Women are undertreated and underserved when it comes to cardiovascular disease and stroke. Now, more than ever, this may even be more important due to several recent studies that have been published recently.
Several investigations have demonstrated two troublesome facts. In certain areas of the country, life expectancy for women is decreasing and women who smoke are much more likely to have lung cancer than men who smoke. These facts argue ...
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A few years after I entered my practice as a newly certified internist, about two decades ago now, I started to burn out. I felt I was becoming a documentation drone and a guideline-following automaton. I was embarrassed for some of the care I gave--attempting to fit patients’ round needs into the square peg of the medical model. Patients who came to talk about depression were marched through a complete review ...
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With the announcement that the FDA granted 510(k) approval for the AliveCor EKG case for the iPhone 4/4S, the device became available to "licensed U.S. medical professionals and prescribed patients to record, display, store, and transfer single-channel electrocardiogram (ECG) rhythms."
While this sounds nice, how, exactly, does one become a prescribed patient? Once a doctor prescribes such a device, what are his ...
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Recently, over 520 of our doctors began sharing their office visit notes with patients.
All primary care doctors and general pediatricians, and selected physicians within pediatric subspecialties, dermatology, endocrinology, pulmonology, nephrology, rheumatology, cardiology, cardiothoracic surgery, vascular surgery, neurosurgery, and women’s health—including obstetrics and gynecology and gynecologic oncology—are participating in OpenNotes.
That means tens of thousands of our patients will have access to the notes doctors write about them. After each ...
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In a word, no (unless you have cancer). So, let’s take cancer out of the picture and discuss hysterectomy for non-cancerous (benign) reasons.
First of all. A hysterectomy (removing the uterus) can be done via one of the 4 methods:
1. Vaginal, a small incision at the top of the vagina and the uterus is removed entirely through the vagina without any incision on the abdomen.
2. Laparoscopic surgery, where incisions are made ...
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“Something bad has happened. I’ve got eyelash extensions,” singer and actress Kristin Chenoweth confessed on the "Late Show with David Letterman" last year while wearing large dark sunglasses, and visibly drowsy on Benadryl. “Here’s the problem: The glue has formaldehyde in it, and I’m allergic,” Chenoweth said. “I swelled up and I’m sneezing. . . . It looks like I have lips ...
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We live in a strange world. What would happen if tomorrow a common sedative was found to cause 21,000 cancer deaths every year? What if it resulted in breast cancer, mouth cancer, hepatoma and esophageal malignancies, and if the average patient lost 19 years of life? What if the drug also killed by cirrhosis, massive upper GI bleeding, accelerated dementia, and for ...
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Brought to you by MedPage Today.
1. Hospitalists Work Longer, Patients Stay Longer. Long work hours for hospitalists led to longer patient stays and unnecessary orders.
2. Automated BP Device Not Cutting It. An automated BP cuff billed as an in-office substitute for ambulatory monitoring may substantially underestimate pressures.
3. No Hike in Mass. Hospital Use Post Health Reform. Healthcare reform ...
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Much has already been written about the Oregon Medicaid study that came out in the New England Journal of Medicine. Unfortunately, the vast majority is reflex, rather than reflection. The study seems to serve as a Rorschach test of sorts, confirming people’s biases about whether Medicaid is “good” or “bad”. The proponents of Medicaid point to all the ways in which Medicaid seems to help those who were enrolled ...
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Too often patients feel like they’re in the passenger seat when entering the hospital. Even in the best of circumstances — such as planned admissions — patients often don’t feel in control of their own care.
One of the most unnecessary issues facing patients when they enter the hospital is untreated (or undertreated) pain. Often the focus of the medical team is to treat a condition, and controlling a patient’s pain ...
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I empathize with people who don’t take an active role in their health care decisions. There are real barriers to any of us really getting engaged: limited information about price and quality, a perpetuated culture of “doctor knows best,” and a daunting and confusing set of rules about coverage. Who wants to think about it?
There are only so many minutes in the day or neurons in the brain. So, we ...
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Not old enough to remember any sort of “glory day” in medicine, I still enjoy hearing from older colleagues who recount days when they were respected, paid fairly, and able to practice medicine autonomously at the highest and most uncompromising level. What was that like, I wonder?
For five years, I’ve been a busy practicing anesthesiologist. And for five years, I’ve listened carefully to and cataloged the gripes and woes of ...
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After six weeks in the accelerated bachelor of science in nursing program at the University of Rochester, I was already on clinical rotations in the hospital. I was learning clinical functions that my second-year medical school friends had no idea how to perform: catheterizations, wound dressing changes, how to calculate and administer medications. There’s just not enough time in the first two years.
On the other hand, in the nursing program, ...
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Psychotic and manic depressive disorders can not only disrupt the life of the person suffering with one of these illnesses, but the lives of family and friends as well.
You should seek professional advice if you suspect that you, a friend or a relative or even a spouse may be experiencing a psychotic or bipolar disorder. It's important not to attempt a diagnosis yourself. There are many external factors that can ...
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What is the measure of successful technology adoption? Is it never having to hunt for a missing chart? Is it a reduction in specific operating cost line items? Is it about access to clinical information when you need it and where you need it?
Technology implementation has a significant effect on profitability. The Medical Group Management Association Cost Survey Report beginning with 2010 data shows that total medical revenue after operating ...
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I recently took part in a "civil discourse," an unusual occurrence in this era of media pundit-orchestrated shouting matches.
Unlike a debate with winners and losers, a civil discourse begins with the premise that, when there are different points of view on a topic, it is better to understand those with whom we disagree than to turn off the sound.
By listening and asking probing questions, we come to understand how such ...
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Medical and surgical errors are very common in the hospital setting. They increase malpractice lawsuits, the cost of medical care, patients’ hospital stays, and morbidity and mortality. As an infectious diseases specialist for over forty years, I was not aware how common these errors are until I became a patient myself after being diagnosed with hypopharyngeal carcinoma. My initial cancer was successfully removed, but a local recurrence occurred twenty months ...
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I have witnessed a lot of obesity bias in my career, and I have railed against it on more than one occasion. But it's not the focus of my career, as it is for some of my colleagues. I have long thought those colleagues who do devote themselves to the topic may tend to overlook a very fundamental question, namely: Why would obesity bias ...
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Choosing a new doctor is never easy. You need to know about convenience factors, such as office location, available appointment times, and accepted insurance plans. You will probably also consider background information, such as education, board certifications, and licenses. But the most important question you likely have involves results: Is this doctor any good?
Unfortunately, there just isn’t a single, perfect way to measure the quality of individual doctors. ...
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 45-year-old man is admitted to the hospital for a 2-day history of fever and abdominal pain. His medical history is notable for cirrhosis due to chronic hepatitis C, esophageal varices, ascites, and minimal hepatic encephalopathy. His medications are furosemide, spironolactone, nadolol, lactulose, zinc, vitamin A, and vitamin D.
On physical examination, temperature is 36.5 ...
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-Eric Topol, MD, author of The Creative Destruction of Medicine
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Past 6 Months
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