Medical training could serve its patients better by developing a more cost-effective model -- more physician extenders to do triage, prevention and simple problem-solving, instead of more time-consuming and expensive training required for a smaller number primary care docs. We could also do a better job of it in larger, centrally planned groups, using salaried extenders and niche specialists working together. What do you think?

In the interest of transparency and accountability, two things this world is very short on, here are some follow-ups on previous columns and ruminations. Was I right, wrong, incomplete, or just wandering in the fog? Like everything in life, it's probably a mélange of all of the above, so let's see.

We all know that the impression you make in the first 30 seconds of meeting someone can never be redone. And we know from a small series of studies that a physician’s appearance is important to a patient’s perception of ability and caring. Unfortunately, doctors are known for sometimes being unconcerned about their dress and that can adversely affect our effectiveness, and in turn will have an impact on our economic success.

Travel can be broadening, but it can also be expensive. It doesn't have to be costly particularly, though the fact that a private practice doctor won’t be producing revenue to cover ongoing high office overhead makes travel an expensive proposition even before the first ticket is bought.