About the blogger: Dr. Rangel is a physician practicing internal medicine in Texas.
What makes this blog so fierce? Dr. Rangel is not afraid of tackling complicated topics that would scare less intrepid commentators away. Several articles look at economic motivation theory and how it could explain why P4P won't work in medical practices. Hint: Part of the explanation has to do with the failure of extrinsic incentives to motivate a worker who requires complex thought and problem-solving skills.
Focus: Medical politics, lawyers, doctors, reform and medical ethics.
Quote: "'Cookie-cutter' physicians try to minimize risk while maximizing profits. One way to do this is to minimize the time spent with the patient and on complex problem-solving. It is more efficient and profitable to perform a very basic linear diagnostic and treatment evaluation. If knee pain then -> MRI. If nervousness then -> prescribe sedatives. If fever -> antibiotics. If chest pain then -> cardiologist referral. If vomiting then -> gastroenterologist referral. Most of the complexities and nuances of medical care are tossed aside in favor of a rote if-then decision tree that can be done by any couch potato who's watched too many episodes of 'ER'."