In America, the art of doctoring is dying

This piece appeared on Feb. 12 in the Washington Post. It is a heart-felt article written by a retiring physician who is very candid about how the art of medicine is being replaced by the mindset that it is more efficient to feign caring and use technology to replace the time honored method that physicians had relied on to diagnose patients accurately and compassionately, namely to talk to them and do a good physical examination. Unfortunately, with the demands on physician time, this is no longer possible for most to do, even if they want to.  Primary care physicians must see … Continue reading

Rebel MD: My Professional Thanksgiving

The following comes from the Rebel MD blog.  It echoes my sentiments exactly.  Often,  when you are caring for patients, there are intangibles in your relationship with them that cannot be quantified in a government imposed metric. In fact, I would argue that only focusing on metrics can do more harm than good because of unintended consequences.  For example, if a doctor is penalized because he has an inordinately high number of uncontrolled diabetics and/or smokers, does that automatically mean that he is a bad doctor?  Perhaps that doctor is the only one willing to take care of all the … Continue reading

Dr. Big Brother

This entry below comes from the Authentic Medicine Blog edited by Douglas Farrago, M.D. He brilliantly points out that time of Big Brother is here.  The government and insurance companies are third parties that have been inserting themselves into the once sacred doctor:patient relationship for decades.  While they had always claimed that they are not practicing medicine or telling doctors what they can or cannot do for their patients, they really did.  If they refuse to pay for something, that thing will likely not get done, especially because the prices are overinflated because of the administrative cost of dealing with insurers. They … Continue reading

Do You Want To See A Physician Or A “Provider?”

The article below gives voice to the sentiments I feel, as do most of the physicians I know. I believe it is all part of the commoditization of medicine in our society. Patients are pegs being put into the holes that are the overbooked schedules in big box clinics. One size fits all. It doesn’t matter to the hospital administrator or insurance conglomerate whether or not a patient is seeing a physician who went to a top ranked medical school and has 20 years experience, or if they are seeing a nurse practitioner who barely passed their tests in a third … Continue reading

A Huge Overnight Increase in a Drug’s Price Raises Protests

Posting this article puts me in a somewhat uncomfortable position.  First, I am quoting  The New York Times.  Secondly, and more uncomfortably, I am agreeing with Bernie Sanders. That being said, let me qualify things.  Because in our practice we pride ourselves in being advocates for our patients, we pay attention to drug pricing, especially generics.  We dispense many generics in our practice at prices at or lower than our patients would pay at Walmart.  For medications we don’t stock in the office, we do web searches to find our patients the lowest price for their medications.  We have been … Continue reading

A Brave Doctor Takes A Stand

Dr. Kris Held is an ophthalmologist in Texas.  She is someone who puts a higher value on the doctor:patient relationship as defined by Hippocrates than she does working in a bureaucratic system where doctors and patients must get permission from a third party to agree on a treatment plan.  Ever since I started following her even before I joined the Association of American Physicians and Surgeons, I have been impressed with her intelligence, courage, and tenacity.  It was brave doctors like her, Dr. Jane Orient, Dr. Keith Smith (at Surgery Center of Oklahoma), and Dr. Lee Hieb who inspired me to … Continue reading

Will direct primary care be offered by employers?

The following article was published in the Kevin MD blog. Will direct primary care be offered by employers? STEPHEN C. SCHIMPFF, MD | POLICY | OCTOBER 1, 2014 Part of a series. Comprehensive primary care for employees means better employee health, greater productivity, less presenteesism and lower costs for both employee and employer. That is why some companies are making health care a strategic imperative rather than just a tactic as part of human resource cost management. Some are developing full service enhanced primary care clinics on site with excellent success as described in my last post. Some companies with fewer employees have partnered together to … Continue reading

ICD 10:  Is there a code for “WTF?”

As most of us know, the government has mandated that when medical bills are submitted to insurance companies, Medicare and Medicaid, they must put certain diagnostic codes on the claim.  That way, they can know why you saw the doctor.  They can also decide whether or not they will pay for your care.  Isn’t it great that there are so many people looking out for you? There is a lot of consternation and anxiety in the medical community because the government has decided to “upgrade” the coding system.  They are compelling any doctor, hospital, or any other medical provider or … Continue reading

The Myth of Americans’ Poor Life Expectancy

The article below appeared in Forbes Magazine in Nov. 2011.  It was written by Avik Roy, a brilliant columnist, who is now at the Manhattan Institute, a policy think tank. He helps to dispel the common myth that American healthcare is inferior to other parts of the world because of low life expectancy.  In reality, the care provided in our country is superb.  Many of the deaths in the U.S. are due to things not controllable by the healthcare system, such as violent crime and accidental death.  If you control for factors such as that, we find our American medicine … Continue reading

Assume The Physician

  If you are looking for a good book to read that is both deliciously sarcastic and entertaining, while at the same time very educational and enlightening, I strongly recommend Assume The Physician by John F. Hunt, M.D. It is a novel that tells the story of a young intern, Dr. Eddie Marcus, as he goes through his first year of training after medical school.  Each chapter addresses a different aspect of the dysfunction of the American medical system, with a few commentaries about society in general thrown in.  It will simultaneously make you laugh, while at the same time … Continue reading