In the spring of 2013, I heard Professor Kelly McGonigal speak at the Stanford Health Innovation summit and learned about her book, The Willpower Instinct – How Self-Control Works, Why It Matters, and What You Can Do to Get More of It. Fascinating, practical, and evidence-based, it is a book highly recommended for every primary care doctor and patient to read. McGonigal wants all of us to embrace our human nature, specifically that we have two minds in one brain. This setup often seems to thwart us from doing the necessary things to be and stay healthy. We have an emotional irrational mind. We have an analytic rational mind. By understanding these differences allows us the opportunity to be successful in what endeavors we pursue, like a New Year’s Resolution. After all, who doesn’t need more willpower? Over the past year, I’ve used many of the stories and strategies in […] Read More »
Tag Archive for primary care
Willpower Instinct – the Book Every Primary Care Doctor and Patient Should Read
Posted on January 30, 2014
The Seven Pillars of High Performing Primary Care Practices – Part Two
Posted on January 9, 2014
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 »
The Seven Pillars of High Performing Primary Care Practices – Part One
Posted on November 27, 2013
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? Was making primary care more professionally satisfying and more attractive to future doctors simply more than lowering panel size? Doctors at the Permanente Medical Group, where I practice, do not have many of the frustrations of other primary care doctors. Doctors are salaried. There is no perverse incentive of doing more tests or more procedures when there is no medical benefit. Doing more is a common pressure […] Read More »
Is Making Primary Care More Professionally Satisfying As Simple As Lowering Panel Size?
Posted on November 3, 2013
As a practicing primary care doctor, I very much enjoy my career choice. I’m fortunate enough to be in a large multispecialty practice that is collegial and forward thinking. If I was in a smaller practice like other colleagues, I would not quite feel the same. Yet concern about how to make primary care attractive for both future doctors and those currently in practice has been something I’ve been occupied with since 2010. It is simply about lowering panel size? Though that may help, the answer is more complex than that. In this post and a future post, I ask that question and propose a framework on how primary care can be better and how physician leaders might best address the problem. In 2006, my medical group transitioned to an electronic medical record (EMR). Interestingly, nothing changed on the amount of time doctors spent in the office. After becoming more […] Read More »
The Brutal Reality of Primary Care – Family Medicine
Posted on September 12, 2013
She was the first Michigan Wolverine I met who taught me their college fight song “Hail to the Victors”, http://www.youtube.com/watch?v=mURDwg_wilE, and demonstrated their rabid pride anytime football or basketball season rolled around. (If you know people from the University of Michigan, you know what I mean). She was also one of the smartest and hardest working doctors in our family medicine residency program and one of our two chief residents. So this past hot Labor Day weekend in Los Angeles, I was thrilled to catch up with my former chief resident. We hadn’t seen much of each other since completing our residency many years ago. She dropped by with her 3 year old and apologized that her 8 year old daughter would be unable to attend since she was taking tennis lessons with her father. How was life treating her? Challenges in being a parent? I heard she had started […] Read More »
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