June 2009

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Physician malpractice deposition observations

in Physician | 22 responses

Emergency physician WhiteCoat continues the chronicles of his concluded malpractice trial.A recent episode focused on the deposition at the plaintiff attorney's office. Along the way, there are observations on whether doctors with thick foreign accents make good witnesses (according to WhiteCoat's lawyer, "juries are not very forgiving of foreign doctors"), or if the bathrooms were bugged. Cloak and dagger stuff.But importantly, with the deposition focused on whether ...

Successful health reform requires changing physician incentives, my take in The New York Times

in Policy | 20 responses

Successful health reform requires changing physician incentives, my take in The New York TimesI have a piece in The New York Times' Room for Debate blog, discussing how reforming physician incentives is a key to health reform.Here's an excerpt:

Some health policy analysts blame the medical profession entirely for the role they play in rising health care spending. And indeed, doctors have tremendous influence in the tests being ordered and treatments prescribed. But singling out ...

Retail clinics are not for patients with chronic disease

in Patient | one response

A patient recounts a dubious recent experience at a retail clinic.Blogging over at Ill and Uninsured in Illinois (via Duncan Cross' new patient-focused blog carnival), the patient correctly surmises that, "they're a stop-gap, not a replacement for a primary-care physician," and, "if you rely on on such clinics for your medical care, it's very possible that underlying problems will go on unrecognized."Worse, studies have shown that many of these ...

How Twitter can strengthen the doctor-patient relationship

in Social media | 6 responses

Pauline Chen goes social media on us in a recent column.Focusing on Twitter, she recalls a patient with Buerger’s disease who tried to quit smoking. Unfortunately, the patient wasn't successful, and had to have multiple amputations.Dr. Chen wonders if like Twitter, blogs or Facebook had existed back then, would the patient "have felt a little less isolated and perhaps been able to quit smoking if [she] texted ...

Why this private health insurance CEO is against a public plan

in Policy | 4 responses

It's not because of what you think.The common thought is that health insurers will quiver at the sight of a government plan, with the public option offering lower premiums to patients due to leaner administrative burdens.But Charlie Baker, CEO of Massachusetts' Harvard Pilgrim Health Care, isn't so worried about that. Instead, he first wonders about the government's competence in handling another large bureaucratic program:

I worry less about the impact ...

Do you miss old-fashioned journals at the medical library?

in Tech | 2 responses

Back in the old days, one had to go deep into the recesses of a medical library, find a dusty, bound old journal, and photocopy the article you wanted.But those days are over, as pretty much everything is available online.Although certainly more convenient, Abraham Verghese laments the loss of camaraderie that the digital age of medical information brings. Indeed, as Dr. Verghese reflects with his typical eloquence, "I ...

Do physician quality measures tell patients who’s a good doctor?

in Patient | 4 responses

Not always.Most quality measures are based on billable data, such as rate of breast or colon cancer screening, or in young women, the rates of chlamydia screening.But do these numbers necessarily tell patients who are the best doctors?Over at Better Health, Evan Falchuk has his doubts. He asserts that "the information is simply not valuable to consumers. Worse, I think it is deeply misleading. A medical ...

The worst medical malpractice cases you can possibly imagine

in Physician | 8 responses

Read it to believe it.It's not often that this blog links to Cracked, but here it is, The 6 Most Terrifying Medical Malpractice Cases Ever. (via WhiteCoat)Among them is a psychiatric case where the doctor gave a patient, who unfortunately eventually committed suicide, "several thousand pages of sadomasochistic fantasies [in] an extensive effort to brainwash him into believing he was a child and that the doctor was ...

What do patients want from their doctors?

in Patient | 22 responses

With doctors pressed for time, and patients increasingly dissatisfied with their care, how can physicians do it all?According to a 2006 study, patients want their doctors to be "confident, empathetic, humane, personal, forthright, respectful and thorough." But in the age of conveyor-belt medicine, and the standard 15-minute office visit, it's becoming apparent that today's physician will have trouble fitting that mold.There are some tips a busy doctor can ...

How difficult is it to measure medical errors?

in Patient | 4 responses

It's not as easy as you think.In this piece from Slate, two physicians question the numbers circulating in the media that sensationalize medical mistakes. For instance, when citing the Institute of Medicine's popular assertion that close to 100,000 patient deaths are preventable, they say that, "had [the researchers] used a different calculation method, the number of estimated deaths would have been less than 10 percent of the original."Determining ...

My reaction to President Obama’s speech to the AMA

in Policy | 78 responses

I was seeing patients during the actual speech, so I had to rely on the transcript.The points that interested me the most were any language pertaining to malpractice, addressing the AMA's recent concerns about the public plan option, and reforming the physician payment system.I think he did pretty well.Regarding the physician payment system, he again addressed McAllen, Texas, which is fast becoming the symbol of what's wrong with American ...

Is Obama serious about medical malpractice reform?

in Policy | 11 responses

Or is it a red herring?President Obama is making a much-ballyhooed address to the American Medical Association today (and will be live-Tweeted over at MedPage Today), and perhaps not coincidentally, there's a piece in today's New York Times saying that Obama himself is one of the few supporters willing to address the issue of malpractice reform.According to the piece, "In closed-door talks, Mr. Obama has been making the ...

Does alternative medicine work? Or does it harm patients?

in Patient | 26 responses

In a scathing review, the Associated Press reports that $2.5 billion in federal funding has been spent on researching alternative therapies.None have been conclusively shown to work.Despite this, more medical schools and hospitals are embracing alternative medicine, and in some cases, offering them to patients who are gravely ill. Also, health insurers are making deals to provide alternative services, as well as nutritional supplements, to their members.The main reason ...

How should Oprah handle medical issues?

in Patient | 8 responses

Oprah Winfrey has been taken to task, rightly, by both bloggers and mainstream media on her advice on health issues.Most prominently is a recent front page story on Newsweek, titled, Live your best life ever!Pediatrician Rahul Parikh was ahead of the curve on this topic, blogging a similar stance a few weeks before the Newsweek piece was published. But how should Oprah, who, as Dr. Parikh writes, ...

5 top medical comments, June 14th 2009

in Patient | one response

Here are some of the more interesting comments readers have left recently.1. Carla Kakutani on how Massachusetts' health reform won't relieve ER overcrowding: Insurance does not equal access (although it’s better than nothing). Nothing changes until every stakeholder recognizes they have to control costs and allow a rebuilding of primary care in the US. That includes doctors and patients, along with everybody’s favorite villians, the insurance companies and big pharma. ...

Tips for doctors who use Twitter

in Social media | 2 responses

Like everyone else, the medical establishment is increasingly using Twitter these days.Over at Better Health, Bryan Vartabedian gives some sage advice for physicians who may not be used to the technology. Like every other social media platform, Twitter can be used to both help, and potentially harm, a doctor's brand. And with that brand being essential to growing a practice, that means Twitter can yield tremendous influence.So ...

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