I just received a flyer in my mailbox from my city magazine asking me to vote for the top docs of 2012. I talked to a veteran of the magazine industry several years ago who told me the back story. These issues are big money makers for local magazines. They can...
Read More »

I want to pause for a moment and thank a few people who richly deserve it. First is Chris Gregory, my pit bull buddy advocate for family medicine. His website DocOnomics (www.doconomics.com) is  a mixture of common sense primary care advocacy and concern about the overall financial health of our country....
Read More »

A study in Archives of Internal Medicine surveyed a national sample of internists and family physicians about cost issues in medicine. Over 600 responded. 42% felt that most patients in their own practices receive too much care, only 6% said too little. When asked why some patients received too much care,...
Read More »

As the suits in the healthcare industry continue to try to change the healthcare system in their own MBA image, words such as targets and metrics are commonly used. A recent commentary from the BMJ reminds us of how sometimes when one process is improved another suffers. Patients want quick access...
Read More »

Now that the “supercommittee” of Congress has failed to reach a compromise to restore some fiscal sanity to our national debt, let us consider for a moment what a monumental failure of leadership this waste of time turned out to be. For starters, their task was to reduce the federal deficit...
Read More »

In a recent statement published by the journal Pediatrics, an advisory panel sponsored by the National Heart, Lung, and Blood Institute of the NIH recommended universal cholesterol screening for all children ages 9 to 11. I’m sure they meant well, but this statement means important people in leadership positions have officially...
Read More »

I’m being a little facetious with this back-of-the-envelope calculation, but not much. In several of the PCMH demonstration projects, other providers of primary care services such as WeCare, the historical record of the Starfield work, and the experience of QuadMed primary care shows that just having a typical American population shift...
Read More »

The National Quality Foundation is a non-profit founded in 1999 as a collaborative effort between representatives of many healthcare entities. Its description of itself from its website reads: NQF’smore than 375 members represent virtually every sector of the healthcare system: consumers, purchasers, health plans, providers, healthcare professionals, suppliers, community health organizations,...
Read More »

I confess that I feel slightly guilty for writing this post. As a general rule, I don’t like overly critical people who create an ideal past world in their head, compare their forefathers (and mothers) to that world, then complain that the previous generation’s leaders did not live up to the...
Read More »

I’ve taken some time recently to read about some of the earliest thinking about family medicine prior to its creation and into its early years. I find that for the most part, the same unresolved tensions we feel today were present 45 years ago. I’ll spend the next two weeks exploring...
Read More »