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You could argue that medicine was never meant to become a for-profit business the way selling cars, cosmetics, and fast food are businesses. And yet, in the United States, health care has become a for-profit business. The story of how this happened is complex, but decisive elements include the advent of Medicaid and Medicare in 1966 and the widespread availability of employer-sponsored health insurance.

Splenic Infarction

A 53-year-old woman presented with sudden onset of left upper quadrant abdominal pain. She had a history of atrial fibrillation, hypertension, and congestive heart failure.

Apple Core Lesion

A 48-year-old woman was hospitalized for acute-onset abdominal pain. She had a history of adult-onset Still disease and severe osteoarthritis. She had been taking 650 mg of aspirin every 4 hours to relieve her arthritis pain and fevers.

Based in Atlanta, Elizabeth Woodcock is a speaker and author with more than 20 years of experience in the practice management industry. Author of ten best-selling books, she holds an MBA from The Wharton School. Learn more at www.elizabethwoodcock.com. You can also reach her directly at elizabeth@elizabethwoodcock.com.

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Bacterial meningitis and herpes simplex virus type 1 (HSV-1) encephalitis are both associated with significant morbidity and mortality. Thus, hospitalization and prompt initiation of therapy are essential.

Cheap Bonus Ideas

Be creative with performance rewards. Give movie tickets to employees who go “above and beyond” the call of duty.

Simple Quality Check

Assign one clinical staff member to check the expiration dates on all prescription samples once a month, and keep a log of these inspections.

Saving Face

At sites where cosmesis is critical, such as on the face, use aluminum chloride and pressure for hemostasis rather than electrocautery.

About 70% of patients with gout are treated exclusively in the primary care setting. Because the prevalence of gout is rising, particularly among older patients, you are increasingly likely to encounter this disease in your practice.