A local reporter pulled another fast and loose assumption on unsuspecting readers recently, though this time I’ll cut her some slack. She was merely conveying a conventional belief shared by many other Americans. The story was very sad. A well-loved perfectly healthy minister, the Rev. Ken Diehm, became suddenly ill and...
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A study by the AARP in 2010 found that the cost of brand-name prescription drugs grew 8% in 2009, compared with the overall inflation rate of -0.3%.  Over a 5-year period, retail prices for 207 brand name drugs increased 41.5 percent by December 2009, compared to the general inflation rate of...
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Two more recent studies I didn’t mention last week documented how little influence electronic medical records (EMRs) had on outpatient care. One study measured 20 markers of quality between practices with and without EMRs over 255,402 national ambulatory patient visits. 19 of the 20 quality indicators were no different between the...
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What are we getting for our national $100 billion investment in electronic medical records (EMRs), or $200 billion, or $300 billion – who knows what the final cost will be? In the primary care ambulatory world, not very much. It’s not that EMRs are useless, they just don’t help very much....
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Doctors love to talk about tort reform – states passing laws to put limits on awards such as non-economic damages for harms such as pain and suffering, and on the legal process of suing a doctor for malpractice. They speak of defensive medicine – the practice of ordering extra tests, treatments,...
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My local newspaper is struggling with the growth of web-based news — as are so many papers nationwide — and shrinking as a result, but it still has its own health beat reporter. I’ve never met this reporter and the tone of her articles implies she is a nice and well-meaning...
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Most observers of the American healthcare system conclude there is a primary care shortage, though opinion varies on what to do about it. Nurse practitioners and other mid-levels such as physician assistants have been suggested to fill the gap. Could they become the primary care providers of the future? I think...
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As America begins to grapple with realization that it doesn’t have enough family physicians, a common suggestion is that the shortage can be solved by growing the mid-level workforce, i.e. nurse practitioners and physician assistants. I’ll talk more about mid-levels’ role in primary care next week. Today, let’s step back and...
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A colleague of mine who is a family physician in Arlington, Texas, let’s call him Dr. Smith, was sued several years ago for medical malpractice. His patient had reached the age where routine screening for colorectal cancer is recommended. Dr. Smith performed flexible sigmoidoscopies (flex sigs) in his office, which is...
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A commenter (I believe a physician) on one of my posts wrote the following: I can prevent heart attacks and strokes (caused by atherosclerosis – “blockage”) in people (minimal cost) who have NO symptoms. If I wait for their heart attack or stroke – it costs a WHOLE lot more. The...
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