The following is the first in a series of original guest columns by the American Medical Association.
by J. James Rohack, M.D.
In an unprecedented endeavor aimed at achieving health-care reform this year, the American Medical Association (AMA) stood with President Obama and other key health-care stakeholders Monday to announce efforts to "bend the spending curve" on health care. U.S. health-care ...
May 2009
All Stories
10 health reform posts you may have missed
With entries dating back to 2004, here are 10 classic blog posts on health care reform:
1. Convincing doctors to accept a public health care plan option
2. Why health reform is going to be difficult, and the trouble with saying no to American patients
3. Should a public plan option be part of any health reform initiative?
4. The Obama health ...
Is Cheerios really a drug, and why is the FDA targeting the cereal?
The FDA sent a stern-sounding letter to the makers of Cheerios.
Not happy with their claims of being clinically proven to lower cholesterol, MedPage Today reports that Cheerios, by making "unauthorized health claims," is going to be treated as an "unapproved new drug."
Pharma watchdog John Mack thinks the FDA is going overboard by targeting Cheerios, with rampant, false claims by herbal and alternative supplements going ...
The secret to being a good teacher
When teaching his students how to feel for an enlarged spleen, physician-educator Abraham Verghese recalls the first time he managed to become proficient at the technique.
The best teachers know that, although the material they are teaching can become repetitive, it's the first time it's being heard by the student. And when talking about his own mentor, Dr. Verghese notes that, "Every single time he said the phrase, ...
How increasing payments for office visits can help specialists
As we know, the physician reimbursement system is skewed heavily towards performing procedures.
Increasing payments for office visits will obviously help primary care doctors, but as this orthopedic surgeon notes, can also help proceduralists. Studies have shown that in cases of knee osteoarthritis, patients who undergo arthroscopy do not necessarily have better outcomes.
With this in mind, "there are countless examples of orthopedic care that might ...
Before you ask a doctor out on a date
Not your doctor, for obvious ethical and legal reasons, but what about your friend's physician?
Doc Gurley looks at the pertinent issues when considering dating a doctor. Including, of course, how much debt you're looking at taking on.
"Nowadays, the myth of the rich doctor has tumbled faster than a Madoff investment scheme," she writes. "More accurately, that's true if your doc is a ...
Should we rename primary care?
The term, primary care, currently garners little respect among medical circles.
Prospective doctors pick up on this during training, making it one reason why they tend to gravitate towards specialties.
So, should "primary care" undergo re-branding?
Internist Robert Centor thinks so, saying, "Primary care suffers in part because so few decision makers really understand how complex primary care is. So I recommend that we no longer ...
What is the most accurate medical show on television?
Believe it or not, some say it's Scrubs.
Aside from the goofy and absurd moments, I've always found that the anecdotes in the show hit the right notes of medical training. Far more than, say, House or Grey's Anatomy.
Slate agrees in this essay, and explains why: "Scrubs . . . is mostly about what happens at hospitals between ...
Physician payment reform by capitation, will it work this time?
Paying physicians via capitation was soundly rejected by patients when it was tried in the HMO era a decade ago.
Massachusetts is trying again. According to a state commission, they recommend "replacing fee-for-service with a system that would use a single payment to cover most of a person's care for an entire year."
The last time this was tried, patients rebelled as it was perceived that there ...
How the physical exam can affect the doctor-patient relationship
The physical exam is increasingly being overlooked, and replaced by diagnostic tests, which are easier, and take less time, to order.
At this new blog over at The Atlantic, Abraham Verghese talks about how the physical exam, when done well, "earns the trust of the patient, and it also lays the foundation for the patient-physician relationship."
However, when done poorly, "it does the opposite--it creates ...
Poll: Should doctors use Wikipedia for medical information?
According a recent study, 50 percent of physicians who go online for professional reasons use Wikipedia to answer health questions, and the number of doctors who this popular user-generated web encyclopedia has doubled over the past year.
The explanation for this is simple. Doctors, like everybody else, often turn to search engines like Google to quickly find information, and Wikipedia entries tend to come up among the top results.
Rahul Parikh: Does violence on TV and in the media really lead to violent behavior?
The following is a reader take by Rahul Parikh.
We've become accustomed the notion that media violence is bad for children, and that exposure to it can lead to all kinds of problems, including violent behavior. Those us who remember Columbine in 1999 will certainly recall reports that the killers played the videogame Doom and listened to Marilynn Manson before ...
6 top medical comments, May 10th, 2009
Here are some of the more interesting comments readers have left recently.
1. Anonymous on whether emergency physicians best served to staff urgent care centers:
As an ED doc, I understand the problem. We are taught to always rule out the emergencies, and I am constantly worrying about the worst case scenario, and likely will order more tests since they are at my disposal, which is ...
Physicians for a National Health Program doctors arrested, and why is PNHP resorting to criminal activity to push their agenda?
A few zealous single-payer advocates, Physicians for a National Health Program included, were arrested this past week for disrupting Senate hearings.
Pictured here is psychiatrist Dr. Carol Paris, who was among the doctors arrested.
I'm not going to rehash the single-payer debate in ...
Can you really kill a man by gluing his anus shut?
A recently reported method of torturing gay men in Iraq sounds horrifying.
Andrew Sullivan points to an article that spares no graphic details: ". . . anti-gay Shiite death squads are sealing their anuses with a powerful glue, then inducing diarrhea, which leads to a painful and agonizing death."
But, can someone really die from this novel form of torture?
Emergency physician Shadowfax has his ...
How you can catch the flu after touching money
Yes, cash can transmit the flu.
In an interesting report (via Well), it's noted that the flu, including the H1N1 virus, can last for as long as an hour on money and other forms of paper currency. Worse, "mix in some human nasal mucus, and the potential for the virus to hang on long enough to find a victim increases, according to one of the few ...
Is IV sedation being overused?
Prior to a breast or bone marrow biopsy, intravenous sedation is typically offered to, and accepted by, patients.
But, what if some don't really need such heavy sedation?
Over at Better Health, Harriet Hall wonders if some patients would do just fine with a simple local anesthetic: "Has it become a knee-jerk reflex to sedate everyone as a general principle? Why? To avoid complaints and keep ...
Hydroxycut causes liver damage, and why we need to regulate supplements
The popular weight-loss supplement, Hydroxycut, has been recalled.
A 19-year old man died, and another needs a liver transplant. MedPage Today reports that these events occurred in 2007, but wasn't reported to the FDA until two years later. In all, 23 events were reported, ranging from the aforementioned serious side effects, to elevations in the liver enzyme levels.
Who knows how many more will be ...
How is swine, or H1N1, flu affecting your doctor’s office?
Coverage on the H1N1 influenza has been nothing short of constant.
But, how is it affecting your physician's office? For me, there's been many questions, some patient anxiety, and lots of diagnostic nasal swabs. But, being in New Hampshire, the prevalence of the H1N1 virus has been relatively low, compared to other parts of the country.
For a more detailed look behind the scenes, Rob Lamberts ...
Convincing doctors to accept a public health care plan option
There's no question that the possible inclusion of a public plan is one of the most contentious issues that will be debated as health reform moves forward.
As I wrote previously, I'm somewhat indifferent about the option, but, feel strongly that doctors need to maintain the ability to opt out of the plan, and stress that reimbursements need to be competitive with those of private insurers.
Well, ...
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....
