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Severe Paperwork Burden Tempts Physicians To Quit Medicine

For physicians, and especially those in primary care, it seems like there is a form for every purpose imaginable—often for purposes that are hard to imagine.

An ACP member in Rhode Island recently gave this example:

“I was just asked by my Medicare Advantage plan to sign a form for [a well-known pharmacy benefit manager]. This form is to be faxed to them in order for them to send me a prior authorization form for a med. So in other words, I had to complete a form in order to get another form. This is nuts!”

Or how about this, from another ACP member in a private internal medicine practice:

“The documentation that is getting to me, is that documentation that the ‘durable medical equipment people want including repetitive- recurrent documentation, whenever we see a patient to document “continued need”. The list of things we have to document, sign, approve or prior authorize, I believe is what makes most physicians think they chose the wrong field. A PBM letter to me about my prescribing practices today nearly did me in! Luckily I just shredded it. If I am kicked out of this business, I am so close to retirement it would be a blessing!”

Or this: Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Despite Uncertainty, Why Doctors Should Hang In There

There is discontent in the house of medicine. So many physicians struggle. They seem to wade through uncertainty every day — uncertain about diagnoses, about pain, about disposition. We find ourselves uncertain about our jobs, our futures, our finances.

The consultants we call are uncertain about their practices and whether they can remain viable in the coming years as medicine evolves into something we may find unrecognizable.

Some days, as I enter my 17th year of practice, I don’t know if I can bear to walk around our little department for 10 or 20 more years, like some gerbil on an exercise wheel. I am uncertain if I can bear the weight of more entitlements, more confabulated stories, more regulations, and manufactured drama. I wonder if I can endure decades more of circadian assaults on my brain. Read more »

*This blog post was originally published at edwinleap.com*

Are E-Cigarettes Anything More Than A Theater Prop?

E-cigarettes continue to create a lot of media buzz and chatter among smokers and smoking cessation experts alike. Today, Professor Thomas Eissenberg of Virginia Commonwealth University published an important study demonstrating that E-cigarettes, despite claims on the packaging and advertising, deliver almost no nicotine to the user.

The study is published in the latest edition of the journal, Tobacco Control. Professor Eissenberg had 16 smokers abstain overnight, then come to the lab. on different days and (a) smoke two of their usual cigarettes (b) puff on two unlit cigarettes or (c) “smoke” 2 leading brands of E-cigarette using their “high nicotine” cartridge (16mg), each brand on a separate occasion. On each occasion he measured the blood nicotine levels before, during and up to 45 minutes after using the products. Read more »

This post, Are E-Cigarettes Anything More Than A Theater Prop?, was originally published on Healthine.com by Jonathan Foulds, Ph.D..

Could Sugar Pills Improve Smoking Cessation Rates?

Professor Robert West, at University College London, has an interesting theory which suggests that glucose tablets can help smokers to quit. It is well known that when smokers quit smoking they put on weight, and that nicotine appears to act like a mild anorectic drug…it dulls the appetite. It has also been noted that smokers often crave high carbohydrate foods when they quit smoking. So it seems as though smoking dulls the hunger for carbohydrates. The glucose theory (or at least one version of it) suggests that when an addicted smoker quits smoking they experience a strong hunger/craving sensation, sometimes located in their stomach. When trying to interpret that sensation they think, “what am I craving? I just gave up cigarettes, it must be that.” Read more »

This post, Could Sugar Pills Improve Smoking Cessation Rates?, was originally published on Healthine.com by Jonathan Foulds, Ph.D..

Classic Smoking Cessation Study Suggests You Can Save A Life For $2000

Every now and again I like to pick one of the classic research studies on smoking cessation in order to highlight some of the key findings. Today I’m going to focus on the part of the Lung Health Study.

The Lung Health Study is certainly one of the best smoking cessation studies ever carried out, partly because of the comprehensive nature of the assessment and follow-up of its 5,887 participants and partly because it was way ahead of its time in delivering a truly “state-of-the-art” intensive smoking cessation intervention which was compared in a randomized manner to the effects of “usual care”. The Lung Health Study (LHS) was a randomized clinical trial of smoking cessation and inhaled bronchodilator therapy in smokers 35 to 60 years of age who did not consider themselves ill but had evidence of mild to moderate airway obstruction. Read more »

This post, Classic Smoking Cessation Study Suggests You Can Save A Life For $2000, was originally published on Healthine.com by Jonathan Foulds, Ph.D..

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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