1) Congress is considering “counter-detailers” to combat Big Pharma propaganda.

My take: The only way to fight pharmaceutical companies is with money. Having the government behind this effort is a promising start.

2) Match Day, the annual rite of passage for 4th year medical students, is today.

My take: Once again, there will be stories about how dermatology and radiology residencies fill easily while primary care struggles to fill their slots with American medical graduates.

After reading yesterday’s NY Times article (work 20 percent more hours for half the pay!), why should any other result be expected?

3) Tara Parker-Pope writes that the medical culture is “seemingly designed to prevent anybody from actually contacting a doctor while at work.”

My take: That’s true. This is unfortunate, as communication should be a pillar of any health care system. However, this is something that the physician payment system completely devalues. Patient e-mails and telephone calls, as well as communicating with specialists and other aspects of coordinating care are rarely reimbursed.

The only thing that pays are patient visits and procedures. Which not surprisingly, are what doctors focus on.

The first step to improving communication would be to appropriately compensate for it. Multiple studies have shown that physicians respond best to financial incentives. Sounds crass and mercenary, but that’s the reality.