Imagine a world where consumers all knew about the latest developments in preventive health.
Earlier this month the Advisory Committee on Immunization Practices (ACIP) released the 2010 immunization schedules. Revised annually, the immunization schedules are what doctors in the U.S. use to decide who should be immunized against what diseases. Far from esoteric, the schedules pertain to every single person living in the United States. If the H1N1 pandemic and subsequent mayhem over vaccination have taught us anything it’s that in the 21st century vaccines still matter.
Despite this, the release of the new guidelines was accompanied with little fanfare. Popular media mostly ignored the story. Even at my own academic medical center there has been little circulation or discussion of the new guidelines.
The newest media doc on the block is Dr. Mehmet Oz. When he was first seen on Oprah, he seemed engaging and answered some interesting questions in a real and professional way. The audience loved his blue scrubs and boyish clean cut open style.
That was then.
Let’s face it . . . the media spotlight seems to corrupt even the best physicians. Dr. Oz now has his own show and website and production company. That is a pretty big infrastructure to maintain and we know that the public is fickle. So what does he do?
Raising seniors’ copayments for ambulatory care to offset increasing healthcare costs may backfire on insurers, researchers asserted.
Seniors enrolled in Medicare plans that increased copayments had significantly fewer outpatient visits but spent more time in the hospital than patients in plans that left copayments untouched, according to Amal Trivedi, MD, MPH, of Brown University in Providence, R.I., and colleagues.
Assuming an average reimbursement of $60 for an outpatient visit, seven annual visits per enrollee, and an average copay increase of $8.50 per visit, a plan should save $7,150 for every 100 enrollees, they noted in the Jan. 28 New England Journal of Medicine.
More graduating doctors are making family and personal life a priority, and opting for part-time work.
But when primary care doctors are needed more than ever, is that contributing to the shortage?
That’s a question that Dr. Gwenn asks over at Better Health. In pediatrics specifically, more “are now opting for part time work right out of the gate, just after training or during, in their 30s. And, that more men are going part time as well as subspecialists along with the women and generalists that have been steady part timers for a while. All tolled, as of 2006, 23% of the pediatric work force was documented as part time – and growing!”
The words we use may comfort or shock, allay or provoke, sooth or batter. Words often imply layers of meaning that are not explicitly articulated, yet rest beneath the surface:
“I worry that time is short for you” (You are dying) (I care about you)
“I wish we could have done more” (Nothing would have changed her death) (I am on your side)
“I hope with you that you’ll get better, but I think we should prepare in case things don’t go as we hope” (You are not getting better) (I support your hope)
A Massachusetts anesthesiologist accused of fabricating data in studies of pain drugs will plead guilty to federal criminal charges under an agreement with prosecutors.
Scott Reuben, MD, a well-known pain researcher at Baystate Medical Center in Springfield, Mass., was charged with one count of healthcare fraud.
The common thought among health reformers is that we spend too much on care, and the additional care patients receive doesn’t necessarily help them.
What inevitably follows is a discussion on how to streamline care, yet maintain quality. To that end, most hospitals and emergency rooms are using algorithm-based care based on the best available evidence. Where doctors actually had to hand write admission orders, they are now checked off – like a menu at a restaurant.
Another study has found that hypertension may contribute to increased risk of dementia, this time with evidence of actual brain abnormalities.
Data from an offshoot of the Women’s Health Initiative found that participants’ baseline blood pressure was strongly correlated with volume of lesions in their brains’ white matter, according to Lewis Kuller, MD, DrPH, of the University of Pittsburgh, and colleagues.
Along with earlier studies linking blood pressure to clinical dementia, the evidence “supports tight control of blood pressure levels, especially beginning at younger and middle age as a possible and perhaps only way to prevent dementia,” Kuller and colleagues concluded online in the Journal of Clinical Hypertension.
A patient learns about a treatment for his condition. So he goes to his physician to suggest the treatment as an option. Is there anything wrong with that?
It depends on how his “suggestion” is presented.
In today’s age of patient advocacy and direct-to-patient marketing of pharmaceuticals, a new phenomenon is flourishing in doctors’ offices: patients asking for specific diagnostic tests or therapies.
More than 85% of American military medical evacuations from the Middle East were not the direct result of enemy action, but the result of non-battle injuries and disease, researchers said.
Of some 34,000 military personnel in Iraq and Afghanistan who shipped out for medical reasons from 2004 to 2007, only 14% had been wounded or injured in combat, according to Steven P. Cohen, MD, of Johns Hopkins, and colleagues.
There is a veritable epidemic of doctor-writers out there. What is going on?
Are doctors suddenly in the kiss-and-tell mode? What about confidentiality? Professionalism? HIPAA?
As one of the aforementioned doctor-writers, I look upon this trend with both awe and trepidation. I suspect that that this flourishing literary phenomenon relates to the public’s fascination and fear about all things medical. It also relates to the falling away of previous, pedestal-like images of doctors and doctoring. Lastly, it may have occurred to the medical profession—and this has taken a few centuries, it seems—that doctors have profound emotional reactions to the work we do, and that exploring these reactions may offer benefit to both patient and doctor.
