April 2009

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Why giving free care to the uninsured is good business

in Patient | no responses

Walgreens made some headlines with their program to give free acute care services to those who are unemployed.

Before you think that they're doing this out of the goodness of their hearts, Jaan Sidorov gives a more practical reason.

Doctors rarely would drop patients who have recently gone on Medicaid, or worse, lost their health insurance altogether. Why? As Dr. Sidorov ...

Does jet lag really need to be cured?

in Conditions | 4 responses

With Provigil going generic in 2012, Cephalon is looking to replace that lost revenue.

Enter Nuvigil.

The drug company is trying to add a new indication, that is, "curing" jet lag, to give it a leg up over its predecessor.

That, and also drastically hiking the price of Provigil, may entice doctors to make the switch to the newer medication prior to patent expiration.

But, ...

What if the economy was treated like a sick patient?

in Policy | 2 responses

Physician-writer Rahul Parikh's take on the economy is an entertaining one.

What if the economy was the patient, and how is it reacting to interventions meant to improve its prognosis?

"Shortly after the New Year, the doctors had a long discussion," Dr. Parikh writes. "Some argued that that a Prescription for a broad-spectrum stimulus was called for. Others felt that a more careful approach, ...

Why do softball pitchers experience more anterior shoulder pain?

in Conditions | no responses

Ever see softball pitchers do their big, windmill windup prior to a pitch?

MedPage Today finds a small study shows that it may strain their anterior shoulders more than an overhand throw.

Softball pitchers, who underwent photographic motion analysis and surface electromyography analysis of their biceps, were found to have an increased risk of injury to their biceps, caused by increased "peak biceps brachii muscle activation during ...

A cancer missed, who’s responsible for telling the patient?

in Conditions | 5 responses

Amy Tuteur's father tragically passed away, but could it have been prevented?

She recounts the story, where, after presenting coughing up blood, her father was then diagnosed with lung cancer. However, 7 months earlier, that mass was seen on a pre-operative chest x-ray.

The urologist who ordered the test failed to inform her father, and he was later sued, but was found not to be ...

Poll: Should men still be screened for prostate cancer?

in Conditions | one response

Screening for prostate cancer has become controversial.

The US Preventive Services Task Force concludes that the evidence is insufficient to fully endorse prostate cancer screening in younger men and they recommend against screening for prostate cancer in men over the age of 75.

And a recent study from the National Institutes of Health found that, after 7 to 10 years of follow-up, screening men with a prostate specific ...

Is the nursing shortage overblown?

in Policy | 8 responses

We've been hearing for years that nurses are in short supply.

But the economy has put a damper on that notion. Contrary to that popular belief, nurses looking for a job are having a hard time finding work. The recession has forced nurses close to retirement to keep on working, and part-timers looking for more work.

At one hospital near Washington DC, there were precisely ...

Are quality measures doing more harm than good?

in Physician | 5 responses

With a second poignant op-ed in the Wall Street Journal within the span of a month, Drs. Jerone Groopman and Pamela Hartzband take on quality measures.

It's no secret that I've been a proponent of increased standardization in medical care, adhering the evidence-based practice guidelines.

That assumes, however, that the recommendations themselves are rigorous and have been shown to help patients.

And that assumption, as the ...

5 top medical comments, April 12th 2009

in Uncategorized | no responses

Here are some of the more interesting comments readers have left recently.

1. Dr. Gwenn on limited health literacy:
For us to do a better job with patients and teach them to be better advocates for themselves, we need more time - plain and simple. At the same time, patients need more community supports to understand the complex health world and build the skills they need ...

Should we start screening women for ovarian cancer?

in Conditions | 5 responses

The answer is no.

Besides the fact that the USPSTF already recommends against ovarian cancer screening, MedPage Today reports a study concluding that screening led to a high rate of unnecessary surgery.

During four years of screening with a transvaginal ultrasound and the CA 125 biomarker , "the surgery-to-cancer ratio was 19.5:1," meaning that almost 20 surgeries would be needed for every case of ovarian ...

The cost of limited health literacy, and how can it be fixed?

in Patient | 6 responses

Patients who have trouble understanding, or acting upon, the information as it relates to their health are more than twice as likely to die.

So writes Pauline Chen in recent column, where she writes about how patients need to take a more active role understanding their health. It's indeed a big problem, especially given the trend towards a more patient-centered orientation for medical care.

But, that ...

Are we wasting money on Alzheimer’s care?

in Conditions | 5 responses

According to the Alzheimer's Association, now is the time to address the burgeoning Alzheimer's crisis, especially with baby boomers in the midst of Medicare age.

Alzheimer's dementia boosts the cost of caring for the elderly almost three-fold, from about $10,000 to $33,000 per year, and as Amy Tuteur blogs, "the report of the Alzheimer's Association assumes that the enormous cost of Alzheimer's care is a morally necessary burden, but ...

How building your brand can improve your medical practice

in Physician | no responses

Some basic public relations skills can come in handy when building your practice.

I'm cited in a recent piece from the American Medical News, which talks about how consciously creating a "brand" can help shape your practice, and perhaps, make your medical work more rewarding.

With more patients having high-deductible health plans, "patients are going to be more picky about where and with whom they spend their ...

Can patients and doctors handle the truth?

in Patient | 2 responses

An inspiring post supporting the use of evidence-based medicine.

Often times, what's deemed common-sense and based on ideology is proved wrong by the evidence. And it's up to both patients and doctors to accept the findings of studies that disproves previously accepted dogma.

Physician David Newman gives us his best Jack Nicholson impression in driving that point home: "The critical question that looms ...

Should children be screened with an EKG prior to starting stimulants for ADHD?

in Conditions | 3 responses

According to some cardiologists, the answer is yes.

However, MedPage Today reports that, in a recent study presented at the American College of Cardiology meetings, the positive predictive value of such a strategy was low, and that, "To screen enough children to identify one with complex congenital heart disease or potentially life-threatening arrhythmia, the cost was $42,904."

Pediatricians have challenged this finding, calling mass screening for children, ...

Rationing health care by waiting times, or by cost

in Policy | one response

How do Americans ration health care?

It's by cost, as well as the number of uninsured.

Ezra Klein actually has a pretty balanced take on health care rationing issue. He says that what's happening Stateside is equally as dismal as the waiting times both in Canada and the UK, calling each system opposite ends of "awful extremes."

The ACP's Bob Doherty picks up on that, ...

Why hospitalized Medicare patients get re-admitted so frequently

in Policy | 11 responses

Hospital re-admissions are hitting Medicare patients particularly hard.

Otherwise known as "bouncebacks," MedPage Today reports on a recent NEJM study showing that, during a 15-month period, 20 percent of hospitalized Medicare patients were re-admitted with 30 days of discharge.

When you consider how few outpatient doctors accept Medicare, compounded by the appointment shortage that many primary care physicians face, it's no wonder that these elderly patients who ...

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