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Primary care is worthless, and we're all idiots. Or, haven't you heard?

Discussion in 'Family Medicine' started by Blue Dog, Dec 26, 2008.

  1. Blue Dog

    Blue Dog Fides et ratio.
    Physician Gold Donor SDN Advisor Classifieds Approved 10+ Year Member

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    Based on the quality of his writing...er, ranting, I suspect that Dr. Jonathan Glauser is a frequent poster on SDN. Any guesses as to his screen name?

    From Kevin, M.D.: The Primary Care Backlash Begins

    A follow-up from Kevin, M.D.: Dr. Jonathan Glauser, Your Reviews Are In

    And a not-so-nice followup from Frankie, a left-handed anesthesiologist: Who's the Sex Offender? and The Placebo: Dr. Douchebag
     
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  3. Joe Richards

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    Buckle up. There is going to be more of that. Much more.

    If congress starts to take away from the specialist to give to primary care (and that's exactly what they are working on) don't be surprised the next time you go to a show up at the hospital and get a few looks.
     
  4. flumazenil

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    Guys, primary care and prevention is the road of the future. No way can the health care industry keep up with such high costs. In fact, with more funding for primary care- that bitter ER doc would probably not be seeing half the things in his ER which could have been prevented or taken care of at a primary care physicians office...
     
  5. andwhat

    andwhat Senior Member
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    and offff we go.... yes the ED has significant problems, that I will not delve it into at this very moment..
     
    #4 andwhat, Dec 26, 2008
    Last edited: Dec 28, 2008
  6. DaveinDallas

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    I'm just a know-nothing 3rd year but I don't see why people look down on Family Practice? I recall hearing one of our top 10% classmates talking about what certain board scores would qualify you to do and one of the phrases used was 'banished into Family Medicine hell'....

    Having just completed the clerkship -- which obviously qualifies me to pontificate on all things Family Practice :rolleyes: -- the interns, residents and attendings have to know a lot about everything....at least enough to know when it's time to refer or when it's treatable. It was a real wake-up call my first week and never got any better.

    I learned to start developing a thick skin when having to say,'I don't know' when an attending asked about the latest recommendation from the USPSTF/ACOG or whatever.....

    Can anyone explain the mindset of the critics to me?
     
  7. Blue Dog

    Blue Dog Fides et ratio.
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    This is the official response from the AAFP's President, Dr. Ted Epperly.

    He's a lot more diplomatic than I would've been.

     
  8. Blue Dog

    Blue Dog Fides et ratio.
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    Ignorance and insecurity, generally.
     
  9. zmeister22

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    So you respond to the doctor-who-bashes-others by doing the same? Quite professional. Yes, I do realize that primary care needs a MUCH stronger role in US health care, but managing an ER where you have up to 40 patients at one time is not easy. They did just as much school as did, so please play nice.
     
  10. Faebinder

    Faebinder Slow Wave Smurf
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    While I do agree that they seem to be so simple now a days with them just consulting and doing nothing....the answer to the primary care problem is not "reducing ER physician fees". What needs to be done is killing the incentive for people to go to the ER or fixing EMTALA to allow ER physicians to kick people out as opposed to just treating them and consults. The typical ER case that needs to be kicked out but still requires $2000 worth or work up is "Toothache" and "Ran out of meds" and of course my favorite "I have a tootache and I ran out of pain meds".
     
  11. andwhat

    andwhat Senior Member
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    Please do rotations first, and then understand what I mean. ER is a complete dumping ground. It is awful. I do not at all discredit your opinion, but it is a liability issue, that needs to be rectified.
     
    #10 andwhat, Dec 28, 2008
    Last edited: Dec 28, 2008
  12. tkim

    tkim 10 cc's cordrazine
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    That much I agree with you. The rest is colleague-bashing, which I will not get into.
     
  13. andwhat

    andwhat Senior Member
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    I agree, inappropriate.... however, I do prefer better communication than

    "a NH guy with weakness cum and get it, his urine looks dirty its a simple UTI!"

    ummmmm for what exactly? How long has he been weak? Why is he in the NH? What would the patient and family like done? Did you conveniently forget to tell me about the Troponin of 8.7?? Is it me, or did you notice that his right side is not moving, and he has stuttering speech, OH WAIT that probably just happened while I was coming down the elevator to see him correct? Man... it is unbelievably frustrating at times let me tell you..
    Admitting 13-15 at night (from all over --- different counties, including our own overburdened ED system), plus cross covering over 100 patients, is significantly more challenging than seeing 40 patients (mostly acute care) in the E.D.
    Overall it is very nice -- however it presents its own unique challenges.
     
    #12 andwhat, Dec 28, 2008
    Last edited: Dec 28, 2008
  14. secretwave101

    secretwave101 Senior Member
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    Had a chance to meet the guy last summer. He really is as cool as his letter suggests. He's also a true believer in FP. The guy travels over 250 days a year, or something insane like that, evangelizing for primary care in America.
     
  15. andwhat

    andwhat Senior Member
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    please don't forget the hospitalists ;-)) consulting every single physician in the directory to cover up negligence, is more like it.... needs to stop, and will not stop unless people make a stand for it.
    ER is a complete and utter nightmare. Discombobulated circus. I am not being sarcastic, stating that my Medical Assistant in residency had a higher level of thinking some of these ER "docs". That is serious -- and it is shameful. Something that I am not at all proud to be a part of.
     
    #14 andwhat, Dec 28, 2008
    Last edited: Dec 29, 2008
  16. MedicineDoc

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    I am not surprised there are uninformed mentally unstable jackasses. After all I saw them sprinkled about all through medical school and beyond. I am surprised that the garbage was actually published. It is wrong on so many levels. Hospital care and outpatient care are very intertwined and not only on the front end. Hence the direct admits bypassing the ER completely and the hospital followup visits helping to shorten and prevent hospital stays.
     
  17. medicienne

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    I hope nobody applies to Family Medicine, and I am the superstar in all the interviews and ranked #1 in all programs! :D
     
  18. mikereno1

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    I'll 2nd that!!
     
  19. iatrosB

    iatrosB trying not to kill anyone
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    Be careful what you ask for.
     
  20. ghost dog

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    As a Canadian family doctor, you have my sympathy and respect. It seems that it is becoming progressively more difficult to practice proper family medicine in the U.S. with each passing year. Antagonistic ER MD jerks who write articles about family medicine being "a waste of resources" hardly help this issue.
     

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