Physician

Patient wants an apology, not money, after medical malpractice

by Tricia Pil, MD

This is the true story of a hospitalization as told from three points of view: first, the recollections of the patient (who happens to be a physician); second, events as recorded in the medical charts by doctors and nurses; and third, the version put forth by the hospital.

FRIDAY

Patient:
It is fall 2005, and I am nine months pregnant. A healthy 33-year-old pediatrician, I am a longtime patient of …

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False patient contact information worsens emergency care

One of the biggest emergency room problems is contacting patients after they leave.

Patients sometimes leave false contact information — which makes it difficult for the emergency room staff should problems arise after the visit.

The issue was illustrated in a piece from msnbc.com. Many times, results like blood cultures or x-ray findings take time to return. And if there’s something that needs to be acted upon, contacting the …

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Avoiding the ER and arranging a direct admit is not easy

Are emergency departments solely responsible for the bulk of unnecessary tests?

Most would like to believe so, but emergency physician Edwin Leap says that’s not the case.

He cites an instance involving a primary care doctor and hospitalist:

Local physician, who does not admit to the hospital, sees patient in the office. Patient has uncontrolled hypertension and is having some chest pain and shortness of breath. Local physician contacts hospitalist. …

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Internal medicine is dead, will concierge physicians thrive?

by Steven Knope, MD

For the last several years, writers in the New England Journal of Medicine and the Journal of the American Medical Association have authored doomsday editorials about the prognosis of primary care medicine. There has been much discussion about the fact that internists and family practitioners cannot keep pace with rising overheads and falling reimbursement under the traditional third-party payment system.

Paraphrasing a recent …

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Primary care is burdened by excessive paperwork

by Charles R. D’Agostino, MD

We’ve all seen the headlines –- “Primary Care Physicians Becoming a Scarce Breed”, “Wait Times for Appointments Increasing”, “Primary Care in Crisis” –- and have heard the pundits pontificating on the deteriorating state of primary care.

But rarely do we hear what’s happening from physicians on the front lines, those actually seeing patients. Consequently, with direct access to the primary care trenches, replete with an overworked …

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Patient satisfaction scores improve when doctors sit

Patient satisfaction, as I wrote previously, is being increasingly focused upon.

Doctors are often pressed for time, and appear rushed — which can potentially lead to unhappy patients.

I saw this small study showing that the simple act of sitting down while talking to patients can have a profound effect. Many doctors I know already do this, but now there’s some data to support sitting.

According to the study, performed at …

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Primary care needs better physical exam skills

by Joseph Biundo, MD

Not long ago, primary care physician Rob Lamberts did a blog post about the economics of seeing Medicare and Medicaid patients, stating that doing so was bad business. While I agree with most of his points, I have a quarrel with his statement that primary care physicians keep down the cost of care by keeping people healthy, away from specialists, and out of the hospital.

That may be …

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Primary care is the loss leader of medicine

Medicare’s sustainable growth rate, or SGR, has been the bane of doctors for years now.

To encapsulate, this is the reason for Medicare’s annual threat to cut doctors’ fees by 20% or more, only to be staved off at the last minute.

Emergency physician Shadowfax has a nice take on it, explaining why it has devastated primary care:

Primary care has many fixed expenses in addition to those we bear: they pay …

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CRNA salaries surpass those of primary care doctors

I received several requests asking me to comment on this CNN story, “Some nurses paid more than family doctors.”

This isn’t really news, as CNRA salaries have been on a trajectory surpassing primary care physicians’ for a few years now. In fact, I wrote about it back in June of 2008.

According to the latest numbers, “Primary care doctors were offered an average base salary of $173,000 in …

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Tips for doctors who negotiate reimbursement rates with insurance companies

Originally published in HCPLive.com

by Ed Rabinowitz

When it comes to negotiating fees with health plans, practices and physicians have more leverage than they realize. The problem, says John Schmitt, a managed care expert with EthosPartners Healthcare Management Group, is that practices often don’t even try. “Groups negotiate an agreement with a payor and then, for whatever reason, just fi le it away. Most medical groups do not have a good, proactive …

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Physician burnout in the operating room and emergency department

It’s no secret that burnout is prevalent among primary care doctors, with 30 percent wanting the leave the field within five years.

It gets no better in other specialties.

I recently read that, frighteningly, almost 9 percent of surgeons admitted to a lapse in medical judgment within the past 3 months, in part due to the fact that nearly 40 percent admitted to burnout.

The author of that post, an emergency physician, …

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