I'd say elements of both criticisms are true, but both also lack nuance. The federal government actually has a fair amount of experience measuring quality, as evidenced by HHS' Hospital Compare; whether such measurement translates into improvement remains to be seen. Regarding Heritage, we know that when physicians are entirely left to their own devices, non-evidence-based care can result. However, requiring levels of 100% compliance for given ...
December 2006
All Stories
Milk instead of barium?
Milk tastes better and is significantly cheaper. A small study suggests little clinical difference for X-rays.
Sealed settlements
Confidentiality agreements are keeping malpractice settlements from health-care regulators:
A lawsuit involving a Group Health doctor was improperly sealed by a King County judge. Settled for $5.5 million, the case shows up in a database used by lawyers, but only as Confidential v. Confidential. Also termed "confidential": names of county, defense lawyers, medical experts.
Pioneering patients: "Public intrusion is a given"
Patients in first-ever medical procedures are under the public microscope - whether they like it or not:
For patients involved in historic medical procedures, there's no such thing as keeping a low profile. Medicine may have advanced at just the right time to help them, but seizing the moment often means subjecting their lives, their decisions and their most intimate post-op problems to broad scrutiny. Public interest is understandable: ...
Newsflash: Santa is a poor role model for obesity
More from the physician/grinch who performed this study:
Dr Miles Fisher, consultant physician at Glasgow Royal Infirmary said: "The image of Santa is of a round, jolly person and it is meant to be one of hilarity but if you have obesity around your tummy, then it is very bad for you.
"Before, we thought it was just not good to be overweight but now we know that ...
Whole body CT scans
In addition to a lack of evidence-based benefit, many are downplaying the very real radiation risk. Take this typical exchange with a Florida "scan and tan" center:
Or "Come to Florida, for a scan and a tan," flashes a Web ad for HealthTest Scan Center, where a pelvic, abdomen and chest scan will set you back $895, with a heart scan thrown in.
When Tania answered the ...
A series on hip fractures
The Boston Globe does a series on hip fractures - one of the biggest causes of mortality in the elderly.
A woman loses 10 lbs of skin to a spider bite
The spider venom led to abdominal skin necrosis.
A physician is on the hook for a $9M malpractice case
Sketchy details here, but this is what we have:
The case arose because Jessie Sturdivant suffered an aneurysm and Barrau admitted him to Parkway Regional. After a disagreement with another physician, Barrau stopped acting as coordinator for Sturdivant's care and stopped checking on the patient, the complaint said.Not sure what the "disagreement" was. Perhaps it was an argument over ...
Sturdivant fell into a coma and died.
"Useless. Dangerous. Even crooked."
Who gives this brutal verdict on complementary medicines? Orac? No, UK's first professor of complementary medicine.
Peanut allergy controversy
Is it better to hold off on exposing infants to peanuts? A new study aims to find out:
Many experts believe the current advice to parents to keep peanuts away from their babies may be making the problem worse.
In Africa, Asia and China, where peanuts are a staple food and routinely given to young children, rates of peanut allergy are lower than they are in the ...
Luxury hospitals
If you were to get sick, these hospitals are the places to be.
"Treating people as rational adults means letting them do things they may bitterly regret later"
NY Times' case: What to do when you don't agree with a patient's decision.
More on Medicare’s P4P introduction
This will surely be a framework for a much larger expansion in the coming years. One point to note - this will surely be an excuse to lower fees in the future:
"Doctors and others who like pay-for-performance have to remember that it's a zero-sum game." As a result, he said, most doctors will have to accept lower fees if Medicare is to pay bonuses to the best ...
Energy drinks crossing the line?
A new entry, Cocaine, amps up the caffeine - raising health risk fears:
This year, in a study published in the Journal of Analytical Toxicology, a team of researchers analyzed the caffeine content of 10 popular energy drinks and found concentrations as high as 141 milligrams per 16-ounce can. While the Food and Drug Administration does not regulate the amount of caffeine in soft drinks, agency guidelines for colas ...
Parents sue hospital . . .
. . . after their son undergoes a gender-changing procedure:
A couple whose only son underwent a sex change operation has sued a hospital for compensation and to have the surgery reversed because their "family line" was broken, a Chinese newspaper reported.(via The Health Care Blog)
The Pulse Of The Healthcare Blogosphere
Results from a comprehensive survey of the healthcare bloggers are in.
Physicians are getting sued by patients they never met
Where does the madness end?
According to court documents, the plaintiff, Jeremy Arsenault, sued Peter C. McConarty, MD, alleging that Dr. McConarty discharged Israel Ortiz from the hospital without warning him about the potential risks of taking antiglycemic medications when blood sugar levels are low. About 45 minutes after Ortiz was discharged, he lost consciousness as a result of low blood sugar, crossed the center line of traffic ...
The "Rodney Dangerfield" of diseases
Pneumonia gets no respect:
Dr. Levine leads a worldwide effort to raise money for more pneumonia vaccines. He is seeking a tiny fraction of the amount spent on AIDS, tuberculosis and malaria, but it is still proving a struggle.
Part of the problem, he argues, is that pneumonia specialists "have a collective inferiority complex because our disease is so hard to diagnose."
Not-for-profit vs for-profit hospitals
Which provides better patient care? The answer is somewhat obvious:
Bruce Landon, MD, MBA, associate professor of health care policy at HMS, and colleagues found that overall, not-for-profit hospitals consistently performed better than for-profit hospitals when it came to delivering high-quality care for three common medical conditions: congestive heart failure (CHF); heart attack (acute myocardial infarction, AMI); and pneumonia.
Kevin Pho, MD
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Warren Buffett’s prostate cancer choices aren’t right for every man
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
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Many medical decisions require shared decision making
The following column was published on April 1, 2012 in USA Today. I recently saw a middle-age man in my primary care clinic...
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Patients deserve a medical malpractice early offer
The following column was published on March 25, 2012 in the Nashua Telegraph. Medical malpractice historically has been a contentious issue. Doctors...
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Discussing whether tests actually help patients or cause more harm
The following column was published on April 11, 2012 in CNN. When you visit the doctor, chances are you are given a...
Physician
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How we deliver bad news is critical to how families deal with grief
As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during...
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His father’s suffering had already been too great
He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I...
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Diversity provides color to the tapestry of human experience
I was recently appointed the Assistant Director of the Yale Cancer Center with the portfolio of Diversity/Disparities. While I’m not sure I’m...
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Necessary is a word best defined when looking back in time
How do you define a “good” doc? I was reading the patient responses to an article here on KevinMD.com and was saddened...
Patient
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How death can be a beautiful experience
I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law...
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What meaningful encouragement can be given to someone who is dying?
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
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Health care journalists have tendencies similar to those of doctors
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
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Adaptation can be painful, but it can also be a gift
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
Policy
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Hospitals around the world aim to remain relevant to patients
"It was the best of times, it was the worst of times ..." So begins a story called A Tale of Two...
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Repairing the tear in health care’s safety net with social media
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
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Look to technology to reduce health costs
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
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How to save a trillion dollars in health care
It is both conventional wisdom and factual truth that, unimpeded, American healthcare cost inflation will bankrupt the United States economically, educationally, socially,...
Tech
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Doctors, use Google to get more patients in less than 7 minutes
Every month, hundreds of thousands of people look for a doctor on Google. As an amazing practitioner, your site deserves to be...
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The user interface for EHRs should be uniform
The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with...
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EMR liability needs to go further than just the physician
This example of a disaster waiting to happen, in the form of an error-promoting CPOE, is a poster example of why the...
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AMA: Changes are needed in the stage 2 meaningful use EHR proposal
A guest column by the American Medical Association, exclusive to KevinMD.com. Continuing our efforts to move medicine forward while prioritizing patient care and minimizing...
Social Media
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We need to see the potential harm of social media
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
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Why social media may not be worth it for doctors
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
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Transparency defines social media success for doctors
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
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How Twitter was used in a potential mass casualty scenario
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
