling tired? If so, it’s not surprising. Fatigue is one of the most common problems people report to their doctors. The Health and Retirement Study of more than 17 million older people ages 51 and up reported recently that 31% said they feel fatigued.
Fatigue is a symptom, not a disease. Different people experience it in different ways. The tiredness you feel at the end of a long day or after a time zone change might feel similar to that resulting from an illness. But fatigue from stress or lack of sleep usually subsides after a good night’s rest, while disease-related lethargy is more persistent and may be debilitating even after restful sleep.
Finding the cause. How do you know if your low-energy is caused by an underlying illness or is the result of stress, poor diet, or lack of sleep? For example, could you have chronic fatigue syndrome? That is an unusual illness and an uncommon cause of persistent fatigue, says Anthony Komaroff, M.D., professor of medicine at Harvard, world-renowned expert on chronic fatigue syndrome, and medical editor of a new Harvard Special Health Report, Boosting Your Energy. About 4 to 8 of every 1,000 adults in the United States suffer from chronic fatigue syndrome, which is about twice as common in women as in men. The causes of chronic fatigue syndrome are still unknown, and there is no accurate diagnostic test. However, scientists have found abnormalities in the brain and peripheral nervous system, in the immune system, and in energy metabolism in people with this syndrome. Read more »
*This blog post was originally published at Harvard Health Blog*
July 7th, 2011 by Peggy Polaneczky, M.D. in Health Tips
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A friend of mine had a hard time getting in to see her doctor for an urgent visit last week. Reeling from an unexpected and sudden family upset, she was depressed and anxious, unable to sleep or function, and her therapist was advising an antidepressant. She called her family doc, who works at a large hospital-based multispecialty group, and told the woman at the call center that she wanted to see the doctor on an urgent matter. She was given an appointment 6 weeks in the future.
Summoning her courage, my friend told the woman her story – and that she was really worried about herself and did not think she could wait that long.
“Sorry, that is the best I can do” was the reply.
Increasingly upset, my friend told the woman that if she had to wait that long, she just might kill herself in the interim. Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
July 3rd, 2011 by Toni Brayer, M.D. in Opinion
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Close your eyes and think of a doctor. Do you see a Marcus Welby type? A middle aged, smiling and friendly gentleman who makes house calls? Is his cozy office staffed by a long time nurse and receptionist who knows you well and handles everything for you? If that is what you envision, either you haven’t been to the doctor lately or you are in a concierge practice where you pay a large upfront fee for this type of practice. Whether you live in a big city or a rural community, small practices are dissolving as fast as Alka Selzer. Hospitals and health systems are recruiting the physicians, buying their assets (unfortunately not worth much) and running the offices.
Doctors are leaving small practices and going into the protection of larger groups and corporations because of economic changes that have made it harder and harder for small practices to survive. The need for Read more »
*This blog post was originally published at EverythingHealth*
June 26th, 2011 by Toni Brayer, M.D. in Health Policy, Opinion
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An article by Brian Klepper and Paul Fischer at Health Affairs has me all fired up. Finally these two health experts are calling it like it is. The Wall Street Journal, New York Times and EverythingHealth have written before about the way primary care is undervalued and underpayed in this country and how it is harming the health and economics of the United States.
A secretive, specialist-dominated panel within the American Medical Association called the RUC has been valuing medical services for decades. They divvy up billions of Medicare and Medicaid dollars and all insurance payers base their reimbursement on these values also. The result has been gross overpayment of procedures and medical specialists and underpayment of doctors who practice primary care in internal medicine, family medicine and pediatrics). These payment inequities have led us to a shortage of these doctors and medical costs skyrocket as a result. As Uwe E. Reinhardt says, “Surely there is something absurd when a nation pays a primary care physician poorly relative to other specialists and then wrings its hands over a shortage of primary care physicians.”
Klepper, Fischer and author Kathleen Behan make a bold suggestion. Let’s quit complaining about the RUC and their flawed methodologies. Let’s quit admiring the problem of financial conflicts of interest and the primary care labor shortage. It’s time for the primary care specialty societies, Read more »
*This blog post was originally published at ACP Internist*
June 25th, 2011 by RyanDuBosar in Health Policy, Research
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Primary care physicians are getting paid more, two surveys agree, while hospital employment is rising.
Internists earned $205,379 in median compensation in 2010, an increase of 4.21% over the previous year, reported the Medical Group Management Association’s (MGMA’s) Physician Compensation and Production Survey: 2011 Report Based on 2010 Data. Family practitioners (without obstetrics) reported median compensation of $189,402. Pediatric/adolescent medicine physicians earned $192,148 in median compensation, an increase of 0.39% since 2009.
Among specialists, anesthesiologists reported decreased compensation, as did gastroenterologists and radiologists. Psychiatrists, dermatologists, neurologists and general surgeons reported an increase in median compensation since 2009.
Regional data reveals primary and specialty physicians in the South reported the highest earnings at $216,170 and $404,000 respectively. Primary and specialty-care physicians in the Eastern section reported the lowest median compensation at $194,409 and $305,575. This year’s report provides data on nearly 60,000 providers.
Recruiting firm Merritt Hawkins reported that general internal medicine was one of its top two most requested searches for the sixth consecutive year. Family physicians were the firm’s most requested type of doctor, followed by internists, hospitalists, psychiatrists, and orthopedic surgeons.
Average compensation for internists Read more »
*This blog post was originally published at ACP Hospitalist*
