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"Those who work in geriatric care are among the worst paid in the health care system. Is the time I spend as a surgeon excising a patient's cancer worth 10 times more than the time the primary care doctor spent finding the cancer in the first place?" Dr. Gawande, who examined the problems of medical care for the aged last year in The New Yorker, pointed out that as we grow older, "we don't get one problem at a time." "People with multiple problems need time, and that is not cheap and is currently not paid for by medical insurance," he said. "It's not possible to address five different problems in a 20-minute visit." Dr. Gawande, who examined the problems of medical care for the aged last year in The New Yorker, pointed out that as we grow older, "we don't get one problem at a time.... People with multiple problems need time, and that is not cheap and is currently not paid for by medical insurance," he said. "It's not possible to address five different problems in a 20-minute visit."

Most prestitious hospitals receive billions to train residents, few of whom go into primary care, where society needs them most.

1ry Care Erosion by "ROAD"

Bob Doherty is the main Washington lobbyist of the ACP - after the AMA, the largest organization of US doctors (representing internal medicine physicians, whether primary care or subspecialist). He's had some very interesting posts since the Massachusetts Senate upset. His blog is a finalist in the sixth annual Medical Weblog Awards for the Best Health Policies/Ethics Weblog. Doherty articulates the ACP's case for supporting the current Senate&House Health Care Reform legislation (whose failure he & many others will end up leading eventually to more draconian limits on doctors & patients, in order to control the currently unsustainable growth in US health care costs (now approaching 20% of GDP).

Pho is a fairly conservative primary care doctor in New Hampshire, but believes that defeat of the current Senate/House legislation will eventually lead to more draconian restrictions on doctors and patients, since the cost of medical care will otherwise become untenable in the U.S.

Most readers favor palliative sedation if its primary intent is to allay intolerable suffering even if it may accelerate dying - as opposed to allowing the suffering because its treatment may lead to an earlier death.