tag:blogger.com,1999:blog-58576482011-11-12T11:47:19.365-08:00A Family Medicine Doctor Goes From HMO to Soloakifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comBlogger2291100tag:blogger.com,1999:blog-5857648.post-26599570887203256532010-11-01T12:11:00.000-07:002010-11-01T12:15:49.616-07:00

[From Roger Ebert's Journal by way of Daring Fireball.] OK, I don't post often lately. But I think remembering is important. Voting is, too. I encourage you to do both.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-30002905694550877252010-06-29T16:53:00.000-07:002010-06-30T00:02:35.844-07:00

I see that Practice Fusion is showing a "sneak preview" of their iPhone app on their Facebook page. How cool would that be if I could access my patients' charts with just my iPhone? Especially when I'm on vacation like now. Answer: Really cool. Location:Unseo-dong,Incheon,South Korea

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-81333662844263783842010-06-29T16:23:00.001-07:002010-06-29T16:23:57.352-07:00

I'm currently in Seoul, South Korea waiting for our connecting flight to Beijing. I'm taking a 2 week trip to China with my family. I thought this was an optimal time to go with my aging parents, who are from China, and my two teenage daughters, one of whom will be headed to college next fall. There won't be many chances for us to do this again. I want to show that even though I have a solo

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-17381831194379878472010-06-15T16:49:00.000-07:002010-06-15T16:49:05.041-07:00

To match my retro solo family practice, I figure I should get myself one of these. Right after I get my iPad, that is. And my iPad comes as soon as Practice Fusion can port their EMR over to the iPad. Even though it currently requires Adobe's Flash to run, Practice Fusion is hopefully coming to the Flashless iPad soon. According to their Facebook feed: We'll be testing a wide variety of

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-46407265024889806452010-04-22T22:00:00.000-07:002010-04-22T22:00:00.296-07:00

My last two posts have been what medical students have been saying about my micropractice. Now, a short commentary about medical students and the future of family medicine. It has been well documented that fewer and fewer medical students are choosing to enter primary care specialities, such as family medicine. In order to combat this, there has been an effort in some circles to expose more

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-5578757133838258952010-04-21T22:00:00.000-07:002010-04-21T22:00:05.348-07:00

As I mentioned in yesterday's post, I am ashamed to say that I have been sitting on a couple of essays from medical students who rotated with me since 2007-2008. I kept meaning to post them but time just sort of slips away and before you know it, it's the next decade. So with apologies to Erin for the late posting, here are her thoughts on her 5 week rotation with me from 2008: I did not know

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-32762998498856737682010-04-20T23:26:00.000-07:002010-04-20T23:28:34.051-07:00

Periodically I have a medical student do a clinical rotation with me and at the end, I ask them to write an essay about their experience working with me in my micropractice. I am ashamed to say that I have been sitting on a couple of essays since 2007-2008. I kept meaning to post them but time just sort of slips away and before you know it, it's the next decade. So with apologies to Andrew for

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-86902959597188616542010-03-26T09:47:00.000-07:002010-03-26T09:47:41.335-07:00

So despite my attempts to publicize the offer to provide "Pay What You Can" medical care for a day, I ended up seeing 4 patients that day (with one cancellation). The other doctor doing this with me, Dr. Tsai, also saw 4 patients, and we agreed that though the numbers seemed low, we were thankful not to have been overwhelmed by too many patients. I think the patients I saw were grateful to

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-82441262901748951262010-03-23T21:55:00.000-07:002010-03-23T21:55:50.387-07:00

But did he call bank?  This at least gives me hope that America is back on the right track towards reforming its broken and dysfunctional healthcare system. Next: getting more primary care doctors.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-80854746617277417212010-03-22T17:22:00.000-07:002010-03-22T17:22:58.307-07:00

It all started with a question: "How much do patients value primary care?" I was having an online discussion with other primary care physicians and this question came up. Someone suggested that one way to find out was to offer medical visits and have patients pay whatever they thought the visit was worth. Okay, I said, I'll give it a try. But when? For the past few years, I kept intending to do

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-14505428871037300022010-03-21T15:38:00.000-07:002010-03-21T15:38:24.258-07:00

In the late 1990s, an engineer named Tony Fadell came up with the idea of a hard drive-based MP3 player coupled with a Napster-like music store to complement it. He shopped the idea around to several companies but was turned down at all of them except for one. That company was Apple. After modifying, improving, changing Fadell's original concept, Apple released a new device in 2001 they called

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-90379002849892344132010-03-10T23:00:00.000-08:002010-03-10T23:00:01.271-08:00

Found this illustration via The Examining Room of Dr. Charles. I'd say it captures the feel of most family doctors' offices just right except that the tape the woman sitting behind the doctor is tangled up in should be red instead of white. For other depictions of various medical specialties, go to this exhibition on the art of Jose Perez.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-49379136077729143012010-03-09T22:59:00.000-08:002010-03-09T22:59:00.453-08:00

My blog is number 35 on this list which came out a while ago and is in no particular order. Amazing, considering how infrequently I post. But I am more about quality than quantity. That is, after all, why I left seeing 24+ patients a day and now see about 4-6 patients/day in my little micropractice. Speaking of Top 50 blogs, I notice over on the excellent DB's Medical Rants site that he is

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-37780489202226093142010-03-08T22:19:00.000-08:002010-03-09T09:35:46.744-08:00

Once upon a time, there were six doctors in a hospital. One day the admission clerk told them, "Hey, there is a patient in the hospital today." They had no idea why the patient was in the hospital. They decided, "Even though we have no old chart, let us go and examine the patient anyway." All of them went to where the patient was. Every one of them touched the patient. "Hey, this is atopic

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-29626872834370758322010-03-07T18:00:00.000-08:002010-03-07T18:00:01.996-08:00

That's the difference between how much time my patients get with me per year vs a typical primary care practice, using the same kind of calculation from this article posted at kevinmd.com found by way of the Ideal Medical Practices blog. Assuming 2 weeks of vacation a year and a patient panel of 500: 50 weeks a year x 30 hours per week divided by 500 patients = 3 hours. Compare this to the 36

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-82033893431639302792010-03-06T22:25:00.001-08:002010-03-07T01:20:56.299-08:00

I am currently in Sacramento wearing my California Academy of Family Physicians (CAFP) delegate hat at the Annual Congress of Delegates. Lots of civic-minded, concerned and caring family doctors doing a relatively thankless job. None of us get paid for this. Most family doctors in the state don't even know what we are doing at this meeting or that there is a meeting. But we are just trying to

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-29608956863976900122010-02-24T06:55:00.000-08:002010-03-09T21:58:13.203-08:00

Aaron Blackledge, MD, of CarePractice in San Francisco has a message that he would like to share with the public about the current state of the healthcare system. Being a primary care doctor these days is becoming more and more discouraging with the current payment system and insurance hassles, so much so that doctors are working less hours as noted in this Washington Post article: Average

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-23056179670371676422010-02-20T09:53:00.000-08:002010-02-20T09:53:25.993-08:00

The weather is starting to warm up a little. Spring is in the air. It was about time I spruced up the place. But mainly it was because the old commenting system I used (Haloscan) went kaput, and I wanted to implement Blogger's commenting system in its place. All the old comments got trashed (sorry) but I had no control over that. Give the new layout a spin. Make some new comments. Click on some

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-36562077998284525052010-02-20T08:32:00.001-08:002010-02-20T08:43:53.920-08:00

The National Committee for Quality Assurance, better known as NCQA, wants to know what you think are the most important features are of the Medical Home. Go to this link and tell them. Personally, I thought these listed features were all important, but narrowed it down to my top 5: wait time seeing the same doctor or nurse listens and answers your questions (well, duh!) knows you well access to

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-4580779942652291792010-02-17T23:45:00.000-08:002010-02-19T08:45:57.754-08:00

Ben Chan, a family physician, has just opened his new solo practice and writes: It has been 8 years since I read Gordon's article. Now, I am sitting in my office in this opening day, waiting for the first patient to call and make an appointment. So this is what you all went through. Emotionally, it has been like a roller coaster ride. At one time, I am happy that I made this tiny leap. On the

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-40318072114960189312010-01-20T08:00:00.000-08:002010-02-20T09:43:56.988-08:00

From Candorville.com Unfortunately, the Republican win in the Massachusetts Senate election probably means that these kinds of shenanigans will keep happening.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-31582263949958355232010-01-19T10:16:00.000-08:002010-01-30T19:42:33.175-08:00

Anyone who has been following my blog won't find this article from today's Rochester Democrat and Chronicle unusual: When Dr. Linda Lee sees patients, she brings them from the waiting room, typically spends a half hour with them, cleans up the exam room and submits the insurance claims online. She's the one who returns phone voicemails, and she gives patients her cell phone number for urgent

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-49581191044634765992010-01-10T22:56:00.000-08:002010-01-10T23:27:45.157-08:00

So even though I haven't been keeping up with my blog, I thought I should point out some excellent bloggers who not only manage to write something on a regular basis, but also have something meaningful to say.The Ideal Medical Practices Blog's focus is on the myriad problems facing America's healthcare system and especially its beleaguered primary care physicians, and what can be done to bring

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-49323908911665295652010-01-04T23:45:00.000-08:002010-01-05T00:53:49.818-08:00

From Sage, Ink at The Atlantic.com.Happy New Year!

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-3074621114145229732009-09-17T15:16:00.000-07:002009-09-17T15:35:37.384-07:00

A survey published 3 days ago in the New England Journal of Medicine says that 63% of doctors support the public option.When you compare this to the American Medical Association's stand opposing the public option, it is no wonder that groups like Sermo, a growing online physician community, say that "the AMA does not speak for me".

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-49908939440264885702009-09-04T05:00:00.000-07:002009-09-04T05:00:01.382-07:00

All politicians are crooks. All lawyers are dishonest. All doctors are rich. All insurance companies are greedy. All government is incompetent. When a significant proportion of the population hold these views, is it any wonder there is no confidence among some that healthcare reform can succeed? All that the forces of the status quo have to do to keep their gravy train going is to just keeping

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-12060565272015839712009-08-29T10:58:00.000-07:002009-08-29T14:25:42.324-07:00

Last night, when I drove past the corner where the anti-war protesters show up every Friday night, I saw some new signs. Instead of the usual "US out of Iraq!" anti-war signs, they were now holding up "Health Care For All!" signs. Is health care reform surpassing Afghanistan and Iraq as the most important issue right now? I see this as a good thing. Maybe something will actually get done.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-13775627902896455692009-08-29T09:25:00.000-07:002009-08-29T09:26:03.104-07:00

According to some people, the only possible choices we have for healthcare reform are bad ones. And not just simply bad. Horribly, maniacally, twisted-evil, crimes against Nature bad. So let's just keep everything the way it is and keep our eyes focused down at the ground and ignore that large boulder rolling down the mountain towards us. Sorry, I meant boulders with an "s" because it's actually

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-13036548068638951872009-08-12T00:47:00.000-07:002009-08-12T01:33:55.675-07:00

Tonight there was a local town hall meeting with my Congressman but I didn't go because I was packing to leave for IMP Camp tomorrow. Hopefully it was a civil affair with thoughtful discourse and respect for differing viewpoints. Not like the scuffle in St. Louis (via Daring Fireball):Anti-health-care-reform activist, reportedly injured in a fight at a town hall meeting last week, is collecting

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-53781118768871745442009-08-10T17:12:00.000-07:002009-08-10T17:29:05.091-07:00

NY Times piece about a day in the life of a family doctor, in this case, Dr. Timothy Malia. Sounds about right to me. I've had days (and weeks) like that, too.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-75900623189772658672009-07-20T16:19:00.000-07:002009-07-20T16:26:25.919-07:00

Unfortunately, under the current system, it's not patients. Or doctors.(Via Salon.com.)

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-21699987130187576582009-07-17T17:58:00.000-07:002009-07-17T18:05:54.249-07:00

You get sweet, sweet harmony.Click here for the backstory about this video.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-30475466337068886192009-07-16T00:16:00.000-07:002009-07-16T01:02:14.794-07:00

If anyone wants to know why we need healthcare reform yesterday, all they have to do is read this newspaper article about a patient who spent 12 hours at the Fort Walton Beach Medical Center in Florida and racked up charges totaling $211,941.50 before being transferred to a 2nd hospital where an additional $400,000 in charges were run up in 12 more hours.Granted, this case sounds like the patient

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-24229626033926715882009-07-10T17:23:00.000-07:002009-07-10T17:23:42.027-07:00

One of my patients posted this article about my practice, I am sorry to confess, back in February. I have been meaning to post a link to it, but always put it off, waiting for an opportune time to write a decent entry for this well-written article about alternative practice models, including the Ideal Medical Practice movement:There is a revolt afoot across the land.Doctors are rebelling against

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-3668532574831280962009-07-06T14:05:00.000-07:002009-07-06T14:17:25.692-07:00

Well, it's as good an explanation as any, and frankly more comprehensible than most.From Gods Playing Poker:

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-6533279107912978522009-06-21T08:36:00.000-07:002009-06-21T08:39:58.329-07:00

It is not necessary to change. Survival is not mandatory.--W. Edwards Deming“The superior doctor prevents sickness; The mediocre doctor attends to impending sickness; The inferior doctor treats actual sickness.” --Ancient Chinese quotationI haven't been posting regularly for a while because, well, it takes a lot of work to keep up a blog. I mean, I do have a day job. And that day job has changed

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-80050424734126458982009-06-19T21:59:00.000-07:002009-06-20T00:28:37.990-07:00

Even as physicians, patients, insurers, business leaders and politicians converge on Washington, DC to focus on healthcare reform, Ideal Medical Practices are making the news, this time in Anchorage, Alaska: During a typical visit to the doctor, most people spend more time in the waiting room than in the examination room.On average, a physician spends about 10 minutes with a patient, according to

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-23435521433352409932009-06-16T08:27:00.000-07:002009-06-16T08:28:17.118-07:00

Dr. John Brady runs a successful micropractice in Newport News, VA, and was Virginia's 2008 Family Physician of the Year. He has written a letter to his state legislators and President Obama regarding the healthcare crisis that is so well written that I am reposting it here, with Dr. Brady's kind permission:-----Dear President Obama,I feel obligated to express my opinions on health care reform. I

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-7609477665413646552009-06-14T07:11:00.000-07:002009-06-14T07:31:40.047-07:00

Dr. Atul Gawande is a general and endocrine surgeon at the Brigham and Women's Hospital in Boston, MA, who also writes wonderful articles for New Yorker magazine. One of his recent articles, The Cost Conundrum, is a disturbing in-depth exploration into why health care costs in McAllen, TX, one of the highest in the US, are twice as high as those in El Paso, TX, despite its similar

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-53289595464285095432009-06-09T23:00:00.000-07:002009-06-10T02:40:56.285-07:00

From the Washington Monthly, this article quotes Senator Richard Shelby's (R-Ala) June 7th comments about the current healthcare reform efforts:One, we don't know how much [a reform package is] going to cost and who's going to pay for it," he said. "Secondly, it will be the first steps in destroying the best health care system the world has ever known."The best health care system the world has

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-89142906500373991932009-06-07T23:31:00.000-07:002009-06-08T08:51:06.776-07:00

From today's New York Times:LILI SACKS, a primary care doctor in Seattle, says she began thinking differently about her work on the day she realized she was beginning each appointment with the words, “Sorry I’m late.”Scheduled to see as many as 25 patients a day at a large clinic, she lacked the time for thorough examinations and discussions. Because of this, she said, primary care doctors are

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-47977828143162228962009-05-10T23:22:00.000-07:002009-05-11T00:15:39.942-07:00

Like many other physicians, I get free medical journals. Not as many as I used to get, but still more than I have time to read. Every now and then, I get one that I've never heard of, and I wonder why I am suddenly getting it. Most of the time, I toss them without a second thought. Strangely, I never seem to receive another copy of those once-appearing journals. Maybe now I know the reason why.It

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-2781878284365660792009-05-01T09:39:00.000-07:002009-05-01T09:56:55.484-07:00

From the Los Angeles Times: Hospitals swamped amid flu fearsAt Loma Linda University Medical Center near San Bernardino, emergency room workers have set up a tent in the parking lot to handle a crush of similar patients. In Chicago, ER visits at the city's biggest children's hospital are double normal levels, setting records at the 121-year-old institution. So far, few of the anxious patients

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-29895426471500493132009-04-23T15:42:00.001-07:002009-04-23T17:42:24.637-07:00

Vaccinations are an important tool for keeping people healthy. Like many family physicians, I give vaccines to my patients. Unfortunately, also like many other family physicians, giving vaccines is often not cost-effective and in some cases, a money-losing endeavor. Part of the problem is that some vaccines cannot be purchased as a single dose. That leads physicians to decide if they should buy

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-66308689108379998932009-04-18T22:47:00.000-07:002009-04-18T22:47:36.785-07:00

I met Beatrice (not her real name) a little more than 2 years ago. She had just turned 90, and her daughter brought her in because she had been feeling a little more tired and short of breath lately. As she put it, she was having problems "getting going" in the morning. She had rarely been to a regular medical doctor, preferring homeopaths, in line with her beliefs as a Christian Scientist. Up

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-25431695647462242142009-04-03T07:58:00.000-07:002009-04-03T08:36:29.145-07:00

This article by syndicated columnist Ellen Goodman from yesterday's Washington Post gives a nice summary of what ails our current US healthcare non-system: "The Care in Health Care":I was tickled to hear that the insurance industry is beginning to commence to start to think about lifting bans on the pre-existing conditions that keep a slew of Americans from getting health coverage. This has

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-73840387505675047152009-03-08T19:40:00.000-07:002009-03-08T19:44:14.129-07:00

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-7010909281275836732009-03-07T22:26:00.000-08:002009-03-08T00:59:45.117-08:00

When I arrived this morning in Sacramento, I wasn't sure why I was here. I am attending the California Academy of Family Physicians 2009 Congress of Delegates. I am one of many family physicians who have come from all over the state. They are leaders in their community, faculty in academic medicine and residency programs, department chairs, chapter presidents. I am here because I happen to show

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-41174922982898845382009-02-10T22:24:00.000-08:002009-02-11T00:40:18.626-08:00

An ad for a longevity-enhancing product in today's Washington Post:INDICATIONS AND USAGE: Marriage is the therapy of choice for treatment of the condition of being unmarried. Marriage is approved to manage the dread of growing old alone and missing the opportunity to have dinner every night with a special someone, but without talking. Clinical trials indicate that marriage is recommended if you

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-54672173414741497792009-01-23T19:37:00.000-08:002009-01-23T19:50:18.403-08:00

Dr. Atul Gawande has a thoughtful article in the New Yorker about the transformation of healthcare in other countries and how it might happen here in the US. He feels that Massachussetts' new law that requires everyone to get health insurance is a good but imperfect start:For all that, the majority of state residents would not go back to the old system. I’m among them. For years, about one in ten

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-67260388763588346612009-01-19T20:01:00.000-08:002009-01-19T20:18:20.578-08:00

I have a dream . . . . . . that I can post regularly to my blog again. In the meantime, here is what I wrote on the Ideal Medical Practices Blog, a new blog with contributions from others in the Ideal Medical Practice (IMP) Movement.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-90412202508204857102008-09-26T14:11:00.000-07:002008-09-26T14:20:52.163-07:00

While Medicare officials advise seniors to shop around, I recall that the federal Medicare program itself is prohibited from shopping around for the lowest drug prices:As written, the legislation complied with a drug industry demand that Medicare be prohibited from negotiating with manufacturers for lower drug prices. Among those helping the industry make its stand was Rep. Billy Tauzin (

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-41451954991541606522008-09-25T22:43:00.000-07:002008-09-25T22:45:27.376-07:00

Via joyoftech.com

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-89365536344026131882008-09-22T22:29:00.000-07:002008-09-22T22:44:06.691-07:00

From Sen. Bernie Sanders at DemocracyNow.org:For years now, they’ve told us that we can’t afford—that the government providing healthcare to all people is just unimaginable; it can’t be done. We don’t have the money to rebuild our infrastructure. We don’t have the money to wipe out poverty. We can’t do it. But all of a sudden, yeah, we do have $700 billion for a bailout of Wall Street. It's

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-54984731836933648332008-09-07T00:12:00.000-07:002008-09-07T01:47:00.130-07:00

The following was recently posted in a listserve that I subscribe to. It is insightful and published with the author's permission (plus it saves me the trouble of writing an entry myself).Imagine going to your favorite restaurant. You are greeted at the door by the hostess, who seats you and takes your drink order. You order through your favorite waiter, Andrew, who recommends the special of

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-83898492964378491642008-09-05T15:06:00.000-07:002008-09-05T16:49:12.147-07:00

From the Newport News Daily Press, an interview with this year's Virginia Family Physician of the Year:When was the last time that your family physician made a house call? Or you were able to make a same-day appointment, see the doctor without waiting -- and then spend a half hour talking over your treatment plan?These seemingly old-fashioned images are at the core of practicing medicine for Dr.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-89545550486990915262008-08-31T19:45:00.000-07:002008-08-31T20:16:28.361-07:00

The good news is from today's Portland Press Herald: "Smaller is better, say doctors who reduce practice"Dr. Jean Antonucci says a physician can learn a lot by meeting a patient in the waiting room. She notes how difficult it is for the patient to get out of the chair, how easily he walks, whether his speech is slurred and whether his mind is confused.Antonucci, a family practitioner in

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-29864636756709502022008-08-26T08:42:00.000-07:002008-08-26T08:55:22.029-07:00

Yet another article on an Ideal Medical Practice from today's Washington Post: "Making Practices Perfect":The waiting room of Ramona Seidel's family medicine practice is empty, and she works hard to keep it that way.After several years in a traditional suburban group practice that blended pediatrics and family medicine, Seidel quit to start her own micro-practice in Annapolis: a low-overhead,

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-66381828464718109562008-08-15T12:06:00.000-07:002008-08-15T13:11:00.720-07:00

Anonymous recently wrote a comment:Are you sure you want to call youself "IMP" ? The word imp has a negative connotation in its definition.Hello, Anonymous. You are absolutely right. From FreeDictionary.com, the definitions of "imp" are:1. A mischievous child.2. A small demon.While it may sound like a medical office run by small demons, IMP (short for Ideal Medical Practices) is a practice model

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-67346809851651696322008-08-13T13:07:00.000-07:002008-08-13T13:15:31.940-07:00

One common question that comes up with doctors looking into doing an IMP/solo model practice is: how do you take vacation?This is a problem encountered by all solo physicians, not just those doing the IMP model. For myself, when I first went solo 4+ years ago, I didn't know any FPs in the local community and didn't know who to ask for coverage. So that first summer, I took my own call when my

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-50876568055570386802008-08-01T23:25:00.000-07:002008-08-02T01:22:08.519-07:00

OK, I meant to post these last week when I went to Comic-con. Better late than never. Sick, but funny. Trust me, I'm a doctor.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-12803883337734702302008-06-22T17:49:00.000-07:002008-06-22T18:09:24.957-07:00

From The Olympian in Washington State: "Old-fashioned touch: Micropractice helps doctor humanize modern medicine"Dr. Marius Laumans strives to run an old-fashioned medical practice with modern-day conveniences.Need a same-day appointment? Patients can go to his Web site, check his availability and schedule one.Wondering if an over-the-counter allergy drug could mix poorly with prescription

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-76283470662634322342008-06-20T20:43:00.000-07:002008-06-20T21:32:04.415-07:00

IMP Camp 2008 is underway and full of bright-eyed and bushy-tailed (and even tail-deficient) doctors! From Soma's blogI had started my medical practice in Manhattan in the summer of 2006. They say if you can make it there you can make it anywhere…Oh boy is that true. I started my business before I even knew the existence of the IMP group. I didn’t realize that the same concepts and the similar

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-76587734514354064182008-06-20T19:56:00.000-07:002008-06-20T20:05:08.861-07:00

From the June 2008 issue of Medical Economics, "Small practice evolution: The medical micropractice":Every so often, a new patient of internist Jean Antonucci in Farmington, ME, looks puzzled when the doctor herself—and not a medical assistant—walks into the waiting room and escorts him to a 125-square-foot room.In that room, which looks out on pine trees and a stream, Antonucci takes vital signs

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-15302449644741811042008-05-13T00:48:00.000-07:002008-05-13T00:55:40.578-07:00

From The New Yorker MagazinePass it on.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-74074485831867076292008-02-13T07:58:00.000-08:002008-02-13T08:26:14.317-08:00

From the NY Times: "Number of US Primary Care Doctors Down".Fewer American doctors are focusing on primary care, but the decline is being covered by physicians from other countries. The General Accountability Office said Tuesday that as of 2006 there were 22,146 American doctors in residency programs in the United States specializing in primary care.That was down from 23,801 in 1995, the research

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-42814627846081876032007-12-11T23:13:00.000-08:002007-12-12T01:40:09.168-08:00

Gerald left the following comments:I read about your idea several years ago. Here's the deal, that bugged me from the start, and still gets to me.While on the one hand you do spend more time with patients, and likely make better decisions, you also miss out on a crucial element of civilization. Division of labor! Why on earth do you have to waste hours at a stretch calling insurance companies

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-4954506054232803122007-12-11T10:48:00.000-08:002007-12-11T11:27:04.952-08:00

You may be getting a phone message like this in the near future (as I did a few days ago):"My name is Carl Sibley and I'm with Congressman Tom Cole and the National Republican Congressional Committee in Washington. For your role as a business leader in California, we want to recognize you with our highest honor, the Congressional Order of Merit. I need to speak with you about it as soon as

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-18376764078170041662007-11-10T01:25:00.000-08:002007-11-10T01:35:35.246-08:00

Unfortunately, that title doesn't belong to the one in the United States.(Comic by Ted Rall)

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1142219125892013152007-11-09T00:13:00.000-08:002007-11-09T00:42:43.574-08:00

Medpundit had a taste of the micropractice way of life, but doesn't sound like she enjoyed it. That's probably because she was seeing her usual amount of patients with less help (ie. short-staffed) rather than the smaller volume (less than 10 patients/day) that most micropractices enjoy. So all the pain but none of the joy of a micropractice = bad experience.The truth of the matter is that

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-62532443519054946352007-09-19T00:15:00.000-07:002007-09-19T00:41:47.802-07:00

What do you get when you cross "Talk Like a Pirate Day" with Universal Health Care? Why, a song, of course!You also get this video below describing the exploits of the dread pirate, Captain Blue Shield:

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-15814079686979761972007-09-15T15:18:00.000-07:002007-09-15T15:43:05.871-07:00

From the Seattle Times: "Doctors find going solo painless":If patients getting a checkup at Dr. Donald Stewart's clinic in Sammamish feel at ease — like they're visiting the family doc at his home — it's because they are.On July 28, Stewart began his new life as a downsized solo physician, chucking his previous career running a group clinic.With high-tech help and by cutting his overhead — such

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-90970184468106664682007-09-15T15:14:00.000-07:002007-09-15T15:42:48.206-07:00

Anonther micropractice article from the Lincoln County News in Maine.It might seem like a good idea at the time, when the thought first enters an administrator’s mind, but layers of bureaucracy and multiple steps in the chain of command can eventually mire the patient-doctor relationship in layers of inefficiency.The answer is not more bureaucracy.“The goal is to give patients unfettered access

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-76732677301192868182007-09-15T14:47:00.000-07:002007-09-16T16:44:32.345-07:00

From the Albany Times Union: "Doctor cuts staff, buys time"One thing about Dr. John Pramenko's new practice: Patients won't feel rushed. The 41-year-old family physician is opening one of the region's first micro-practices, a relatively new model in health care that has no nurses, office manager or receptionist. Patients make appointments online, and records are kept electronically.Without the

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-48413797972814290682007-08-30T00:16:00.000-07:002007-08-30T00:48:05.882-07:00

I saw a patient today who was having heart palpitations, probably due to drinking too much coffee. I basically advised the patient to cut back on caffeine, but had I known, I would have employed visual aids such as the one below:I know some patients who would benefit from these instructions in "How to Explain Yourself to a Doctor". But he left out "Answer the question the doctor asked you without

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-4337633879241760232007-08-29T23:35:00.000-07:002007-08-30T00:55:44.829-07:00

Here is a good description of "usual care" vs. micropractice care from a patient's perspective: I've waited for three hours for an appointment. I have had the temporary "doctor of the day" in a group practice override written instructions left by my midwife (who I can't see because she has to be scheduled five weeks in advance -- in fact my monthly appointments have to be "fit in"). A number of

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-55160269761849573052007-08-17T23:51:00.000-07:002007-08-17T20:51:15.680-07:00

One of the things doctors considering solo practice always want to know about is, "What about vacations? Who covers for you when you are out of town?" Some even wonder, "Can solo practitioners even go on vacation?"In my 4th year of solo practice, I am again on vacation, this time visiting relatives on the East Coast. In my first year of practice, I had so few patients (plus I didn't know any

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-74580624215844900362007-08-15T07:30:00.000-07:002007-08-15T07:37:24.821-07:00

Dr. Chad Magnuson just opened his new micropractice in Vashon Island, WA. Here is a news paper article about his new venture which is starting to sound very familiar (at least on this website):In a world of increasingly high-tech medicine and huge practices teeming with professionals, Dr. Chad Magnuson’s new office in downtown Vashon provides a striking contrast.Walk into his waiting room — a

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-79628917375377555652007-08-11T08:40:00.001-07:002007-08-11T13:41:41.134-07:00

Here is yet another internet article about a doctor doing the "micropractice thing".One thing you're not likely to do if you have an appointment with family physician Dr. Janice Pegels is spend a lot of time in her waiting room."I don't like waiting, so I don't like to make my patients wait, either," she says.You'll also be booking your own appointment online and will get a reminder call from the

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-31358822773372196562007-07-17T01:00:00.000-07:002007-07-17T01:27:34.224-07:00

If I don't answer my office phone for the next few days, it's because my VOIP phone provider (SunRocket) suddenly went out of business. Grrrr!The problem with being on the bleeding edge of technology is that frequently you get cut.Now I have to decide if I should go crawling back to the safety of a landline, or take another chance with a different VOIP provider. I'd consider VOIP with my cable

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-42714070715072983662007-07-10T01:29:00.000-07:002007-07-10T01:53:51.032-07:00

Here's something unusual: TWO newspaper articles about micropractices in one day. From today's Los Angeles Times: "It's about time, say doctors in vanguard"In a 150-square-foot tin-ceilinged office in a building that once housed a speakeasy, Dr. Moitri Savard checks her laptop to see whether any patients have scheduled themselves to see her. Wait, scheduled themselves? Yes. Savard's patients

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-72968341916579591992007-07-04T10:54:00.000-07:002007-07-04T11:21:29.228-07:00

To this day, I still remember what it was like having a rectal exam done on me by a fellow classmate in medical school, and I think it has made me a better doctor. No camping out by the prostate for me. I think that is the rationale behind this idea of having resident physician get a taste of what it is like to be a hospital inpatient.Clad in hospital gowns and assigned various ailments, six

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-46633953754113202502007-07-02T21:46:00.000-07:002007-07-02T21:57:23.835-07:00

Just what I need: an excuse to get an iPhone. "But it's for work, honey! Honest! Only $5999!""Hmmm, okay, maybe just the iPhone then?"Well, it's worth a try.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-5203800967620090972007-06-04T22:44:00.000-07:002007-06-04T23:10:46.345-07:00

Found this article by way of Dr. Ben Brewer, a family physician who also happens to write a column for the Wall Street Journal called, "The Doctor's Office".Is Health Care Making You Better -- Or Dead?We asked [Regina] Herzlinger, the Nancy R. McPherson Professor of Business Administration Chair at the Harvard Business School, to discuss her latest work and her more than 30 years of research in

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-81420345352354548972007-05-15T00:05:00.000-07:002007-05-15T00:18:27.215-07:00

I'd like to think that every family doctor experiences this kind of moment at least once in their career. For many of us, more than once. For someone who doesn't practice medicine, they may not "get it". But there is power in just simply caring, even when there is nothing else that can be done. This is the power of a man who cared, and which is so strong, some of his magic still lives in his

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-66688022727423252362007-04-30T23:49:00.000-07:002007-05-01T01:33:40.543-07:00

As further proof that our healthcare system is totally screwed up, I present the following.On the one hand, we have a family doctor making $500 house calls in New York City which one patient describes as "ideal medical care". (Hint: it's not.)Then as a polar opposite we have another family doctor in Chicago who chose to go "bare" (that is, go without any malpractice) in order to maintain his solo

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-90226989893158136142007-04-23T22:54:00.000-07:002007-04-23T23:17:50.430-07:00

Another opportunity for me to talk about ideal micropractices, this time on public radio's, "Marketplace". Thanks, Pat!But I'm even more proud and honored to be mentioned (albeit briefly) in this soon to be literary classic.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-39297463347587987572007-04-10T22:23:00.000-07:002007-04-11T18:13:01.985-07:00

(With apologies to the Wachowski Brothers)Dr. Moore: I imagine that right now you're feeling a bit like Alice. Tumbling down the rabbit hole? Or perhaps like you’ve been running on a hamster wheel?Dr. Neo: You could say that.Dr. Moore: I can see it in your eyes. You have the look of a doctor who accepts the amount of work he gets because he's expecting to get paid a fair price for his services.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-42876692781613938552007-03-29T19:32:00.000-07:002007-03-31T17:36:46.763-07:00

Well, I had meant to post something on my practice's 3rd year anniversary (Feb 14th) but . . . better late than never.I recently got mentioned in various media sources: a WSJ article on micropractices, a podcast on the CAFP website. (Perhaps that's why you're here?) So this is an indication to me that word about Micropractices and Practice Redesign is continuing to spread.Brief background:

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1169656498101078702007-01-24T08:25:00.000-08:002007-01-24T09:08:31.993-08:00

As another example of what is wrong with the current US health care system, here is an article from today's New York Times describing how insurance companies would sooner pay for an expensive coronary stent than for a patient to sit down and talk with their healthcare provider about low cost changes in diet and exercise."We have made major improvements in prevention," Dr. Gregg W. Stone, the

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1155374540855281782007-01-24T00:22:00.000-08:002007-02-09T23:28:19.323-08:00

The North Dakota Supreme Court has finally ruled in favor of that state's medical board and said it had the right to revoke the medical license of Dr. George Hsu because of what it considered inappropriate care.A quick summary of the case (detailed version here): An anonymous complaint was made to North Dakota Board of Medical Examiners against Dr. George Hsu. After an investigation they

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1169544490361317612007-01-23T00:25:00.000-08:002007-01-23T02:04:56.446-08:00

Date: Monday, January 22, 2007Radio Station: KSOR, Jefferson Public Radio, Ashland, ORProgram: The Jefferson ExchangeHost: Jeff GoldenGuest: David Carroll, Research Director for the California Budget Project and former director of finance policy for the California Association of Public Hospitals.Caller: JanJeff: Let's take a call from Jan in Eugene. Jan, you're on with David Carroll of the

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1166230884733013212007-01-04T23:50:00.000-08:002007-01-05T00:25:00.136-08:00

As before [1] [2], when I have a medical student do a rotation with me, I ask them to give me a write-up about their experience working with me in my micropractice. Even though he doesn't mention anything about UCLA's defeat of USC in this year's annual football melee (which took place during the rotation), it still shows some insight and thoughtfulness. (Just kidding, Anto!)Family medicine is a

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1165044943305172342006-12-01T23:26:00.000-08:002006-12-02T11:43:12.226-08:00

From Medical Economics:For five years before opening her innovative solo practice in Woodland Park, CO, FP Michelle Eads worked in a very traditional, very busy primary care group. Located in Colorado Springs, it employed lots of doctors, operated with an enormous overhead, and processed scores of patients each day."I was forced to crank them through as fast as I could," says Eads, whose panel

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1159198197671271132006-10-15T23:02:00.000-07:002006-10-15T23:21:00.733-07:00

Recently I had the pleasure of hosting another 3rd year medical student from USC who was doing her primary care clerkship. I always warn students before they come that rotating through my office will offer far fewer patients than if they went to a more mainstream type of practice. On the other hand, they'll probably get a chance to spend a lot of time with individual patients and develop their

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1160436732937973242006-10-09T16:28:00.000-07:002006-10-09T16:38:37.580-07:00

I found this link via SlashDot about a computer that only allows you to use it as long as you are pedaling.Just for the record, I thought of this idea a year ago. Someone should do the same for a wide-screen plasma TV and an exercise bike.Now how many of you reading this now need one of these things?

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1158732552303988332006-09-19T22:43:00.000-07:002006-09-19T23:11:07.233-07:00

One last post for "Talk like a Pirate Day": a humorous music video about Healthcare Pirates from the Foundation for Taxpayer and Consumer Rights.Who would've thought a sea-shanty called "Go Ahead and Die" could have such a toe-tappin' beat?From their website: "Half of every dollar spent on health care is wasted on administration, insurance company profits, and overpriced pharmaceuticals." With a

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1158647436952158032006-09-19T00:04:00.000-07:002006-09-19T02:23:26.063-07:00

In recognition of Talk Like a Pirate Day, I though I would give some modern-day examples of Pirate-speak:Example 1Avast matey:Afterrr rrreviewin' th' inforrrmation, ourrr barnacle-co'erred Medical Dirrrectorrr has a fierce fire in his belly that tharrrwe must upbe holdin'th' denial o' co'errrage ferrr 'ese 'errreserrrvices on th' basis that tharrrtherrre be no documentation o' medical necessity

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1156922810137802982006-08-30T00:16:00.000-07:002006-08-30T02:44:50.533-07:00

I have a patient who occasionally e-mails me interesting articles related to healthcare. Recently he (Hi, Mr. S!) sent me an article about how doctors are nickel and diming their patients for things like filling out forms, refilling medications or giving advice over the phone:When Jill Wolfson called the psychiatrist last year for a prescription refill for her son, she had an unpleasant surprise.

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.comtag:blogger.com,1999:blog-5857648.post-1154672256391545002006-08-11T23:45:00.000-07:002006-08-12T02:46:30.206-07:00

I have been following the story of Dr. George Hsu over the past year, and like a Hollywood movie, it is finally approaching the climactic ending, though I still don't know if it's going to be one of triumph or tragedy. Here's the timeline version:March 2004 - Dr. Hsu, a small town family physician in Elgin, North Dakota, has his license revoked by the State Board of Medical Examiners based on an

akifoxhttp://www.blogger.com/profile/13323623583713883085noreply@blogger.com