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.

Is medical technology making doctors less relevant?

Conditions and Diseases
September 23, 2009

It happens over and over. I call a surgeon about a patient with abdominal pain.

‘Well, what’s the white count?’

‘Normal.’

‘Did you get a CT Scan?’

‘Yes, and it was normal. But they just look uncomfortable.’

‘Sounds like nothing for me to do. Call the hospitalist.’

It happens in other specialties. Cardiologists who aren’t interested in a patient with a normal stress test, pediatricians unimpressed with negative chest x-rays and normal labs. ENT’s unconcerned if …

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Is medical technology making doctors less relevant?

How long are you contagious after being infected with H1N1 influenza?

Conditions and Diseases
September 16, 2009

by Michael Smith, North American Correspondent, MedPage Today

People infected with the H1N1 pandemic flu strain continue to shed virus after the point where current recommendations say they can go back to work or school, two studies here suggested.

medpage-today The question, experts said, is whether those people are still contagious and whether a longer stay-at-home period would prevent enough additional …

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How long are you contagious after being infected with H1N1 influenza?

Why price transparency won’t affect health care costs

Health Policy
September 15, 2009

by Kumud B. Jindal, MD, MPH

Many patients and self-appointed health care experts view medical services as commodities, and openly express frustration with seemingly opaque pricing for a visit to the doctor’s office. “Doctors should publish their fees so we know what we’re paying!” The idea that this matters significantly with regard to health care costs is a terrible myth, one that deserves much closer scrutiny.

The health insurance industry and …

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Why price transparency won’t affect health care costs

Don’t wait for the H1N1 vaccine before you get your flu shot

Conditions and Diseases
September 15, 2009

by Cole Petrochko, Staff Writer, MedPage Today

Don’t wait for the pandemic H1N1 vaccine to become available before getting an inoculation for seasonal flu, the National Foundation for Infectious Diseases warned.

medpage-today Putting off routine flu shots in hopes of one-stop-shopping would defeat the primary line of defense against a proven threat, according to a panel representing some of the nation’s …

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Don’t wait for the H1N1 vaccine before you get your flu shot

How comfortable are compression stockings for post-surgical thromboprophylaxis?

Patient
September 14, 2009

by Crystal Phend, MedPage Today

“Every 10 years a doctor should be the patient,” said my doctor, squeezing me into pair of compression stockings that would make a sausage casing seem spacious by comparison.

medpage-today “Seems like a good idea,” I thought, as I lay there on the table feeling optimistic about the opportunity for first-hand experience.

It was my first minor …

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How comfortable are compression stockings for post-surgical thromboprophylaxis?

Op-ed: Why the doctor won’t see you now

Health Policy
September 12, 2009

The following op-ed was published on August 20th, 2009 in CNN.com.

When President Obama recently cited the number of Americans without health insurance, he declared that, “We are not a nation that accepts nearly 46 million uninsured men, women, and children.”

Uninsured patients often delay preventive care, waiting to seek medical attention only when their conditions worsen. This leads to more intensive treatment, often in the emergency department or hospital where …

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Op-ed: Why the doctor won’t see you now

Does counseling kids to lose weight and increase exercise work?

Patient
September 9, 2009

by Todd Neale, Staff Writer, MedPage Today

Overweight and obese children who received counseling from a family doctor did not lose more weight or get more exercise than youngsters who did not receive counseling, Melissa Wake, MD, of Royal Children’s Hospital in Melbourne, and colleagues reported online in the British Medical Journal.

medpage-today Because the screening and counseling are so expensive, …

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Does counseling kids to lose weight and increase exercise work?

eRoentgen for the iPhone puts a radiologist by your side

Conditions and Diseases
September 5, 2009

The following is a sponsored guest post by Constantine Brocoum, a radiologist in Concord, NH. I have personally used eRoentgen, and recommend the product without reservation.

by Constantine Brocoum, MD

Like most inventions, eRoentgen was developed to respond to a need. As a practicing radiologist, I take frequent calls from primary care providers who need assistance in choosing the smartest way to diagnose their patients’ illnesses. They often need …

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eRoentgen for the iPhone puts a radiologist by your side

Why following a delayed vaccine schedule may be dangerous

Conditions and Diseases
August 29, 2009

by Steve Perry, MD

I recently read a post by Dr. Bob Sears which listed several “Vaccine Friendly Doctors” in Colorado and across the nation.

As a pediatrician and vaccine advocate, I thought I’d be on this list. I am “vaccine-friendly doctor” who works with moms and dads to find the best health care plan for their babies. I read the information on both sides of the issue and weighed the science …

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Why following a delayed vaccine schedule may be dangerous

Will nurses solve the primary care crisis?

Physician
August 23, 2009

by Derek Mazique

Between “death panels,” a NICE-style cost effective analysis board, and Obama’s slowly graying hair, one conspicuously absent part of reform are reimbursement rates. Medicare and private insurance typically reimburse for expensive procedures, which ultimately rewards procedure-heavy specialists while discourage those cognitive-heavy services like primary care docs.

The result? As a recent Baltimore Sun op-ed and this very blog pointed out, a combination of pay and burn-out are encouraging …

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Will nurses solve the primary care crisis?

Do patients really need their complete lab and radiology reports?

Conditions and Diseases
August 21, 2009

Most prefer the bottom line, sparing them the raw data.

Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.

So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):

lab-valuesRead more…

Do patients really need their complete lab and radiology reports?

A doctor in Cuba becomes a nurse in the United States

Physician
August 20, 2009

When physicians in other countries come to the United States, they often become nurses or lab technicians, rather than re-taking rigorous board exams to remain doctors.

One example includes doctors from Cuba. According to this story in The New York Times, “6,000 medical professionals, many of them physicians, have left Cuba in the last six years.” Cuban doctors, who often earn $25 per month, find it significantly more …

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A doctor in Cuba becomes a nurse in the United States

How to fix the primary care shortage

Physician
August 17, 2009

The primary care physician (PCP) shortage has attracted a lot of attention recently, and for good reason. Individual Americans are concerned that they will not have timely access to needed medical care, and policy makers are concerned that our specialist-heavy medical system is failing, giving us expensive but disjointed, poor quality care. Many experts rightly think that a robust primary care system would give us better health care for …

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How to fix the primary care shortage

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Will the lack of primary care doctors make universal coverage useless?

Physician
July 23, 2009

It appears that one source of agreement among health reformers is that there isn’t enough primary care doctors.

The New York Times wrote a front-page piece on this issue last month, which I had commented on.  Now, an article in the Washington Post re-iterates the same theme:

As the debate on overhauling the nation’s health-care system exploded into partisan squabbling this week, virtually everyone still agreed on one point: There are …

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Will the lack of primary care doctors make universal coverage useless?

Should doctors support Congress’ health reform efforts?

Health Policy
July 20, 2009

The American Medical Association recently gave unqualified support to the House health reform bill, H.R. 3200, and that is drawing the ire of some of their supporters.

To be sure, H.R. 3200 is the most left-leaning of the proposals, and there is clear ideological opposition to the so-called “public plan,” which expands the government’s role in our health care system. It’s a tremendously sensitive topic, with some expressing their outrage …

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Should doctors support Congress’ health reform efforts?

Health Care Reform: Putting Patients First, medical bloggers at Washington, DC

Health Policy
July 20, 2009

Well, that was fun.

kevinmd This past Friday, I participated in Health Care Reform: Putting Patients First, an event put together by Better Health’s Dr. Val Jones. It was an impeccably organized gathering, and provided medical bloggers a valuable opportunity to discuss health care reform. Great timing too, given the fact that two major reform bills were introduced earlier …

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Health Care Reform: Putting Patients First, medical bloggers at Washington, DC

Improve primary care access before guaranteeing universal health coverage, my address at the National Press Club

Health Policy
July 17, 2009

The following are my prepared remarks at Health Care Reform: Putting Patients First, held at the National Press Club in Washington, DC, on July 17th, 2009.

President Obama recently declared that, “We are not a nation that accepts nearly 46 million uninsured men, women, and children.” And indeed, finding a way to provide universal health coverage to every American is one of the focal points in today’s health care debate. …

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Improve primary care access before guaranteeing universal health coverage, my address at the National Press Club

How soon should patients receive their test results?

Conditions and Diseases
July 9, 2009

And should you assume that no news is good news?

The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent.

That’s almost a quarter of abnormal test results from that center that patients were never …

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How soon should patients receive their test results?

5 top medical comments, July 5th, 2009

Health Policy
July 5, 2009

Here are some of the more interesting comments readers have left recently.

1. Rogue Medic on how Oprah should be handling medical issues:
If she is going to give medical advice, and she is giving medical advice, and she is going to focus on giving advice contrary to the guidelines of reputable medical organizations, maybe some of her viewers need to start suing her for the bad medical advice.

I am guessing …

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5 top medical comments, July 5th, 2009

My reaction to President Obama’s speech to the AMA

Health Policy
June 15, 2009

I was seeing patients during the actual speech, so I had to rely on the transcript.

The points that interested me the most were any language pertaining to malpractice, addressing the AMA’s recent concerns about the public plan option, and reforming the physician payment system.

I think he did pretty well.

Regarding the physician payment system, he again addressed McAllen, Texas, which is fast becoming the symbol of what’s wrong with American …

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My reaction to President Obama’s speech to the AMA

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