Via Blogborygmi, our surgeon friend from A Cut to Cure . . . gives us a quote that summarizes many of the challenges and frustrations facing physicians today:
An older physician brought this up the other day during a discussion about liability premiums and declining reimbursement. It is a good, simple expression about the frustration many physicians feel:
"Why am I worth so little when I do ...
As was commented on by RangelMD and Medpundit, I only have to re-iterate it here. A study was released detailing the harms of full-body scans:
. . . a 45-year-old who has annual full-body scans for 30 years would accumulate an estimated lifetime cancer mortality risk of 1.9 percent, or almost one in 50.
"The radiation dose from a full-body CT scan is comparable to the ...
In a blatant attempt to capitalize on the MIRACL study sponsored by Pfizer, it seems that Merck's attempts have blown up in their faces. As a reminder, the MIRACL study reported a 16% lower rate of death and nonfatal major cardiac events 4 months after acute coronary syndrome (ACS) in patients receiving 80 mg/d of atorvastatin compared with placebo. This is contrast to the current Zocor study, ...
. . . take vitamin supplements every day, and I receive continual questions during my office visits about whether they work or not. This nice article summarizes the bottom line: save for a few, most vitamins do not have the appropriate evidence to back their general use.
In a study that will be published in The Lancet shortly, comes the most definitive look at risk factors causing heart disease. Some key observations:
* 90% of the risk factors can be prevented
* risk factors are similar across different regions and race
So, what are the risk factors? Here they are, in order of importance:
1) poor HDL/LDL ratio
2) smoking
3) diabetes
There is an interesting discussion going on at Blogborygmi. Nick applied the evidence-based Ottawa ankle rules in a situation, only to be overruled by his attending - "in our country, I can't afford not to get an X-ray." Discussion ensued in the comments, with arguments discussing whether EBM is merely a cost-containment strategy versus good medicine.
I would agree with the attending in this ...
So I was having a discussion with a friendly drug rep about McNeil's drug, Flexeril. Now, this is not a new medication, but the 5mg formulation is. The big selling point is similar amount of muscle relaxation with less sedation. What's left out is that the regular 10mg of Flexeril is a generic medication, but 5mg is brand-name only, meaning it's third tier on most health plans. ...
. . . frivolous lawsuits are an American-only phenomenon, fear not - it happens in Korea as well.
Singapore is offering "medical tourism", slashing rates of medical procedures to lure overseas patients. I guess that's one way to increase revenue.
As we continue to get blitzed with happy-meal style medications like Azithromycin Z-paks and Tri-paks, Biaxin XL-paks, and Levaquin Leva-paks, consider the most recent review from NEJM on bacterial sinusitis. Some excerpts:
In an analysis of a large pharmaceutical database, 29,102 patients were identified with a billing diagnosis of acute sinusitis and a related prescription for an antimicrobial agent. Clinical success was defined as the absence of an ...
I'm sure that they're in damage control mode after reading about how Vioxx increases heart attack risk.
Patients taking Merck & Co. Inc.'s Vioxx arthritis drug had a 50 percent greater chance of heart attacks and sudden cardiac death than individuals using Pfizer Inc.'s rival Celebrex medicine, according to a large study financed by the U.S. Food and Drug Administration. . .
The study also found patients taking the ...
Trent has written a dissenting opinion on the piece by Mr. Baker yesterday in the Boston Globe. He writes:
Consumers only want and seek the information if the benefits of such information exceed the costs of finding it. Part of the reason things stand as they do is that patients do not save from finding this pricing information. This is the fundamental problem with third-party payers, whether ...
. . . gives Charlie Baker's opinion on disclosing health care costs to the public. He is the CEO of Harvard Pilgrim Health Care, an HMO in Massachusetts. I completely agree with his comments.
. . . on physician blogs.
Fascinating interview with Bruce Fagel, a former ER physician who is now a malpractice attorney. He touches on which doctors he sues, the costs of litigation, and opinions on tort reform.
I am a pretty big supporter of e-health - that is educating and empowering patients to take control of their health using the internet. With this new resource, comes many dangers - especially in the form of incorrect medical information and misinterpretation of information. Two articles from the BMJ discusses the effectiveness and challenges of e-mail consultations.
There's a disturbing new trend - pro-anorexia websites. Sad, in more ways than one.
Maybe I shouldn't laugh, since we also outsource our transcription to India. But, I couldn't help but to chuckle at some of the transcription errors from outsourcing.
A good case for same-day appointments. Our practice currently uses this model (allowing several same-day urgent care visits per physician) with good success. Patients are happy with the improved access, and these slots invariably fill.
. . . Carotids.com - "an irreverent look at the latest medical news. We as health professionals enjoy learning, discussing, and laughing at the latest news and research. Get your real research from your journals. Come here to laugh and chat about our wonderful professions."
Some good stuff on this website and more than a few laughs. I've added it to my Blogroll.
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
I've only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case...
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to...
One of the things I love about family medicine is that I get to care for people of all ages. I almost...
I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by...
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an...
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives....
A guest column by the American Medical Association, exclusive to KevinMD.com. This week, I’m joining hundreds of physicians and medical students in Washington, DC...
Everyone in the world is talking about “value-driven health care.” Or so it might seem if you pick up a medical journal...
CNN recently posted an article titled "Doctors Going Broke." It described several cases of independent physicians who are near bankruptcy although they once...
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate...
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going...
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively...
Paul Conslato, MD, director of clinical affairs for Lancaster General Medical Group, recently was quoted in the PAMED Better Health Network eZine...
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and...
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
