A byproduct of the anti-vaccination movement is chickenpox parties.
"My 7-year-old daughter has been to six of these parties. Unfortunately, we have not caught the pox yet, but I'm keeping my eye out for more parties," says a concerned parent.
Some believe that ...
February 2009
All Stories
Will the government delay comprehensive health reform?
With the economy worsening, health reform appears to be taking a back seat.
Or is it?
Bob Doherty sounds the alarm, citing the contentious opposition to reauthorizing SCHIP, which once enjoyed bipartisan support.
Several outlets are also reporting that prominent politicians, including Pete Stark and Max Baucus, have privately admitted that comprehensive health reform will be pushed back until 2010.
MedPage Today somewhat concurs ...
Max Baucus on single payer: "I’m not going to waste my time"
I find it interesting that single payer supporters are so inflexible in their vision of what health reform should be like.
Progressive blogger Ezra Klein says that the opponents of single payer supporters actually are moderate Democrats, rather than the right. "Their enemies are on the left," writes Mr. Klein. "Their targets tend not to be those blocking reform, but those promoting the wrong type of reform."
Why Americans fear radical health care reform
Despite faring poorly in metrics that compares the American health care system with other countries, the public may fear the unknown that radical change brings.
Prominent economist Uwe Reinhardt (via The Health Care Blog) provides some insight in a recent interview.
There is little question that the United States provides the best specialist-based care in the world. As Mr. Reinhardt says, "people imagine having ...
Should patients be treated as customers, and if so, are they always right?
More patients are being referred to as consumers, and some don't agree with the connotation.
"That puts a bigger emphasis on how much profit the patient can make a company, which can lead to less-than-optimal decisions on behalf of the patient later on," says diabetes blogger Manny Hernandez.
However, patients are now encouraged to advocate on their own behalf, and entities like high deductible health plans and health ...
Will integrated systems become a reality in American health care?
Many of the country's large-scale health systems, like Kaiser Permanente, the Mayo Clinic or the VA, operate at a greater cost-efficiency when compared to a traditional practice.
Currently, however, they are an exception to the norm. Most doctors are affiliated with small-group practices, with little interaction between each other. That is one reason why care is so fragmented, with only a minority of doctors using electronic medical ...
Should Darvon be withdrawn? The implications of banning propoxyphene
The FDA advisory committee voted to ban Darvon, generically known as propoxyphene, in the United States.
MedPage Today reports on the 14-12 vote, which was prompted by numerous fatal overdoses, and non-fatal complications, as well as questioning its efficacy.
Anti-pharmaceutical crusader Sidney Wolfe made his presence felt, as he presented data claiming that in 2007, according to data gathered from emergency departments, "503 deaths were 'related' ...
Is there really a physician shortage?
Or is it a declining number of doctors refusing the accept certain insurances, or subject themselves to the abuses of the health system?
Emergency physician WhiteCoat cites a number of stories where patients are not receiving timely access to care.
In one, which I alluded to last week, parents unable to find pediatricians in California willing to accept Medi-Cal. As he wryly observes, "the fact [is] ...
Do doctors who use social media prescribe more medications?
Doctors are increasingly using social networking tools like Twitter, Facebook, and Sermo.
A recent study showed that 60 percent of doctors use, or are about to use, various Web 2.0 applications. That's no surprise.
The unexpected finding was that physicians who reported they used social media prescribed 24 more medications each week when compared to their peers who reported that they did not.
So that begs ...
Tom Daschle withdraws, and how that will impact health care reform
There's no shortage of informed opinions on the Tom Daschle debacle, and how this will affect the chances of successful health care reform.
I don't pretend to be a political pundit, so instead, here is a collection of selected insights from news sites and health policy blogs that I regularly read.
First off, the NY Times says it will likely halt the momentum for health reform, and ...
Is depression more prevalent in medical students?
It appears so.
Chris Rangel points to a study showing that 21.2 percent of medical students (that's more than 1 in 5), suffer from depression, compared to 10 percent in the general population.
Depression seems to hit its peak during the second year of medical school, and then gradually improves. In general, the rates of depression for students were generally higher than in residency.
Indeed, ...
Remove a kidney through the vagina? Is natural orifice surgery the future?
For the first time, a living donor had her kidney removed through her vagina.
She was left with three small scars, with one hidden in her navel. There's hope that the procedure, which reduces recovery time and is generally more tolerable than the traditional laparoscopic method, can encourage more people to donate.
Gynecologist Amy Tuteur takes a closer look at the procedure, and likens it ...
A shot of adrenaline, for asthma?
Cheap, generic albuterol inhalers for asthma are being phased out in favor of more expensive, more environmentally friendly, inhalers.
Patients, however, are bearing the brunt of the cost, with what used to cost less than $10 now costing several times more.
This country doctor relates a story of one his patients who injected himself with epinephrine for his asthma attacks. "When his asthma kicked ...
Do you know the name of your hospital doctor?
And if you don't, does it really matter?
Bob Wachter discusses a recent study concluding that very few could actually name their hospitalist one month after an admission.
Ideally, "patients need to have a personal connection to their physicians, particularly at times of great need and uncertainty," writes Dr. Wachter.
I agree, but the health system has incentives geared towards giving more disjointed, fractionated care. ...
Can medical school expansion revitalize physician training?
We are in the midst of a golden age of medical education, with schools expanding at an unprecedented level.
MedPage Today reports from a recent summit of medical educators, where they concluded that, with nine medical schools set to open and the majority of the remaining 126 schools planning to expand class size, this is an "unparalleled opportunity" to reform physician training.
That time can't come soon ...
Does masturbation really cause prostate cancer?
A small study garnered significant media attention last week, with headlines blaring an association between masturbation and prostate cancer.
Before anyone gets really worried, obstetrician-gynecologist Amy Tuteur takes a closer look at the data, and is not impressed.
The retrospective, case-control study actually didn't reveal any significant initial findings, so the authors kept manipulating the variables until they saw a possible association.
Dr. Tuteur believes that ...
How was Nadya Suleman impregnated with octuplets? Is IVF, the mother, or her doctors to blame?
Many have been asking me to comment on the recent octuplet case in the news.
I have to admit, this is out of my field, so I'll point to a few other physicians who have been talking about the case.
When it was first reported, it was speculated that Ms. Suleman used fertility medications indiscriminately, and then had intercourse. Gynecologist Amy Tuteur suspected illicit use of ...
Doctors asking patients to pay more of their bill up front
As health care costs rise, more patients are switching to high-deductible insurance plans.
When that deductible hasn't been met, doctors are becoming more aggressive in asking for their payment up front.
This move entirely makes sense, since like other businesses, physician practices are also wading through the difficult economic times.
According to the LA Times, 13 percent of a practice's revenue comes from patients, and by becoming ...
Family murder-suicides, or, what drives a man to kill his own wife and children?
The economy is leading to a disturbing rise in family murder-suicide cases, with two high-profile cases in January.
And that's just the beginning, according to sociologists.
"The economic situation also portends a significant increase in other forms of family violence, including spousal and child abuse, child neglect and other forms of dysfunctional behavior like substance abuse," says sociology professor Sampson Blair at the University of Buffalo.
A ...
Kevin Pho, MD
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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....
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Radiologists who cheat on their board exams: Who’s to blame?
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
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Doctors: Don’t be ashamed about going bankrupt
Are doctors really going broke? According to this piece from CNN Money, some are: "Doctors list shrinking insurance reimbursements, changing regulations, rising...
Physician
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Patients will understand an honest mistake if the doctor tells the truth
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned...
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Diagnosing an illness is an art
Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. ...
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Physicians have a natural role as advocates
As physicians, we are often called upon to be advocates for our patients. Sometimes they have no other person to turn to....
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Our society expends huge sums on futile care
Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for "feeling good", but...
Patient
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How will the Baby Boomers age and die?
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in...
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Patient engagement is the holy grail of health care
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a...
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Why do doctors delay hospice referrals?
This is a response to Deb Discenza's article requesting a one page informational sheet informing a patient about hospice or palliative care. This would...
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How touch can calm patients
So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence. The following passage really caught my attention: "Question is: are...
Policy
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Improve patient safety to improve healthcare quality
It has taken 13 years for us to revisit the issues in To Err Is Human, the 1999 landmark government report that...
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A lack of incentive for medical schools to train primary care doctors
A social media movement is happening before our eyes with action starting to take shape. The #occupyhealthcare movement has begun within to...
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What should be the stated aim of health care in America?
The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering...
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How Moneyball applies to healthcare
The storyline is familiar. An organization is challenged to achieve better results without spending more money. An executive is committed to obtaining...
Tech
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New classes of devices to diet and exercise
For many celebrities, their livelihoods depend on their physical appearance and they rely on armies of personal assistants, schedulers, stylists, trainers and...
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Repetition is the curse of the doctor-patient engagement
How many times as a doctor do you ask the same questions over and over again as part of the routine process...
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Why the prognosis of patients is difficult
Many clinical decisions in older persons are dependent on life expectancy. For example, as life expectancy declines, cancer screening is likely to...
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Innovative technologies can markedly enhance safety
“To Err Is Human” is the title of the now famous book from the Institute of Medicine on patient safety published about...
Social Media
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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...
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5 ways doctors can benefit from professional connections
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
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Twitter Is my third office location
The physician’s decision to first dive into social media can be stress-inducing. Issues of time management, maintaining professionalism, and determining a return...
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The impact of social media on a physician assistant
The impact of social media on medicine could arguably be compared to the impact of the industrial revolution on the human condition....
