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The challenge and importance of being a generalist

April 22, 2004

I love General Internal Medicine – both outpatient and inpatient. The intellectual and patient interaction challenges never diminish. We must maintain broad knowledge and develop the skills to apply that knowledge to our patients. Unfortunately, most physicians can improve their performance. However, I am often frustrated by the repeated complaints about generalist performance. Here are [...]

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Making oral narcotics non-abusable

April 20, 2004

Physicians are damned if we underprescribe narcotics to pain patients, and damned if we prescribe to those who abuse drugs. Some pharmaceutical companies are trying to make oral narcotics effective, yet not abusable. Drug Makers Hope to Kill the Kick in Pain Relief Cooperating closely with government officials and pain specialists, the companies are educating [...]

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Can primary care survive?

April 19, 2004

The End of Primary Care The very quality of primary care that made it so attractive is what led to its downfall. Legislators, insurance companies, even physicians themselves began to look for ways to harness the expertise of primary care doctors to expand care and limit cost. But no one seemed to recognize that the [...]

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Vacation

April 14, 2004

Going on vacation. Will resume blogging either Sunday or Monday. Playing golf and giving health care thoughts a rest. Have a great weekend!!! viagra free viagra buy viagra online generic viagra how does viagra work cheap viagra buy viagra buy viagra online inurl viagra 6 free samples viagra online viagra for women viagra side effects [...]

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Good news – ephedra ban upheld

April 14, 2004

Ephedra ban takes effect nationwide after judge rejects supplement makers’ request. The supplement makers’ lawyers tried! Unlike medications, which must be proven safe and effective before they are allowed to be sold, federal law allows dietary supplements to be marketed without any such proof. To curb a supplement, the FDA must show it poses a [...]

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Why paternalism does not die

April 13, 2004

Ordering Treatments à la Carte Many patients reject the idea of deciding on their own treatments. Overwhelmed by a confusing array of alternatives, they do not want the added stress of being forced to make hard decisions. They turn to their physicians for guidance. Many doctors are also uncomfortable ceding decision making authority to their [...]

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Good news from Medicare

April 12, 2004

Medicare Web Site to Provide Comparative Data on Prescription Medicines viagra free viagra buy viagra online generic viagra how does viagra work cheap viagra buy viagra buy viagra online inurl viagra 6 free samples viagra online viagra for women viagra side effects female viagra natural viagra online viagra cheapest viagra prices herbal viagra alternative to [...]

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Challenges with the ACGME work guidelines

April 12, 2004

Residencies pinpoint work-hour hurdles According to an Internet survey of resident program administrators, the specialty facing the biggest compliance hurdles was surgery, with 67.7% of 105 surgical programs represented in the survey saying they were greatly challenged by the new work hours. This was followed by neurological surgery, internal medicine, ob-gyn and thoracic surgery. The [...]

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A Medicare alert on concierge practice

April 12, 2004

Alert warns of Medicare conflict for concierge practices Those who start concierge practices (I prefer the term retainer practice) must carefully examine Medicare billing rules. One can still bill Medicare, however, one must be very careful not to claim that the retainer fee covers any service for which the provider also bills Medicare. viagra free [...]

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Not a free market

April 10, 2004

Our buddy Trent McBride has stirred up a great controversy. So When Are We Going To Get That Free-Market Health Care Everyone’s Complaining About? . If you find that interesting, he has 2 follow-up posts. His rant explains (and I agree here) that we do not have a free market health care system. We have [...]

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