Any rhyme or reason? OnThePharm thinks not.
May 2007
All Stories
Big Pharma, data-mining, and the AMA
Some are saying the AMA's "opt-out" clause for physician prescribing patterns is too subtle. With millions of dollars at stake, the AMA is caught in the middle.
Man slept through a gunshot wound in his head
Apparently he was a sound sleeper.
Canadians continue to be offended by Michael Moore
They're not happy with the portrayal of Canada's health care system in Sicko:
Moore started with a stunningly stupid statement that essentially told these socialized medicine ingrates to quit their whining about 18 month-long waits for gallbladder surgeries because it means they apparently live three years longer...somehow. Moore lashed out at these legitimate questions about his habit of propping up an unrealistic portrayal of a socialist utopia (or ...
Convicted for treating al-Qaida
A Florida physician is guilty for providing material support to terrorists.
Mental health and racism
A report wondering if they are linked:
The debate has now largely moved on and the focus is now on outcomes and experiences in the mental health system.
For example, regardless of the higher rates of psychosis, it seems that when in contact with mental health services, outcomes for Afro-Carribean people are much worse than white people.
This is where the subtlety in the debate lies. Higher ...
Physician-pharma relationship: "It make sense"
PhRMA defends itself from the heat surrounding its relationship with physicians:
Who better to know about the scientific complexities of prescription medicines than the companies that create them? Pharmaceutical experts are a key source of information for healthcare providers on side effects and new studies regarding medicines they may prescribe. Clearly, patients benefit from these exchanges. Picture the opposite. What would a patient's reaction be if a doctor shrugged ...
HIV screening in the ER
Should this be routine?
Avandia, MI, and cardiac death
More fallout from yesterday's big news about Avandia and its association with heart attacks and cardiovascular death.
Dr. Charles:
"The 43% increase in heart attacks/myocardial infarctions and the 64% increase in death from cardiovascular causes is also sensational. It is the same statistical trick the pharma companies use to promote the efficacy of their products, and the same eye-catching method the Women's Health Initiative reported when hormone replacement ...
Doctors and lawyers agree on a malpractice bill
Hell has frozen over in NC:
In a turnaround from previous years, both doctors and lawyers are supporting a bill that would cap monetary damages at $1 million in some medical malpractice cases.
Both the North Carolina Medical Society and the N.C. Academy of Trial Lawyers support a bill, set for House debate Monday night, that caps monetary damages in negligence cases at $1 million, but only for those ...
Avandia and heart attacks
Could Avandia be the next Vioxx? The NEJM with some smoke. Will fire be far behind?
Rosiglitazone was associated with a significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes that had borderline significance. Our study was limited by a lack of access to original source data, which would have enabled time-to-event analysis. Despite these limitations, ...
The American public is confused about cancer
Blame the media, says Gary Schwitzer:
I'm a journalist so I always look in the mirror first and I blame journalists for creating much of this confusion. The "cure" or "killer" emphasis in many stories - in order to compete for space or airtime - shows no appreciation for public understanding. Fulltime health, medical and science reporting jobs are being slashed all over the country.
Single-payer: Read the fine print
Eric Novack comments on the difficulties of a single-payer system:
. . . single payer advocates like to have it both ways. On the one hand they speak of inability to get care, while simultaneously decrying that up to 50% of care is unnecessary. Which is it? Or is it both? And, again, how is it that an unelected bureaucracy, given complete authority over what care you can choose to ...
Tradeoffs for covering the uninsured
What will we have to give up if we go to universal coverage? That's something that isn't covered by the media:
You might think that providing universal health care coverage is going to solve a big health care problem in America. If that's what you think, I'm guessing that you have not delved into the matter in any great detail . . . My first eye-opening discovery was that ...
Physician shortage in Boca Raton
The usual suspects are reasons: malpractice, reimbursement and high cost of living.
One new reason is cited however. The rise of concierge practices:
Dr. Greenwald also noted another significant reason for physician shortages "“ not a physical lack of physicians, but rather many physicians changing to so-called "concierge" medicine . . .
. . . Greenwald said this means that when one doctor leaves general private practice ...
Moore on Canadian health care
"I recognize that there are flaws in your system, but that's not for me to correct, that's for you to correct."
It's safe to say that he won't be doing a documentary attacking Canadian health care anytime soon.
Cyberchondria
It's what you get when you add Google + hypochondriacs:
Ninety percent of hypochondriacs with Internet access become cyberchondriacs, according to Fallon. He said it's a natural progression.
Med school accidentally gives refunds
Last August most members of the Medical College of Georgia's 2008 class found a $2,961 tuition refund deposited in their bank accounts. In April, though, the sweet deal turned sour. The school sent certified letters informing students it wanted the money back.
Instead of owing $18,000 in tuition for the year, these students must pay $21,000 due to an erroneous refund.
Side effects of life
All drugs have side effects, but so does life:
Their findings surprised them. For example, taking Vioxx (rofecoxib), which was withdrawn from the market in 2004, or Tysabri (natalizumab) for multiple sclerosis was comparable to or exceeded the risk of dying in a car crash, working as a truck driver or rock climbing.
Remaking a nose
Complex surgery replaces a veteran's nose:
In a series of six operations over a year-long period that ended with removal of the last sutures on May 2 - and that rank as one of the most complicated nasal reconstructions ever performed at Johns Hopkins - facial plastic and reconstructive surgeons have pieced together more than a dozen bits of bone, cartilage, skin, arteries and veins to rebuild Fletcher's nose. ...
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...
