Seeking an expert interpretation

Article Abstract:

A physician's clinical specialty can provide both the expertise required for difficult diagnoses and the limitations of narrow clinical evaluation. A case of unexplained fever, ankle pain and, ultimately, bowel symptoms in a young woman illustrates this lesson. Diagnostic testing focused primarily on infectious diseases, the specialty of her physician. Inflammatory bowel disease can explain the intestinal symptoms, joint pain, abnormal liver function and fever. Routine diseases present unusual symptoms more often than unusual diseases present ordinary symptoms.

Diagnosis, Inflammatory bowel diseases

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The intensity of physicians' work in patient visits: implications for the coding of patient evaluation and management services

Article Abstract:

The coding system for billing Medicare and other insurers for the cost of medical care could be simplified. In a study of 19,143 doctor-patient visits, the amount of work performed by the doctor was linked to the duration of the visit. However, work intensity, defined as the amount of work per minute, was greater with new patients, regular patients with new problems, and patients referred by other doctors. A new coding system could be based on the time the doctor spends with the patient plus a few other characteristics.

Statistical Data Included, Management, Reports, Work measurement, Medical examination, Periodic health examinations

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