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Between Patients: The Myth of Multitasking Print E-mail
Written by A Country Doctor Writes   
Thursday, 07 December 2017 00:00

Primary care doctors don't usually have scheduled blocks of time to read incoming reports, refill prescriptions, answer messages or, what we are told the future will entail, manage their chronic disease populations. Instead, we are generally expected to do all those things "between patients". This involves doing a little bit of all those things in the invisible space between each fifteen minute visit, provided we can complete those visits, their documentation and any other work generated in those visits, in less than he fifteen minutes they were slotted for.

Last Updated on Friday, 08 December 2017 19:23
Physicians must embrace the business side of medicine Print E-mail
Written by FHI's Week in Review   
Monday, 27 November 2017 00:00

Davis Liu, MD asserts in a KevinMD post dated November 26, 2017 that the "issue lies in the false dichotomy...often create<d> by asking whether physicians or business people should ultimately be responsible for hospital care."

Read more in the current issue of Week in Review>>

Last Updated on Friday, 01 December 2017 17:42
Why Curbside Consults are Dangerous Print E-mail
Written by MD Whistleblower   
Monday, 13 November 2017 00:00

One of the skills and stresses about being a doctor is giving advice to or about patients we have never seen. If readers think these are rare events, it happens nearly every day.  Often during weekend or evening hours when I am on call, my partners' patients will call with questions on their condition or about their medications. Radiology departments contact me during off hours with abnormal CAT scan results of patients I do not know. Or, a doctor may call me during the day for some informal advice about one of his patients. These physician-to-physician inquiries are called 'curbside consults', which are appropriate for simple questions that do not require a formal face-to-face consultations.

Physicians must be cautious when providing a curbside opinion on a patient he has not seen as even informal advice could result in legal exposure if the patient later files a medical malpractice claim. Consider this hypothetical example...

Last Updated on Tuesday, 14 November 2017 19:32
Polypharmacy in the Elderly: Who's Responsible? Print E-mail
Written by MD Whistleblower   
Tuesday, 07 November 2017 20:17
There's a common affliction that's rampant in my practice, but it's not a gastrointestinal condition. It's called polypharmacy, and it refers to patients who are receiving a  pile of prescription and other medications. I see this daily in the office and in the hospital. It's common enough to see patients who are receiving 10 or more medications, usually from 3 or 4 medical specialists.
Last Updated on Tuesday, 12 December 2017 19:48
Caught between two paradigms Print E-mail
Written by A Country Doctor Writes   
Friday, 20 October 2017 17:27
In the very near future, clinics like ours will be paid according to how well our patients do medically, or at least according to how consistently we provide certain medical tests and interventions. This includes frequency of diabetic blood tests, foot exams, eye exams, prescriptions for heart and kidney protective medications, achievement of pre-set targets for blood pressure, body mass index and immunization rates, and other measurable "quality indicators".
But paychecks for medical providers as well as short term financial viability of clinics like my Federally Qualified Health Center depends, besides Federal grants for being open in the first place, almost entirely on the fixed revenue we receive from every face to face encounter we have with patients.
Last Updated on Friday, 20 October 2017 17:29
What Makes Singapore's Health Care So Cheap? Print E-mail
Written by The Incidental Economist   
Saturday, 07 October 2017 09:27
Singapore's health care system is distinctive, and not just because of the improbability that it's admired by many on both the American left and the right. It spends less of its economy on health care than any country that was included in our recent tournament on best health systems in the world. And it spends far, far less than the United States does. Yet it achieves some outcomes Americans would find remarkable.
Last Updated on Saturday, 07 October 2017 09:32
The Best Healthcare System in the World: Which One Would You Pick? Print E-mail
Written by The Incidental Economist   
Saturday, 23 September 2017 11:41

"Medicare for all," or "single-payer," is becoming a rallying cry for Democrats. This is often accompanied by calls to match the health care coverage of "the rest of the world." But this overlooks a crucial fact: The "rest of the world" is not all alike. The commonality is universal coverage, but wealthy nations have taken varying approaches to it, some relying heavily on the government (as with single-payer); some relying more on private insurers; others in between. Experts don't agree on which is best; a lot depends on perspective. But we thought it would be fun to stage a small tournament.

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Last Updated on Tuesday, 03 October 2017 18:15
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