Bookmark for later reading

Freakonomics on the underground economy:

not just illegal stuff like Drugs and prostitution: it includes your neighbor who cuts your hair or does your taxes, fixes your faucet, or does your yard work...

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SenseOfEvents links to this paper on why docs hate Obamacare: (it's not the money)...
it's the idea that doing the paper work is more important than talking to the patient:

Unnecessary regulations and increased paperwork are drowning us and reducing quality of care. We have allowed just "one more thing" to be added over and over again. The camel's back is now breaking. I have never seen physicians as depressed and stressed in my 20 years of practice. At each visit, I am required to tell the government whether the patient I am seeing had a flu shot last winter! Please help me understand how that improves care. I know the many quality metrics (i.e.: check this box) mean well, but they are having the opposite effect.  They are diminishing quality because they (the boxes) become the focus of each visit, rather than the human interaction.   

as to nurse practitioners, I agree with this:

The suggestion that non-physician practitioners can fill the primary care needs of the American people is simply false. Their training, knowledge base, and ability to form a complete differential diagnosis is limited. The press often proclaims that nurse practitioners can replace doctors.  There is a role for the NP and we need to support that role. But to suggest that someone with two years of training can provide equivalent care to that of a physician who, after college, has spent four years in medical school, three to four years in residency (working days and nights), and who, each day, makes hundreds of decisions for which he or she is ultimately responsible is not only wrong, it disrespects the training and ability of the physician. Remember, quality care is not measured by patient satisfaction surveys, but instead, by the ability to properly diagnose and treat a patient.  

full article:



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