"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
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"I hear and I forget. I see and I remember. I do and I understand." - Confucius
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"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
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" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
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"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
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"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
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"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
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"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
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"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
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"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
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"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
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"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
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"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
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"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
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"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
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"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
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"There are no facts, only interpretations." - Nietzsche
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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
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"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow
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Workouts by month - Goal 200 from 11/1/09 through 10/31/10
http://ow.ly/1mYi7 - ABIM MOC program - two differing viewpoints - you can guess my voteMarch 16, 2010 5:06
RT @yejnes: My thoughts on the annual exam, etc., final letter ACP Internist, March 2010 http://bit.ly/9FNcXn wel-stated & importantMarch 15, 2010 12:47
A note to the professors, from the "real" world, on the use of ICDs in a fee for service community... http://ow.ly/1jaPy - great postMarch 13, 2010 2:19
RT @paulinechen: New "Doctor and Patient"; Learning to Keep Patients Safe in a Culture of Fear http://nyti.ms/bYA14V - blog post comingMarch 12, 2010 1:35
RT @tom_peters: @kevinmd Spoken like an MD. - true primary care is very complex - it is not simple care -March 11, 2010 12:43
RT @efalchuk: Seriously, what is Nancy Pelosi Talking About? http://bit.ly/9sHSc2 #healthreform #hcr #healthcare think Dazed and ConfusedMarch 10, 2010 7:53
Obama Says Health Overhaul Should Trump Politics - http://nyti.ms/bwKRyo - and he is correctMarch 8, 2010 7:28
@BertDecker multiples of 37 - trivial - any factor of 111 would factor into the others. The key here is that 37 * 3 = 111March 7, 2010 9:00
Physicians have allowed their practice terms of engagement to be dictated by others either directly as in some HMOs or large clinics or indirectly by insurance plans controlling the fees to the point where physicians decide that in order to survive economically they have to increase their output by seeing more patients in less time. Their job satisfaction plummets, patients get short changed if they get any change at all and the error rate accelerated with the risk of malpractice rising with it and patient satisfaction tanks. This may not apply to all physicians and practices but it is closer to the rule than the exception.
I still believe most physicians are still imbued with the ideals that prompted them to go into medicine. There is no doubt, however, entrepreneurship is now rampant in medical practice, particularly when physicians coming out of their training get confronted with debts of as much as $150,000. One way to erase that debt quickly is to go into a more lucrative specialty; another trick is to go into primary care and see as many patients as possible daily. Getting hooked with HMOs may just complicate the problem.
Before I retired, I just could not believe reports of some physicians seeing as many as 40 to 60 patients within a 6 to 8-hour working day. Those reports reminded me of an old English physician-friend, an immigrant here, who routinely saw close to 100 patients in a single day while in Great Britain. At least that’s what he told me. I could not think of any scenario closer to the brink of disaster than this production-type medicine.
Having said that, I live in a community where the main hospital runs one of the best FP programs in the Southeast. Over one half of its alumni have stayed and have become some of the most respected pnysicians in our area. Which is one reason I think those few physicians who stray from the straight, narrow path are more the exception rather than the rule, contrary to what Retired Doc had observed.
Medicine is rewarding in many more ways than we can imagine. Money is just one of them, but it ought not to
overwhelm our better nature as members of a profession whose primary devotion continues to be the caring, compassionate care of our patients.
2 Responses to It’s about time
R. G. Lacsamana, M.D.
July 21st, 2005 at 2:56 pm
Very apt observations!
I still believe most physicians are still imbued with the ideals that prompted them to go into medicine. There is no doubt, however, entrepreneurship is now rampant in medical practice, particularly when physicians coming out of their training get confronted with debts of as much as $150,000. One way to erase that debt quickly is to go into a more lucrative specialty; another trick is to go into primary care and see as many patients as possible daily. Getting hooked with HMOs may just complicate the problem.
Before I retired, I just could not believe reports of some physicians seeing as many as 40 to 60 patients within a 6 to 8-hour working day. Those reports reminded me of an old English physician-friend, an immigrant here, who routinely saw close to 100 patients in a single day while in Great Britain. At least that’s what he told me. I could not think of any scenario closer to the brink of disaster than this production-type medicine.
Having said that, I live in a community where the main hospital runs one of the best FP programs in the Southeast. Over one half of its alumni have stayed and have become some of the most respected pnysicians in our area. Which is one reason I think those few physicians who stray from the straight, narrow path are more the exception rather than the rule, contrary to what Retired Doc had observed.
Medicine is rewarding in many more ways than we can imagine. Money is just one of them, but it ought not to
overwhelm our better nature as members of a profession whose primary devotion continues to be the caring, compassionate care of our patients.
Jerry Flanagan
July 21st, 2005 at 3:47 pm
DB -
Thanks for your blog. Did you see our “Pig People from Outer Space (PPOs)” animation targeting health insurer greed?
Take a look:
http://www.consumerwatchdog.org/healthcare/PigPeople/
Thoughts?
Jerry Flanagan
Foundation for Taxpayer and Consumer Rights