A recent, albeit retrospective, study suggests a correlation.
MedPage Today reports on a recent JAMA study that looked at patients who had an acute coronary syndrome. It found that those who took both a proton pump inhibitor (PPI), like omeprazole, Nexium or Protonix, with Plavix had a 25 percent increased risk of death or rehospitalization.
If true, that's a pretty significant finding, especially since PPIs are ...
March 2009
All Stories
Laborists, and how rising malpractice premiums and the physician payment system are fueling the rise of hospital-only obstetricians
Meet the obstetric version of hospitalists, known as laborists.
Faced with rising malpractice premiums, and the increasing financial pressure to see more patients in the office, more obstetrician/gynecologists are ceasing to deliver babies. In fact, according to Massachusetts' largest malpractice carrier, more than half of the OB/GYN's they cover have dropped obstetrics.
It's no wonder, as "an obstetrician-gynecologist in Massachusetts generally pays between $75,000 and $100,000 ...
Do doctors already have a source of comparative effectiveness research?
Comparative effectiveness research is the current, trendy buzzword in the health care debate.
And certainly, doctors need an authoritative, unbiased, source in which to base their decisions on.
But, do we already have that kind of information? Why, yes, we do. It's called UptoDate.
For those who don't know, UptoDate is a peer-reviewed, evidence-based, medical encyclopedia available via DVD or online that's revised every 3 ...
Calling health care a right limits opposition and crushes dissent
I don't believe that health care is a right.
That has been debated many times here before, but in reading the ACP's Bob Doherty, he brings up another reason I hadn't thought of.
"Once something is defined as a right," says Mr. Doherty, "it paints people who disagree as wanting to deny those same rights. This places people who have legitimate concern about the role of ...
One doctor’s unnecessary procedure is another physician’s mortgage payment
"I make my living off unnecessary procedures."
So will be the rallying cry of some doctors once the true impact of comparative effectiveness research (CER) is felt.
Proponents of CER have been very careful not to associate its evidence-based findings with the coverage decisions of Medicare and other health insurers.
But let's face it, that eventually has to happen. I see CER as the initial ...
Does pay-for-performance work, and will it improve health care quality or patient outcomes?
Currently, most physicians are paid by the number of patients they see, or the amount of procedures they do.
Pay-for-performance, a payment system where doctors are paid based on meeting patient outcome measures, is how most insurers, along with Medicare, would like to see the payment system be reformed.
But does it really improve health care quality?
Pauline Chen looks at the data, and finds precious ...
Most Americans have health insurance, and what health reform is going to do for them
Backed by more than $600 billion, there appears to be genuine health reform momentum.
Much of the focus has been on covering the 15 percent of Americans who are uninsured, but as Ezra Klein points out, that also means that 85 percent of the country have health insurance. In fact, 95 percent of the people who voted for Obama are insured, and as Mr. Klein quotes one ...
How will the economy affect hospitalist salaries?
It's been said that hospitalists are the fastest growing specialist field in the history of medicine.
Hospitals are constantly recruiting, and the increasing demand is continually pushing salaries up. But, in the midst of the current recession, what does the future hold?
Writing in Today's Hospitalist (via Dr. RW), Erik DeLue predicts that salaries are likely to plateau, or even fall. Most hospitals ...
AstraZeneca’s weight gain and diabetes side effect cover up, and the sleazy Seroquel sex scandal
In the staid world of drug research, this is about as scandalous as it gets.
The antipsychotic drug quetiapine, or Seroquel, is coming under fire. As MedPage Today reports, damning e-mails from the past are resurfacing, implicating the drug maker for "burying" studies linking the drug to weight gain and diabetes.
But here's where it gets juicy.
AstraZeneca's former US medical director has admitted prior sexual ...
Using checklists in the ICU, a real world patient safety success story
Initially skeptical of using seemingly commonsense checklists in the intensive care setting, an infectious disease specialist is now a convert supporting the practice.
In his regular Washington Post piece, Manoj Jain writes about his hospital's initiative in conjunction with patient safety guru Donald Berwick. The program, instituted in 2002, required checklists to be followed prior to common ICU procedures, such as the insertion of central lines, endotracheal ...
Ten top medical blog posts, February 2009
Here are the top posts from this past month, based on the number of times they were viewed. Enjoy.
1. How was Nadya Suleman impregnated with octuplets? Is IVF, the mother, or her doctors to blame?
2. Nadya Suleman's fertility specialist Michael Kamrava, and how he's able to stay in practice despite a poor history of successful implantations
3. Ways you can die ...
Kevin Pho, MD
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Why Priscilla Chan may become the country’s most influential doctor
Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from...
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Confused about prostate cancer screening? Make a shared decision
In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men. Case closed, right? Hardly. The prostate...
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When it comes to doctors and social media, hospitals fail miserably
When it comes to medicine and social media, much of the attention is negative. Doctors losing their hospital privileges because of Facebook....
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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...
Physician
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Why test recalls should not be considered cheating
I was appalled recently by the coverage of radiology “test recalls” by CNN, amplified by Dr. Gary Becker of the American Board...
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Why physicians are susceptible to hardball tactics
I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the...
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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...
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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What should America’s health care vision be?
America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the...
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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...
Tech
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When patient care becomes secondary to filling out the medical record
The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above...
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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...
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...
