The day of solo practitioners is coming to an end. In its place will be gaggles of gastroenterologists and flocks of physicians. Mega practices are becoming the norm in American medical care. Here’s a few pictures of this trend, somewhat dated (they on…
Category: primary care
The art of off-label prescribing
Some drugs are used for indications beyond their original FDA approved ones that make complete sense. I mean, if old seizure medications help nerve pain, it might be reasonable to try new ones for the same purpose if everything else fails. Sometimes th…
What to do with disparaging doctors
Doctors who disparage, or even ridicule, what parents tell them are, fortunately, rare. Nevertheless, sometimes parents may infer from what the doctor says or how he acts that he does not value what they are telling him, even though he did not mean to …
Why is it so difficult for Americans to make doctors’ appointments?
Jill Ladkin was already having a terrible autumn. It began with a seizure that put her in the hospital with what seemed like scores of unfamiliar physicians attending to her state of health. The brain scan revealed a mass in the lining of her brain, a …
In the age of EHRs, why are we still asking patients to fill out paper forms?
From the sublime to the ridiculous. That’s sort of how my day went yesterday. It started out with an early morning meeting with a colleague who has been implementing a telehealth program at one of our institution’s practices, learning about…
A key strategy to use for difficult conversations: Ask questions
No matter what profession you are in, having uncomfortable and difficult conversations is something you have to get used to. Tim Ferris said in his bestselling book, The 4-Hour Workweek (which I’d highly recommend), “A person’s success in life can usua…
Why patients should read their medical notes
For centuries, doctors felt that their notes were their property, and none of the patients’ business. This attitude slowly shifted, and the Health Insurance Portability and Availability Act (HIPAA) of 1996 put into law the fact that patients must be al…
Medicine is the last bastion of faxes and printers
Yesterday, I went into an exam room to print out some orders for a patient who needed to get his labs done at an outside facility. Due to his insurance, he cannot get his labs drawn in our office during a scheduled appointment, but must do it at one of…
Losing my first patient as a primary care physician
The first time I spoke to her was in the hospital when I was a relatively new intern caring for her. She was ailing for a while with complications of liver cirrhosis. She was new to the area. She had relocated from a different city to live close to her…
What health care can learn from a robotic delivery service
Several weeks ago, as I was walking through the halls of our hospital, out from an intersecting hallway drove a robotic delivery cart. Unmanned and adorned with sensors so it could tell where it was in the world, it motored along on its way, heading so…
