This year, America has a once-in-a-generation chance to fix our broken health care system. As policy-makers discuss implementation of the Accountable Care Act, they should learn from China's experience and decide whether they see medical care as a commodity or social provision.
Why not eliminate this anachronistic charade of the general practitioner and use nurse practitioners and physician assistants to fill the gap? This is already happening in rural areas, which sometimes lack even a single primary care physician.
Private practices will not disappear, but increasingly they will become a niche to provide good old fashioned service to the generation in the habit of "going to see my doctor," while the more mobile young have already discovered the instant gratification of clinics and particularly the ERs.
When you visit your physician -- or general practitioner -- what usually happens? They usually give you a referral. Even if you don't have the type of insurance that requires referrals, if you have anything that requires a skill set beyond giving a flu shot, you will be referred elsewhere.
Policymakers should be aware that even well-informed patients with good access to primary care need the ER. Legislation should aim to increase availability of primary care, but not penalize for use of emergency services.
The insufferable pace of primary care combined with the erosion of the doctor-patient relationship deters young physicians from entering the field. In my graduating class of 30 or so internal medicine trainees, only two of us chose to go into primary care.
Although it may be a little tricky to schedule an appointment, it is well worth the wait. To get an initial meet-and-greet exam with the nurse, one must have all standard vaccines previously administered.
For those of you who get annual physicals, check out with your physician whether this is a necessary checkup. You may be pleasantly surprised that you can forego this routine ritual and see that your kids do it, instead.
During our primary-care crisis, should the U.S. be using valuable resources to deport Harvard-trained primary-care physicians who want to serve patients and also remain in the same country as their spouses? According to DOMA, it should.
The day a family member enters the hospital is the day to start planning for the trip back home. Nobody wants to go to the hospital, but as hospital stays get shorter, an increasing burden is falling on family caregivers.
No other country in the developed world allows insurance companies to control its health care system like the U.S. does, and the fact that we do is one big reason why America spends so much more on health care than anyone else on the planet.
Fewer medical students are entering general internal medicine these days. This is a huge problem because the numbers of those in need of general medical services are going in the other direction: up, up, up.
There is little time in an office visit to experience a true doctor/patient relationship these days, for time is money as insurers squeeze every nickel they can out of a billing. This is not true in Dr. Rogova's office, however.