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Archive for December, 2010

Nurse Practitioners, Part 2 – Are They the Answer for Primary Care?

December 29, 2010

Most observers of the American healthcare system conclude there is a primary care shortage, though opinion varies on what to do about it. Nurse practitioners and other mid-levels such as physician assistants have been suggested to fill the gap. Could they become the primary care providers of the future? I think...
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A Better Use for Nurse Practitioners, Part I – Heart Caths

December 18, 2010

As America begins to grapple with realization that it doesn’t have enough family physicians, a common suggestion is that the shortage can be solved by growing the mid-level workforce, i.e. nurse practitioners and physician assistants. I’ll talk more about mid-levels’ role in primary care next week. Today, let’s step back and...
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Early Detection Doesn’t Necessarily Prevent Bad Outcomes–Colonoscopies

December 11, 2010

A colleague of mine who is a family physician in Arlington, Texas, let’s call him Dr. Smith, was sued several years ago for medical malpractice. His patient had reached the age where routine screening for colorectal cancer is recommended. Dr. Smith performed flexible sigmoidoscopies (flex sigs) in his office, which is...
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An Ounce of Prevention Costs a Ton of Money-Preparticipation Screening of Young Athletes

December 5, 2010

A young man streaks down the basketball court with only one man to beat. A subtle head fake to the right causes his opponent’s weight to shift ever so slightly. The dribbler crosses the ball from his right hand to his left, dips his shoulder just past his opponent’s, and pushes...
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