1) Family physicians are natural health system leaders (5/26/14)
Compared to all others, students entering family medicine were statistically more likely to recommend generic over brand-name medications and favor initial lifestyle change counseling to starting medication for a mild chronic condition.
2) The demise of the small practice has been greatly exaggerated (9/22/14)
In addition to providing superior service, solo physicians or small groups can create their own economies of scale by pooling resources and collaborating with other practices in areas such electronic health record systems and quality improvement.
3) 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?
4) Nurturing the next generation of diverse family physicians (7/21/14)
The good news is that family physicians are diversifying; the bad news is that Black and Latino physicians still have a long way to go to "catch up" to their numbers in the population. America's need for the next generation of diverse family physicians has never been greater.
5) Don't do stupid sh*t in cancer screening (8/25/14)
Think twice before reflexively doing things to elderly patients that can't possibly help and, therefore, can only hurt. And keep in mind that electronic clinical decision support should never, ever substitute for a physician's brain.
6) Why are doctors still prescribing bed rest in pregnancy? (9/8/14)
71 percent of maternity care providers would recommend bed rest to patients with arrested preterm labor, and 87 percent would advise bed rest for patients with preterm premature rupture of membranes at 26 weeks gestation, even though most of them did not believe it would make make any difference in the outcome.
7) The problem of pain (8/13/14)
Like many doctors, I have complicated feelings about prescribing for chronic pain. On one hand, I recognize that relieving pain has been a core responsibility of the medical profession for ages. On the other hand, deaths and emergency room visits from overdoses of prescription painkillers have skyrocketed over the past 25 years.
8) For homeless patients, housing is preventive health care (11/9/14)
I have come to realize that some of my patients will not be able to fully address their chronic health issues until they have roofs over their heads and the stability and security that comes with having a place to call home.
9) There are many ways of "knowing cancer" (6/5/14)
All of us involved in confronting cancer in all its forms - specialist and primary care clinicians, advocates, patients, family and loved ones - know cancer in different ways, and none should be held up as inherently superior to any other.
10) 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.