Archive for the 'Primary Care in America' Category

Throwing It To The Dogs

Tuesday, July 15th, 2008

Robert Pear reported this week in the New York Times that, in narrowly averting the scheduled 10.6% pay cut for doctors (and in the process taking the popular Medicare Advantage program away from seniors), congresspersons of both parties have come to recognize that “the formula for paying doctors is broken.” For their insight in reaching […]

Posted in Healthcare economics, Primary Care in America | 8 Comments »

Getting Square With the Nurses

Wednesday, July 9th, 2008

Last month, DrRich wrote about how “doctor-nurses” are fixing to displace primary care doctors, and how the noble American Medical Association – champion, as always, of the American PCP – is mobilizing with decisive action to prevent this tragedy from taking place.*
One of the more remarkable responses to this article came in the form of […]

Posted in Primary Care in America | 5 Comments »

Another Reason To Let the Doctor-Nurses Take the Whole Thing

Wednesday, June 18th, 2008

According to NewScientist Magazine, David Fishbain, Professor of Psychiatry and Behavioral Sciences at the University of Miami, says that up to 1 in 20 patients would like to kill their primary care physicians.*
He learned this interesting tidbit in a survey he conducted among 800 patients undergoing physical rehabilitation or suffering significant pain. He presented his […]

Posted in Primary Care in America | 7 Comments »

Hey PCPs - Here They Come!

Tuesday, June 17th, 2008

The June 16 issue of AMANews reports that the National Board of Medical Examiners will begin offering a certification examination this fall for graduates of “doctor of nursing practice” programs. Revealingly, the test will be based on Step 3 of the U.S. Medical Licensing Exam.
Doctor-nurses will soon be Board Certified, just like, uh, doctor-doctors.
The […]

Posted in Primary Care in America | 14 Comments »

Hope for the Medical Home?

Tuesday, June 3rd, 2008

Last summer DrRich wrote a post that was pretty hard on the Medical Home, and since that time he has seen no good reason to reconsider his opinion. Rather (as usual after officially pontificating on some topic), DrRich has remained smugly satisfied that he nailed it.
But now something has happened to make DrRich wonder whether […]

Posted in New business models for healthcare, Primary Care in America | No Comments »

Smile When You Call Me Optimist

Monday, April 14th, 2008

In a previous post, DrRich gave his thoughts on the distressing condition of the American primary care physician (PCP), and described how the feds, the insurance companies, and the currents of history are conspiring to fundamentally devalue and disrupt their once-honored profession. Further, he attempted to describe some options that disaffected PCPs might explore which […]

Posted in New business models for healthcare, Primary Care in America | 4 Comments »

Primary Care: Time to Reboot

Tuesday, April 8th, 2008

American primary care medicine has entered into a period of change. “Change” is perhaps too mild a term; many - especially the primary care practitioners (PCPs) themselves - might call it a period of crisis. In any case it is change so profound that one might be forgiven for thinking Senator Obama is […]

Posted in New business models for healthcare, Primary Care in America | 19 Comments »

More Guidelines: What Are They Smoking?

Friday, April 4th, 2008

This is a heads-up for all you primary care doctors out there, who struggle during each and every patient visit to get through your Pay for Performance Checklist of Vital Healthcare Services (different checklists for different patients, of course, depending on their insurer), during the 7.5 minutes that the feds and the insurance companies have […]

Posted in General Rationing Issues, Primary Care in America | 8 Comments »

Strawberry Pickers and Primary Care Doctors

Friday, March 28th, 2008

DrRich has never done one-off postings specifically to call attention to enlightening quotes appearing in the medical blogosphere. That’s Kevin’s job; he’s uniquely good at it; and DrRich has no wish to step on turf he does not have the means to defend.
But David E. Williams of the Health Business Blog has captured the the […]

Posted in Primary Care in America | No Comments »

Capitation and Ratting on Patients

Wednesday, February 13th, 2008

Recently the Wall Street Journal Health Blog reported that California Blue Cross, in reaction to “getting slammed by everybody from Arnold Schwarzenegger to Hillary Clinton,” has agreed to stop sending letters asking doctors to help them find patients who failed to disclose medical conditions on their health insurance applications, so the Blues could cancel their […]

Posted in Gekkonian Rationing, Primary Care in America | 4 Comments »

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