Dear Patients: You have it very hard, much harder than most people understand. Having sat for 16 years listening to the stories, seeing the tiredness in your eyes, hearing you try to describe the indescribable, I have come to understand that I too can’t understand what your lives are like. How do you answer the [...]
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The recent discussion of the appropriateness of bringing patients back to the office has really gotten me thinking about my overall philosophy of practice. What are the rules that govern my time in the office with patients? What determines when I see people, what I order, and what I prescribe? What constitutes “good care” in [...]
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PLACE OF OCCURRENCE, HOME ICD-E849.0 6:00 AM Alarm goes off. Hit snooze button. CIRCADIAN RHYTHM SLEEP D/O IRREG SLEEPWAKE TYPE ICD-327.33 6:30 Alarm goes off for third time. Ready to hit snooze button, but knee in ribs from wife prevents more snooze button procrastination. CONTUSION OF CHEST WALL ICD-922.1, ADULT MALTREATMENT UNSPECIFIED NEC ICD-995.8 Feeling [...]
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I am a flaming moderate. Yes, I know that is an oxymoron but the fact remains that I am both passionate and moderate in my political opinions. And I am in the mood to rant, so beware. Living in the deep south, I often seem like a radical communist to those I see. I frequently [...]
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Since many of my readers are newer, they may not have gone through all of my old posts (if you did, I give you my deepest condolences). For this reason, I am re-posting some of my favorite oldies. The following appeared in October 2007. The payment system in the US is complex. There are multiple [...]
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Dear Patients: I know you get frustrated with our office. We make you come in for visits when you think we should handle things over the phone. We seem more focused on your chart sometimes than on you. Sometimes you may even wonder if money has become more important than patients. To this, I say: [...]
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I was sitting in a conference recently; the speaker was talking about the Medical Home and how one practice was getting nearly $150K for managing a patient population using a new computerized tool. Sounds good. During the question and answer period I asked the speaker: “Shouldn’t we wait until insurance companies are willing to pay [...]
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I kind of figured that I would not get much disagreement with my previous post (at least from patients). It is easy for me to criticize my own profession and feel fairly safe, but turning the spotlight on patients makes is riskier. My purpose in writing these posts is to get both sides looking at [...]
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Why are patients mad at their doctors? In comments on my previous post, people expressed real frustration and distrust – mainly from a lack of listening and connection. Those who loved their doctors (and there were some) expressed the opposite. They had a relationship with their doctor. Here the rules I have for getting along [...]
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It has been a long time since I did a post on the physical exam. For those who have not read them, I have done a series on the nuances of a physical exam from the perspective of one who has done them for 20+ Years. For those of you who were relieved by the [...]
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