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.

The National Consortium of Breast Centers (NCBC) response to the USPSTF breast cancer screening recommendations

Conditions and Diseases
January 26, 2010

I’ve been given permission to deliver the National Consortium of Breast Centers (NCBC) position statement. It does a far better job with a critique of the USPSTF Screening recommendations than I did when I shared my first thoughts. As the President for the NCBC, I want to acknowledge the work done on behalf of our organization by our Policy Chairpersons, Drs. John Bell and Barbara Rabinowitz, both of whom are …

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The National Consortium of Breast Centers (NCBC) response to the USPSTF breast cancer screening recommendations

Extended military deployments to combat areas increase stress, anxiety and depression among families

Conditions and Diseases
January 26, 2010

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

The longer that U.S. Army soldiers spent in Iraq and Afghanistan, the greater the likelihood that their wives would seek psychiatric treatment, researchers said.

The risk that a woman would receive a new mental illness diagnosis during her husband’s deployment was significantly higher when he was overseas for a year …

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Extended military deployments to combat areas increase stress, anxiety and depression among families

10 cost effective preventive medicine services

Conditions and Diseases
January 25, 2010

Here are the top 10 preventive services. These items were chosen by the National Commission on Prevention Priorities, and highlight those preventive services including immunizations, screenings, preventive medications, and counseling that give “the most bang for the buck.”

For an in depth discussion of methods and results, read Am J Prev Med 2006;31(1):52–61

Discuss Daily Aspirin Use

This counseling does not mean everyone should take aspirin to prevent heart attack and stroke, but …

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10 cost effective preventive medicine services

Talking to a patient, without a translator, in mutual non-native languages

Patient
January 22, 2010

“Je m’a…,” I stuttered to Aristede Mezondes, the serious young man in a grey wool overcoat, standing before me with ramrod posture. “Je m’appelle Dr. Ofri.”

There. I’d gotten it out.

The language of Descartes, Voltaire, and Balzac had clearly vacated my cortex. Despite those years of French classes and one brief visit to Paris, “Je m’appelle” was the best I could come up with. And even that was a struggle. Pushed …

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Talking to a patient, without a translator, in mutual non-native languages

Teaching doctors the art of negotiation

Physician
January 22, 2010

Originally posted in HCPLive.com

by Jeff Brown, MD

When I am in a civilian situation and someone asks me what I do, if I am feeling whimsical, I sometimes answer “I’m in sales.”

Think about it – almost all of our professional interchanges can be seen as: 1) trying to talk someone out of doing something, like smoking, or 2) trying to talk someone into something, like exercising. Using a broader brush, you …

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Teaching doctors the art of negotiation

Primary care needs a face lift, and a better agent

Physician
January 21, 2010

General medicine is not sexy. Less than a fourth of the doctors in the United States are currently primary care providers like Pediatricians, Ob/Gyns, and Internists. According to a recent study published by the Journal of the American Medical Association, only 2% of medical students intend on pursuing a career in general internal medicine. So when health-care reform becomes a reality, and the 46 million uninsured men, women, and children …

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Primary care needs a face lift, and a better agent

Primary care doctors should discuss organ donation with patients

Conditions and Diseases
January 21, 2010

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Primary care physicians rarely discuss organ donation with patients, even though most of the doctors believe organ donation is within the scope of their practice, a survey of primary care physicians showed.

Fewer than 4% of physicians said they discussed organ donation with patients, compared with 30% who discussed end-of-life issues. …

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Primary care doctors should discuss organ donation with patients

How to prevent diabetes with diet and exercise

Conditions and Diseases
January 20, 2010

By all accounts, Frances Vasquez ought to be a diabetic. Raised on a diet of fried steak, fried pork chops and lots of rice, her father, mother, and two sisters suffered from the disease. At age 47, Frances was overweight and already experiencing high blood sugar.

But over the past 11 years, Frances has been able to avoid diabetes, and her sugars are now normal. By participating in a ground-breaking, government-funded …

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How to prevent diabetes with diet and exercise

Why scaring patients to quit smoking may not be effective

Physician
January 20, 2010

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Telling people about the benefits of quitting is more likely to help smokers break the habit than scaring them with the dangers of continuing, researchers found.

Callers to a tobacco quitline were nearly twice as likely to stop in the short term when they got positive messages rather than …

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Why scaring patients to quit smoking may not be effective

Did Martha Coakley kill health reform, and what Senator Scott Brown means for healthcare

Health Policy
January 20, 2010

In case you haven’t heard, in a stunning result in yesterday’s special election in Massachusetts, Republican Scott Brown won the Senate seat previously occupied by the late Edward Kennedy.

Needless to say, pundits are going crazy analyzing the results, and its implications on health reform. I’ll leave the political commentary to them, but I’ll comment on what this means for health reform’s future.

In essence, what turned into a 95% likelihood …

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Did Martha Coakley kill health reform, and what Senator Scott Brown means for healthcare

Tips for doctors who negotiate reimbursement rates with insurance companies

Physician
January 19, 2010

Originally published in HCPLive.com

by Ed Rabinowitz

When it comes to negotiating fees with health plans, practices and physicians have more leverage than they realize. The problem, says John Schmitt, a managed care expert with EthosPartners Healthcare Management Group, is that practices often don’t even try. “Groups negotiate an agreement with a payor and then, for whatever reason, just file it away. Most medical groups do not have a good, proactive methodology …

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Tips for doctors who negotiate reimbursement rates with insurance companies

Good doctors sometimes may make patients unhappy

Physician
January 18, 2010

Most of us went into medicine because, in addition to being good students, we wanted to help people. How many oceans of ink and forests of paper have been used explaining that point to admissions committees we’ll never know. Suffice it to say, it felt very good when our professors wrote us glowing letters of recommendation. Of course, we were also saying, “I want to feel good about helping people. …

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Good doctors sometimes may make patients unhappy

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How a doctor’s office can affect patient trust

Patient
January 17, 2010

Originally published in MedPage Today

by Marianne Mattera

Trust is an essential element in the doctor-patient relationship.

You’re well aware of how important it is that you can trust the history the patient gives you. You know the problems that can arise in planning and managing care if you’re working with only part of the story. And you probably even feel a twinge …

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How a doctor’s office can affect patient trust

We are becoming a nation of people with multiple chronic diseases

Patient
January 15, 2010

by Monte Ladner, MD

Many Americans are resolving that this will be the year they finally lose weight. Sadly, most of them will reach the end of 2010 heavier than when they started. We continue losing the weight loss game because our efforts are misplaced. The issue is lifestyle.

Dr. Dana King of the Medical University of South Carolina recently published two papers on the erosion of American lifestyle …

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We are becoming a nation of people with multiple chronic diseases

What doctors should expect with health care reform

Health Policy
January 14, 2010

What should health care providers be doing in anticipation of the likely passage of an historic health reform bill?

There are at least three possibilities: (1) Lament the passing of the good old days and oppose it; (2) Insist that it isn’t good enough because it is lacking some key provision (tort reform; SGR replacement; robust public option); or (3) Embrace it, because incrementalism works, and prepare for what’s coming down …

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What doctors should expect with health care reform

Balancing the risks and benefits of cancer screening is an individual decision

Conditions and Diseases
January 13, 2010

by Abraham Verghese, MD

I can’t get over the incredible images generated by our latest CT scans and MRI’s. The details of organ anatomy and the 3D reconstructions they can do are just amazing. One side effect of getting such fine resolution, is that more and more we are stumbling onto abnormalities that we were not necessarily looking for–incidentalomas, we call them.

Sometimes the discovery is fortuitous and lifesaving. But often …

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Balancing the risks and benefits of cancer screening is an individual decision

Why physician practices find it difficult to upgrade their computers to Windows 7

Health Technology
January 13, 2010

Originally published in HCPLive.com

by Jonathan Bertman, MD

I recently talked about Microsoft’s newest desktop operating system, Windows 7, and outlined several reasons why you might want to purchase it when it comes out this year. Windows 7 will include some really cool features—like multi-touch technology and usability improvements—that can benefit medical practitioners and their office staff.

Because it is in Microsoft’s best interest …

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Why physician practices find it difficult to upgrade their computers to Windows 7

Why I had to fire my primary care doctor

Physician
January 12, 2010

I like my PCP. She is knowledgeable, kind, efficient, and trusts that I know my body best. All great qualities in a doctor.

But I need to fire her and find someone new. Why? Her support staff and their administrative systems don’t work for me. They make it difficult for me to access timely care and I dislike that very much.

Some background: I rarely visit the doctor. Overall, I’m healthy and …

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Why I had to fire my primary care doctor

How sleeping late can lead to depression in teenagers

Conditions and Diseases
January 12, 2010

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Later parent-set bedtimes and correspondingly shorter sleep durations appear to be related to the development of depression in adolescents, a cross-sectional analysis showed.

In addition to depression, adolescents with later bedtimes also had a greater risk of having suicidal thoughts, James Gangwisch, PhD, of Columbia University in New York City, and …

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How sleeping late can lead to depression in teenagers

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