Yes, I am a Rhodes Scholar who is “just” a family doctor. Here’s why.
“So you’re a Rhodes Scholar, and you’re just a family doctor?”
If I was paid a dollar each time I’m asked this question, I can safely retire. It seems innocent enough, and it’s usually asked without malice. But the fundamental assumption behind this question alarms me: that family doctors are somehow less competent and less valuable to society than specialist doctors. It’s an assumption that cannot be more wrong. Not only is such implicit stigmatization unfair to family doctors, it also misleads the future of our profession and harms the patients we serve.
Are family doctors less competent?
Common accusations...
Source: Kevin, M.D. - Medical Weblog - August 17, 2015 Category: Journals (General) Authors: Yan Yu, MD Tags: Physician Primary care Source Type: blogs
The Latest Example of the Anechoic Effect - AllTrials US Initiative Launches to Deafening Media Silence
Every now and then, someone tries to persuade me how much more open discussion of various kinds of recent unpleasantness in health care has become in the US. I admit there has been more media attention to certain issues, but unfortunately must maintain that the issues most likely to be make those who profit the most from our current health care system uncomfortable remains anechoic. Now I have my latest exampleAllTrials AllTrials is a UK based organization that advocates for registration and public reporting of all clinical trials. AllTrials explains the reasons for this simply:Clinical trials are the best way we h...
Source: Health Care Renewal - August 10, 2015 Category: Health Management Tags: AllTrials anechoic effect suppression of medical research Source Type: blogs
New doctors are not kind to their predecessors. Here’s why.
I had the good fortune of practicing family medicine from the 70s to the early 10s. It was the Golden Age. After doing a family practice residency in a community hospital and serving a short stint as an assistant residency director, I started out in my practice that lasted almost 40 years.
Here is the story of how I got the ball rolling. I was part of a large family practice group. Dr. A was an elderly GP with a devoted patient clientele. His patients loved him. He gave them prescriptions, vitamins, B-12 and cortisone shots. He did use the lab and x-ray but never referred. He would diagnose an MI correctly and then treat t...
Source: Kevin, M.D. - Medical Weblog - July 18, 2015 Category: Journals (General) Authors: Dr. B Tags: Physician Primary care Source Type: blogs
I started a family medicine practice for $11,000. You can, too.
I am presenting my startup costs here, to give some ideas for those providers who are considering starting their own family practice, or for those who say it can’t be done anymore.
To become a business, I spent $50 for the state LLC filing, and $12 for business cards. I already had my medical license and DEA from residency, so the only certificate I needed was a $200 CLIA waived certificate so I could do in-house labs. One-year insurance was $400 for business liability, $333 for workers comp, and $900 for malpractice. Yes, only $900, for family medicine, without OB, in my state, in the first year out of residency. My ...
Source: Kevin, M.D. - Medical Weblog - June 7, 2015 Category: Journals (General) Authors: P.J. Parmar, MD Tags: Physician Primary care Source Type: blogs
Physician Assistants Easing the Primary Care Shortage
After logging five decades of high-quality, cost-effective care, physician assistants are gearing up for their time in the spotlight. The stage is set: fewer physicians are entering primary care, older family practice physicians are retiring, and the U.S. population is growing, aging and — thanks to the Patient Protection and Affordable Care Act (Obamacare) — […]
The post Physician Assistants Easing the Primary Care Shortage appeared first on Inside PA Training. (Source: Inside PA Training)
Source: Inside PA Training - May 26, 2015 Category: Universities & Medical Training Authors: Paul Tags: PA Profession primary care shortage Source Type: blogs
Physician Assistants Easing the Primary Care Shortage
After logging five decades of high-quality, cost-effective care, physician assistants are gearing up for their time in the spotlight. The stage is set: fewer physicians are entering primary care, older family practice physicians are retiring, and the U.S. population is growing, aging and — thanks to the Patient Protection and Affordable Care Act (Obamacare) —...The postPhysician Assistants Easing the Primary Care Shortage appeared first onInside PA Training. (Source: Inside PA Training)
Source: Inside PA Training - May 26, 2015 Category: Universities & Medical Training Authors: Paul Tags: PA Profession primary care shortage Source Type: blogs
Physician Assistants Easing the Primary Care Shortage
After logging five decades of high-quality, cost-effective care, physician assistants are gearing up for their time in the spotlight. The stage is set: fewer physicians are entering primary care, older family practice physicians are retiring, and the U.S. population is growing, aging and — thanks to the Patient Protection and Affordable Care Act (Obamacare) — […]The postPhysician Assistants Easing the Primary Care Shortage appeared first onInside PA Training. (Source: Inside PA Training)
Source: Inside PA Training - May 26, 2015 Category: Universities & Medical Training Authors: Paul Tags: PA Profession primary care shortage Source Type: blogs
Physician Assistants Easing the Primary Care Shortage
After logging five decades of high-quality, cost-effective care, physician assistants are gearing up for their time in the spotlight. The stage is set: fewer physicians are entering primary care, older family practice physicians are retiring, and the U.S. population is growing, aging and — thanks to the Patient Protection and Affordable Care Act (Obamacare) — [...]The postPhysician Assistants Easing the Primary Care Shortage appeared first onInside PA Training. (Source: Inside PA Training)
Source: Inside PA Training - May 26, 2015 Category: Universities & Medical Training Authors: Paul Tags: The Basics primary care shortage Source Type: blogs
Physician Assistants Easing the Primary Care Shortage
After logging five decades of high-quality, cost-effective care, physician assistants are gearing up for their time in the spotlight. The stage is set: fewer physicians are entering primary care, older family practice physicians are retiring, and the U.S. population is growing, aging and — thanks to the Patient Protection and Affordable Care Act (Obamacare) —…Continue readingPhysician Assistants Easing the Primary Care ShortageThe postPhysician Assistants Easing the Primary Care Shortage appeared first onInside PA Training. (Source: Inside PA Training)
Source: Inside PA Training - May 26, 2015 Category: Universities & Medical Training Authors: Paul Tags: The Basics primary care shortage Source Type: blogs
When Health Care Transformation Fails
Last year was tough for the transformation of health care from volume to value. Two major medical home studies (Friedberg and Rosenthal) and two major readmission prevention studies (Goldman and Dhalla) had negative to underwhelming results. Thirteen of the original 32 Pioneer Accountable Care Organizations (ACOs) have dropped out of the program.
Of the original 220 Medicare Shared Savings Program ACOs, only 53 held spending enough below their targets to receive performance payments. Given the significant investments these ACOs made in the infrastructure needed to manage risk, and that the top 12 ACOs were responsible for...
Source: Health Affairs Blog - April 27, 2015 Category: Health Management Authors: Stuart Pollack Tags: Featured Health Professionals Hospitals Organization and Delivery Quality ACOs adaptive reserve Health Reform National Demonstration Project PCMH triple aim Source Type: blogs
Structuring Physician Leadership To Promote Accountable Care
Physician leadership is widely seen as crucial to drive accountable care and population health, but the question is how. A recent survey of accountable care organizations (ACOs) across the country has shown significant interest and motivation by physicians for participating and playing strong leadership roles in ACOs.
There have been significant challenges with physicians providing effective leadership of population health programs:
Physician-led population health services have not been achieving the overall outcomes and demonstrating value.
Physician services have not been coordinated with the hospitals and health pl...
Source: Health Affairs Blog - April 17, 2015 Category: Health Management Authors: Shantanu Nundy Tags: Organization and Delivery Accountable Care Organizations Physicians Source Type: blogs
Patch Down the Hatch
A 42-year-old man presented with somnolence. Initial vital signs include: heart rate 54 bpm, blood pressure 92/68 mm/Hg, temperature 37°C, respiratory rate 6, pulse oximetry 90% on room air. Physical examination is remarkable for depressed level of consciousness, miosis, and bradypnea. His mental status and respiratory rate temporarily improved with the administration of 0.04 mg naloxone. He reports swallowing several “patches” in a suicide attempt.
What are examples of medications available as a transdermal patch? Compare the dose of drug delivered and the patch content.
Popular transdermal patches are listed bel...
Source: The Tox Cave - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Don't forget to floss . . . and take your drugs
An MD friend is a substance abuse counselor here in Massachusetts. She reported to me that a substantial percentage of her clients have been able to maintain their addiction through supplies of opiates prescribed by dentists. In all the recent talk about excessive use of opiates, I had never heard about this source.So I wondered if there has been any study of this by the profession or coverage of this issue by the media. After a search, I found this 2010 report from the Tufts Health Care Institute Program on Opioid Risk Management. Excerpts:The top specialty prescribing IR [immediate release] opioids in t...
Source: Running a hospital - February 1, 2015 Category: Health Managers Source Type: blogs
We forget to ask patients what their goals are
Mr. Dwyer isn’t my patient, but today I’m covering for my partner in our family practice office, so he’s been slipped into my schedule.
Reading his chart, I have an ominous feeling that this visit won’t be simple.
A tall, lanky man with an air of quiet dignity, Mr. Dwyer is eighty-eight. His legs are swollen, and merely talking makes him short of breath.
He suffers from both congestive heart failure and renal failure. It’s a medical catch-22: When one condition is treated and gets better, the other condition gets worse. His past year has been an endless cycle of medication adjustments carried ...
Source: Kevin, M.D. - Medical Weblog - January 29, 2015 Category: Journals (General) Authors: Mitch Kaminski, MD Tags: Physician Palliative care Source Type: blogs
