Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Women can wait longer for their first Pap smear and then repeat the test less frequently, according to recommendations from the American College of Obstetricians and Gynecologists (ACOG).

When women should have their first Pap smear; the new cervical cancer screening guidelines The organization now says women should begin cervical cancer screening with a Pap test at age 21. Subsequent tests should occur at two-year intervals until age 30, when the interval can be increased to once every three years for women who have had three consecutive negative tests.

ACOG previously advised women to have an initial Pap test within three years of becoming sexually active or at age 21, whichever came first. The organization also recommended annual screening.

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by Dan Walter

We found out that her real name was Cindy Chapman, and that she died alone and afraid.

jane q patient Cindy was a paralegal, an activist and a fighter of lost causes who lived in Worcester, Massachusetts. She was part of an online community called RATEMDs, where she had many soul mates. Her posts on health care were funny and cynical and wise. Her screen name was Jane Q. Patient.

My wife, Pam, was especially fond of trading comments and barbs with her. Like others on the forum, Jane Q. was prone to drop off the screen for days or weeks at at time. But she always resurfaced with stories of her battles with the system, her fights for the poor as a paralegal, or her volunteer efforts with the Obama campaign. A few months ago, as the fight for health care reform was reaching a fever pitch, Jane started posting about her own medical complaints. She told of emergency room visits and fights over insurance, and pain, pain, pain. Her postings became erratic, with uncharacteristic typos, misspellings, and fragmented thoughts.

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Originally published in HCPLive.com

by Colleen O’Leary, RN, MSN, AOCNS

Last time I talked about how I had never really experienced the concept of nurses eating their young in action.

Are older nurses being forced out of the profession? However, I have seen the opposite begin to evolve. I see this as a bigger issue in nursing these days. The “putting out to pasture” of seasoned, experienced nurses is happening more often and for a variety of reasons.

First, and foremost, is simply the fact that the pool of nurses inevitably follows the general aging of the nation. As baby boomers who once filled the halls of healthcare institutions caring for others begins to age, they will certainly have a more difficult time meeting the demands of current healthcare. More and more institutions are requiring nurses to work longer and longer shifts, changing from an 8-hour day to a 12-hour day. This, along with the fact that patients in the inpatient settings have much higher acuity and a variety of complex issues, makes the demands on nurses even greater.

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Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

Drug and device makers are urging the FDA to establish clear guidelines that will allow the industry to discuss and promote products in the unsettled world of online social media.

How should the FDA regulate the social media advertising of drugs? The FDA is hearing testimony from drug and device companies, online marketing experts, and consumer groups about what steps the agency should take to move medical advertising and promotion into online communities.

“The Internet is an important tool for consumers looking for answers about medications,” Michele Sharp, a spokeswoman for Eli Lilly, said at the FDA gathering today.

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Primary care disrespect starts early in medical school

November 20, 2009

In medical schools, primary care continues to be among the least respected fields a student can choose.
No where is that more starkly illustrated than in Pauline Chen’s recent New York Times piece, where she tells a story of a bright medical student who had the audacity to choose primary care as a career:
Kerry wanted to [...]

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Can less aggressive cancer screening recommendations be better for patients?

November 19, 2009

by Amy Tuteur, MD
Doctors have understood for some time that it was inevitable. The American Cancer Society has acknowledged that cancer screening has been oversold.
It seems like every day you read in the newspaper that what was standard medical care yesterday is now no longer recommended. Don’t doctors know anything? Well, actually they do. And [...]

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How to choose the right electronic health record (EHR) consultant

November 19, 2009

Originally published in HCPLive.com
by Jonathan Bertman, MD
You may have seen advertisements, or may already have been contacted by people who’ve promised to help you figure it all out so you can get your share of the stimulus money. Be wary. The truth is that the Obama administration is still defining many essential elements of the [...]

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Why health reformers should be worried about the breast cancer screening backlash

November 19, 2009

What if a non-partisan, authoritative entity wrote a robust, evidence-based guideline, but nobody followed it?
That is precisely what’s happening with the USPSTF’s recent revision of their breast cancer screening recommendations. The change most find problematic is their recommendation that women younger than 50 not undergo any breast cancer screening, such as with a mammogram.

58 comments Read the full article →

Senate health reform plan analysis

November 19, 2009

Originally published in MedPage Today
by Emily P. Walker, MedPage Today Washington Correspondent
After weeks of closed-door meetings, the Senate leaders released their $849 billion healthcare reform bill on Wednesday evening, paving the way for a procedural floor vote soon.
The bill, combining versions approved by the Finance Committee and the Senate Health, Education, Labor and Pensions [...]

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How a personal injury lawyer views the medical malpractice system

November 18, 2009

Personal injury lawyer Eric Turkewitz responds to my recent USA Today piece on fixing the medical malpractice system.
by Eric Turkewitz
In a USA Today op-ed, Kevin Pho tackles the medical malpractice liability system. Some stuff I agree with, but suggestions regarding improvement of the current system are unlikely to work.
Kevin correctly states that malpractice legal fights [...]

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Medical students post inappropriate content online

November 18, 2009

Originally published in Insidermedicine
The posting of unprofessional and inappropriate content online by medical students is a relatively common occurrence that medical schools are going to have to learn to deal with, according to research published in the Journal of the American Medical Association.

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Can family doctors do safe first trimester abortions?

November 18, 2009

Originally published in MedPage Today
by Chris Emery, MedPage Today Contributing Writer
Complications from first trimester abortions performed by family practitioners are rare, and family doctors could help address abortion provider shortages across the U.S., a new study found.
Among more than 2,500 abortions performed by family physicians, abortion was successful without complications in 96.5% of patients [...]

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A lack of computer skills will make a doctor unemployable

November 18, 2009

How important is it for doctors to have computer skills?
It’s imperative.
Emergency physician Shadowfax is recruiting doctors for his hospital, and balances the typical choices one must make balancing clinical knowledge versus interpersonal skills.
One deal breaker, he notes, is the lack of computer skills:
Unfortunately, in this modern age, if an employee can’t use a computer effectively, [...]

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Why doctors are doing so many unnecessary Pap smears

November 17, 2009

by Matthew Mintz, MD
The Wall Street Journal and other sources reported on a study from the Annals of Internal Medicine that showed that most US doctors don’t know the guidelines of how often women should get a pap smear. More importantly, doctors were doing a lot of pap smears on women who didn’t need them. [...]

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Will patients accept the new, evidence-based, breast cancer screening guidelines?

November 17, 2009

Breast cancer screening has been scaled back, according to the recent recommendations of the USPSTF.
That’s the right move. Although women aged 50 to 74 years should receive a mammogram every 2 years, evidence of breast cancer screening in other age groups has been marginally conclusive at best, and non-existent when it comes to clinical [...]

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Can primary care doctors actually increase health care costs?

November 17, 2009

Poor McAllen, Texas.
The much maligned city has been in the health policy crosshairs ever since Atul Gawande’s seminal New Yorker article on health costs.
Now, it has the added distinction of being the worst place in the country to live with allergies.
The reason? Apparently, there’s one allergist for the entire city. One. And [...]

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