Primary Care

Physicians writing on KevinMD about the primary care shortage, the fifteen-minute visit, panel size, what primary care is paid against procedural specialties, continuity, and the administrative load that has grown around the work. Four maintained records draw on this archive: Primary care: what physicians say, in their own words, Direct primary care: what physicians say, in their own words, Prior authorization: what physicians say, in their own words, and Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words.

We’re smart doctors. But why aren’t we so smart about our health?

Jenny Hartsock, MD

Physician

July 9, 2017

As doctors, we are good at lots of things — we are smart, efficient, hard-working, proficient, role models and leaders. Then why do so many of us place our own health and well-being after our jobs?

As a physician, my most prevalent discussions with patients always boil down to very simple recommendations: eat right, exercise, sleep and manage your stress. Lifestyle changes are really the key to solving many of the …

Is the medical profession at its end?

James C. Salwitz, MD

Physician

July 8, 2017

At the graveside, they still talk about judgment, intelligence, and the wisdom that is the practice of medicine.

Deans and health care leaders wax poetic as they tell stories of great cures to lift in memoriam remarkable healers. Yet, though we bow to Hippocrates, Osler, and Salk, the time has come to mark a revolution in human history: The art of medicine is dead.

It is not that doctors have fallen from …

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Is the medical profession at its end?

Communication in health care should be better than it is

Fred N. Pelzman, MD

Physician

July 4, 2017

A few days ago, just after dawn, while I was out walking the dog, our home phone rang and my wife answered it.

She’s used to my pager, cell phone, and home phone ringing at all hours, and so she was not all that surprised when an unidentified voice said,”We’re looking for the methadone dose for patient John Q. Smith.”

She told him I was out of the house at the moment, …

Laying the foundation for a lifetime of eye health

Andrea P. Thau, OD

Physician

July 4, 2017

After life itself, it is said that God’s great gift is vision. 80 percent of what we learn is through vision. Babies are not born with perfect vision. They develop vision over time. A child who never developed good vision does not know what normal vision is — he or she assumes that however they see is normal. There is nothing like the overwhelming emotion I have each time I …

A wealth of medical knowledge in a country that lacks resources

Yul Ejnes, MD

Physician

July 3, 2017

A guest column by the American College of Physicians, exclusive to KevinMD.com.

For many years, I’ve wanted to visit Cuba. When travel restrictions to Cuba were relaxed a few years ago, I hoped that I would get there before the first Burger King opened in Havana. I had my chance in May, as a member …

The 3 phases of a physician’s career transition

Neil Baum, MD, Joel M. Blau, CFP, Peter Moskowitz, MD, and Ron Paprocki, CFP, JD

Physician

July 3, 2017

An excerpt from The Three Stages of a Physician’s Career: Navigating from Training to Beyond Retirement.

The practical aspects of making a medical career transition can be divided into three phases or stages: waking up, taking stock, and taking the leap of faith. Note that this process is the same whether the physician is anticipating a transition out of full-time practice, planning a transition …

A warning to women doctors: You are more at risk for burnout

Maiysha Clairborne, MD

Physician

July 2, 2017

Physician burnout has become the new “buzzword” in the medical industry that is the catalyst for ongoing research and the implementation of new “pilot projects” in the academic world of medicine. However, the research that is being done, is fairly (and predictably) narrow-minded when it comes to teasing out who really is at highest risk for these burnout, depression and even physician suicide.

The research indicates that there are several risk …

Doctors and patients want the same thing in health care

Robert Pearl, MD

Physician

June 29, 2017

The “doctor-patient” relationship is tightly woven into the culture and history of medicine. But that special bond is under enormous pressure today. And to keep it from fraying, we need periodically to examine the fabric. Last month, the Council of Accountable Physician Practices (CAPP), representing 28 of the nation’s largest and best medical groups in the U.S., did just that.

Annually, CAPP sponsors a meeting in Washington D.C. where it invites …

A more careful examination would have saved her expensive procedure

Hans Duvefelt, MD

Conditions and Diseases

June 28, 2017

“Noncardiac chest pain” was Laurie Black’s discharge diagnosis. Her chest CT angiogram didn’t show a pulmonary embolus, her troponins were negative for a heart attack and her nuclear stress test was negative for coronary ischemia.

“So what do you think it was?” she asked while I read through her hospital discharge summary.

“I don’t know. Show me where the pain was,” I answered.

“It started on my back, on the left side, and …

11 ways to be an doctor and still live your travel dreams

Sightsee, MD

Physician

June 27, 2017

So, you’re a physician with a love of travel — awesome! One week of your salary allows you to travel anywhere in the world (coach, at least) — double awesome! But, as you are acutely aware, there is a catch … a big one. As a full time doc, how do you possibly get the time off to explore new cultures, hike/bike amazing trails and eat/drink around the globe?

As physicians …

Pay off your medical school loans for free? Here’s how.

Robert A. Felberg, MD

Physician

June 27, 2017

We are all panicked over student loan debt. The size of the loan can be worrisome — sometimes overwhelming. The average medical student debt is over $160,000, and it’s not unusual to owe $300,000 to $450,000! The compounded interest is growing every day and adding to your anxiety. Most early career physicians state the stress related to paying off these loans is their greatest emotional burden. Think about that — …

How to respond to physician burnout in a colleague

Gail Gazelle, MD

Physician

June 25, 2017

Two hours of administrative tasks for every hour with patients. A proliferation of non-physician administrators deciding how the day is going to run. Little in our training about how to cope with uncertainty and change. It’s no surprise that burnout rates are approaching 60 percent. Despite being so common, when we see a colleague struggling with physician burnout, we may not know what to say. Responding appropriately can bring someone …

Doctors should fight fake health news at the checkout aisle

Benjamin Mazer, MD, MBA

Physician

June 24, 2017

I see them every time I wait in the inescapably long lines at the grocery store. They’re offering me so much. Fat-melting foods that “work like gastric bypass.” Sleep masks that prevent breast cancer. One day diets. And, of course, the perennial “medical miracles.” All these revelations can be mine with a simple magazine purchase.

It’s easy to dismiss the medical advice being propagated through the supermarket checkout aisle. Who would …

Doctors and cops can fight mistrust the same way

Nonye Aghanya, FNP-C

Physician

June 22, 2017

I read an article by Dr. Jarret Patton that reminded us that “Cops and doctors have the same problem: People don’t trust them.”

I remember thinking to myself that I had to do something to help clarify the source of this age-old problem and also to help improve the situation. It is important for us to remember that our past life experiences, diverse cultures, goals and …

Open up. Doctors need more transparency.

Stephanie Cudjoe, MD

Physician

June 22, 2017

“Transparency” is the name of the game in the 21st century. Transparency is now required in any service-oriented profession, whether plumbing, law or real estate. Now, transparency has made its way into the field of medicine. I say this because medicine has historically been an opaque profession. Many physicians leveraged the fact that they were put on a pedestal to deliver a paternalistic style of medical care.

With the advent of …

Before my first job, I wish someone had told me a few things

Uchenna O. Njiaju, MD

Physician

June 21, 2017

I remember one sunny day in Chicago, in June 2011, when my husband and I packed up our two young children, aged 2 and 5 months. Professional movers had collected our belongings and had driven off a day prior. We were headed out of state, to my first job at an academic hospital. It had been a rather hectic few months for me, having just had a baby 5 months …

Is direct primary care doomed to fail?

Niran S. Al-Agba, MD

Physician

June 19, 2017

A recent Medical Economics article asked “Is the DPC model at risk of failing?”

The piece focuses on two large DPC-like organizations, Qliance Medical Management of Seattle, Washington and Turntable Health of Las Vegas, NV, working in partnership with Iora Health, which recently closed their doors. Qliance and Turntable were not actually DPC practices by strict definition; they were innovative large business operations providing health care services to patients and excluding …

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Is direct primary care doomed to fail?

Being a doctor makes me a better father. Being a father makes me a better doctor.

Cedrek L. McFadden, MD

Physician

June 18, 2017

I take my 10-year-old son to school as many school days as possible. We recap events from the prior day, and I give him early morning pep talks. It is a rarity, however, that I pick him up from school. During one of those rare occasions, he got into the car, smiling as he handed me a project he completed in class. It was an assignment in which he was …

The future is hopeful for direct care physicians

Michel Accad, MD

Physician

June 17, 2017

On the surface, the news from America about health care seems rather grim: cost and dissatisfaction keep rising, reforms are stalling, and, for some, even life expectancy may be declining. If that wasn’t bad enough, President Trump issued a tweet on March 25 predicting that “Obamacare will explode.”

For a small but growing number of doctors and patients, however, the future is surprisingly hopeful. The nascent direct care movement is made up …

Science has been hijacked by puritans and needs rescuing by heretics

Dr. Saurabh Jha

Physician

June 17, 2017

In college, I once marched for the plight of Tibetans. Forty of us marched in Hyde Park, London; after an hour, half retreated to the nearest pub to discuss global injustices. Recently, over a million, including five penguins, marched for science. There were no penguins at our march for Tibetans but our goal, though naïve and unrealistic, was clear — we wanted Tibetan independence from Chinese rule. The goals of …

Primary Care

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