The FDA has declared war on acetaminophen, with Vicodin and Percocet being collateral damage. You can bet Dr. Gregory House is sweatin' pretty hard over this news.
In the last few days, acetaminophen, otherwise known as the brand name Tylenol, has been squarely in the FDA advisory panel's crosshairs. In general, it's a very safe medication, but there is ...
June 2009
All Stories
Reader take: Moral hazard, and whether patients should consider cost in their health care decisions
The following is a reader take by an anonymous medical student.One of the ideas that comes up in the search for explanations of high healthcare costs is the so-called “Moral Hazard”—the idea that insured patients are more likely to agree to unnecessary procedures because they don’t pay for them directly. Not everyone thinks it is real—does a patient have the medical knowledge to make an informed decision? ...
Why would a doctor stop seeing patients?
It's no secret that training a doctor takes a tremendous amount of time and money, both from the physician and the government, who subsidizes a substantial amount of the cost of training.So, in the midst of a physician shortage, internist Toni Brayer wonders about doctors who simply decide to stop seeing patients.After talking to a young physician who made such a decision, and instead, is starting a a pharmaceutical ...
Why did Michael Jackson have a heart attack, and CPR by Dr. Conrad Murray
Michael Jackson suffered a cardiac arrest. And still, that's really all we know for sure.
Medical websites continue to speculate on the possible causes. Over at theheart.org, doctors who were interviewed continue to speculate on Jackson's narcotic use, including Demerol, which I wrote about a few days ago. Indeed, a spokesperson for the American College of Cardiology, cardiologist ...
Can the American Medical Association still be an influential voice in health reform?
The repercussions after Obama's speech to the AMA's delegates continue to be felt.Not least of which are the murmurings of the other professional physician groups, who say that the AMA does not represent a majority of physicians. In this piece from pediatrician Rahul Parikh, he notes that about 30 percent of physicians are AMA members. Remaining doctors belong to groups with more liberal political leanings, including the ...
Does insulin cause cancer, and should you stop taking Lantus?
The potential link between a specific form of long-acting insulin, known as insulin glargine and branded as Lantus, and cancer, could be gaining momentum.First off, let me say that both human and porcine insulin are safe, and have no association with cancer. The report specifically relates only to a synthetic, long acting form of insulin.
According to a series of ...
Patients die when doctors don’t talk to one another
Poor communication in medicine can kill.I wrote a piece a few years ago on the issue (What we have in health care today is a failure to communicate), and fellow primary care doctor Rob Lamberts revisits the topic in a recent post.In fact, he goes one further, saying not only does it cost money, "It kills. Patients have died because of this."Hospitals and emergency rooms rarely have access ...
The biggest threat to President Obama’s healthcare reform efforts comes from his own party
I wrote back in February that one of the biggest threats to health reform was not from conservatives and the right, but from within President Obama's own party.Today, some four months later, the Washington Post reports that that's pretty much what's happening. In its report, the Post writes:
In the high-stakes battle over health care, a growing cadre of liberal activists is aiming its sharpest firepower against Democratic senators ...
Did Demerol cause Michael Jackson’s cardiac arrest and death?
Michael Jackson's death continues to consume the news cycle.
There is currently no clear explanation. Some have speculated that it may be related to the narcotic pain drug, Demerol. According to this report from the UK's The Sun, "An Emergency Room source at UCLA hospital said Jackson aides told medics he had collapsed after an injection of potent ...
How did Michael Jackson die, and the medicine behind sudden cardiac death
Michael Jackson is dead at age 50.I've received several e-mails to comment on this story, but there's really too few details to go on. I'm sure more will emerge in the near future.
According to news reports, emergency medical services were called to his home in Los Angeles, where he was found in presumed cardiac arrest. CPR ...
How much access should patients have to their medical record?
As more patient records go electronic, there is debate as to how much of it a patient should see.This is a particularly sensitive topic, which I touched upon a few months ago, and brings out some contention between patients and their doctors.Primary care physician Rob Lamberts' practice is introducing a patient portal, and in this blog entry, he tries to delineate what patients should see, and what they need ...
ACP: Embracing a culture of cost-effective health care
The following is part of a series of original guest columns by the American College of Physicians.by Steven Weinberger, MD, FACPIn his column in the June 1 issue of The New Yorker, Dr. Atul Gawande used the example of McAllen, Texas, to illustrate the widely disparate spending on health care around the country. This oft cited article captured the attention of President Obama, who reportedly has made it required ...
How patients can annoy their doctors
A study suggested that doctors rated up to 15 percent of patients they see as "difficult."What does that mean? This piece from MedPage Today and ABC News, gives six examples of what patients can do to frustrate their doctors.I'll leave the obvious ones for you to read, such as stopping medications without notice, or keeping silent about the herbs and supplements patients may be taking, and instead focus ...
Placebo Television gives another take on President Obama’s address to the AMA
Family physician Doug Farrago, of Placebo Journal fame, gives his take on President Obama's speech to the AMA.width="425" height="344">
Why do health policy experts and wonks hate doctors?
Health policy experts have never been shy about their antagonism towards doctors.The focus now appears to be on physician pay, with the Washington Post's Steven Pearlstein, for one, continuing his anti-physician columns. Derek Thompson, over at The Atlantic (via @AllergyNotes), continues the assault, with a recent blog entry wondering if doctors deserve to be paid less.I touched upon this topic last year, in a USA Today op-ed, ...
Should patients lie to their doctors?
Apparently, there are some legitimate reasons why a patient may lie to their physicians.A recent article in the Los Angeles Times discusses the phenomenon, which as Dr. Gregory House would aptly summarize as, "Everyone lies."In fact, a recent survey suggests that "38% of respondents said they lied about following doctors' orders and 32% about diet or exercise."One interesting reason is that patients are wary disclosing potentially damaging information ...
ER crowding and your risk of dying from a heart attack
It's not a secret that emergency departments are becoming more crowded by the day.Especially if universal health coverage is enacted without appropriate primary care doctors to see the newly-insured, expect the problem only to worsen.So, it comes as no surprise that those who wait longer, especially for symptoms that could be cardiac in nature, potentially can have worse outcomes.As reported in MedPage Today, a study shows that, "emergency ...
Steve Jobs received a new liver, and the ethics surrounding his transplant
Orac, a general surgeon who blogs at Respectful Insolence, writes the most comprehensive entry I've seen thus far on Apple's Steve Jobs' liver transplant.
For those interested in the medicine behind the transplant, go and read his post in its entirety. I'd like to highlight some of the potentially questionable ethics surrounding the case.For one, there is the question why ...
Poll: Should a doctor blog his medical malpractice trial?
Emergency physician WhiteCoat has been blogging a detailed account of his recently concluded malpractice trial at Emergency Physicians Monthly.In 2007, pediatrician known as Flea live-blogged his malpractice trial. He shared his thoughts on the defense strategy and frank, unflattering opinions of the opponent's legal counsel. The plaintiff's attorney discovered the blog, confronted him during cross examination, and the case was settled the next day.In these litigious times, there’s been ...
Reflections from the AMA: President Obama’s Speech
The following is part of a series of original guest columns by the American Medical Association.by J. James Rohack, M.D.We have a historic opportunity for health reform this year and the AMA was delighted to welcome President Obama to our Annual Meeting in Chicago earlier this week. Like the President, we are committed to health-care reform that will provide all Americans with affordable, high-quality health coverage.I was personally honored ...
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...
