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America has a medical care system not a health care system

by | in Policy | 5 responses
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As Americans we believe we have the best healthcare system in the world. But think again, it’s really not the truth. We do have superb medical schools, very well trained providers, superb science and technology but the delivery of medical care is just not what it should be. We spend more for healthcare than any other country does on a per capita basis.And yet when we compare ourselves to other ...

Why physicians don’t want patients to have their cardiac device data

by | in Tech | one response
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There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers. I have discussed in other articles why patients deserve their data and the benefits derived thereof.  There are no substantive arguments against this practice, and I always thought, throughout my 12 years of remotely monitoring patients with these devices, that they not only were entitled to the ...

Impersonal communication on the Internet fuels cyberbullying

by | in Tech | no responses
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In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over another, typically from a roughly similarly aged peer group. The bullying could be mild such as occasional name calling and having one’s books knocked down when walking in the hallway. This does not mean the effects of the bullying were mild but comparatively speaking, this is generally not ...

Saving patients from Internet health information

by | in Physician | 11 responses
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Lately, I get the feeling that I’m doing something wrong.  I’m supposed to form a partnership with my patients.  My patients are supposed to be the working partner and I’m supposed to be the consulting partner.My job as the consulting partner is to offer sagely medical advice to the boss (working partner).  As a consultant, I’m supposed to help in the making of key decisions, find the appropriate tools to ...

Understanding what patient centered care really means

by | in Physician | 6 responses
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There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He often cringed as he walked by the examining room and imagined the hand holding that was taking place behind closed doors.Privately, they argued about the different approaches. One saw the world in terms of black and white, while the other was steeped in a foggy haze of gray. ...

A letter of thanks to my organ donor

by | in Physician | one response
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I have tried to write a letter of thanks but don't know what to say or even how to begin. I don't know the persons I am writing to, but part of their loved one is literally now a part of me.It began with a phone call from my brother. "Jim, what the hell is Fuchs' Dystrophy anyway - do you have it too?"I racked my brain and tried to ...

Health IT and doctors: A framework for successful partnerships

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We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology.  We have firsthand experience of the shortcomings in the healthcare industry, and we know that it’s going to take a concerted effort to upend the system.  Those of us who are able to adapt and apply new technology solutions to existing problems will undoubtedly make positive changes.Barriers to entry into entrepreneurship ...

Answers to common vaccine questions

by | in Meds | 10 responses
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Here are some of the most common questions I encounter regarding vaccines and my answers.  I’m writing this post, from a parent to a parent, because I want to equip you with accurate information to protect your child.We give so many vaccines now and it seems like we are constantly adding more.  Isn’t this too much for my child’s immune system?  Isn’t it antigen overload? The immune system is very complex, ...

Doctors cannot be expected to be financial engineers

by | in Physician | 6 responses
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Peggy was in her early 70s and suffered from a terrible lung disease known as pulmonary hypertension. So bad in fact, that she had a pump infusing a medicine under her skin 24 hours a day to keep the blood supply to her lungs open. Once started, this medicine, treprostinil, was known to improve life in those with pulmonary hypertension. Unfortunately, like all continuous infusion medicines of this type, it ...

Defining recovery from mental disorders and substance use disorders

by | in Conditions | 7 responses
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Are you a recovering alcoholic?Be honest.How about a recovering nicotine addict, or recovering from an addiction to some illegal drug, or maybe addiction to gambling, or sex, or football, or even your computer screen, or Angry Birds?I have worked in the addiction field most of my professional life. For me, addiction to a chemical includes physical and mental dependence, tolerance, withdrawal, and, of course, drug seeking behavior, despite recognized ...

Reading between the lines of breast cancer treatment studies

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Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently, breast cancer has certainly gotten a lot of play in the media as of late.Every major news outlet in America covered the breast cancer study released by JAMA which said that nearly half of the women who had second surgeries for breast cancer may not have needed the ...

Why patient engagement is reciprocal

by | in Patient | 20 responses
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It is said that "turn around is fair play."So if providers (physicians, hospitals and other health care professionals) expect patients to become more engaged in their own care, isn’t it fair for patients to expect their physicians to also get more involved in their care?If you look closely at "proxy measures" for physician engagement, you will see that this is a legitimate if not equally important line of inquiry.Hello? Hello? ...

A diagnosis of stomach cancer profoundly changes an oncologist

by | in Physician | 9 responses
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I was jogging one day while on a business trip in LA and collapsed during the run.  Within hours, I was at the hospital at UCLA Medical Center on a gurney headed for a CT scan of my abdominal cavity.  I remember telling the ER physicians that I was a doctor and recommending my own course of action.  As my advice to the ER doctors went largely ignored, I realized, ...

What you need to know about antithrombotic guidelines

by | in Conditions | no responses
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The lack of evidence supporting the “economy class syndrome” myth in air travel made major news headlines recently. While certainly interesting and accurate, that topic was just one among many topics addressed in the larger framework of the new evidence-based guidelines.The American College of Chest Physicians (ACCP) released the Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in its February issue ...

Why are labor and deliveries closing?

by | in Policy | 21 responses
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Labor and deliveries are slowly closing across the United States:  California, Pennsylvania, and Ohio.  In regional areas where there have been no closures, conversations in hospital boardrooms are probably questioning whether they should be.  But why?  Because of health care reform, increasing medical expenditures, hospitals are making less money due to reduced reimbursement, and because of the financial margin of obstetrics.  To explain the complex answer further, we need to ...

A Grammy artist with Tourette Syndrome

by | in Conditions | no responses
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Would you consider a career as a singer if you had involuntary tics from Tourette Syndrome?Well, it apparently didn’t stop 20-year-old Contemporary Christian musician Jamie Grace.In fact, Grace attributes singing with helping her cope with her disease.And now she is being rewarded with a Grammy nomination for best contemporary Christian music song, Hold Me.  The song features TobyMac, who is a Grammy winning Christian recording and hip/hop artist. He ...

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