Physicians are human, like everyone else.
And when things go wrong, like making a medical error or having a patient die, they suffer like most people would.
Pauline Chen writes about Schwartz Rounds in the New York Times, where, in a confidential environment, doctors and other health professionals can discuss challenging cases.
As Dr. Chen writes, “the discussions that ensue are …
Patients should care about physician stress and burnout
One of my patients thanked me for saving his life. Apparently, many years ago I had told him that most men’s first complete physical is in the emergency room in the midst of their heart attack or stroke. I have been in practice long enough to have forgotten many of the things I have told patients. I try to capture the pearls I have learned over the last 30 …
Using the emergency room for routine physicals
One of the main considerations in physician pay under CMS’ relative value system is the training required to complete a task. This is generally thought to be well understood but is, in fact. a quagmire of controversy.
Take for example the specialty of family medicine compared with dermatology, anesthesiology, or ophthalmology. Family physicians make between 1/2 and 1/3 of what these other specialties make, so one would think that there …
Does longer physician training merit more pay?
You’ve had the sex talk, the smoking talk, and the drugs and drinking talk. But have you talked to your kids about tanning beds?
You should. Tanning bed use can cause skin cancer, including the deadliest form, melanoma. And, using tanning beds before age 30 increases a person’s risk of melanoma by 75%.
Equally worrisome: tanning beds can become addictive. A recent study showed that 80% of college-age tanning beds users couldn’t kick the habit.
This …
How to talk to teens about tanning beds
A recent study from Health Affairs took aim at physician salaries.
Well, not exactly their salaries, but fees. It’s a subtle difference, but that nuance is lost in the mainstream media narrative.
According to the study, “American primary care and orthopedic physicians are paid more for each service than are their counterparts in Australia, Canada, France, Germany and the United Kingdom.”
Thankfully …
Targeting physician salaries is a poor strategy for health care costs
A guest column by the American College of Physicians, exclusive to KevinMD.com.
In April 2011 I finished seven years on the Board of Regents of the American College of Physicians (ACP) including two years as Chair of the ACP Health and Public Policy Committee and serving during the last year as President. During that time I had the opportunity to …
ACP: Current and future payment and practice trends in medicine
The Annals of Internal Medicine occasionally reviews the articles and studies of note in a particular field of internal medicine for those of us who don’t read all of the specialty journals. Recently, there was an update in pulmonary and critical care medicine, the internal medicine specialty that is most intimately involved with caring for the very ill and those people who are at the ends of their lives. …
The problem of inadequate discussions of end of life wishes
Today was a rough day at work. My schedule of 10 patients for the afternoon rapidly ballooned into 17. People were sick and miserable. Those who were healthy were frustrated by the long wait. I heard myself apologizing over and over to each family.
The day was mostly a chaotic blur. Babies crying, phones ringing, parents reprimanding children on the brink of a meltdown. I don’t remember much of it, except …
Children who curse, and the power of words
The elderly population can be fun to take care of (they have more stories than you have time to hear), or they can be a handful in regards to all of their chronic complaints and numerous medications. But then, there are those senior citizens that come into clinic and tell us, “I don’t need to take medications, I haven’t taken medications my whole life, and look at where it’s …
How elderly patients can be stubborn to their own detriment
As a physician recruiter of prominence, a number of times during any given week I get a fair number of calls from physicians in training who, honestly, should not be calling me whatsoever and I am very frank in telling them this. The call normally starts something like this:
“Hi Bo, my name is Dr. Doe. I am finishing up my dermatology residency and I want to be there in …
When not to use a physician recruiter
I read an interesting article by Jason Luban, a licensed acupuncturist, on why so many patients flock to alternative practitioners. Mr. Luban brought up an interesting question, “What is health?”
Is health simply the absence of disease? If it is, there certainly aren’t very many healthy patients in my neck of the woods. Most of the patients I take care of have something that’s not quite right. I only know one perfect …
Parents often wonder when is the appropriate time to introduce solid foods to their infant’s diet. It seems like a simple question. So simple that the American Academy of Pediatrics (AAP) cannot agree on the answer. The AAP Committee on Breastfeeding recommends starting complementary foods (rice cereal and baby foods) after six months of age and the Committee on Nutrition recommends the introduction of complementary foods between four to six …
When is the right time to introduce solid foods to an infant’s diet?
If the media and Internet are to be believed (and these days, really, what is the difference?), the act of parenting has become a full-scale cultural war. How to raise your kids. On what to raise your kids. How your kids sleep, eat, play, and practice “Little White Donkey” on the piano–nowadays, these are all grist for the mill.
But if modern parenting feels like a war, its bloodiest battlefield surely …
When people decide not to vaccinate their children, I take it personally
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Most of us who write about health believe that knowledge can make a difference. But is the primary health issue facing us today a lack of knowledge? Or is it, instead, something I’d call the tenth-patient-of-the-day challenge?
Here’s what I mean: You pick up a chart and head to Exam Room B, reading as you speed-walk. Your patient’s blood sugar is running high again, she didn’t show at the smoking cessation …
10 ways to make a difference in the lives of your patients
The airlines, in an effort to recoup revenue, started charging passengers to check luggage a while back. Seems like a great strategy. Not only are they recuperating revenue, they are giving passengers a reason not to bring luggage they don’t need. This of course saves money on fuel.
The result? More bags in the main cabin.
Since there is an incentive not to check a bag, more people bring their bags as …
Medical practice unintended consequences
I’m in Israel, home to some of the most innovative care in the world. Doctors here wanted to know if the high-tech tests that are an increasing part of their work help. A couple of weeks ago, they published their results.
It turns out that in about 90% of cases, it didn’t matter.
A physical exam, the patient’s history, and the basic set of tests that doctors have done for decades …
The CSI effect and high tech medicine are driving up tests
All day I badger and cajole my patients to take better care of their bodies:
“We really need to get some of this weight off, Mr. Jones.”
“This blood sugar level means diabetes is right around the corner – it’s time to get serious about changing your diet, Ms. Smith.”
“This blood pressure reading tells me that you’re not getting enough exercise, Bill.”
I’ve got pills for everything, it seems. I just wish I …
How diet and exercise beat high blood pressure
Most women in their 40′s believe they should have annual mammograms, regardless of what screening regimen their doctor might recommend.
So say researchers in Massachusetts who surveyed women (primarily white, highly educated) ages 39-49 presenting for annual checkups. They gave the women a fact sheet about the new USPSTF guidelines on mammogram screening in their age group, and asked them to read one of two articles either supporting or Read more…
An informed screening choice for breast cancer
The federal health reform bill included a little-noticed clause allowing for Direct Primary Care (DPC) models to be a part of the state health exchanges. I believe this will fundamentally alter the health insurance market and is leading to what I call a “Do it Yourself Health Reform” movement. That little-noticed clause (item #3 in 1301(a) of HR 3590) should have the effect of massively …
Overcoming barriers to building a direct primary care practice
“Doc, it’s only $10. I can’t believe you’re throwing me out of the practice for a measly $10. You, docs, are all the same. It’s all about the money!”
Unfortunately, the money is important. It costs money to keep a practice running. It costs money just to collect the money owed to the practice.
So, let’s look at some simple facts. Your physician’s office is one of the few places where you …
Money keeps a physician practice running
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