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 ...
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 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....
