Physician voices

12,713 articles · Since 2006

Articles, page 608

Will more primary care doctors keep patients out of the ER?

October 9, 2009Oct 9, 200911

One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I…

Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency …

Does the bulk of excessive medical care happen in the ER?

Michael Kirsch, MD

September 25, 2009Sep 25, 200926

by Michael Kirsch, MD The concept of medical excess is very difficult for ordinary patients to grasp. The medical community has worked hard for decades teaching them that more medicine meant better medical care. The public has learned these lessons…

by Michael Kirsch, MD

The concept of medical excess is very difficult for ordinary patients to grasp. The medical community has worked hard for decades teaching them that more medicine meant better medical care. The public has learned these lessons well. Physicians who sent their patients for various diagnostic tests or specialty consultations were regarded as conscientious and thorough. Patients approved of doctors who prescribed antibiotics regularly for colds and other …

How hospitals should deal with disruptive physician behavior

Mark N. Simon, MD

September 20, 2009Sep 20, 200912

What can hospital medical staff leaders learn from University of Oregon football coach Chip Kelly? In the morning of September 4th, Kelly had an opportunity to review video tape from the conclusion of his team’s game with Boise State University the night before. What he saw was his senior running back LeGarrette Blount punch an opponent and then lose his cool with the fans in attendance. He …

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Medical malpractice reform by President Obama and the White House

MedPage Today

September 19, 2009Sep 19, 200912

by Emily P. Walker, Washington Correspondent, MedPage Today The White House today announced details of a $25 million grant program to test alternatives to the tort system for medical liability cases. In his Sept. 9 speech before Congress, the president…

by Emily P. Walker, Washington Correspondent, MedPage Today

The White House today announced details of a $25 million grant program to test alternatives to the tort system for medical liability cases.

In his Sept. 9 speech before Congress, the president announced he would direct Kathleen Sebelius, Health and Human Services secretary, to launch pilot programs meant to cut down on physicians …

Violence in the emergency department and how to promote ER safety

Patricia B. Allen, MBA, RN

September 12, 2009Sep 12, 20097

by Patricia B. Allen, MBA, RN What would you differently tomorrow if you had a violent episode in your emergency department today? Violence in the ED is a growing and alarming phenomenon. A recent survey conducted by the Emergency Nurses…

by Patricia B. Allen, MBA, RN

What would you differently tomorrow if you had a violent episode in your emergency department today?

Violence in the ED is a growing and alarming phenomenon. A recent survey conducted by the Emergency Nurses Association (ENA) revealed that 25 percent of the RN respondents report experiencing physical violence more than 20 times in the past three years and 20 percent of the respondents revealed encountering …

Op-ed: Why the doctor won’t see you now

Kevin Pho, MD

September 12, 2009Sep 12, 20097

The following op-ed was published on August 20th, 2009 in CNN.com. When President Obama recently cited the number of Americans without health insurance, he declared that, "We are not a nation that accepts nearly 46 million uninsured men, women, and…

The following op-ed was published on August 20th, 2009 in CNN.com.

When President Obama recently cited the number of Americans without health insurance, he declared that, “We are not a nation that accepts nearly 46 million uninsured men, women, and children.”

Uninsured patients often delay preventive care, waiting to seek medical attention only when their conditions worsen. This leads to more intensive treatment, often in the emergency department or hospital where …

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Op-ed: Why the doctor won’t see you now

A patient dies after doctors fail to communicate in the operating room

Jerry I. Meyers, Esq

September 10, 2009Sep 10, 200931

by Jerry I. Meyers, Esq. Communication is essential between health care providers but sometimes communication fails because of the arrogance or carelessness of the persons involved in the needed medical communication. Several years ago, a female client about to enjoy…

by Jerry I. Meyers, Esq.

Communication is essential between health care providers but sometimes communication fails because of the arrogance or carelessness of the persons involved in the needed medical communication.

Several years ago, a female client about to enjoy an important anniversary was admitted to a University affiliated hospital for the purpose of having a colostomy wound debrided.

This was to be a one-day inpatient hospital procedure and was associated with little …

Does being on the America’s Best Hospitals list affect patient outcomes?

MedPage Today

September 4, 2009Sep 4, 2009

by Charles Bankhead, Staff Writer, MedPage Today A news magazine's rankings of top-rated hospitals for heart failure care did not include many hospitals that performed at least as well as the ranked centers, according to a comparison of the magazine's…

by Charles Bankhead, Staff Writer, MedPage Today

A news magazine’s rankings of top-rated hospitals for heart failure care did not include many hospitals that performed at least as well as the ranked centers, according to a comparison of the magazine’s list and government data.

Hospitals that made the U.S. News & World Report list had a better 30-day mortality than …

How hospitalists can provide high quality patient care at the lowest possible cost

Robert Wachter, MD

September 3, 2009Sep 3, 200911

Much has been made of the superior performance – on both cost and quality – of integrated health care organizations like the Mayo and Geisinger Clinics. But since the defining characteristic of these standout systems is at least 50 years of integrated history, few believe that the rest of us – namely the docs and hospitals that provide the bulk of American health care – can quickly achieve such seamless …

Is alternative health a form of fundamentalism?

Amy Tuteur, MD

September 1, 2009Sep 1, 200917

There once was a time when all food was organic and no pesticides were used. Health problems were treated with folk wisdom and natural remedies. There was no obesity, and people got lots of exercise. And in that time gone…

That’s right. For most of human existence, according to fossil and anthropological data, the average human lifespan was 35 years. As recently as 1900, …

Are relationships being lost in medicine, and are hospitalists partly responsible?

Edwin Leap, MD

August 29, 2009Aug 29, 20099

An emergency physician, like me, may be the worst possible person to discuss relationships with patients. I mean, one of the reasons I chose this specialty was that I didn’t want long-term relationships with my patients. I see, now, that…

See, the county I landed in after residency is small enough that I do know many of my patients, and I do see them …

Will medical malpractice reform be included in the final health bill?

Jeffrey Segal, MD, JD

August 27, 2009Aug 27, 200916

Believe it or not, some element of federal tort reform is not only possible, but likely. Sounds counterintuitive? We all know that Congress has a strong majority with Democrats. We know the President is also a Democrat. We know the…

Believe it or not, some element of federal tort reform is not only possible, but likely.

Sounds counterintuitive? We all know that Congress has a strong majority with Democrats. We know the President is also a Democrat. We know the plaintiff’s bar strongly supports the Democratic Party. We know that Democrats have traditionally shied away from specific reforms, such as caps on pain on suffering. So, this would seem the worst …

Will nurses solve the primary care crisis?

Derek Mazique

August 23, 2009Aug 23, 200939

by Derek Mazique Between “death panels,” a NICE-style cost effective analysis board, and Obama’s slowly graying hair, one conspicuously absent part of reform are reimbursement rates. Medicare and private insurance typically reimburse for expensive procedures, which ultimately rewards procedure-heavy specialists…

by Derek Mazique

Between “death panels,” a NICE-style cost effective analysis board, and Obama’s slowly graying hair, one conspicuously absent part of reform are reimbursement rates. Medicare and private insurance typically reimburse for expensive procedures, which ultimately rewards procedure-heavy specialists while discourage those cognitive-heavy services like primary care docs.

The result? As a recent Baltimore Sun op-ed and this very blog pointed out, a combination of pay and burn-out are encouraging …

A doctor in Cuba becomes a nurse in the United States

Kevin

August 20, 2009Aug 20, 200914

When physicians in other countries come to the United States, they often become nurses or lab technicians, rather than re-taking rigorous board exams to remain doctors. One example includes doctors from Cuba. According to this story in The New York…

When physicians in other countries come to the United States, they often become nurses or lab technicians, rather than re-taking rigorous board exams to remain doctors.

One example includes doctors from Cuba. According to this story in The New York Times, “6,000 medical professionals, many of them physicians, have left Cuba in the last six years.” Cuban doctors, who often earn $25 per month, find it significantly more …

The consequences of doing everything in end-of-life-care

Marya Zilberberg, MD, MPH

August 19, 2009Aug 19, 200930

Fear-mongering about health care reform killing grandma really burns me: I have delivered "everything", I know what "everything" looks like. I know its dark side. I also know that these deliberate and self-serving lies will ultimately hurt not only grandma,…

Fear-mongering about health care reform killing grandma really burns me: I have delivered “everything”, I know what “everything” looks like. I know its dark side. I also know that these deliberate and self-serving lies will ultimately hurt not only grandma, but the rest of us too. Here is what I mean.

When I was in practice I cared for critically ill patients. I loved the ICU for its complex physiology and …

How to fix the primary care shortage

John Horstkamp, MD

August 17, 2009Aug 17, 200943

The primary care physician (PCP) shortage has attracted a lot of attention recently, and for good reason. Individual Americans are concerned that they will not have timely access to needed medical care, and policy makers are concerned that our specialist-heavy medical system is failing, giving us expensive but disjointed, poor quality care. Many experts rightly think that a robust primary care system would give us better health care for …

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How to fix the primary care shortage

Robert Ricketson and the surgical screwdriver medical malpractice case: The medical records revisited

Kevin

August 11, 2009Aug 11, 200955

Robert Ricketson is a spine surgeon who was involved in a high profile 2003 medical malpractice case in Hawaii where a surgical screwdriver was implanted into a patient's back. This is his account of the ordeal. by Robert Ricketson I…

Robert Ricketson is a spine surgeon who was involved in a high profile 2003 medical malpractice case in Hawaii where a surgical screwdriver was implanted into a patient’s back. This is his account of the ordeal.

by Robert Ricketson

I am writing today out of frustration and anger, as I am frankly quite tired of passively going along as my name appears year after year in malicious “medical blogs” and …

Will the lack of primary care doctors make universal coverage useless?

Kevin Pho, MD

July 23, 2009Jul 23, 200923

It appears that one source of agreement among health reformers is that there isn't enough primary care doctors. The New York Times wrote a front-page piece on this issue last month, which I had commented on. Now, an article in…

It appears that one source of agreement among health reformers is that there isn’t enough primary care doctors.

The New York Times wrote a front-page piece on this issue last month, which I had commented on. Now, an article in the Washington Post re-iterates the same theme:

As the debate on overhauling the nation’s health-care system exploded into partisan squabbling this week, virtually everyone still agreed on one point: There are

…

Op-ed: Doctors are forced into running a business

Kevin Pho, MD

July 3, 2009Jul 3, 200920

A version of this op-ed was published on June 18th, 2009 in The New York Times' Room for Debate blog. In his recent address to the American Medical Association, President Obama noted that our health care system "rewards the quantity…

A version of this op-ed was published on June 18th, 2009 in The New York Times’ Room for Debate blog.

In his recent address to the American Medical Association, President Obama noted that our health care system “rewards the quantity of care rather than the quality of care.” This perverse incentive leads to unnecessary and potentially harmful medicine, while also being a major contributor to spiraling health care costs.

Doctors …

ACP: A practice model for increasing the appeal of General Internal Medicine

American College of Physicians

June 1, 2009Jun 1, 20099

The following is the first in a series of original guest columns by the American College of Physicians. by Steven Weinberger, MD, FACP Much is written and discussed these days about the importance of care coordination by a primary care…

The following is the first in a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

Much is written and discussed these days about the importance of care coordination by a primary care physician, not only to facilitate patient-centered quality of care, but also to curb the unsustainable growth in the nation’s health care tab. Yet, we hear that the current shortage of …

Physician voices

Articles, page 608

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