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	<title>Comments for the glory and the horror</title>
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	<link>http://rmfo-blogs.com/philber</link>
	<description>Much of what we do is both frightfully profound and mundane, with a thin line between life and death.</description>
	<lastBuildDate>Sat, 22 May 2010 05:27:11 +0000</lastBuildDate>
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		<title>Comment on Dog GERD by Phil</title>
		<link>http://rmfo-blogs.com/philber/2010/05/18/dog-gerd/comment-page-1/#comment-2775</link>
		<dc:creator>Phil</dc:creator>
		<pubDate>Sat, 22 May 2010 05:27:11 +0000</pubDate>
		<guid isPermaLink="false">http://rmfo-blogs.com/philber/2010/05/18/dog-gerd/#comment-2775</guid>
		<description><![CDATA[I didn&#039;t even realize it was 6 months... Ha... I&#039;m just slowly trying to revive things. I think that I could definitely write pages about all the stuff that&#039;s happened this year - job, moving, fatherhood, etc.]]></description>
		<content:encoded><![CDATA[<p>I didn&#8217;t even realize it was 6 months&#8230; Ha&#8230; I&#8217;m just slowly trying to revive things. I think that I could definitely write pages about all the stuff that&#8217;s happened this year &#8211; job, moving, fatherhood, etc.</p>
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		<title>Comment on Dog GERD by xacto</title>
		<link>http://rmfo-blogs.com/philber/2010/05/18/dog-gerd/comment-page-1/#comment-2774</link>
		<dc:creator>xacto</dc:creator>
		<pubDate>Fri, 21 May 2010 15:53:35 +0000</pubDate>
		<guid isPermaLink="false">http://rmfo-blogs.com/philber/2010/05/18/dog-gerd/#comment-2774</guid>
		<description><![CDATA[Wow, and I thought this page was dead. Six months later to the day.

Give Buddy our love. And Kathleen and JE, too, of course.]]></description>
		<content:encoded><![CDATA[<p>Wow, and I thought this page was dead. Six months later to the day.</p>
<p>Give Buddy our love. And Kathleen and JE, too, of course.</p>
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		<title>Comment on Dog GERD by Elizabeth</title>
		<link>http://rmfo-blogs.com/philber/2010/05/18/dog-gerd/comment-page-1/#comment-2772</link>
		<dc:creator>Elizabeth</dc:creator>
		<pubDate>Wed, 19 May 2010 03:03:24 +0000</pubDate>
		<guid isPermaLink="false">http://rmfo-blogs.com/philber/2010/05/18/dog-gerd/#comment-2772</guid>
		<description><![CDATA[Our cockapoo has done this occasionally for years.  The only thing we&#039;ve found to help him is just make sure he never goes too long without eating... if one of his meals is delayed for some reason, that&#039;s when he pukes the yucky yellow stuff.  We also give him little pieces of raw carrots for snacks, and that seems to keep his stomach settled.]]></description>
		<content:encoded><![CDATA[<p>Our cockapoo has done this occasionally for years.  The only thing we&#8217;ve found to help him is just make sure he never goes too long without eating&#8230; if one of his meals is delayed for some reason, that&#8217;s when he pukes the yucky yellow stuff.  We also give him little pieces of raw carrots for snacks, and that seems to keep his stomach settled.</p>
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		<title>Comment on Hadn&#8217;t seen this before by Avery</title>
		<link>http://rmfo-blogs.com/philber/2009/05/27/hadnt-seen-this-before/comment-page-1/#comment-2769</link>
		<dc:creator>Avery</dc:creator>
		<pubDate>Sun, 30 Aug 2009 00:02:22 +0000</pubDate>
		<guid isPermaLink="false">http://rmfo-blogs.com/philber/?p=734#comment-2769</guid>
		<description><![CDATA[I had a friend that took a dump while talking to me on the phone in high school. I was pretty grossed out. I told him to finish taking a dump and call me back.]]></description>
		<content:encoded><![CDATA[<p>I had a friend that took a dump while talking to me on the phone in high school. I was pretty grossed out. I told him to finish taking a dump and call me back.</p>
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		<title>Comment on Commentary: Why primary care doctors are fed up &#8211; CNN.com by philber</title>
		<link>http://rmfo-blogs.com/philber/2009/08/25/commentary-why-primary-care-doctors-are-fed-up-cnn-com/comment-page-1/#comment-2768</link>
		<dc:creator>philber</dc:creator>
		<pubDate>Fri, 28 Aug 2009 03:12:52 +0000</pubDate>
		<guid isPermaLink="false">http://rmfo-blogs.com/philber/?p=751#comment-2768</guid>
		<description><![CDATA[I think opening primary care up more to mid-levels is a very good and under-implemented idea, especially when put together in a practice with full-fledged MDs (of course, this all depends on the state you&#039;re in). I am not such a big fan of &quot;doc in the box&quot; urgent care clinics without actual docs, as it&#039;s not truly primary care/medical home and lacking a full-fledged MD. I know I am biased in this, because there are just things that come with more in-depth training that many mid-level providers do not have until well into their career. 

They do tend to be less debt-burdened, so they&#039;re less likely to be looking for the money, although I have to say that in my experience, from a systems cost perspective, they&#039;re just as inclined to order unnecessary tests because they&#039;re less likely to be up-to-date on current guidelines/evidence base, since their training usually doesn&#039;t emphasize this as much. 

The hard part is how to ask patients to &quot;take responsibility&quot; for their primary care - do you ask them to pay more per PCP visit? Or less? How does that get people into see their PCP? How does it deter them?]]></description>
		<content:encoded><![CDATA[<p>I think opening primary care up more to mid-levels is a very good and under-implemented idea, especially when put together in a practice with full-fledged MDs (of course, this all depends on the state you&#8217;re in). I am not such a big fan of &#8220;doc in the box&#8221; urgent care clinics without actual docs, as it&#8217;s not truly primary care/medical home and lacking a full-fledged MD. I know I am biased in this, because there are just things that come with more in-depth training that many mid-level providers do not have until well into their career. </p>
<p>They do tend to be less debt-burdened, so they&#8217;re less likely to be looking for the money, although I have to say that in my experience, from a systems cost perspective, they&#8217;re just as inclined to order unnecessary tests because they&#8217;re less likely to be up-to-date on current guidelines/evidence base, since their training usually doesn&#8217;t emphasize this as much. </p>
<p>The hard part is how to ask patients to &#8220;take responsibility&#8221; for their primary care &#8211; do you ask them to pay more per PCP visit? Or less? How does that get people into see their PCP? How does it deter them?</p>
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		<title>Comment on Commentary: Why primary care doctors are fed up &#8211; CNN.com by Valerie</title>
		<link>http://rmfo-blogs.com/philber/2009/08/25/commentary-why-primary-care-doctors-are-fed-up-cnn-com/comment-page-1/#comment-2767</link>
		<dc:creator>Valerie</dc:creator>
		<pubDate>Fri, 28 Aug 2009 00:45:19 +0000</pubDate>
		<guid isPermaLink="false">http://rmfo-blogs.com/philber/?p=751#comment-2767</guid>
		<description><![CDATA[What about leaving much of primary care to nurse practitioners? Or opening more of primary care to nurse practitioners? They are well trained and able to do much of what PCPs can do, and can take some of the strain off the system. Additionally, because they tend to be less debt burdened, they might not need the money incentives that doctors might.]]></description>
		<content:encoded><![CDATA[<p>What about leaving much of primary care to nurse practitioners? Or opening more of primary care to nurse practitioners? They are well trained and able to do much of what PCPs can do, and can take some of the strain off the system. Additionally, because they tend to be less debt burdened, they might not need the money incentives that doctors might.</p>
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		<title>Comment on Welcome to our world by Emily</title>
		<link>http://rmfo-blogs.com/philber/2009/08/05/welcome-to-our-world-2/comment-page-1/#comment-2764</link>
		<dc:creator>Emily</dc:creator>
		<pubDate>Thu, 13 Aug 2009 07:17:57 +0000</pubDate>
		<guid isPermaLink="false">http://rmfo-blogs.com/philber/?p=743#comment-2764</guid>
		<description><![CDATA[Congratulations! =)]]></description>
		<content:encoded><![CDATA[<p>Congratulations! =)</p>
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		<title>Comment on Welcome to our world by gilda</title>
		<link>http://rmfo-blogs.com/philber/2009/08/05/welcome-to-our-world-2/comment-page-1/#comment-2763</link>
		<dc:creator>gilda</dc:creator>
		<pubDate>Thu, 06 Aug 2009 03:39:55 +0000</pubDate>
		<guid isPermaLink="false">http://rmfo-blogs.com/philber/?p=743#comment-2763</guid>
		<description><![CDATA[Congrats!! And I get the privilege in sharing his birthday too. Hope Kathleen and babe are doing well.]]></description>
		<content:encoded><![CDATA[<p>Congrats!! And I get the privilege in sharing his birthday too. Hope Kathleen and babe are doing well.</p>
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		<title>Comment on Hanging out in the hospital by gilda</title>
		<link>http://rmfo-blogs.com/philber/2009/08/04/hanging-out-in-the-hospital/comment-page-1/#comment-2762</link>
		<dc:creator>gilda</dc:creator>
		<pubDate>Wed, 05 Aug 2009 17:56:52 +0000</pubDate>
		<guid isPermaLink="false">http://rmfo-blogs.com/philber/?p=740#comment-2762</guid>
		<description><![CDATA[Can&#039;t wait to hear the news! Thinking of your family from far away!]]></description>
		<content:encoded><![CDATA[<p>Can&#8217;t wait to hear the news! Thinking of your family from far away!</p>
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		<title>Comment on Hanging out in the hospital by kristen</title>
		<link>http://rmfo-blogs.com/philber/2009/08/04/hanging-out-in-the-hospital/comment-page-1/#comment-2760</link>
		<dc:creator>kristen</dc:creator>
		<pubDate>Wed, 05 Aug 2009 04:29:48 +0000</pubDate>
		<guid isPermaLink="false">http://rmfo-blogs.com/philber/?p=740#comment-2760</guid>
		<description><![CDATA[Thinking of you right now and praying for an uneventful birth!]]></description>
		<content:encoded><![CDATA[<p>Thinking of you right now and praying for an uneventful birth!</p>
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