Hello again!  I haven’t written anything in a while. No big worries. I moved recently (same town, same neighborhood), but the remodel of the new house has been a mis-adventure and I’ve been living out of boxes and breathing dust for over a month. Things are kind of finally settling down....
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A lot of healthcare system pundits including the current leadership of the American Academy of Family Physicians feels that fee-for-service payment is the root of all healthcare waste. Obviously, I disagree. Their line of thinking is based on the existing evidence that there are too many joint replacements, cardiac stents, cardiac tests, etc., because...
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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....
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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...
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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...
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Continuing my discussion of the findings in a recently published study on the ways family physicians deliver better care at a lower cost than a multi-ologist model, today I will talk about how family physicians often believe aggressive treatment plans aren’t always the best care. This statement should be less of...
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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...
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This post will be a little longer than usual. If you’re not sure what a full-service family physician can do, this story’s for you. The following is the body of an email sent by one of our 3rd-year JPS family medicine RESIDENTS about his experiences working at a regional hospital in...
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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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