Occasionally, you may encounter patients who you no longer wish to treat. Reasons for ending the physician-patient relationship may include chronic non-compliance, rudeness to office staff, or non-payment of bills.
While these patient behaviors can affect the interactive care-giving process, they may also identify patients with a propensity to file a claim against you. To help reduce the risk …
How to discharge a patient from your practice
I recall with fondness many meetings in 1996-98, when the hospitalist field was still in its infancy. We had invented a new medical specialty, and our gatherings were vibrant and purposeful.
We were determined to remake the healthcare system, learn from each other’s triumphs and disasters, and chart a course that would improve the care of hospitalized patients. These were heady …
Specialty hospitalists joining forces with the generalist hospitalists
by Alison Block
It’s one of my earliest memories: I’m wrestling with my brother, and I’m losing, because I’m five and he’s seven, and he’s bigger and stronger than I am. So I bite him, hard.
Instantly I know I’ve crossed some sort of line, and I employ my most primitive defense mechanism, shouting out, “He bit me! Jon bit me!” I feel shame, because I am old …
A recent blog post in Health Affairs proclaimed The End of Internal Medicine As We Know It. What the article is really asking is the future of primary care in the world of health care reform and the creation of Accountable Care Organizations (ACOs).
While doctors should be naturally concerned about change, I don’t completely agree with this …
The future of primary care in Accountable Care Organizations
by Vanessa Hurley
Like many American patients, the American health care delivery system suffers not only from acute crises, but also from a chronic, poorly managed and debilitating disease.
Primary care is in trouble. Not only are primary care physicians (PCPs) fleeing the profession in droves, but fewer and …
Primary care providers are needed to support health reform
At the age of 56, Jules Levin felt pretty invincible, despite being HIV positive. He went to the gym regularly and controlled his disease well by taking his antiretroviral medicines every day.
Then he slipped one day while on vacation and broke his wrist.
He underwent an operation to insert pins in his bones and needed to wear a cast for a month, keep his arm …
Osteoporosis in patients with HIV
The desire to be touched by and connected with others is among our most primal and, until recently, our most untapped qualities.
There have always been powerful signs of it. Those of us who remember exchanging letters with distant friends and family know the palpable anticipation when a letter arrived.
Years ago I visited the senior center at Pan American Hospital in Miami, an institution beloved by the “abuelos” (grandparents), mostly elderly …
Integrating social media into everyday health care
by Graham Walker, MD
In The Hitchhiker’s Guide to the Galaxy, the Babel Fish was a fish you stuck in your ear that allowed you to understand any language spoken to you. We’re not far off.
Google recently released a new version of their (free!) Google Translate app for Android phones, featuring conversation mode, which allows you to have a back and forth …
Using Google Translate in medicine
by Ted Bacharach, MD
The physicians as a group have been accused of many things. We have been blamed for the high cost of medical care, the depersonalization of physicians and the discontinuity of medical care.
If there was any situation in which we have performed exceptionally well but not been realized by the public, it …
How the medical profession advanced women’s rights
by Christina Palmer
It never surprised me when my medical school classmates said they would “never do family medicine.”
I knew exactly how they felt: why would we choose to go into a field where physicians are undervalued, underpaid, buried under administrative paperwork, and where patients do not get the time or attention that they need?
Despite the warnings against it, I am pursuing family medicine as …
Family medicine is the kind of revolution we want to join
A vaccination policy statement released by the American Academy of Pediatrics has already drawn fire from a number of anti-vaccine groups, specifically for its endorsement of vaccination against HPV infection in boys.
First, let’s examine exactly what the AAP added to its guidelines regarding the HPV4 and HPV2 vaccines: “HPV4 may be administered in a 3-dose series …
Myths about the HPV vaccine for boys
An excerpt from Finally Out: Letting Go of Living Straight, A Psychiatrist’s Own Story.
by Loren A. Olson, MD
I once cared for an aging lesbian who began to have memory problems.
She went to a neurologist who said bluntly, “Get your affairs in order. You have Alzheimer’s disease.” My patient was confused, devastated, and depressed. She asked a companion to accompany her on her return visit. This time the neurologist said, …
Isolated gay people and support from the LGBT community
Patient privacy and social media use in health care often go together when reported in mainstream media.
When physician blogs were a relatively new phenomenon several years ago, the majority of the media coverage focused on edge cases, where doctors inadvertently revealed patient information.
Only a minority of the headlines focused on the positive aspects, such as how …
Doctor reprimanded after patient privacy breached on Facebook, my take
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The new healthcare reform law appears to be using the idea of improved quality to justify the enormous expense of changing the way care is delivered in the United States.
As a justification for the need for change is the reporting currently being touted as a great measure of quality. This information is gathered in many different ways and …
When quality of care becomes customer satisfaction demands
As America comes to grips with the disastrous effects of a national obesity epidemic, there’s a new feeling in the air: defeatism.
Former Carter Administration advisor Amitai Etzioni seemed to succumb to it when he wrote an article entitled “dieting gets you nowhere” for CNN recently.
In it, the liberal sociologist citied a recent nutritional study …
How obesity is a voluntary epidemic, and why we shouldn’t give up
Good primary care physicians are becoming harder and harder to find.
You may not have noticed it yet, but I predict that a year from now we’ll find it almost impossible to find primary care doctors who are willing to take on new patients – at least any primary care doctor worth seeing won’t be …
Smart patients need to establish a relationship with a primary care doctor
I’m often asked how healthcare reform will impact IT planning and implementation over the next few years.
First, some background. The Patient Protection and Affordable Care Act (HR 3590) and Health Care and Education Reconciliation Act (HR 4872) were passed to address several problems with healthcare in the US. We’re spending 17% of our …
Top IT implications of healthcare reform
Recently, 47 American medical specialty societies sent Rep. Jim McDermott (D-WA) a letter, with copies to all members of Congress, containing a detailed defense of the American Medical Association’s (AMA’s) Relative Value Scale Update Committee (RUC).
For 20 years, the RUC has exclusively advised the Centers for Medicare and Medicaid Services (CMS) on physician procedure valuation …
Can the Relative Value Scale Update Committee (RUC) be defended?
When applying to medical school, the American Medical College Application Service (AMCAS) asks aspiring physicians if they would like to be considered “disadvantaged” applicants or not.
Many premedical students find themselves troubled by this question and wonder, what does it mean to be disadvantaged? How does being a disadvantaged applicant affect my medical school application? According to the information American Association of …
Does being a disadvantaged applicant affect my medical school application?
Beth wrote, “I plan on having my daughter vaccinated against HPV when she’s the right age (which is what by the way?). Recently, some friends were saying they were planning to have their sons receive the vaccine as well because although males obviously don’t get cervical cancer, they can spread HPV and put their future partners …
Should the HPV vaccine be given to boys?
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