2010-06-30T00:02:35.844-07:00

I see that Practice Fusion is showing a "sneak preview" of their iPhone app on their Facebook page. How cool would that be if I could access my patients' charts with just my iPhone? Especially when I'm on vacation like now. Answer: Really cool. Location:Unseo-dong,Incheon,South Korea

2010-06-29T16:23:57.352-07:00

I'm currently in Seoul, South Korea waiting for our connecting flight to Beijing. I'm taking a 2 week trip to China with my family. I thought this was an optimal time to go with my aging parents, who are from China, and my two teenage daughters, one of whom will be headed to college next fall. There won't be many chances for us to do this again. I want to show that even though I have a solo

2010-06-15T16:49:05.041-07:00

To match my retro solo family practice, I figure I should get myself one of these. Right after I get my iPad, that is. And my iPad comes as soon as Practice Fusion can port their EMR over to the iPad. Even though it currently requires Adobe's Flash to run, Practice Fusion is hopefully coming to the Flashless iPad soon. According to their Facebook feed: We'll be testing a wide variety of

2010-04-22T22:00:00.296-07:00

My last two posts have been what medical students have been saying about my micropractice. Now, a short commentary about medical students and the future of family medicine. It has been well documented that fewer and fewer medical students are choosing to enter primary care specialities, such as family medicine. In order to combat this, there has been an effort in some circles to expose more

2010-04-21T22:00:05.348-07:00

As I mentioned in yesterday's post, I am ashamed to say that I have been sitting on a couple of essays from medical students who rotated with me since 2007-2008. I kept meaning to post them but time just sort of slips away and before you know it, it's the next decade. So with apologies to Erin for the late posting, here are her thoughts on her 5 week rotation with me from 2008: I did not know

2010-04-20T23:28:34.051-07:00

Periodically I have a medical student do a clinical rotation with me and at the end, I ask them to write an essay about their experience working with me in my micropractice. I am ashamed to say that I have been sitting on a couple of essays since 2007-2008. I kept meaning to post them but time just sort of slips away and before you know it, it's the next decade. So with apologies to Andrew for

2010-03-26T09:47:41.335-07:00

So despite my attempts to publicize the offer to provide "Pay What You Can" medical care for a day, I ended up seeing 4 patients that day (with one cancellation). The other doctor doing this with me, Dr. Tsai, also saw 4 patients, and we agreed that though the numbers seemed low, we were thankful not to have been overwhelmed by too many patients. I think the patients I saw were grateful to

2010-03-23T21:55:50.387-07:00

But did he call bank?  This at least gives me hope that America is back on the right track towards reforming its broken and dysfunctional healthcare system. Next: getting more primary care doctors.

2010-03-22T17:22:58.307-07:00

It all started with a question: "How much do patients value primary care?" I was having an online discussion with other primary care physicians and this question came up. Someone suggested that one way to find out was to offer medical visits and have patients pay whatever they thought the visit was worth. Okay, I said, I'll give it a try. But when? For the past few years, I kept intending to do

2010-03-21T15:38:24.258-07:00

In the late 1990s, an engineer named Tony Fadell came up with the idea of a hard drive-based MP3 player coupled with a Napster-like music store to complement it. He shopped the idea around to several companies but was turned down at all of them except for one. That company was Apple. After modifying, improving, changing Fadell's original concept, Apple released a new device in 2001 they called

2010-03-10T23:00:01.271-08:00

Found this illustration via The Examining Room of Dr. Charles. I'd say it captures the feel of most family doctors' offices just right except that the tape the woman sitting behind the doctor is tangled up in should be red instead of white. For other depictions of various medical specialties, go to this exhibition on the art of Jose Perez.

2010-03-09T22:59:00.453-08:00

My blog is number 35 on this list which came out a while ago and is in no particular order. Amazing, considering how infrequently I post. But I am more about quality than quantity. That is, after all, why I left seeing 24+ patients a day and now see about 4-6 patients/day in my little micropractice. Speaking of Top 50 blogs, I notice over on the excellent DB's Medical Rants site that he is

2010-03-09T09:35:46.744-08:00

Once upon a time, there were six doctors in a hospital. One day the admission clerk told them, "Hey, there is a patient in the hospital today." They had no idea why the patient was in the hospital. They decided, "Even though we have no old chart, let us go and examine the patient anyway." All of them went to where the patient was. Every one of them touched the patient. "Hey, this is atopic

2010-03-07T18:00:01.996-08:00

That's the difference between how much time my patients get with me per year vs a typical primary care practice, using the same kind of calculation from this article posted at kevinmd.com found by way of the Ideal Medical Practices blog. Assuming 2 weeks of vacation a year and a patient panel of 500: 50 weeks a year x 30 hours per week divided by 500 patients = 3 hours. Compare this to the 36

2010-03-07T01:20:56.299-08:00

I am currently in Sacramento wearing my California Academy of Family Physicians (CAFP) delegate hat at the Annual Congress of Delegates. Lots of civic-minded, concerned and caring family doctors doing a relatively thankless job. None of us get paid for this. Most family doctors in the state don't even know what we are doing at this meeting or that there is a meeting. But we are just trying to

2010-03-09T21:58:13.203-08:00

Aaron Blackledge, MD, of CarePractice in San Francisco has a message that he would like to share with the public about the current state of the healthcare system. Being a primary care doctor these days is becoming more and more discouraging with the current payment system and insurance hassles, so much so that doctors are working less hours as noted in this Washington Post article: Average

2010-02-20T09:53:25.993-08:00

The weather is starting to warm up a little. Spring is in the air. It was about time I spruced up the place. But mainly it was because the old commenting system I used (Haloscan) went kaput, and I wanted to implement Blogger's commenting system in its place. All the old comments got trashed (sorry) but I had no control over that. Give the new layout a spin. Make some new comments. Click on some

2010-02-20T08:43:53.920-08:00

The National Committee for Quality Assurance, better known as NCQA, wants to know what you think are the most important features are of the Medical Home. Go to this link and tell them. Personally, I thought these listed features were all important, but narrowed it down to my top 5: wait time seeing the same doctor or nurse listens and answers your questions (well, duh!) knows you well access to

2010-02-19T08:45:57.754-08:00

Ben Chan, a family physician, has just opened his new solo practice and writes: It has been 8 years since I read Gordon's article. Now, I am sitting in my office in this opening day, waiting for the first patient to call and make an appointment. So this is what you all went through. Emotionally, it has been like a roller coaster ride. At one time, I am happy that I made this tiny leap. On the

2010-02-20T09:43:56.988-08:00

From Candorville.com Unfortunately, the Republican win in the Massachusetts Senate election probably means that these kinds of shenanigans will keep happening.

2010-01-30T19:42:33.175-08:00

Anyone who has been following my blog won't find this article from today's Rochester Democrat and Chronicle unusual: When Dr. Linda Lee sees patients, she brings them from the waiting room, typically spends a half hour with them, cleans up the exam room and submits the insurance claims online. She's the one who returns phone voicemails, and she gives patients her cell phone number for urgent

2010-01-10T23:27:45.157-08:00

So even though I haven't been keeping up with my blog, I thought I should point out some excellent bloggers who not only manage to write something on a regular basis, but also have something meaningful to say.The Ideal Medical Practices Blog's focus is on the myriad problems facing America's healthcare system and especially its beleaguered primary care physicians, and what can be done to bring

2010-01-05T00:53:49.818-08:00

From Sage, Ink at The Atlantic.com.Happy New Year!

2009-09-17T15:35:37.384-07:00

A survey published 3 days ago in the New England Journal of Medicine says that 63% of doctors support the public option.When you compare this to the American Medical Association's stand opposing the public option, it is no wonder that groups like Sermo, a growing online physician community, say that "the AMA does not speak for me".

2009-09-04T05:00:01.382-07:00

All politicians are crooks. All lawyers are dishonest. All doctors are rich. All insurance companies are greedy. All government is incompetent. When a significant proportion of the population hold these views, is it any wonder there is no confidence among some that healthcare reform can succeed? All that the forces of the status quo have to do to keep their gravy train going is to just keeping