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The Story of a Man Who Did Not Feel Well Print E-mail
Written by Mark E. Williams, MD | KevinMD   
Thursday, 09 June 2016 00:00

Once upon a time, not that long ago, there was man who lived an uncomplicated life. One morning he awoke and did not feel well. He could not really describe his malaise, but he definitely was not his usual self. Nothing particularly noteworthy had happened to him except that his dog had recently died of old age. William, a scruffy little terrier, was 17 years old, and the man knew for a long time that he was slowly sliding downhill. He was blind and limped, and his death was certainly not a surprise. Anyway, that was weeks ago.
 
The man continued to feel ill and after a while, he decided that he should seek some medical attention. He did not have a primary physician because he had never really been sick, took no prescription medications and no particular diseases ran in his family. He did not smoke and felt that his lifestyle was basically healthy. Sometimes he would enjoy a beer (or two) when he watched sports on television.
 
He called a clinic associated with a large regional medical center. A pre-recorded voice said that if he was having an emergency, he should hang up and dial "911." He did not think his condition was that urgent and he waited and was told to listen carefully since the options had changed. He was impressed that people memorized the options and figured out that option 3 was for him to schedule a new visit.

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Last Updated on Friday, 10 June 2016 17:13
 
When It Comes to Your Healthcare, Buyer Beware Print E-mail
Written by Michael P. Jones, MD | KevinMD   
Tuesday, 07 June 2016 17:12

...I received a call from a patient on whom I had performed an upper endoscopy to remove a small gastric polyp. Because removing stomach polyps can be complicated by bleeding, I did the procedure in the hospital rather than an outpatient center. The whole thing took 15 minutes. Anesthesia wasn't required, just routine conscious sedation. So, my patient wanted to know, what had I done that warranted an $18,000 bill from the hospital?

I had absolutely no explanation. For $18,000, you can just about buy your own endoscope. Amortized costs for an upper endoscopy at this hospital, including the use of the endoscopy unit, salaries for the whole staff, medication, and equipment expenses is probably not more than $200 for 15 minutes. By the way, the doctor doing the procedure - in that case, me - typically gets about $175 for an upper endoscopy.

And then there are the costly procedures you could probably do without.

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Last Updated on Wednesday, 06 July 2016 10:47
 
Thinking of starting a cash-based practice? Here are the pros and cons. Print E-mail
Written by Ashley Maltz, MD, MPH | KevinMD   
Thursday, 02 June 2016 00:00

As an integrative medicine physician, I am often questioned about what I do and how I decided to diverge from the normalcy of allopathic medicine. I usually go into a short spiel about my love for thinking outside the box and creating solutions for patients that seek a kinder, gentler style of medicine; one that blends effective healing modalities from all over the globe with my traditional allopathic training.
 
Most people enjoy this explanation and inquire more into my practice. Others shy away. But the most frequent question I get after this explanation is if I take insurance in practice. The answer is a resounding "no."

Do I not take insurance because I'm a mean and vengeful physician? As it is, families pay an exorbitant amount of money for health insurance with the added load of high deductibles straining their budgets.
 
I get this as, I too, am a consumer of health insurance and know first hand that it is not cheap!

However, what the masses may not understand about being a physician is the hefty price doctors who take insurance pay.

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Intricacies of Antidepressant Interactions Print E-mail
Written by FHI's Week in Review   
Monday, 30 May 2016 00:00

 
Once upon a time there were jokes circulating about putting Prozac (fluoxetine) in the drinking water.
 
The idea was that the modern antidepressants were indicated for most people living in today's society, and that these drugs were completely safe to use.
 
Now, these same drugs have so many warnings that they have become increasingly difficult to use in treating the common maladies of depression and anxiety.

Read more in  the current issue of Week in Review>> http://conta.cc/25tMQw7

Last Updated on Friday, 17 June 2016 12:03
 
EMRs, PCMH and OCD are Limiting Access to Care Print E-mail
Written by A Country Doctor Writes   
Thursday, 19 May 2016 00:00

We have a problem in our clinic.

Between our EMR implementation a few years ago and our PCMH recognition shortly after that, our office visit documentation has become bloated and our cycle time has almost doubled.

There are no brief visits anymore, since every visit entails screening for multiple psychosocial conditions and consideration of various immunization and health maintenance reminders.

Nobody sees over thirty patients a day anymore; we're lucky to exceed twenty.

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Fearing Exodus: American Board of Medical Specialties Issues Statement on Oklahoma Print E-mail
Written by Dr. Wes   
Monday, 02 May 2016 00:00

Fearing a mass exodus of physicians from the lucrative Accreditation Council for Graduate Medical Education (ACGME) mandated Maintenance of Certification (MOC) program, two member organizations of the ACGME, the American Board of Medical Specialties (ABMS) and the American Osteopathic Association (AOA), recently issued statements of "disappointment" or "promising to innovate."

The ABMS stated they were "disappointed" on the passage of the Oklahoma law outlawing the use of the ABMS MOC program for board certification, physician hospital credentialing, or insurance company payments and were "committed to improving their programs for physician certification and assuring that participation in MOC provides physicians with meaningful improvement opportunities." No mention of how they might cut the cost of their "commitment" to physicians was made.

The AOA's statement, issued just after the National Board of Physicians and Surgeons open its credentialing process to osteopaths, "promised to innovate" so they could reach their "Rooftop Goals." Too bad the AOA still doesn't seem to understand that their statement promotes just what physicians don't need: another bureaucratic building project.

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Last Updated on Tuesday, 03 May 2016 18:00
 
PPIs Linked to Kidney Failure Print E-mail
Written by FHI's Week in Review   
Tuesday, 19 April 2016 00:00

Proton pump inhibitors (PPIs) -- might dramatically increase a person's risk for kidney failure and kidney disease, new research suggests. The study was released Thursday <4.14.16> in the Journal of the American Society of Nephrology

Add PPIs to a long list of "totally safe" pharmaceutical products that later have proven to be dangerous. PPIs are one of the most prescribed drugs in the U.S. today. OTC versions are prevalent as well. 

Read more in the current issue of Week in Review>> http://conta.cc/1Vx5Iru

Last Updated on Wednesday, 20 April 2016 08:40
 
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