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Periodically in this blog we discuss physician burnout. A recent medscape survey showed a fairly significant increase in burnout among all physicians, but especially those in primary care. The burnout rate in primary care now exceeds 50%; more than half of primary care doctors are burned out. This leads to worse patient care and satisfaction, as well as more general unhappiness among physicians. A lot of patients now are contending with grouchy, overworked, and frustrated doctors. Pay is part of this. Primary care doctors are paid far less than other doctors while working more hours. It is not an equation that translates to a satisfactory outcome, and it is also not something that is im
PSA has always been a poster child of cancer screening. On the one hand, it does prevent the spread of prostate cancer in some people screened. In fact, a recent study showed that since doctors have been ordering PSA tests, the incidence of metastatic prostate cancer has declined. (Welch, NEJM, 10/15) However, there has never been evidence that PSA screening has reduced survival at all, and there are a tremendous number of false positive PSA’s leading to over-testing and over-treatment. (See BRCT showing that out of 1000 men treated for prostate cancer that may have been discovered incidently by PSA testing, 600 will develop impotence.) After fewer PSA were ordered starting in 2012 (due
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