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…
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.
A version of this op-ed was published on June 18th, 2009 in The New York Times' Room for Debate blog. In his recent address to the American Medical Association, President Obama noted that our health care system "rewards the quantity…
A version of this op-ed was published on June 18th, 2009 in The New York Times’ Room for Debate blog.
In his recent address to the American Medical Association, President Obama noted that our health care system “rewards the quantity of care rather than the quality of care.” This perverse incentive leads to unnecessary and potentially harmful medicine, while also being a major contributor to spiraling health care costs.
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…
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 …
Here are some of the more interesting comments readers have left recently. 1. Carla Kakutani on how Massachusetts' health reform won't relieve ER overcrowding: Insurance does not equal access (although it’s better than nothing). Nothing changes until every stakeholder recognizes…
Here are some of the more interesting comments readers have left recently.
1. Carla Kakutani on how Massachusetts’ health reform won’t relieve ER overcrowding: Insurance does not equal access (although it’s better than nothing). Nothing changes until every stakeholder recognizes they have to control costs and allow a rebuilding of primary care in the US. That includes doctors and patients, along with everybody’s favorite villains, the insurance companies and big pharma. …
Most of us are now familiar with the estimates that as much as one-third of our health care dollars are squandered on ineffective, often unnecessary, unproven and overpriced products and services. But which third? The fat in our health-care system…
Most of us are now familiar with the estimates that as much as one-third of our health care dollars are squandered on ineffective, often unnecessary, unproven and overpriced products and services. But which third?
The fat in our health-care system is not hanging out conveniently on the edges of the steak, waiting to be trimmed. It will take a scalpel, a keen eye, and a steady hand to remove at least …
The following is the first in a series of original guest columns by the American College of Physicians. by Steven Weinberger, MD, FACP Much is written and discussed these days about the importance of care coordination by a primary care…
Much is written and discussed these days about the importance of care coordination by a primary care physician, not only to facilitate patient-centered quality of care, but also to curb the unsustainable growth in the nation’s health care tab. Yet, we hear that the current shortage of …
Here are some of the more interesting comments readers have left recently. 1. Dr. Grumpy on the art of medicine and electronic medical records: I do use an EMR, but patient’s routinely tell me I’m good at listening. I think…
Here are some of the more interesting comments readers have left recently.
1. Dr. Grumpy on the art of medicine and electronic medical records: I do use an EMR, but patient’s routinely tell me I’m good at listening. I think it’s an individual basis. Some doctors are technophiles, and put that first. That ain’t right. Some doctors are so intent on listening, that they may forget a detail, and then it …
A common complaint is that doctors these days are spending more time doing clerical tasks. Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do…
A common complaint is that doctors these days are spending more time doing clerical tasks.
Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do not need a medical degree to do these tasks.
Bob Doherty points to a study that gives some numbers to back up the claims. Primary care doctors spend about 3.5 …
Here are some of the more interesting comments readers have left recently.1. Anonymous on whether emergency physicians best served to staff urgent care centers:As an ED doc, I understand the problem. We are taught to always rule out the emergencies,…
Here are some of the more interesting comments readers have left recently.
1. Anonymous on whether emergency physicians best served to staff urgent care centers: As an ED doc, I understand the problem. We are taught to always rule out the emergencies, and I am constantly worrying about the worst case scenario, and likely will order more tests since they are at my disposal, which is …
Here are some of the more interesting comments readers have left recently.1. Carla Kakutani on the lack of primary care access in Massachusetts:So we have a chicken and egg problem. Do we wait health care reform until we have revived…
Here are some of the more interesting comments readers have left recently.
1. Carla Kakutani on the lack of primary care access in Massachusetts: So we have a chicken and egg problem. Do we wait health care reform until we have revived US primary care, or is that even possible without health care reform to create the disruption needed to change our entrenched fee-for-service, procedure-happy payment …
The following is a reader take, in response to a post on whether patients should own their medical records, by an anonymous nurse.Dear Dr. Pho,I wish to respond to your position on patient access to their medical records both as…
Top story in The New York Times.Excellent.There's hope that maybe, just maybe, we're getting through to the decision makers in Washington.The article itself is old news to regular readers of this blog, and regurgitates many of the arguments impeding health…
Top story in The New York Times.
Excellent.
There’s hope that maybe, just maybe, we’re getting through to the decision makers in Washington.
The article itself is old news to regular readers of this blog, and regurgitates many of the arguments impeding health reform, as well as the problems in solving them.
“Obama administration officials, alarmed at doctor shortages, are looking for ways to increase …
Here are some of the more interesting comments readers have left recently.1. Mediaslackers on the UK's proposed 48-hour physician workweek:I agree there are significant dangers inherent with limiting the number of hours a doctor can work in a week, but…
Here are some of the more interesting comments readers have left recently.
1. Mediaslackers on the UK’s proposed 48-hour physician workweek: I agree there are significant dangers inherent with limiting the number of hours a doctor can work in a week, but I don’t think they are totally insurmountable or all that much greater than when a doctor is working 30 hours straight, getting a divorce …
The following op-ed was published on April 23rd, 2009 in the USA Today. As a primary care doctor, it's heartening to hear President Obama call for "the largest investment ever in preventive care." That means more people, for one, will…
The following op-ed was published on April 23rd, 2009 in the USA Today.
As a primary care doctor, it’s heartening to hear President Obama call for “the largest investment ever in preventive care.” That means more people, for one, will be undergoing tests to screen for various forms of cancer. But this might be one of those cases where what sounds like common sense is actually more …
Here are some of the more interesting comments readers have left recently.1. Manalive on quality measures:It is almost always a leap of faith to apply evidence-based guidelines to the frail elderly, to patients with many medical problems, to alcoholics, to…
Here are some of the more interesting comments readers have left recently.
1. Manalive on quality measures: It is almost always a leap of faith to apply evidence-based guidelines to the frail elderly, to patients with many medical problems, to alcoholics, to the poorly insured — in short, to a large percentage of my practice. Accordingly, I have been on the wrong end of too many …
Here are some of the more interesting comments readers have left recently.1. Dr. Gwenn on limited health literacy:For us to do a better job with patients and teach them to be better advocates for themselves, we need more time -…
Here are some of the more interesting comments readers have left recently.
1. Dr. Gwenn on limited health literacy: For us to do a better job with patients and teach them to be better advocates for themselves, we need more time – plain and simple. At the same time, patients need more community supports to understand the complex health world and build the skills they need …
It's a well known phenomenon that hospitalists are taking over inpatient medicine.And no wonder, the payment system strongly discourages newly minted doctors to practice outpatient medicine, and the demand that hospitals have for inpatient physicians is surging at an unprecedented…
It’s a well known phenomenon that hospitalists are taking over inpatient medicine.
And no wonder, the payment system strongly discourages newly minted doctors to practice outpatient medicine, and the demand that hospitals have for inpatient physicians is surging at an unprecedented rate.
It’s a good time to be a hospitalist, but, as this reader writes to me, that may lead to an increasingly variability in the quality …
More hospitals are resorting to so-called "dayhawk" radiology services to read their x-rays.It's modeled after the "nighthawk" model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.Now, the…
More hospitals are resorting to so-called “dayhawk” radiology services to read their x-rays.
It’s modeled after the “nighthawk” model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.
Now, the phenomenon is happening during business hours as well, which according to radiologist Giles W. L. Boland, means that “some radiologists can no longer assume long-term …
The following op-ed was published on March 26th, 2009 in the USA Today. As a primary care doctor, I am frequently faced with decisions where the choice is not always clear. Do the latest, more expensive drugs work better than…
The following op-ed was published on March 26th, 2009 in the USA Today.
As a primary care doctor, I am frequently faced with decisions where the choice is not always clear. Do the latest, more expensive drugs work better than the less costly, older medications? Will ordering an MRI help me treat a patient’s lower back pain? Often, the answer to these questions is, “I’m not sure.”
Have you ever wondered why doctors have to perform a digital rectal exam?Well, look no further, as primary care doctor Rob Lamberts gives us the answers discerning readers demand.Simply by looking at the rectum, which by the way, indeed "takes…
Have you ever wondered why doctors have to perform a digital rectal exam?
Well, look no further, as primary care doctor Rob Lamberts gives us the answers discerning readers demand.
Simply by looking at the rectum, which by the way, indeed “takes some getting used to,” can lead to significant diagnostic findings. Furthermore, does tight sphincter tone matter? And should you be worried about the large hands …
