I am still a family medicine physician and still see my own patients each day. My nurse and I review all messages for the day and all phone calls are returned before we leave. (A)

Sounds great! But with the transformation of health care more and more physicians are “employed” and not in “private practice.” The Medical Group Management Association reports that more than 50 percent of physicians are now employed by organizations affiliated with health systems. In some specialties, like cardiology, that is closer to 75 percent. Discussion of

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I went on my morning walk committed to losing the weight I gained over the summer

After turning on my GPS app to monitor my walking time, pace, distance, and calories burned, I started thinking about how technology can change physician/ patient communication for the better, if used thoughtfully. For example, an article discussing the stethoscope as a historical artifact, raises the question are our physicians’ early or deferred adopters of

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Insanity: doing the same thing over and over again and expecting different results. (attributed to Einstein). Perhaps increasing access to primary care needs a new approach – rewarding evidenced based care, rather than outpatient visits.

Some highly acclaimed initiatives to improve access to quality primary health care and reduce cost have proved challenging. Over the past several weeks we have seen several glaring examples –  hospitals leaving ACOs, no change in ED use, the uphill strategy to train more primary care physicians, and “whatever happened” to medical homes.  Dartmouth was

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It’s like the Wild, Wild West, the (physician specialty) turf wars…. (A)

My first experience with clinical turf competition was in 1968 as administrator of the Department of Surgery at Wilford Hall U.S.A.F. Medical Center. The Chiefs of general surgery, E.N.T., and Oral Maxillofacial Surgery each needed Head & Neck surgical cases for their residents. Time and time again protocols were agreed upon to rotate the cases

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Do you want to be treated by a stranger when you are admitted to the hospital? Every practicing physician should have hospital privileges.

Two recent health care episodes have sharpened my conviction that every practicing physician should be affiliated with a hospital. In December I was admitted to the hospital for one night for observation. My care was managed by my gastroenterologist and my primary care physician, both of whom I have been with for almost twenty years.

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