A recent survey of physicians asked several questions about prescribing practices. The primary report was that only primary care physicians cited costs as one of the most important considerations in their prescribing habits. Out of 10 factors, all of the ologists ranked cost as the sixth or less most important consideration. Pulmonologists...
Read More »

I assume many readers of American HealthScare have already read this piece from the New York Times. But just in case you haven’t, if you have any anti-nausea medicine at home, take it 30 minutes before reading this. I continue to be flabbergasted that the private sector allows this to happen....
Read More »

Here we go again. There is yet another round of evidence of how the physician workforce hole we’ve dug for ourselves keeps getting deeper, but there has been still no substantive payment reform on the government side (Medicare/Medicaid) or the private payer side. One recent study appeared in the journal Academic...
Read More »

Yet another study has documented the obvious: that the Medicare fee schedule is heavily weighted to favor procedural services. Sinsky and Dugdale added to the previous documentation of this institutional bigotry by being sure to capture the other demands on physician time besides the procedure itself. This includes time spent talking...
Read More »

How can a family physician send home from clinic an 18-year-old woman who reports she’s been having chest pain? Couldn’t she be having a heart attack? Absolutely. How can a family physician reassure a person with hand tingling and numbness without ordering any tests? Couldn’t this be a stroke? Of course....
Read More »

A study about quality of life for patients with terminal cancer was reported by Medscape News. I won’t repeat the whole article here, but let me let you in on a few of their insights. Said the director of a Center of the Dana-Farber Cancer Institute, “Physicians who claim that there...
Read More »

It is so hard to push back against the influence of GIMeC, because people often make up their minds about reality based on stories of other people.  How many times have you seen this story on the TV news, magazines, or TV dramas? A person had some sort of pain or...
Read More »

OK, it’s really called the American Medical Association, but it most often represents the world view of ologists not primary care. The House of Delegates of the AMA is 80%-85% ologists. When there is any conflict between the views of primary care vs. those of the ologists, guess who usually prevails....
Read More »

The U.S. Preventive Services Task Force recently recommended that most women only undergo a Pap smear every 3 years starting at age 21, and even less frequently after age 30 if they also are tested for the human papillomavirus with the Pap smears. A few weeks ago, the OB/Gyns published guidelines...
Read More »

I’m back from the big annual TAFP meeting, and once again my colleagues tell me stories of crazy practices in the private sector. Here is one from a doctor in Plano. A 27-year-old male patient of his went to the ER with chest pain. The EKG showed early repolarization and the...
Read More »