"THE RISE AND FALL OF THE AMERICAN MEDICAL EMPIRE" - Robert Linden - 2010.12.04 - Show #509

Track 1:

Introductions

He talks about his history and schooling

How he got into medical school

Where he went for internship in University of Tennessee in Memphis

Really hands-on work with patients

How he found his town for practice

In 1988 LMD = Local Medical Doctor

• It became PCP

In 2006 he got tired of what was going on in Medicine

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Start Track 2: 21: 24

Track 2:

He was trying to find a replacement

How to find someone who is as passionate as he was.

The new guy came in September 2007

The malpractice issue came up

CMIC - insurance he started-up

The first case then he ended up leaving CMIC

Malpractice company

Robert was very casual with patients

• he didn't have a glass window separating him from patients
  • It seemed like they were trying to get rid of internists
• IF they didn't like certain doctors they just surcharged them

Discussion on this and Jacobus's comments about the change in the medical industry.

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Start Track 3: 42:42

Track 3:

Call about retired physician and Academic Physician

• overordering tests
• No compassion for patients

Call about what is most important thing we can do to stay healthy

• Keep weight down
• Well - balanced diet

Consumer reports: 1 factor trumps everything - aerobic

Call about sewer water

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Start Track 4: 1:02:26

Track 4:

PCP qualifications

PCP = family care physician

• Pediatrician
• OBGYN

PCP = LAST PLACE

Approved drugs are usually used by 3,000 people

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Start Track 5: 1:17:27

Track 5:

Direct Consumer Advertising

There is not a drug for everything

• To offset this they came out with celebrities in ads

There is a SAFETY issue - most studies are based on 3,000 person test

People believe that no ads should play until a product has been out for 2-3 years.

NEGATIVE studies are not being published (publication bias)

Now all studies need to be REGISTERED

Call about do we need more specialists and if so: in what fields

• about 16,000 med-students are graduating every year
• In Europe: work force committees that check what is needed in communities
• PCP SHOULD be able to deal with diabetes and colds in one visit
• Yes many people don't take care of themselves so it is very frustrating to be an internist
• The only students going into PCP are RICH KIDS...

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Start Track 6: 1:35:59

Track 6:

Call about consequences of industrialisation

• need for having a doctor walking side by side someone who knows YOU, whom YOU know!
• We're losing loyalty to losing service
• New doctors are younger and don't connect with their older patients value system
• New enthusiastic students need to be properly nourished

Call about his wife skin-cancer

Problem: the financial charges are astronomical.

• doesn't understand the cost-structure
• 30% of every medicine is wall-street medicine (Big Pharma)
• Also: specialty based system - too many tests

Call about bad side-effects of Vioxx