Dr. Sour Puss

I work 80% full time seeing patients, the rest being various administrative and teaching responsibilities. The average American goes to the doctor 2.3 times per year (yeah, lots of you never go to the doctor but there are a special few who go like 20 times a year, so it averages out). Doing some math, my practice should be full at about 1600 patients, a number I surpassed like 6 months into my career (you know, primary care shortage). However, thanks to the magic of cost sharing, under insurance, and general lack of concern for their health problems on the part of my patients, I can't keep my schedule full at 1600 patients; periodically I have to open the practice back up to new patients, agonizing over the decision each time. There are currently about 2300 people who consider me their primary care physician. In July of this year, as we were looking at empty schedules and rising expenses, we had to bite the bullet and open up again. Though I like not losing money and laying off emp

“Joe stated his case logically and passionately, but his perceived effeminate voice only drew big gales of stupid laughter.” Marc Fisher wrote an interesting op-ed in the Washington Post this week. For Working Moms, 'Flawed' Palin is the Perfect Choice In it, he makes the typical argument that Palin resonates with people because she's one of the common people. But what I think is interesting is what it actually says about the other side. Here's the money quote: "She's just as flawed as we are," Tweddle said. "It's not the fact that she's a woman but the way she does it all. And let me tell you: There're more American parents with unwed pregnant teenaged children than American parents with Harvard grads. She's real." Things have gotten pretty twisted when going to Harvard and raising children who don't get pregnant has become a political liability. There was another fantastic article linked to on Metafilter this week by Jonath

It's a fine line between patriotism and nationalism. According to Webster's dictionary, the only distinction between the two is degree, that nationalism is an "extreme" form of patriotism. In my mind, a patriot is someone who loves his or her country, someone who is willing to serve his or her country, and someone who sees his or her country for what it is, warts and all, and still wants to be here. A nationalist is someone whose love has become fanatic, contingent almost on being number one. Someone who believes that no matter what happens, fidelity to the motherland is more important than anything else. To a nationalist, it is more important to win than to be right. If it weren't so bloody clear that McCain is going to get trounced in November, last night at the Republican convention would have given me an ulcer. While the Democratic party convention (to my surprise actually) was filled with speeches about what we, the patriots who love this country, can do to

With health care reform being such an obvious issue on the minds of American voters this year , it’s surprising to me that we don’t hear more from the candidates about it. I suspect it has to do with the fact that any real, durable solution is going to be controversial. It will be good for some, bad for others, and will involve a great deal of compromise. Not exactly the kind of issue you want to build your campaign around. And so the public debate is limited to the usual meaningless sound bites. “Affordable health care.” “Access to the highest quality medicine.” “Coverage you won’t lose when you change jobs.” As a doctor, people do ask me about the candidates’ positions and sometimes they even want to know my opinion who has the better plan. Those who know me have heard me say over and over again that the best, most cost effective, comprehensive, highest quality system is a single payer plan . I am under no illusions about the chances of this coming to pass in the U.S. But I do see it