Widespread news coverage has heightened concerns by many parents about a severe-symptom viral infection causing respiratory illness in children, predominately in the Midwest. Over the last month there has been a dramatic up-spike in children hospitalized with severe cold symptoms and wheezing. The virus isn’t new, but its effect on children seems to be. The Centers for Disease Control (CDC) has confirmed tests on children both in Kansas City and ...

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“Am I a hypochondriac?” It’s a question I hear with quite some regularity, almost never from people who suffer from bona fide anxiety disorders related to their health. No, the fact that all you have is a simple upper respiratory infection -- the common cold -- instead of a potentially lethal strain of H1N1 avian flu does not qualify. Not when your response to my reassurance is relief. That’s completely appropriate, and ...

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Back-to-school shopping, new sneakers and first-day outfits, sharpened pencils and fresh notebooks in oversized backpacks by the door: As a parent, these are the images I’ve come to associate with the start of every school year. But with my 20-plus-year history as a developmental pediatrician specializing in autism at Albert Einstein’s Children’s Evaluation and Rehabilitation Center, I have an added association with the start of the school year: a particular type of ...

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The joys of September! Parents gleefully shove their reluctant children onto school buses, the palm trees in Los Angeles don’t change color, and everyone realizes that they gained 20 pounds during their summer vacation. It’s time to get serious again about losing weight. But how should you eat to best help you shed the extra pounds? Many people are passionate about their favorite diet, but there is very little data comparing ...

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As a physician who openly despises many aspects of current EMRs (see “How An EMR Gave My Patient Syphilis” or “The Medical Chart: Ground Zero For The Deterioration Of Patient Care” ) I recognize that they are here to stay. And so, since we’re all stuck with these digital middlemen, I have some suggestions (based on popular social media platform functionality) for making them better. 1. Likes. Health care ...

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“Doctor, what do you think of alternative medicine?” a patient with chronic fatigue syndrome asked me the other day. She was interested in doing something more for her severe fatigue. “Would acupuncture help me?” I paused and, as I have done many times before, answered that my training and most of my clinical experience has been in Western, allopathic medicine. (Ironically, the word “allopathic” was first used as a derogatory term ...

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Top stories in health and medicine, September 16, 2014From MedPage Today:

  1. GLP-1 Plus Insulin Betters Glycemic Control. The combination of GLP-1 agonists and basal insulin beat other type 2 diabetes treatments at lowering HbA1c and improving glycemic control.
  2. Obamacare Does Little to Cut Kids' Uninsured Rate. The uninsured rate for kids under age 18 hasn't budged under the health law, ...

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Risk-adjusted 30- to 90-day outcome data for selected types of operations done by specific surgeons and hospitals are now being publicly posted online by England's National Health Service. According to the site, "Any hospital or consultant [attending surgeon in the UK] identified as an outlier will be investigated and action taken to improve data quality and/or patient care." After cardiac surgery outcomes data were made public in New York, some interesting unexpected ...

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On the face of it, the phone call was relatively innocent.  A family member was confused about the test I scheduled.  Apparently the lab refused to draw the blood.  When I inquired why, I was informed that the patient hadn't been fasting.  I calmly explained to the daughter that fasting was not necessary.  Recent studies had shown little effect on lipid panel results and I was using the glycosylated hemoglobin ...

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I don’t remember how many patients I saw at the health fair before George came to me; none of them were as memorable. George was a tall, stooped man with a serious expression. His skin was weathered but he couldn’t be called elderly by any means. I guessed that his age hovered somewhere around forty. He looked serious and spoke quietly. He had no interest in being rude, but no ...

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Everyone involved in health care, and particularly hospital care, has witnessed a sea change over the last decade. Things that were never even thought about, let alone formally taught to frontline doctors and nurses, have now come to the forefront. Chief among these is the drive towards improving patient satisfaction and delivering a more optimal hospital experience. True, a large part of this is due to federal incentives and tying reimbursements ...

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Recently, the Los Angeles Times reported on California pediatrician Dr. Bob Sears’ role as a favorite among vaccine-fearing parents. What he tells them is absolute nonsense that he has freely admitted he made up in a Reddit interview. Now he’s let a little more honesty shine through. He told the reporter: “I do think the disease danger is low enough where I think you can safely raise an unvaccinated child in today’s society,” ...

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There are minor operations and procedures, but there are no minor anesthetics.  This could turn out to be the one lesson learned from the ongoing investigation into the death of comedian Joan Rivers. Ms. Rivers’ funeral was held on September 7.  Like so many of her fans, I appreciated her quick wit as she entertained us for decades, poking fun at herself and skewering the fashion choices of the rich and famous. ...

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Top stories in health and medicine, September 15, 2014From MedPage Today:

  1. Diabetes Pathogenesis Takes Center Stage. The research focus in diabetes may be shifting from developing new treatments to better understanding the pathogenesis of the disease.
  2. The Yelp Phenomenon. Patients can complain about their medical experiences on Yelp, snap photos of doctor's offices for their Instagram account, and even post ...

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Part of a series. Employers have seen their health care costs rise dramatically over the years. To compensate, they have expected employees to pay an increasing portion of the health care insurance premium, expected employees to pay significant co-pays with each physician visit and have purchased policies that restrict individuals to a narrow network of doctors and hospitals. Largely these have not worked. They have offset some of the expenditures but ...

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The Canadian health care system is often held up as an example to model or to avoid at all costs in the debates on health care in America, and elsewhere.  Yet there are a startling number of misconceptions -- on both sides of the partisan divide -- about how the Canadian health system actually works, often from experts who should know better.  Here are the facts. 1. Doctors are self-employed, not ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 32-year-old man is evaluated for a 3-day history of productive cough, sore throat, coryza, rhinorrhea, nasal congestion, generalized myalgia, and fatigue. His sputum is slightly yellow. His two children (ages 3 years and 1 year) had similar symptoms 1 week ago. He is a nonsmoker and has no history of asthma. On ...

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When I hear the term "charity hospital," my thoughts turn to the grand bastions of 20th century public hospitals -- Bellevue Hospital in New York City, Cook County Hospital in Chicago, and San Francisco General Hospital. These hospitals were generally affiliated with medical schools and relied on government appropriations, rather than fees, to provide care for the poor. Decades of legislation have brought about sweeping changes in hospital financing, accounting, and social ...

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I read an article recently that implied the practice of hospitals acquiring physician groups encouraged “clinical integration and multidisciplinary team-based health care.” I guess that would depend on your definition of clinical integration. The American Hospital Association has a particularly cogent one, which is: “[A practice] needed to facilitate the coordination of patient care across conditions, providers, settings, and time in order to achieve care that is safe, timely, effective, efficient, equitable, ...

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It's been pretty quiet lately on the Obamcare front. So quiet, that there has been a flurry of articles recently over how Obamacare has dropped to a second or even third tier issue and will hardly matter come election-time. Wishful thinking. Obamacare has largely been out of the news cycle for a couple of months but that is about to change. A few thoughts. The 2015 rate increases have been largely modest. Does that prove Obamacare ...

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