Podcasting with Old Friends

September 13, 2012 Just Stuff Kind of Thingys

  This evening I had the pleasure on being interviewed by Dr. Mike Sevila for the “Family Medicine Rocks” podcast.  I talked about old times (I was the first guest on his show 5 years ago) and a lot about my decision to go into solo practice.  It was a great chance to talk about [...]

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Sick of Cheesecake

September 12, 2012 Health Care - How it's Broken

In a well-publicized and well-written article in the New Yorker, Atul Gawande (one of my doctor writing heroes) talks about his visit to the popular restaurant, The Cheesecake Factory, and how that visit got him thinking about the sad state of health care. The chain serves more than eighty million people per year. I pictured [...]

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More Drug Pens: Misguided Marketing Decisions

September 10, 2012 Pharmaceutical Junk

I’ve got a bunch of pen pics taking up my memory, so I’m going to do my second post spawned by my discovery of a motherlode of drug pens in my desk.  Today’s menagerie will feature some questionable decisions by the marketing departments.  It’s bad enough to have doctors hate you (and throw things at you), or [...]

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Dropping Out

September 8, 2012 Being a Doctor

After 18 years in private practice, many good, some not, I am making a very big change.  I am leaving my practice. No, this isn’t my ironic way of saying that I am going to change the way I see my practice; I am really quitting my job.  The stresses and pressures of our current [...]

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Pharmaceutical Junk

September 2, 2012 Pharmaceutical Junk

I cleaned out a drawer in my desk today.  There were a lot of pens, many of which had drug company logos attached to them.  As I looked over this menagerie, I was mildly awed and moderately amused by the variations on a pretty mundane medium.  I ended up taking a bunch of pictures, and [...]

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Burn-out

September 1, 2012 Being a Doctor

It happened again.  I was talking to a particularly sick patient recently who related another bad experience with a specialist. “He came in and started spouting that he was busy saving someone’s life in the ER, and then he didn’t listen to what I had to say,” she told me.  ”I know that he’s a [...]

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The Drug Formulary Death Cage Match of Awesomeness

August 21, 2012 Health Care - How it's Broken

I got an unusual request last week.  I written a prescription of a generic medication (which has been generic for a couple of years) and the prescription was denied by the insurance carrier.  The reason for denial: I had to try a brand-name medication first. Stop.  Read that again.  They wouldn’t allow me to give [...]

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Feeling Vulnerable

August 14, 2012 Health Care - How it's Broken

“The specialist rescheduled me again,” the patient told me, looking embarrassed.  ”I think he doesn’t want to see me any more.” “I’m sure that it isn’t that he doesn’t want to see you,” I replied.  ”This has to be a miscommunication with the front desk.  It happens all the time; it drives doctors crazy.” “I [...]

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Bad Directions

August 11, 2012 Health Care - How it's Broken

I love the GPS analogy for health care.  Patients need a GPS for their health, showing them the reality of their past, present, and future health.  The analogy has not only shown me how I want to give care for my patients, it has also given me insight into the pitfalls of automated medical care. Way [...]

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10 Ways to Make EMR Meaningful and Useful

August 5, 2012 EMR

OK, I am an EMR geek who isn’t so thrilled with the direction of EMR.  So what, I have been asked, would make EMR something that is really meaningful?  What would be the things that would truly help, and not just make more hoops for me to jump through?  A lot of this is not [...]

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