1) Movings and dislocations in life and medicine (2/9/14)
Will newly formed alliances of clinicians and hospitals succeed in organizing themselves to provide accountable care that improves population health outcomes? In other words, is this seemingly inexorable movement toward a brave new health system forward progress, or a temporary dislocation?
2) What can Rwanda teach the U.S. about primary care? (12/2/13)
It's sometimes easier for a patient with musculoskeletal low back pain to get an appointment with a spine surgeon or for a patient with panic attacks see a cardiologist than it is to find a family physician. You can get a same-day MRI for any number of problems that probably don't require any imaging at all. ... To improve population health in the U.S., we need to flip the pyramid so that primary care services are the base for all other health care structures.
3) Will Choosing Wisely change the way family physicians practice? (2/3/14)
The ultimate success or failure of the campaign will depend on how well physician societies can convince their members to curtail commonly accepted but nonbeneficial services, such as the annual physical examination in healthy adults.
4) Of impersonal statements and meaningless use (2/26/14)
Perhaps these electronic exercises collectively known as meaningful use will someday improve care and outcomes. Until then, I know it's only a matter of time before I read a personal essay from an earnest medical school applicant who once aspired to be a professional coder but decided he could have his nonsensical documentation requirements and treat patients, too.
5) Two types of "scut work" (12/16/13)
I am not nostalgic about trying repeatedly to place an 18-gauge IV in a patient with no palpable veins at four in the morning, or replacing a delirious patient's nasogastric tube for the fifth time in as many hours because he kept pulling it out. But at least that kind of scut, unlike the tedious tasks involved in electronic documentation, was work that was meaningful to patients.
If you have a personal favorite that isn't on this list, please let me know. Thanks for reading!