women s health, family practitioner or a general internist, which is what i am. someone who does the internal organs of the pwaopbd say body and says i m not going to become a lung specialist, i m going to stay as a general doctor. you re sick, you re having high blood pressure, high cholesterol, i m the guy you see. people need doctors like that. without doctors like that what are we going to do? there was another study two years ago, the american college of physicians determined that 17% of general internists that start out that way leave. they say i do not want to do that, i can t afford to do that. 60% of what i do is involved in no fee. paperwork, submitting claims, figuring out how to get the office running, all of the business of medicine. bill: all great votes, instead of pursuing primary care they are becoming specialists and there s got to be a reason for
after she becomes positive, it has huge implications for how she will do and her health will do. susan, it feels to me like part of the reason that we end up with these rates is because the idea of just getting tested is not really part of our annual checkup. the idea that americans are running in having annual checkups is naive. it is not as if we think i will get my blood pressure, my annual pap smear and my annual hiv test. is there a way to start moving young people towards testing as a routine part of medical care? the cdc recommends that all people who are sexually active and people going to their doctors get tested. it is really a push for general internists and family practice doctors to test every patient between the age of 13 and 65. i would argue that you shouldn t stop at age 65. certainly, people who are sexually active at any time really should have an annual
the bill if they pay the hospital directly within 30 days. for those patients in a position to pay the bill promptly, it s good for them because they get a discount. it s good for the hospital because it saves us money on the back end on the collection side. administrators say collecting payments cost hundreds of thousands of dollars. after they bill the insurance company, it can take up to six months to get reimbursed. only then do they bill the patient. bad debt is putting hospitals at risk. an industry that faces hard times. most would say if you can collect something, it s better than taking a chance on collecting nothing. take five or six really deep breaths. doctors like alameda, california, internists are giving deals to patients giving them cash upfront. if someone comes to me with a $50 billion, can you see me, i don t have to bill the insurance company that doesn t give me a major headache. his website, true cost of healthcare, advises patients to negotiate and
tests and they re done excessively. i actually looked at my own panel which is the american college of physicians which covers internists. when i started to look at actual tests and what they re saying i got concerned. look, if they say we re overimaging back pain, fine. you know doctors do that? because they re afraid of lawsuits. if they re saying we re doing too many routine ek. abouts, i worry that insurance companies will get ahold of the information that i won t do the routine ekgs as a baseline. going for surgery and need a chess x-ray. if you re going to be on a respirator i think you do to be on a baseline. i want to do the art of medicine to choose the tests. bill: in a word you re disagreeing with this? i am disagreeing with this i think it is overinterpreted and i think it could have a big downside. bill: doctor, is he onto something? i think his points are very important. i think to one wants the art of medicine to be lost. i think this document is a
that s all. i don t know what he wears, it doesn t matter. i will not admit it and from an internist point of view, make sure the person is not smoking. that can cause infertility or lead to it. alcohol, drugs, drug use an certain medications you might take including steroids. and the most important thing, you never heard from me on the show before, don t let your internist work this up, send the patient to a urologist like dr. samadi, internists can screen for it but shouldn t be involved in then tire workup. jamie: the experts are the urologist. jamie: good to know what you wear might not interfere. that s all. jamie: thank you very much. there s a new inhaleable caffeine product that could offer a quick energy boost but is that type of caffeine fix safe for us? our doctors will weigh in, next.