Atul Gawande, MD, a Harvard surgeon at Brigham and Women’s Hospital in Boston, regularly contributes significant and provocative articles to the New Yorker under the head “Annals of Medicine”. In recent years I have written about several of these, including the “The Cost Conundrum”, June 1, 2009 (my comments in Medicare Costs: "All Politics are Local", June 11, 2009), “The Hot Spotters”, January 24, 2011 (Freedom abroad, health at home: experiments in preventive health care, February 13, 2011 and Camden and you: the cost of health care to communities, February 18, 2011), and “Cowboys and Pit Crews”, May 26, 2011 (EMRs and Primary Care:...
So, two things. 1. I changed the blog template. I hope you like it; I'm not sure I do, but it seems that blogger doesn't actually offer the old one anymore anyway.2. I still, despite changing my pw and using Google "verify" am getting what I interpret as hacked spam -- items I obviously didn't create appearing in my "draft blog" list. I'll change pw again, but don't know how this is happening, and apparently no one else does eith...
0 The Primary Care Conundrum
.The primary care conundrum:We need more primary care doctors.We treat primary care doctors relatively poorly, thus discouraging medical students from entering the field.This issue has been one of the recurring themes in the discussion of health reform, and I have written about it often. People argue around the edges of the conversation: · It is not only primary care doctors that are relatively underpaid; so are many non-procedural specialists.· There is not going to be an increase in the payment to physicians, so higher-paid specialists are going...
0 Medical errors: to err may be human, but we need systems to decrease them
An op-ed by Sanjay Gupta, MD, the Atlanta neurosurgeon and CNN medical correspondent, appeared in the New York Times on August 1, 2012. “More treatment, more mistakes” makes the case that medical errors are common and that they are largely due to the pressure to “do more”, to do more tests, to do more x-rays, to do more surgery. This is not news in itself; the Institute of Medicine (IOM) of the National Academy of Sciences published its study “To Err is Human” in September 1999, observing that between 44,000 and 98,000 deaths occurred per year as a result of medical errors (full text available at http://www.nap.edu/openbook.php?isbn=0309068371)....
0 Doctor shortage or shortage of the right doctors?
.The lead article in the New York Times (right column, front page, by Annie Lowrey and Robert Pear) on Sunday, July 29, 2012, has the provocative headline “Doctor shortage likely to worsen with health law.” My first instinctive reaction was “What? I don’t know of any part of the new health law, the ACA, that will reduce the number of doctors!” Then, reading the first sub-head, I realized what they meant. “Primary care is scarce”, something I well know and have written a lot about, and then, in smaller type, “Expanded coverage, but a greater strain on a burdened system.”What they are saying is that the shortage of physicians, especially primary...
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