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Employed versus Independent Physicians - Which is Better?

In my illustrious (or at least long) career, I have had 3 jobs.   After I finished all of my training, I was an employed physician for nearly 10 years.   Afterwards, I joined a small private practice group where I remained for 20 years.   Over time, as partners in the practice left or retired, I became the practice’s president by default.   I don’t really have an authority persona, which my staff was well aware and hopefully appreciated.   In nearly all cases when a decision could either favor the interests of our employees or the practice, I favored our staff. This earned a huge measure of staff loyalty, but no achievement award from the Chamber of Commerce. I am more than content to be regarded as a caring boss than a shrewd businessman.   Three years ago, I joined a rather large Cleveland medical enterprise where I now serve as a physician employee. Employment                         Independent I know the advantages and drawbacks intimately of both models – employment vs business

What is Causing My Stomach Pain?

One of the most vexing issues for patients and their doctors is dealing with unexplained abdominal pain.  Indeed, over the course of my career, I have treated thousands of these patients.  Every day, one or two of them are on my office schedule. Many of them have had abdominal distress for decades.   Many have had several visits to emergency rooms and have seen multiple gastroenterologists and other doctors over the years.   Diagnostic tests are done and often repeated in the ongoing quest to find an explanation.   When I review a patient’s entire medical record, I am often astonished to learn how many CAT scans have been repeated to evaluate the same pain. These patients understandably are operating under the notion that the medical profession should be able to explain the cause of their pain. This is the primary reason that these individuals seek care.   This is, after all, the job of a doctor.   In addition, they also want decent pain control so that they can live a more normal

Fake News - Why are We So Gullible?

It’s certain that you have heard the phrase ‘Fake News’ bandied about these past few years.   It seems there is no consensus defining this term.   Here are a few differing interpretations. Inaccurate reporting where minor, immaterial errors appear, but the essence of the story remains true.   For example, if an article wrongly names a restaurant where a meeting is held, the article should not crumble. Deliberately slanted reporting to serve a political agenda.   I do believe that this happens daily.   Reporters and editors are charged to compartmentalize their own views, similar to judges, but they are human like the rest of us.   The next time you open a newspaper, read the headlines carefully and you will find examples of wording that is less than fair and balanced News reports that are completely on the level, but are attacked by those whom are threatened by the reporting.   I don’t feel that I need to give examples here. Fake or On the Level? A close cousin of Fake

Will Smith Gets Slap Happy at the Oscars!

In my own life, I do my best to use one set of weights and measures.  By that I mean applying the same standard always when judging individuals, businesses, politicians and even nations.  There is not a day that passes that we do not see exasperating evidence of double and triple standards being applied.  We saw Republican senators recently excoriating a nominee under consideration for Associate Justice of the Supreme Court by senators who previously voted to confirm her!  No gloating here, Democrats.  Your treatment of Justice Brett Kavanaugh during his Senate Judiciary hearings was not your finest hour either.  The Cleveland Browns recently acquired a superb quarterback, Deshawn Watson whose 5 year contract will provide him with a miserly $230,000,000. Presumably, after taxes, he should still have enough to live comfortably.   As everyone in Cleveland who is breathing knows, Watson is facing 22 civil lawsuits accusing the athlete of sexual abuse.   In fairness, two grand juries dec

EMR - Promises Made, Promises Broken

 Over the past 15 years or so, I have endured several electronic medical record (EMR) systems. Indeed, there is an entire category, EMR Quality , on this blog where I share with readers the good, the bad and the ugly in the EMR space.  If you are suffering from insomnia, I invite you to review these posts nightly. When EMR was creeping onto the medical landscape, physician grunts like me were salivating over the prospect that one of our thorniest and frustrating challenges was about to be solved.   EMR promised that all of our patients’ records could be accessed with a couple of keystrokes in our own offices.   This made sense as we all knew that the digital world could create linkages that would permit access to all of a patient’s medical experiences.   Regrettably, this promise that was made to medical professionals and the public remains unfulfilled. Here’s why physicians were so ripe for the EMR seduction.   Consider this typical scenario in the pre-EMR era. A patient comes t

Is the West Doing Enough for Ukraine?

 The world is watching as a maniacal dictator methodically levels a country, displaces millions of citizens and attacks civilian infrastructure and lives.  The Ukrainian response has been unexpected, effective and downright inspiring.  To paraphrase JFK’s iconic remark in a 1963 speech in West Berlin, ich bin ein Berliner , we are all Ukrainians today. By all accounts, the Russian military assault or war or invasion has stalled.   Their current ‘military’ strategy now appears to be that if you can’t occupy a Ukrainian city, then destroy it.   The ghastly footage is reminiscent of newsreel footage from London in 1941, when the city was bombed for months by another maniacal dictator.   The entire world, except one country, is aware of the deliberate targeting of maternity wards, schools, residential neighborhoods and civilians.   Of course, the Russians deny all of this and maintain that they are liberating Ukraine from genocide and other crimes. The West, under the guidance of the A