Meet Elaine.
We lost touch for a while, but caught up with each other recently.
Like most girlfriends, we shared adventures of love, travel, and work. I told Elaine that I left assembly-line medicine. Now I host town hall meetings-inspiring citizens nationwide to design ideal clinics and hospitals.
Elaine shared: “If I’m kept waiting, I bill the doctor. At the twenty-minute mark, I politely tell …
Patients who bill their doctor for being late
Do doctors have any business asking patients about whether or not they own a handgun?
Like many other paternalistic inquiries with which doctors routinely harass their patients (car seats, bicycle helmets, smoke alarms, etc), my answer to this question is “no.’”
There is a fairly well delineated sphere of knowledge which is medical in nature and in which I have some expertise and other topics which are purely personal, moral, or lifestyle considerations and in …
Why HB 155 undermines the trust doctors have with patients
Everyone liked him. Though his later years (the only ones in which I knew him) took away his ability to do most things, and though he was in great pain every day, it was easy to see the mischief in his eyes. The subtle humor was still there, coming out of a man who was weak, in pain, dying.
She lived for him. She was always telling me of his pain, …
Death is inevitable, but it is almost always seen as tragic
The following op-ed was published on June 1st, 2011 in the New York Times’ Room for Debate blog.
Medicare should stop paying for prostate cancer screening in men over the age of 75.
You may be surprised to hear that, especially coming from a primary care doctor. But evidence is mounting that screening for prostate cancer is not only ineffective in older men, but may actually be harmful.
The cornerstone of …
Medicare should stop paying for prostate cancer screening in men over age 75
In an age of family physicians literally not being able to give away their practices, Brian Forrest has built a successful model that is similar to the age of Marcus Welby where there was a direct relationship between a patient and their doctor. Practices such as Forrest’s Access Healthcare in North Carolina run unencumbered by insurance hassles.
As word of Dr. Forrest’s Read more…
How direct primary care reduces primary care costs
After playing around with Google+ today, I’ve come away on a more positive note than my speculative post on Google’s social network recently.
Before experiencing Google+, I asked whether doctors can separate their personal and professional relationships, and how the Google Circles feature would help.
Well, if Google+ ever takes off for physicians, it will be because of Circles.
Tech blogs, …
Google Circles may be why physicians will embrace Google+
To do nothing is sometimes a good remedy.
-Hippocrates
Edna Frost is 88 years old, a slender, slow-talking woman with a dry sense of humor and a blood pressure that’s all over the place. At best, she runs ten points higher than any of her previous doctors wanted to put up with. At worst, she flirts with systolics over 200, but that doesn’t seem to be a common occurrence.
Edna has been my …
Sometimes the treatment is worse than the disease
Imagine using Skype to contact your physician for a consult.
In the midst of this rapidly progressing technologic era, our delivery of medical services is being transformed by health information technology (HIT), electronic medical records (EMR), and advanced telecommunications. In meeting criteria for “meaningful use,” physicians are driven to use these technologies to empower patients with communication through electronic medical records. A primary goal is to allow patients to …
Online physician access is key to future patient communications
It happened 25 years ago and I never forgot it. I’d been in the forefront of women’s consciousness-raising; I recognized that women had been professionally downtrodden for years (in certain fields), and hoping to do my part to balance the inequity, I opted for female doctors whenever possible.
But using gender as sole determinant for my choice of doctor would prove to be a huge mistake … as I’d learn.
At …
Using gender as sole determinant for a choice of doctor
As a recently minted physician, I am often on the receiving end of the gripes and grouses about the medical profession.
Often I get complaints of office visits that are too short, doctors who seem too preoccupied to hear their patients’ complaints, medical bills that are too high and medications that do nothing but cause adverse effects. On the other hand, I can’t count the number of times I have …
Patients are often intimidated and confused by the medical experience
Sometimes, you just can’t win! In medicine, sometimes is way too often. “Doc, do I need that test?” reviewed the issues surrounding screening colonoscopy exams. The dilemma is always the same. Do I order a test or don’t I?
If I order a test, there are consequences. Some are obvious; some are not. Tests cost money and money is in short supply. One consequence of ordering a test …
How ordering tests sometimes have consequences for patients
Your staff members are your most important (and costliest) resource. Have you invested in them? Do they know what is expected of them? Have you asked them if they have what they need to do their jobs?
Optimizing staff performance is a process. It starts with a plan, not the formal performance review.
You can’t do a successful performance evaluation without establishing accurate standards against which the employee’s performance can be …
How to review the performance of your office staff
The government is going to find out about the primary care physician shortage for themselves.
They’re resorting to “mystery shoppers,” used frequently in other industries, to see what the wait times really are for a new primary care doctor. As mentioned before, come 2014, there will be over 30 million newly insured patients looking for a doctor. This will further stress a system short of primary care resources.
Doctors, as …
Should doctors be scared of government mystery shoppers?
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The following op-ed was published on June 7, 2011 in USA Today.
More than ever, I find myself fielding questions from patients about the health care reform law. The most common one is, “How will reform affect me?” It’s a complicated question, with a different answer for each patient. But as the law’s full effects unfold, one of the more significant changes will be in how patients interact with their …
Team based care in health reform needs patient involvement
The physical exam – looking into the eyes and throat, taking the blood pressure, sounding the chest – is part of the process of medical diagnosis. It’s one way a physician attempts to determine the cause of a patient’s complaint.
In recent times, doctors have asked themselves whether the physical exam is becoming a lost art. It’s been replaced by an array of laboratory tests and high tech machines that …
Doctors are asking whether the physical exam is becoming a lost art
As a primary care physician in private practice, I have my own little taste of celebrity.
Every day attractive people come to my office seeking time to speak with me and collect my autograph. They fawn over my partners and I, and bring us food for lunch, and will invite us to the nicest restaurants in town for dinner. These people also used to bring gifts, until they were barred from …
The tragic irony of pharmaceutical coupons
It may not be rabbit season or duck season but it definitely seems to be doctor season.
Physicians are lined up squarely in the gun sights of the media, government agencies and legislators, our health care industry employers and coworkers, not to mention our own dissatisfied patients, all happily acquiring hunting licenses in order to trade off taking aim. It’s not enough any more to wear a bullet proof white coat. …
Reasons why your doctor is running late
One of the major efforts of the Affordable Care Act is to consolidate physician groups, so they can be modeled after integrated health systems like the Minnesota’s Mayo Clinic or California’s Kaiser Permanente.
According to health reformers, these integrated systems can reduce variation in care, which improves quality, and potentially reduces costs.
There’s been a major effort to re-organize hospitals and physicians under guises of Patient Centered Medical Homes and Read more…
Physician consolidation places health reformers in an ironic dilemma
A guest column by the American College of Physicians, exclusive to KevinMD.com.
by John Tooker, MD, MBA, MACP
Recently, I commented on cost saving, quality, and care coordination requirements in the proposed rule that physician practices will likely need to meet to be eligible for additional Medicare payments.
The public comment period on the proposed rule for …
ACP: ACOs – On to the final rule
“Twitter? I don’t have time for that, besides, my life is boring; nobody wants to hear about my boring life.” This is a common response when I talk to people about social media.
One of the reasons I think many have a hard time persuading docs to adopt social media, is because docs don’t understand what they can do with social media or how they can use it for …
Why your medical practice should adopt social media
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