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The Pain Pendulum

I have been in medicine for almost 30 years. I have seen the same idiots in charge claim we were NOT doing enough to treat pain. That’s when the 5th vital was created, with the help of the Joint Commission. JCAHO made up cards with those smiley faces and those cards coincidentally had Purdue Pharmaceutical…

Patients Over Paperwork

Here is what the CMS is up to now. I guess they want to fix things. They want “public input on how to continue progress in the Patients over Paperwork initiative to reduce administrative burden and lower costs.” Here is what they want to improve. I put my thoughts in parentheses: Reporting and documentation requirements…

Doctors Going Over to the Dark Side

Over the years, I’ve watched primary care doctors leave their practices and become hospital administrators.  The reasons are obvious:  The paycheck and benefits are way better than being in clinical practice. Do these practitioners-turned-administrators bring any benefits to the hospital? More than anything, the benefit is those of us in regular practice still remember they were once…

Ridiculous Study of the Week: EHR Investment

This will blow your mind. A recent study found private practices are less likely to maintain EHR technology than clinicians in other care settings, such as hospitals or group practices. And now some more: Ultimately, researchers found 49 percent of independent physicians successfully attested to meaningful use at least once during the program. Comparatively, 70…

M.D. to NP Education Programs: Mixed feelings

I was reading a Facebook post the other day discussing a program for M.D.s to become nurse practitioners and I was like, “What the heck” is this?  My immediate guttural reaction was this is crazy, this is ridiculous, this is insane. Why would someone who has dedicated now 8 years of undergraduate education and medical…

Dangerous Road Ahead

More than 1 in 10 patients are harmed in the course of their medical care…………..and half of those injuries are preventable.  And there she was, by the time she reached the inpatient geriatric psychiatry inpatient ward in serotonin syndrome delirium, Ms. X was on Lexapro, Prozac, Effexor, Risperidone, Ingrezza, Austedo and Trazodone according to medication…

Resiliency Programs Not Very Resilient

I am no statistician but I still think this article called Resiliency Program Reduces Burnout Symptoms in FM Residents looks a little fishy. Doesn’t the title seem to look positive to you? Here is the basics to the study: Thirty-two family medicine residents at two residency programs in Toledo, Ohio, were recruited to participate; 19…

Why Am I So Miserable?

Do you find yourself anxious, upset, irritable on Sunday nights or the night before going into work? My friend, you are experiencing Sunday dreads. It is a symptom of a large problem. So, let’s just acknowledge that this IS NOT NORMAL even though it is common (In a 2013 poll from the career site Monster.com,…

New Ideas from the Volunteer State

Medicaid has been busting state budgets for decades, and there is not end in sight.  The authors of the Affordable Care Act actually bragged about putting more people on the welfare program, with some pols and wonks even claiming the expansion was an economic good.   That is absurd on its face, as it still represents…