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 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....
