Health care reform is the headline-maker these days, and I give my take in a couple of recent articles.
First, Congressional Quarterly wonders if there are enough primary care doctors for every patient newly insured under a universal coverage plan (a familiar take, I must say). Anyways, here's my contribution to the piece:
The biggest problem is that primary care physicians are paid far less for their ...
In a surprise, President Obama has signaled a willingness to discuss medical liability as part of the health reform process.
Good for him for standing up to the trial lawyers, a core constituency of the left.
That's a good sign, as the costs of defensive medicine brought on by the broken malpractice system, should be addressed if there is any hope of reducing health care spending.
Recent data has suggested that we may be finding too many cases of prostate cancer.
This is important, since there are no studies suggesting that screening for early prostate cancer saves lives. In many cases, "most prostate tumors grow so slowly that had they not been screened, those men would have died of something else without the anxiety."
In fact, the USPSTF recently recommended that ...
Who knew that doctor chatter could be so profitable?
The two major physician-only social networking sites, Sermo and Medscape Physician Connect, are making news, as this piece in Newsweek notes how both the pharmaceutical and the financial industries are listening in on the conversations.
These sites, however, are a relatively new phenomenon, and some wonder what would happen if doctors post something unsavory, or even illegal, on the ...
Is the cover-up becoming worse than the proverbial crime?
According to the WSJ Health Blog, Jonathan Leo, a professor of neuro-anatomy from a small university in Tennessee, critiqued a study published in JAMA, and pointed out an association between the study's author and a pharmaceutical company. He posted his thoughts on the website of the British Medical Journal.
None too happy, Leo then received calls from ...
Patients in need of a kidney often wait years for a suitable donor.
Instead of waiting, more patients are taking matters into their own hands by arranging private kidney transactions, through internet classifieds on Craigslist or social networking sites like Facebook or MySpace. Those who seek organs outside the traditional system can potentially save up to ten years of waiting.
But ninety percent of the transplant centers in ...
A study recent came out showing that specialists are providing a greater proportion of primary care services to patients.
According to the Annals of Family Medicine, "Researchers looked at more than 1 billion ambulatory visits to U.S. office-based specialists in 2002-04 and found that 46.3% of visits were for routine follow-up and preventive care of patients already known to the specialist, while referrals accounted for only ...
Well, duh.
Many patient encounters, like those involving medication refills for instance, can be done without an office visit. An e-mail or telephone conversation would suffice in most cases. However, with Medicare and other private insurers refusing to reimburse for such claims, it is no wonder that many doctors insist on a face to face visit that gets reimbursed.
HMO Kaiser Permanente recently published a study ...
Hospitalists are here to stay, for good.
MedPage Today reports on a NEJM study, not surprisingly concluding that "hospitalists now account for nearly 40% of inpatient Medicare claims for general internist services, up from less than 10% in 1995."
That's a lot.
How will it affect primary care doctors, who increasingly are confined to the office? Well, it's not a positive as you'd think.
Lost in the zeal of those supporting electronic medical records is how computers can depersonalize the patient encounter.
In a nice op-ed in The New York Times, pediatrician Anne Armstrong-Coben talks about how doctors now have to make a concerted effort to look up from a computer screen simply to maintain eye contact with a patient. "I advise teenagers to limit computer time," she writes, "as I ...
Family physician Doug Farrago returns with a new episode of Placebo Television, which is likened to the Daily Show of medicine. Enjoy.
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A recent study on hospice care has been making mainstream media headlines, and, of course, doctors are cast in a negative light.
The study, from the Archives of Internal Medicine, concluded that patients felt abandoned by their primary care doctors upon transfer to hospice care, and that the "feelings of abandonment resulted from lack of closure for patients and families."
Palliative care physician Christian Sinclair gives ...
Some professors at the Harvard Medical School are the biggest beneficiaries of funding and gifts from the drug industry.
These conflicts of interest are causing some dissension within the student body, with some feeling "violated" when being lectured by professors who are paid consultants to drug makers.
This places the school in a difficult position. On one hand, especially at a school as revered as Harvard, ...
I'm aware that the blog's RSS feed is not working.
Unsurprisingly, the problem is on Blogger's end, and I'll have to wait out a fix.
Sorry for the inconvenience, and thanks to all that gave me the heads up on the problem.
Update 3/14 :
I put in a temporary fix, so the feed should be up again. Thanks for your patience.
Here's a handy resource for patients to calculate their radiation exposure to a variety of imaging tests.
Radiation exposure, and the subsequent risk of cancer, is a small, but very real, risk of X-rays, CT scans, and other radiology procedures. But, how much is too much, and what is the cumulative effect?That's a question I encounter daily, and ...
The work ethic instilled in most physicians may actually be a detriment to patient care.
In this piece in Slate, emergency physicians Zachary F. Meisel and Jesse M. Pines write about the culture in medicine where doctors are expected to show up for work (via RangelMD.com), no matter what their malady is: "Sick doctors have been known to do rounds while dragging IV poles and receiving fluids for ...
One of the pillars of health care reform is modernizing our antiquated health records system.
That means pouring billions of dollars into the current generation of electronic medical records (EMRs), despite both the flaws, and the myriad of reasons why doctors are so resistant to go digital.
In an excellent piece, orthopedic surgeon Scott Haig points to why electronic records are not likely to save money, and ...
People have asked for my take on the President's "health care summit" last week.
Cautious optimism, for now.
Having all the stakeholders in one room, and apparently, agreeing that something needs to be done, is encouraging.
But, compromises will have to be made, whether it will be the insurance companies, doctors, drug companies, or patients, who will bear the brunt of the sacrifices remains to be seen.
I wrote a few months ago that MRI suites can be the most germ-infested room in the hospital.
Now, comes another precaution patients have to consider prior to undergoing an MRI.
MedPage Today reports on a recent FDA announcement, warning patients to remove medication patches, like the fentanyl or nicotine transdermal systems, prior to having an MRI.
"Some patches contain small amounts of aluminum or ...
So, while watching Lost the other night, I saw an add for a local grocery chain advertising free antibiotics.
Apparently, it's a nationwide promotion, with multiple chains using antibiotics as a "loss leader" to bring people into their stores.
Well, it has now gotten the attention of both the CDC and the Infectious Diseases Society of America, with latter organization writing, "If you give antibiotics ...
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...
Are doctors really going broke? According to this piece from CNN Money, some are: "Doctors list shrinking insurance reimbursements, changing regulations, rising...
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned...
Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. ...
As physicians, we are often called upon to be advocates for our patients. Sometimes they have no other person to turn to....
Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for "feeling good", but...
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in...
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a...
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...
So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence. The following passage really caught my attention: "Question is: are...
It has taken 13 years for us to revisit the issues in To Err Is Human, the 1999 landmark government report that...
A social media movement is happening before our eyes with action starting to take shape. The #occupyhealthcare movement has begun within to...
The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering...
The storyline is familiar. An organization is challenged to achieve better results without spending more money. An executive is committed to obtaining...
For many celebrities, their livelihoods depend on their physical appearance and they rely on armies of personal assistants, schedulers, stylists, trainers and...
How many times as a doctor do you ask the same questions over and over again as part of the routine process...
Many clinical decisions in older persons are dependent on life expectancy. For example, as life expectancy declines, cancer screening is likely to...
“To Err Is Human” is the title of the now famous book from the Institute of Medicine on patient safety published about...
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...
The physician’s decision to first dive into social media can be stress-inducing. Issues of time management, maintaining professionalism, and determining a return...
The impact of social media on medicine could arguably be compared to the impact of the industrial revolution on the human condition....
