Category: primary care

Can direct primary care save us from the tapeworms of insurance?

When Amazon, Berkshire Hathaway, and JP Morgan (AmBerGan) announced their health care partnership, Berkshire CEO Warren Buffett declared “the ballooning costs of health care act as a hungry tapeworm on the American economy.”  He is right. Our broken system is infested with tapeworms. Tapeworms are parasites; they exploit their hosts, drain resources, and suck the […]

It’s time for an army of people to help take care of our patients

This was the end-of-the-hallway conversation with an elderly patient after wrapping up a recent office visit, as we walked away from the exam room toward the front desk to schedule her follow-up appointment, and she realized that we were “celebrating” 20 years together. I met her when she was admitted as an inpatient when I […]

Physicians can’t take things personally. Here are some tips.

A natural part of life is emotionally growing (hopefully) with experience. If I was to look back at my own journey, when I was in medical school and just graduating, I would say that without doubt, one of the biggest things I would tell my younger self, would be to not take things too personally. This […]

The problem with telephone messages in primary care

Sometimes I wonder if I am wired differently from other doctors, in terms of what I remember on my own and what I need some help with. The other day I got a “medical call” that simply said, “Mr. Brown called to report his blood pressure is 120/80.” With more than fifty calls in my […]

A strong doctor-patient relationship: why it matters

Writing in Annals of Family Medicine a few years ago, Chicago obstetrician Benjamin P. Brown vividly described his mentor’s interaction with a patient who had just emigrated from Mexico and had no family support. “When he asked earnestly how she was doing, her hard-won defenses seemed to crumple, and all of a sudden she was […]

Physicians must reclaim the medical record

A guest column by the American College of Physicians, exclusive to KevinMD.com. I recently saw a new patient who came to our practice following a lengthy hospitalization. He is in his 80s with a fairly complex medical history typical of many in this age range. Yet, after carefully sifting through my first introduction to this […]

A physician contemplates Medicare blended rates

I am a terrible coder. I think I am a pretty good doctor, but when it comes to coding, the process of figuring out which billing code to pick to assign to a bill for an office visit, I am hopeless. No matter how many times I have had the rules explained to me, or […]

Sorry doctor, you’re already an actor

Following one of my recent articles on how physicians can improve their communication skills and ultimately help attain better patient outcomes, I received an interesting comment from a physician. It went something like this: “Sorry, but I’m not an actor.” This response typifies a small (but not insignificant) subset of responses I get when I’m […]

Making the world a better place for new medical interns

It’s that time of year again. The start of a new academic year, marked by the arrival of a brand-new class of interns starting out in their training. Clutching their freshly-minted medical degrees, they appear so ready, so anxious, so excited, so eager to learn. Now it’s our job to make sure they stay this […]

The nuances of a primary care visit aren’t always appreciated

I subscribe to a financial newsletter that happens to be written by a non-practicing physician in a highly specialized field. His daily updates are a mixture of financial and health advice, and he is a proponent of evidence-based medicine. Based on the letters from subscribers, they are willing to follow his advice eagerly, and when […]