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Today's News:

All Family Practice Jobs

Locum Tenens Family Practice Job in Family Medicine Job in Southeast Wisconsin! Wisconsin with CompHealth Inc
Job 0953831-0549 Facility is seeking a Family Medicine physician to provide full time coverage for them for a couple of months. Call today for more information! Approximately 20-25 patients per day Call
Permanent Family Practice Job in Unique Hybrid hospitalist position seeks family practitioner to see all ages in hospital and ER- Nor Maine with CompHealth Inc
Job 917608 "? Hospitalist/ ER position. MD/DO OK. Rural hospital with less than 10,000 annual ER visits ? Hospital is very flexible with physician?s needs. FP?s take all admits on your off hours. ?
Permanent Family Practice Job in Independent contractor opportunity in CA California with CompHealth Inc
Job 917636 "The clinic is looking for a Family practice physician who is entrepreneurial minded to join them full time in a very busy clinic. See 20-25 patients a day. This is an unusual 1099 employee

Professional Issues

Lack of Payment Reform Leads to Fragmented Care
jarvantes@aafp.org Wed, 16 Jul 2008 16:20:00 -0500
The nation's health care delivery and payment systems primarily are organized to support the diagnosis and treatment of acute or episodic conditions, resulting in fragmented, ineffective and costly care for people with chronic diseases. That's according to a new study conducted by the Center for Studying Health System Change, or HSC. "Getting What We Pay For: Innovations Lacking in Provider Payment Reform for Chronic Disease Care" found "widespread acknowledgement that current provider payment methods do not encourage efficient or effective delivery of chronic disease care."
PhRMA Announces Revised Code Guiding Industry Interactions With Physicians
bbein@aafp.org Thu, 10 Jul 2008 14:35:00 -0500
The Pharmaceutical Research and Manufacturers of America, or PhRMA, announced today it has strengthened the marketing code it uses to guide relationships between the pharmaceutical research and biotechnology companies it represents and physicians.
Americans Experiencing Greater Access-to-Care Barriers
jarvantes@aafp.org Tue, 08 Jul 2008 15:40:00 -0500
The number of people forgoing or delaying health care jumped dramatically between 2003 and 2007, signifying a fundamental reduction in Americans' overall access to health care, says a recently released tracking report from the Center for Studying Health System Change.

Family Medicine Notes

TinyPaste
Jacob Sat, 28 Jun 2008 03:04:26 -0000
TinyPaste Blogged with the Flock Browser...
How to nap - Boston.com
Jacob Fri, 27 Jun 2008 06:05:37 -0000
How to nap - Boston.com Blogged with the Flock Browser...
links for 2008-06-16
Jacob Mon, 16 Jun 2008 02:30:13 -0000
Potential new weapon against TB: free cell minutes...
links for 2008-06-11
Jacob Wed, 11 Jun 2008 02:30:10 -0000
Talkety...
links for 2008-06-07
Jacob Sat, 07 Jun 2008 02:30:07 -0000
Google Public Policy Blog: Google Health, privacy, and HIPAA...
Sermo
Jacob Fri, 06 Jun 2008 02:01:06 -0000
OK .. I'm warming to Sermo.  I posted this silly question about an hour ago and I already have five responses! (only physicians can see the question - sorry if you are not wearing a stethy .. it's not very...

medpundit


noreply@blogger.com (sydney) Wed, 02 Jan 2008 01:22:00 -0000
Year's End, Blog's End: I've been making my annual year end inventory - deciding what to keep and what to toss. It's become obvious in the past several months that this blog is one of the things that it's time to toss. This will be the last post for Medpundit. Truly. Wishing you all the best in 2008 and the years beyond.Click to enlarge
Pilgrim Medicine
noreply@blogger.com (sydney) Fri, 23 Nov 2007 01:31:00 -0000
Thanksgiving Remembrance: Mayflower Medicine.
Genetic Prejudice
noreply@blogger.com (sydney) Mon, 12 Nov 2007 03:02:00 -0000
Any Excuse Will Do: Any excuse to justifying prejudice, or to stir up fear mongering of what may come: At the same time, genetic information is slipping out of the laboratory and into everyday life, carrying with it the inescapable message that people of different races have different DNA. Ancestry tests tell customers what percentage of their genes are from Asia, Europe, Africa and the Americas. The heart-disease drug BiDil is marketed exclusively to African-Americans, who seem genetically predisposed to respond to it. Jews are offered prenatal tests for genetic disorders rarely found in other ethnic groups.Such developments are providing some of the first tangible benefits of the genetic revolution. Yet some social critics fear they may also be giving long-discredited racial prejudices a new potency. The notion that race is more than skin deep, they fear, could undermine principles of equal treatment and opportunity that have relied on the presumption that we are all fundamentally equal."We are living through an era of the ascendance of biology, and we have to be very careful," said Henry Louis Gates Jr., director of the W. E. B. Du Bois Institute for African and African American Research at Harvard University. "We will all be walking a fine line between using biology and allowing it to be abused."We have been living in an era of ascendant biology since Darwin. Remember eugenics? Jews have been offered prenatal testing long before the mapping of the human genome, as have African-Americans. But prenatal screening is not quite the same as the eugenics movement heyday. So why the hyperventilating? It turns out that the Times is taking its cue from blogs commenting on studies studies like this. Well, if the blogs say that genetics justifies prejudice, it must be true! I never thought I would see the day that the New York Times took that attitude on its front pages. It must be part of their plan to join the internet age. Here's the part that's gotten the Times convinced that genetics is going to bring back the days of institutionalized prejudice:There exists a publicly available gene database, The HapMap Project, that contains random samples of genetic sequences from people in China, Japan, Nigeria, and people in the United States with European ancestry. It’s now possible to search the HapMap database for genes that have been linked with intelligence in published scientific studies. In this manner, we can determine if high intelligence genes occur with greater or lesser frequency in the various races.Now, here’s an interesting point. If even a single gene correlated with intelligence occurs with different frequencies in the different races, this alone proves that there are racial differences in intelligence. How is that? Well, the egalitarian theory holds that every race has identical intelligence. Therefore, whatever genes there are that affect intelligence, they must be distributed exactly equally in all human races. Once even a small race difference is proven, the egalitarian theory is proven false. At that point, it’s only a matter of determining which race has the higher average intelligence based on the genetic evidence.Oh, please. Here's a take home lesson for everyone on the science of genetics, and one that should never be forgotten - these studies are about associations of genes with traits, not the concrete coding of a trait by a given gene. Just because a locus on a chromosome can be found more often in people with schizophrenia than in the general population doesn't mean that everyone with that genetic code in that spot will have schizophrenia, anymore than it means that every sibling of a schizophrenic will have the disease. Ditto with intelligence. Ditto, too, with cancer risks and most other traits and diseases human genome mapping is linking to genes. The essence of a man is not written into his DNA. Here's another important point to remember - our science is still young and uncertain:These genomewide association studies have been able to examine interpatient differences in inherited genetic variability at an unprecedented level of resolution, thanks to the development of microarrays, or chips, capable of assessing more than 500,000 single-nucleotide polymorphisms (SNPs) in a single sample. This "SNP-chip" technology capitalizes on a catalogue of common human genetic variations that is provided by the HapMap Project, which was made possible by the completion of the consensus human-genome sequence.......The main problem with this strategy is that, because of the high cost of SNP chips, most studies are somewhat constrained in terms of the number of samples and thus have limited power to generate P values as small as 10–7. In addition, most variants identified recently have been associated with modest relative risks (e.g., 1.3 for heterozygotes and 1.6 for homozygotes), and many true associations are not likely to exceed P values as extreme as 10–7 in an initial study. On the other hand, a "statistically significant" finding in an underpowered study is more likely to be a false positive result due to chance than is such a finding in an adequately powered study, and "statistically significant" associations could be attributable to systematic bias (e.g., from confounding due to ethnic ancestry, also known as population stratification). Thus, the sine qua non for belief in any specific result from a genomewide association study is not the strength of the P value in the initial study, but the consistency and strength of the association across one or more large-scale replication studies. Robust replication should permit the identification of true positive results and the weeding out of false positive results.In other words, take these genome studies that link intelligence and race just as about as seriously as you would take studies linking intelligence to sex, or that predict elections with brain scans.UPDATE: Best of the Web draws an important distinction:Note that "the presumption that we are all fundamentally equal" is quite different from the notion "that all races are equal." The former is a moral principle, a premise about the basic dignity of every individual; the latter is an empirical presumption about group averages in measurable traits. Someone with an IQ of 80 is as human as someone with an IQ of 120; and this is so regardless of whether the average IQ of one race is different from that of another.What worries people like those in the Times story is that racial differences in IQ or other traits seem to lend empirical support to racist theories. But those theories are qualitatively wrong, so that no empirical evidence could make them right. If all individuals are of equal dignity and worth regardless of IQ, then a group is not fundamentally superior or inferior to another group by virtue of differences in average IQ.It seems that some very smart people mistakenly think that intelligence is a measure of fundamental worth. Maybe they're a little too impressed with their own brilliance.

 
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Center for Evidence-Based Practice, SUNY Upstate Medical University: Syracuse, New York region's only Level-1 trauma center (University Hospital) with more than 80 specialty clinics and four colleges.

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familydoctor.org: Health information for the whole family from the American Academy of Family Physicians.

FamilyMDLinx: Features family medicine news, newsletters, peer-reviewed journal articles, CME, conferences, and medical dictionaries. FamilyMDLinx and MDLinx aggregate for physicians, health care professionals, residents, med students the most current medical news, journals, and research.

FamilyPractice.com: The FamilyPractice.com mission is to provide family physicians with advanced yet easy-to-use tools and knowledge needed to provide the highest quality medical care to their patients. We recognize that family physicians are the frontline in health care. By providing the latest in research informat...

Hanover Family Physicians: Family practice residency programs of the Department of Family Practice at the Medical College of Virginia of Virginia Commonwealth University, based in a suburban practice site in the Metro Richmond area.

Hardin MD - Family Medicine and Primary Care: From the University of Iowa, lists of Internet sources in family medicine, general practice and primary care.

Just the Berries: A hospital in Nova Scotia, Canada provides research-based summaries of common clinical problems, with searchable archives and details of on-line courses.

Main Street Doctor: Your online family practice medical site. Features doctor network, medical forum and news and articles from the medical world.

McLaren Family Practice Residents: Web page of the residents in the McLaren Health Care System.

Midwest Center for Rural Health: Provides education for doctors entering the field in a rural area.

Primary Care Clinical Practice Guidelines: Introduction to using clinical guidelines, clinical content listing, and other patient care resources.

Primary Care Internet Guide: The Primary Care Internet Guide is a comprehensive listing of useful Internet sites for primary care

Rachel Naomi Remen, M.D.: Rachel Naomi Remen, M.D. is Clinical Professor of Family and Community Medicine at the UCSF School of Medicine, the Medical Director of the Commonweal Cancer Help Program, and the Director and Founder of the Institute for the Study of Health and Illness at Commonweal. She is the author of the New...

RuralNet: Marshall University School of Medicine's Online Rural Health Magazine, written and published by MUSOM students.

The Neighborhood Doctor: Alternative Healthcare, Support Groups, Senior Care Assist Aids, Assisted Care, Allergy Treatments, Seasonal Depression, Light Therapy, Urgent Care Locator

Virtual Hospital's Family Practice Handbook, 3rd ed.: Virtual Hospital was a digital library of health information in pediatrics, paediatrics, and radiology for pediatric education and radiology education

WebBook of Modern Family Practice: Family Practice Residents and young physicians Online Study Guide.