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How a letter of intent can help with physician recruitment

Bo Claypool

Physician

November 9, 2013

As someone who has recruited a very large number of physicians over the years, I am quite sold on the benefit of a “letter of intent” or “LOI” as a tool for physician recruitment.

While physicians are highly familiar with medical/surgical concepts and while many are in no way intimidated by dissection within the human body, many to most are not qualified or really desirous of dissecting a complex legal document …

How to respond to a Medicare audit: 17 tips from a lawyer

George F. Indest III, JD

Policy

November 9, 2013

Although you may speak of a “routine” Medicare audit, there is really no such creature. This is like saying you have a “routine IRS audit.” The fact is that there is some item you have claimed as a Medicare provider or the amount of claims Medicare has paid in a certain category that has caused you or your practice to be audited.

Having too many claims for level five CPT codes …

What happens to us when we lie about dying?

James C. Salwitz, MD

Physician

November 8, 2013

It is in our nature to lie. Falsehood is one of the most creative things we do and the most remarkable of the human arts. We construct castles from ether and support their ephemeral walls on a foundation of accepted truths, which themselves are wisps of previous lies. The more we live within lies, the greater the challenge and more the harm. We pay a heavy price for fabrication. What happens …

How can we reduce friction in the hospital?

Leslie Kernisan, MD, MPH

Physician

November 7, 2013

Why aren’t people in hospitals more attentive to the needs of patients?

In a post, Dr. Ashish Jha raises this issue as he relates his own story of coming to an ED with a very painful dislocated shoulder. Unsurprisingly, prompt treatment of his pain was deferred while staff diligently completed registration, sent him for an x-ray, and waited for a physician to see him.

On the bike path where Jha …

Who’s in control? Why both doctors and patients are frustrated

Shirie Leng, MD

Physician

November 6, 2013

I hate being told what to do. I will scratch and claw when ordered around. It takes a conscious act of will to smile and say, “sure, I’ll get going on that right now.”

This is a problem since, as an anesthesiologist, I get told what to do all the time. My kids order me around all the time. When I was a nurse I used to bristle at the term …

Solving the weekend effect for patients in the hospital

Robert Pearl, MD

Physician

November 6, 2013

If you knew you were going to be admitted to the hospital for a serious and unexpected medical problem, which day of the week would you pick?

It sounds like a silly question. You don’t get to pick the day you will become sick, of course. It’s unexpected. And why should it make a difference? Isn’t a hospital with a 24 hour nursing staff and on call physicians the safest place …

JAMA removes cover art, and why that matters

Jeffrey M. Levine, MD

Physician

November 6, 2013

JAMA_beforeafter1a

Beginning in 1964 the Journal of the American Medical Association (JAMA) started publishing full color images of art on its cover accompanied by insightful essays. JAMA’s former editor, George Lundberg, wrote that this was part of an initiative to inform readers about nonclinical aspects of medicine and public health, and emphasize the humanities in medicine. Now after almost 50 years of covers …

Should smokers pay higher health insurance premiums?

Carol Duh-Leong

Policy

November 4, 2013

While the Affordable Care Act ends the era of denying people with pre-existing conditions access to health care, it allows insurance companies to charge tobacco users up to 50% more for their monthly premiums. Tobacco use for this purpose is defined as any self-reported tobacco use four or more times a week within the past six months. There are excellent intentions behind this policy — smoking is the number one …

What does it mean to be a medical intern?

Brian J. Secemsky, MD

Education

November 3, 2013

Since the beginning of it all, since that exact moment where I shot up from my friend’s dorm room cot with a revelation to pursue my ancestral calling in medicine, I have been continually questioned by family and friends on exactly where I sit in the totem pole of physicianhood. And I get it. With terms like sub-intern, intern, senior resident and attending, it must be confusing …

A physician expert witness speaks out

Anonymous

Physician

November 2, 2013

I have been actively engaged in the clinical practice of radiation oncology for the last 40 years, and over the last 10 years have been asked to participate as a radiation oncology expert witness in a variety of medical malpractice cases. Radiation therapy, together with surgery and chemotherapy, is one of the major cancer treatment methods. It is estimated that 50-60% of all cancer patients seen in the USA receive treatment with …

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A physician expert witness speaks out

Why insurance is the wrong model for health care

Paul Laband, MD

Policy

November 2, 2013

Insurance, in its traditional form, is the wrong model for health care financing. It is the wrong commodity to be bought and sold. We don’t need health insurance, and I will tell you why. I will also tell you what we do need.

Insurance is something you buy, and then hope you never have to use. It is a hedging of your bets against bad outcomes. Term life insurance is the …

The remarkable resiliency of the human body

David Gelber, MD

Conditions

November 1, 2013

Kerry was only 28-years-old. He showed up in the ER one night complaining of upper abdominal pain which started suddenly that day. The emergency physician did the usual workup and found two things which led to an urgent call: a large intrabdominal mass and free intraperitoneal air.

The large mass was not necessarily an emergency, but free air, that is, air outside its usual place inside the bowel, almost always represents …

An argument against physician-assisted suicide

James C. Salwitz, MD

Physician

October 31, 2013

New Jersey is considering following four other states in legalizing physician-assisted suicide. The Death with Dignity Act would allow people with less than six months to live to receive a prescription for a fatal cocktail and then to commit suicide at the time of their choosing in the privacy of home. Recently, I had the opportunity to participate in a debate on the merits of the proposed law. While I oppose this …

Why I recommend LinkedIn to physicians

Kevin Pho, MD

KevinMD

October 31, 2013

linked in for doctors

When I talk to physicians about dipping their toes into the social media waters, I advise starting with LinkedIn. Spend about 45 minutes or so and create a LinkedIn profile, which is essentially a digital translation of your CV. LinkedIn profiles get ranked highest among the social media platforms, and can push down the influence of …

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Why I recommend LinkedIn to physicians

What we can learn about weight loss from Al Sharpton

John Mandrola, MD

Conditions

October 30, 2013

rev-sharpton

However you see the Reverend Al Sharpton, one thing is certain: you see less of him now. His Twitter pic tells you he is proud of his 167-pound weight loss. Good for him, he should be.

If you care about health, the disappearance of the Sharpton-of-old is worth mention. His story teaches us a lot, and, if one dares to look a little …

Food deserts are incredibly complex problems

Birju Rao

Policy

October 27, 2013

Recently, food has become the center of a revival of interest in cultures that make up Chicago.

The smells, tastes, sounds, and even atmospheres created by cuisine allow both tourists and native Chicagoans to sample our city’s diverse cultural heritage. As such, food has become an increasingly popular and a relatively inexpensive way to enjoy what Chicago has to offer. In fact, one …

When do medical students lose their empathy?

Dr. Sonia Henry

Education

October 26, 2013

It’s common knowledge among third year medical students that statistically a lot of us are mentally damaged in some way. Knowing these stats makes us feel better about our ongoing feelings of low self esteem, high anxiety and sometimes outright panic. In the car on the way to rotations, regular starters of conversation are statements like, “Did you know 35% of med students are depressed at any given time?”, to …

Self-preservation: Why I abandoned clinical practice

Diane W. Shannon, MD, MPH

Physician

October 25, 2013

When I introduce myself as a physician who left clinical practice, non-physicians ask me why I left. They’re generally intrigued that someone who sacrificed many years and many dollars for medical training would then change her mind. But physicians, almost universally, never ask me why I left. Instead, they ask me how. They call and email me with logistical questions, wanting to learn the secret of how I managed the …

Obamacare covers screening colonoscopies, with a catch

Stephen C. Schimpff, MD

Conditions

October 25, 2013

“An ounce of prevention” we all know is good medicine. An example is colonoscopy. It was time for mine so after some lengthy procrastination I called and set up an appointment which I soon found a perfectly good reason to postpone for a few weeks. A common occurrence. The government wants me (and you) to not procrastinate, at least not because of the cost. The Affordable Care Act (or Obamacare) …

David and Goliath lessons for doctors and our health system

Davis Liu, MD

Physician

October 24, 2013

October 1st was a special day. The Affordable Care Act (ACA) also commonly known as Obamacare became official. The federal government shut down because Republicans and Democrats disagreed around Obamacare funding. Most importantly, October 1st was when I could finally read Malcolm Gladwell’s new book David and Goliath.

Gladwell ponders why do underdogs succeed when we least expect them to? Is it possible that advantages a Goliath has can be a disadvantage? …