Musings of a Distractible Mind
Thoughts of an odd, but not harmful primary care physician.
Last day of work. Lots of important questions run through my mind: what do I wear? Do I shave? Do I wear sandals? Should I have gotten a haircut? In the office, I see consults on my desktop – consults that really mean very little to me now, as the majority of these patients won’t [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.This is it. Eighteen years of practice is now condensed to my final four days seeing patients in the practice I built. While I am not bitter about what has happened (in fact, a large part of me is delighted), there is a sense of finality in this as one of my life’s major passings. [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.My change from a traditional practice to direct-care has caused me to challenge some of the basic assumptions of the care I’ve given up to this point. Certainly, the nature of my documentation will radically change with my freedom from the tyranny of E/M coding requirements. Perhaps the biggest change in my care comes courtesy of the [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.In looking through my vast collection of pens I came across a surprise: It raised the obvious questions: Why do I have a pen from Blueboy Chihuahuas? Why would I have a pen from a company in Lowell MA? Did a Chihuahua rep come around to my practice trying to get me to encourage my [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.Probably the hardest part of making the change from a traditional to a direct-care practice is the effect it has on relationships. I am only taking a maximum of 1000 patients (less at the start) and will be no longer accepting insurance. These changes make it impossible for me to continue in a doctor-patient relationship with [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.This evening I had the pleasure on being interviewed by Dr. Mike Sevila for the “Family Medicine Rocks” podcast. I talked about old times (I was the first guest on his show 5 years ago) and a lot about my decision to go into solo practice. It was a great chance to talk about [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.In a well-publicized and well-written article in the New Yorker, Atul Gawande (one of my doctor writing heroes) talks about his visit to the popular restaurant, The Cheesecake Factory, and how that visit got him thinking about the sad state of health care. The chain serves more than eighty million people per year. I pictured [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.I’ve got a bunch of pen pics taking up my memory, so I’m going to do my second post spawned by my discovery of a motherlode of drug pens in my desk. Today’s menagerie will feature some questionable decisions by the marketing departments. It’s bad enough to have doctors hate you (and throw things at you), or [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.After 18 years in private practice, many good, some not, I am making a very big change. I am leaving my practice. No, this isn’t my ironic way of saying that I am going to change the way I see my practice; I am really quitting my job. The stresses and pressures of our current [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.I cleaned out a drawer in my desk today. There were a lot of pens, many of which had drug company logos attached to them. As I looked over this menagerie, I was mildly awed and moderately amused by the variations on a pretty mundane medium. I ended up taking a bunch of pictures, and [...]
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This material, written by me, is free to re-post and share under the Creative Commons agreement. In other words, use it all you want; just give me credit.
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