Family physician, author, blogger, speaker, physician leader.

Tag Archive for NY Times

Why Nurse Practitioners Should Not Do Primary Care Without Physician Oversight

“She said my back pain was caused by micro kidney stones.” So said my newest patient after her previous primary care provider, a nurse practitioner retired. “Micro kidney stones?” I didn’t know what else to say. Having practiced as a board certified primary care doctor for a decade, I’d never even heard this term. Nurses Are Not Doctors So the NY Times opinion piece that “Nurses Are Not Doctors“, penned by Dr. Sandeep Jauhar, author of Doctored: The Disillusionment of an American Physician, resonated with me. The fact that 17 states have legislated nurse practitioners the right to practice primary care medicine without physician oversight is very worrisome. There is a primary care crisis. We do need more primary care providers. Though nurse practitioners can fulfill some of the demand they cannot do so without doctor oversight. Though on paper it seems like what primary care doctors do is easy, […] Read More »

The Seven Pillars of High Performing Primary Care Practices – Part Two

In a previous post titled, “Is Making Primary Care More Professionally Satisfying as Simple as Lowering Panel Size” I observed that lowering panel size and implementation of an electronic medical record did not change how doctors worked. Those doctors who stayed late continued to stay late. Those who left earlier tended to continue to leave earlier. Within a health care organization often touted by many to be an example of how health care should be delivered in the country, this phenomenon existed. Why? Our doctors work in a very large multispecialty group practice. We use a common electronic medical record. Doctors in both primary care and specialty care can discuss cases, review information, and determine together with the patient the best course of action. Our primary care doctors have lower panel sizes than a decade earlier. This panel size is adjusted and normalized for patient age, medical problems, and other […] Read More »

Getting the Best Hospital Care – Beyond the Hype Over Hospital Rankings

The New York Times recently published an article titled, “The Hype Over Hospital Rankings”. It is that time of year when hospitals tout their US News and World report rankings and crank out their marketing programs. Perhaps this is even important with health care reform, decreasing reimbursement, and a push towards a more consumer driven market. Hospitals are jockeying for position. “Nearly every hospital has a banner out front saying they’re a ‘top hospital’ for something in some rating system,” said Dr. Nicholas Osborne, a Robert Wood Johnson Clinical Scholar at the University of Michigan. “Those ratings have become more important for hospital marketing than for actually helping patients find the best care.”” So, how do you find the best care? Especially in health care when there is information asymmetry? Here is an excerpt from my book – The Thrifty Patient – Vital Insider Tips For Saving Money and Staying […] Read More »

The Best Blog Posts For Patients

As I make the transition to my new website, I wanted to highlight the most commonly viewed and best blog posts for patients from my previous website. For Patients Do I Need Cholesterol Medication? Is My Cholesterol High? The Simple Truth. Colon Cancer Screening Guidelines – Colonoscopy Better Than Sigmoidoscopy? The Truth and the Myth Elizabeth Edwards, Breast Cancer, and Mammograms – Her Death a Failure of Healthcare System. The Truth About Prostate Cancer Screening   Other Surprising Facts Life Line Screening – Worth the Money? Routine Annual Physical – Not Worth the Time or Money The Truth and Facts About Concierge or Boutique Medicine   Commentary on Media Stories Newsweek – Just Say No! – One Word Can Save Your Life. Too Simplistic. Doctors Need to Help. What Doctors Wish Their Patients Knew – Critique of the March 2011 Consumer Reports article NY Times – Finding a Quality Doctor […] Read More »

The Truth About Ovarian Cancer Screening – book excerpt

The New York Times editorial “False Promises on Ovarian Cancer” says it all. What is most concerning is that a third of doctors recommend what medical science shows not to be true: screening for ovarian cancer does NOT work. Enjoy the excerpt from my book – The Thrifty Patient – Vital Insider Tips to Staying Healthy and Saving Money – and be smarter than 1/3 of doctors! Simple to read and incredibly informative. Enjoy! Ovarian Cancer Screening One of the most feared cancers for many women is ovarian cancer, which occurs in one out of sixty-eight women. Unfortunately, like many cancers (lung, pancreatic), there is no screening test that has been helpful to detect the illness early and reliably proven to save lives. Until organizations like the American Cancer Society (ACS) recommend certain tests or examinations, everything you may hear on the news or from friends about breakthroughs in screenings […] Read More »