Apparently, the Presidential limousine has a compartment that stores pre-crossmatched blood, just in case.
How necessary is this, considering the fact that a designated emergency department will never be far off for the President?
And in case the unforeseen happens, is transfusing blood in the field the best option for fluid resuscitation, rather than simply giving intravenous saline or crystalloid?
If anything, emergency physician Shadowfax writes, ...
January 2009
All Stories
Will Sanjay Gupta stand up to the lobbyists as Surgeon General?
The controversy surrounding the potential pick continues.
Maggie Mahar has some real concerns about Dr. Gupta's history, including his propensity to support the products and treatments he reports on. With lobbyists having the potential to obstruct health reform every step of the way, the Surgeon General should "serve the interests of patients-ahead of the interests of those who profit from our bloated $2.3 trillion health care system."
The best way for hospitals to improve themselves
During the recession, how should hospitals spend their money?
If this recent report is to be believed, many are spending it to upgrade their service and amenities such as upscale food, a pleasant environment, and attentive staff.
Isn't the money better spent on, say, clinical indicators and quality measures?
Well, no. Data has shown that patients respond positively to amenities, and sadly, "from the patient ...
Her hands and feet amputated, a Brazilian model dies from Pseudomonas aeruginosa sepsis. What happened?
Mariana Bridi da Costa, a 20-year old Brazilian model, tragically died early Saturday morning from Pseudomonas aeruginosa urosepsis.
How can this happen?
Miss Bridi da Costa initially presented on December 30th, and was diagnosed with kidney stones. An ultrasound, ...
How online support groups help patients with psoriasis
Patients with dermatological disease often find it difficult to participate in patient support groups.
Online support options may be particularly helpful in these cases.
MedPage Today reports a small study that looked at patients, mostly with moderate-to-severe psoriasis, who participated in an online support group. Almost half reported an improvement in quality of life, with those who were most involved benefiting the most.
With the ...
Is The Dark Knight’s Two-Face a realistic depiction of third-degree burns?
The answer is no.
Patient-blogger Duncan Cross takes exception to the cavalier treatment director Christopher Nolan gives to third-degree burns in Aaron Eckhart's super-villain.
"There is no way that eye would have survived intact, much less be able to function without a lid and tear ...
First day in the hospital, a trauma to remember
A medical student's first day in the hospital turns into a day to remember.
She gets called in to observe a trauma involving a mother and three children involved in a motor vehicle accident, and this is part of her account of what happened (via WhiteCoat):
Soon the patient's blood pressure fell into the 30s and then into the 20s. The anesthetist, constantly frowning, tried more blood, ...
Why controlling health care costs is so difficult
Because there are very strong forces interested in maintaining the status quo.
Washington Post columnist Robert J. Samuelson finds that American health care system (via Robert Centor) is a reflection of our society: "It's highly individualistic, entrepreneurial and suspicious of centralized supervision. In practice, Medicare and private insurers impose few effective controls on doctors' and patients' choices. That's the way most Americans want it. Patients understandably desire ...
Why are black patients more likely to refuse lung cancer surgery?
Of those diagnosed with early stage lung cancer, 69 percent of black patients opted for surgery, compared to 83 percent of white patients.
MedPage Today reports the findings from a cohort study in the Archives of Surgery. All the patients had Medicare, making insurance a non-factor.
Possible reasons include different racial-based beliefs, including that blacks "were more likely to believe that surgery accelerated tumor ...
Our broken health care system, should we start all over from scratch?
If you're a staunch single payer supporter or a free market advocate, you're likely going to be disappointed with how health reform is going to play out.
In an excellent piece, Atul Gawande discusses the history of health reform (via Ezra Klein) in other countries that have universal care, like Canada, the UK, France and Switzerland, and how those systems came to be.
Completely scrapping ...
How the government is banking on prevention to save money
The common refrain is that an ounce of prevention is worth a pound of cure.
However, numerous studies have concluded that prevention doesn't really save health care dollars. That's because preventive medicine allows people to live longer, which will make them consume more health resources as they age. That may be a noble goal, but at least let's be honest about it.
New York Governor ...
When ear piercings lead to keloid formation
A rare occurrence where a routine ear piercing goes horribly wrong.
Keloids are fibrous growths that uncommonly occur in cases of wound healing. They present predominantly in blacks, and any type of skin piercing can affect those predisposed to the disease.The lesions can be ...
The best medical blog of 2008
I'm humbled by the honor.
KevinMD.com has been voted the best medical blog in the 2008 Medical Weblog Awards.Whether your vote was for me, or for one of the other worthy finalists, your participation in the Awards further cements the status of medical blogs as ...
Some lawyers say defensive medicine isn’t real, but this doctor shows us otherwise
Lawyers and left-leaning policy wonks often discount how pervasive defensive medicine is.
WhiteCoat, an emergency physician, is almost convinced by those who call defensive medicine a figment of the medical profession's imagination.
Then he starts his shift working in the emergency department, an experience that most lawyers and policy experts do not have by the way, and cites specific examples where he made a decision specifically to ...
Poll: Do gifts from pharmaceutical companies influence how physicians prescribe?
As if January 1st of this year, drug companies have voluntarily agreed to stop providing branded gifts to physicians.
Do gifts from pharmaceutical companies influence how physicians prescribe?
Trust in the pharmaceutical industry is at an all-time low. Numerous reports have described lavish events at which the latest, most expensive medications are marketed to doctors. and there is suspicion that clinical studies backed by drug companies have ...
Could privacy laws and bureaucracy derail universal electronic health records?
Health IT is about to receive a $20 billion infusion from the Federal government.
Aside from the fact that the current generation of electronic records may not be ready for widespread use, there are questions as to whether privacy laws will impede the spread.
In general, doctors adopt the path of least resistance. Throwing in added steps, like filling out additional forms or requiring pre-authorization phone ...
Electronic records are supposed to reduce medical errors, right?
Those who advocate for electronic medical records cite a decreased incidence of medical errors.
The VA's universal EMR, VistA, has been hailed as a model to aspire to. That confidence was recently shaken by an AP report, which disclosed a "software glitch" which exposed patients to wrong doses of medications.
One example included heparin, a blood thinner that requires close monitoring. Other problems included vital ...
Ted Kennedy’s brain tumor, and the medical care he receives
As we know, Massachusetts Senator Ted Kennedy has an advanced stage brain tumor, and was recently hospitalized for a seizure.
Seizures are a common side effect of malignant brain tumors, and often controlled with a variety of anti-seizure medications. There will be times where seizures can break through medication control, leading to the frightening episode that occurred on Inauguration Day.
Family physician Doug Farrago asks ...
Did Obama provide any health care clues in his inaugural address?
There were little specifics, but he did give notice that he will use technology to "raise health care's quality and lower its costs."
Indeed, one of his first actions will be to infuse health technology with a significant influx of federal dollars. However, the wisdom of supporting a generation of fragmented digital systems that cannot communicate to one another remains to be seen.
MedPage Today was ...
Despite the best efforts of doctors, here’s how some trauma patients die
When are trauma injuries too severe to overcome?
When this drunk, unrestrained driver hits a tree during a car accident, the bleed into his abdomen is significant. The fact that it takes some time before he is found, causing the sub-zero temperatures to bring his body temperature down into the 80's, makes his chances of survival slim.
Read how "frantic display of 21st century medical technology is ...
Kevin Pho, MD
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How patient satisfaction can kill
Patient satisfaction is all the rage. Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country...
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How I approach ovarian cancer screening with patients
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
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Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
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Should Google censor anti-vaccine claims?
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
Physician
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The analogy between baseball hierarchy and medical systems
From age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but...
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Saving patients from Internet health information
Lately, I get the feeling that I’m doing something wrong. I’m supposed to form a partnership with my patients. My patients are...
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Understanding what patient centered care really means
There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He...
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A letter of thanks to my organ donor
I have tried to write a letter of thanks but don't know what to say or even how to begin. I don't...
Patient
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Why patient engagement is reciprocal
It is said that "turn around is fair play." So if providers (physicians, hospitals and other health care professionals) expect patients to...
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Question the price of drugs and medical procedures
Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure...
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In love there is a life giving force
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
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How to get ready for death
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
Policy
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America has a medical care system not a health care system
As Americans we believe we have the best healthcare system in the world. But think again, it’s really not the truth. We...
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Reading between the lines of breast cancer treatment studies
Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently,...
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Why are labor and deliveries closing?
Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no...
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America has a health care paradox
We have a real paradox in American healthcare. On the one hand we have exceptionally well educated and well trained providers who...
Tech
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Why physicians don’t want patients to have their cardiac device data
There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers....
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Impersonal communication on the Internet fuels cyberbullying
In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over...
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Health IT and doctors: A framework for successful partnerships
We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology. We have firsthand...
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Break out of the prison of the American health care delivery system
Speaker after speaker at the recent Care Innovations Summit in Washington, DC concluded that increasing the quality and decreasing the per-capita cost...
Social Media
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Why doctors should embrace Google+
Lots of pressure out there for you to be on Facebook and Twitter, right? The ultimate question, though, is how are you...
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Using Twitter to deliver health improvement messages
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
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Addressing comments on your medical practice’s Facebook page
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
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The Internet is where patients go for pre-visit consultations
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
