At the start of next year, the drug companies will no longer be giving pens and pads of paper to doctors. The rules regarding pharmaceutical sales practices have grown progressively more stringent over the past few years. The FDA already regulates what the reps say to physicians (they may only assert what is in the [...]
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What do I want to accomplish as a physician? Here’s my list: Get all of my patients very old. See each patient infrequently as possible – Not because of noncompliance, but because they are well. Have our office become a venue for an Olympic event. Spend more time talking about non-medical things than medical things [...]
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If you want grand rounds as you like it, then head on over to Rural Doctoring. Measure for Measure it is definitely well done; not a comedy of errors. Believe me, this is not much ado about nothing, it is truly an epic tale. It may seem like a lot to read, but when you [...]
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It happened today. It’s a sinking feeling in the stomach. The patient comes into the office with a chief complaint and set of symptoms that worrisome, or the x-ray comes back with a “suspicious area” on it. It sounds like cancer. My mind explores the possibilities, hoping for a diagnosis that is not so bad, [...]
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Many have commented on my laments at the difficulty of practicing primary care in the US. One of the recurrent themes centers around whether or not physicians should just stop accepting insurance altogether. One reader commented: For me, the doctors I see most frequently simply don’t take insurance. Less office staff, more doctor time. I [...]
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I was sitting in a conference recently; the speaker was talking about the Medical Home and how one practice was getting nearly $150K for managing a patient population using a new computerized tool. Sounds good. During the question and answer period I asked the speaker: “Shouldn’t we wait until insurance companies are willing to pay [...]
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I thought my highly intellectual readership would be stimulated by this story I saw this morning: Monkey eludes dragnet at Tokyo train station Morning train commuters in Tokyo were joined on their way to work by an unusual companion Wednesday: a wild monkey. A security guard spotted the monkey near ticket gates in Shibuya Station, [...]
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The comments on my recent post Fighting Chaos are some of the most interesting ones I have had. One which particularly sparked my thoughts (not an easy thing to do, mind you) was one that compared being a physician to being a barber. It states: I’m a licensed barber. Does this mean I get to [...]
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I was away at a conference this weekend. We were there to work on the better application of computers to our practice. We give good care, but could do a lot better. There are folks out there doing incredible things, and we need to do them for the sake of our patients. Lots of information, [...]
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Ka-thump ka-thump ka-thump. Listening to the heart. I do it every day on countless patients. While this isn’t the most important thing I do (usually), there is still something special about hearing a person’s heart beating. It is the measure of life. In a patient record, this mystical experience is reduced to: Cor – RRR [...]
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