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Concierge Medicine Is Here and Growing!!

An increasing number of primary care physicians are downsizing to a concierge medical practice (also termed “retainer-based medicine”). In a concierge medical practice, the physician limits the number of patients in his practice and offers exclusive services for an annual fee. The patient pays a surcharge for increased access and additional services from their physician.1 […]

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Where Have the Generalists Gone? They Became Specialists, Then Sub-Specialists.

At the onset of the 20th century, most practicing physicians had received their training in proprietary medical schools, many of which were essentially diploma mills.1 These schools offered a series of lectures over a 1-year period. A minority of physicians had attended university-based medical schools such as Johns Hopkins, which was established in 1893. There were only […]

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electrocardiogram print out with stethoscope

Silent Atrial Fibrillation and Cryptogenic Strokes

A new suspected cause of cryptic strokes is “silent atrial fibrillation.” Pacemakers and other implanted devices allow continuous recording of cardiac rhythm for months or years. They have discovered that short periods of atrial fibrillation lasting minutes or hours are frequent and usually are asymptomatic. A meta-analysis of 50 studies involving more than 10,000 patients […]

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Unnecessary Hospitalizations for Pulmonary Embolism: Impact on US Health Care Costs

  Each year, more than 350,000 patients are treated for pulmonary embolism in US hospitals. Recent reports indicate that the majority of these patients do not have to be hospitalized: they can be safely treated at home, which will result in a tremendous decrease in our health care costs. One of the first reports that […]

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CLINIC

Retail Clinics: A Shift From Episodic Acute Care to Partners in Coordinated Care

The first retail clinic, offering care for common acute medical conditions, opened in a grocery store in Minneapolis in 2000.1 By 2015 there were 1900 retail clinics in the United States.2 Some have estimated that there will be 3000 retail clinics located in drug stores, grocery stores, and “big box” businesses in 2016.3 The majority are operated […]

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