This past spring, I wasn’t sure if I was looking through a fun house mirror when I read that Florida pediatricians were going to face criminal charges for bringing up the topic of gun safety in the office with patients. I couldn’t believe what I was reading.
The irony of the whole charade was the reasoning of those who brought about the bill. “Direct questions about firearm ownership when it …
Florida’s gag order on pediatricians blocked
Billing is way more than billing.
In a typical medical practice, more than 300 insurance cards cross the front desk every month. The variety of plans and coverage along with the complexities of coding and the difference among payers requires expertise and technology to effectively manage accounts receivable, regardless of practice size.
There are two basics required to manage your billing and accounts receivable — a practice management system and a clearinghouse.
The …
Efficient billing in your medical practice
I would have told you, on our first visit, that I don’t do well with soft science. But you appeared rushed, with an office full of patients, and I did not feel that I needed to explain my personality. You see, I am a logical and rational thinker, and my primary goal in life is to understand the world around me. I need proof. And then I probably need even …
The pivotal role of social media in patient support
Kids will swallow or poke up their noses, or into their ears the strangest things. I remember during my student days, I was doing a rotation in pediatrics when a 6 year old came into see us. I went in to take the history and her mom told me that her daughter had a very pungent odor to her, which she couldn’t get rid of.
I examined the patient and …
Kids and their fascination with foreign objects
Sturdy and thickly-built, long since widowed, cheery in a sardonic sort of way, tough and opinionated, Flora’s European roots ran deep; she’d been an Italian farm girl, and she’d rather be in her garden than anywhere else. The only reason she agreed to come inside and go to the doctor was that her bowel movements had finally gotten too painful, and too bloody to ignore. Which she had been doing, …
Discussing a colostomy in a patient with rectal cancer
There has been a significant outcry against the proposed ACO regulations: everything’s wrong and nothing’s right about them, or so some would have us believe.
Today’s “nattering nabobs of negativism” focus on: the estimated price tag for complying with the regulatory requirements (IT and other infrastructure included), the slim chance of success by ACOs in righting the wrongs of decades of bloat in the health care system, the …
Why an ACO is essentially an American product
Something huge happened at the American Medical Association House of Delegates meeting. Although the meaning of what happened will be spun throughout the blogosphere, twittersphere, and schmuckosphere, the bottom line is that the AMA just voted most commercial funding of CME out of existence.
Specifically, the delegates voted to approve a report of the AMA ethics committee that calls for a near elimination of industry support for CME. The report is …
Elimination of industry support for CME
Print out the eye chart, cover one eye, and see how you read it from 20 feet out. I failed line 8 abysmally.
I went for my annual check-up, and I must say, this doctor was thorough. In fact, he was too thorough. He told me way more than I ever wanted to know.
During the two-hour examination, I found out I’ve gained weight (too much ice cream), my blood pressure …
Appropriately dejected after an annual physical
What is fibromyalgia and what exactly what does exercise have to do with the treatment and long-term outcome of the condition? A recent study published in Medicine & Science in Sports & Exercise is helpful in understanding the relationship between fibromyalgia and exercise and how clinicians (and patients) might find better strategies for treatment.
Fibromyalgia is a clinically defined pain syndrome estimated to affect about 5 per cent of the general population with criteria for …
Exercise can help treat fibromyalgia
There is a lot of speculation about why there are fewer and fewer primary care physicians joining the workforce every year. Some have focused on the choices that medical students are making when choosing residencies. Whether due to laziness, desire to make money or the drive to be perceived as “successful” in choosing a more prestigious specialty, the new generation of physicians are being blamed for Read more…
Are medical students responsible for the primary care shortage?
I grew up playing a variety of different organized sports. Looking back now, I notice that no matter what the sport my best performances were always on teams which were led by inspiring coaches. The same could be said about my education, with teachers replacing the coaches. Whether I knew it at the time or not, throughout my life I have had a number of mentors who have brought the …
The value of a mentor during medical training
Ever dream of quitting your job, moving somewhere deliciously tropical and spending the rest of your days doing what you love (and even making a good, or great, income from it)?
This story isn’t about me, though some of you may know that I spent 2004-2008 living my dream life in Mexico (Puerta Vallarta and Los Cabos), making much of my income from my writing, dancing, coaching and speaking and occasional …
Quitting your job and living the dream
An article released by the Centers for Disease Control and Prevention in their weekly publication Morbidity and Mortality Weekly Report provides an assessment of the progress we have made in the diagnosis and treatment of cancer.
Clearly, since 1971, we have made substantial advances in the cancer treatment. We have become a larger and older …
The progress we have made in the diagnosis and treatment of cancer
ADVERTISEMENT
A recent article in the New York Times business section discusses an increase in the number of doctors getting M.B.A.’s in addition to their M.D. degree. In fact, there have even been many new programs that combine getting both of these degrees together. The article emphasizes the importance of seeing that “healing is an art, medicine is a profession and health care is a business.” However, is adding more …
A place for business in medical school
I just received a Groupon for dental services. I have seen Groupon’s in the past for medical services and I can’t figure out how selling medical services via a social coupon (the generic name for Groupon like sites) is legal. This is dangerous, uncharted territory. Consult your attorney before running a Groupon.
As I run practices in New York, I will focus on the their statutes. New York has some of …
Why doctors should be careful with Groupon and other social coupons
How many times have you said to a friend or relative in need, “Let me know if there’s anything I can do to help,” and when you didn’t hear back, fail to follow-up? I’ve lost count of the number of times I did just that—fail to follow-up when I didn’t hear back from someone in need, even though I would have been happy to help in any way I could.
Yet, …
How to ask for help when chronic pain or illness strikes
We are all guilty of confirmation bias from time to time.
Confirmation is something that resident physicians in particular are guilty of more so than experienced, qualified physicians. Resident physicians and attending physicians alike may quickly form a diagnosis in their mind during a brief discussion with a patient. Now they will try to convince themselves (sub-consciously) that the other complaints and physical exam fit that diagnosis. They …
Confirmation bias in both physicians and patients
As the new school year begins, it’s only natural that there’s more awareness about learning and behavior issues. One of the most controversial topics that came up frequently is ADHD, or Attention Deficit Hyperactivity Disorder. It’s thought that 2-4% of children have this condition, and a shocking 50% of children with this condition are on some form of prescription medication. Not only is it seen in children, but adults …
ADHD and the lack of quality sleep
Our first assignment for medical school involved reading and discussing Anne Fadiman’s The Spirit Catches You and You Fall Down, which describes how a clash of two cultures (medical and recently immigrated Hmong), miscommunication, and misunderstanding led to tragedy. Poignantly narrated, the book had the take-home message: if a patient does not agree with a physician’s reasoning why a disease developed and how it can be cured, then even the best …
What do you think caused your disease?
Year: 2002
Setting: Gleneagles Hospital, Singapore
Position: Private general practitioner
I am the first and only non-Anglo-Saxon, foreign, private general practitioner in the city-state and the physician of reference for 14 embassies, consulates and a high commission from Europe, Asia, South America and Africa. One afternoon, a nurse comes into my consulting room saying that an ambassador from a European country has had an accident and that he insists on being seen immediately.
I …
You cannot treat a patient against his will
Get free updates delivered free to your inbox.
