It seems that most industries are rushing to jump aboard the Twitter bandwagon.That's true for most cases, with the pharmaceutical industry being the exception.David Williams points out the lack of Twitter activity from the major pharmaceutical companies, where many of the Pharma-related keywords being owned by those not affiliated with the company.Worse, when he looks at the Twitter names for the top 10 prescribed drugs, they're owned by ...
June 2009
All Stories
Will the public limit the degree of health reform?
Despite the poor shape of the American health system, public preference is the limiting factor in how far we can change the system.Ezra Klein notes the lessons learned from 1994, saying that there is a status-quo bias, and that people "want more options," and "don't want to be forced out of their current arrangements."This is one reason why something radical, like a single-payer health system, won't take off. ...
Why doesn’t medical peer review work?
Reporting bad doctors seems like a pretty simple task.Why then, is physician peer review seemingly inept?Bob Wachter comes up with some theories, including the fear of litigation. Although doctors who perform peer review are supposed to be legally immune, many hospitals have little faith in these protections. As Dr. Wachter concludes from an analysis of the National Practitioner Data Bank, "these protections must be unambiguously robust," but ...
A surgeon dumps post-op patients to hospitalists
Is it ever ok for a hospitalist to be the primary physician in post-op cases?The answer is no, but as The Happy Hospitalist reports, it's happening in some cases.He details an instance where a hospitalist program is being asked by an orthopedic surgeon to provide care for his post-op cases, with the surgeon only coming in for a visit on the day of discharge.As Dr. Happy correctly states, it's ...
Does ePrescribe cost pharmacies money?
Electronically prescribing medications has been heavily pushed and marketed to both physician offices and pharmacies.But in some cases, it's not working out as planned. The Angry Pharmacist unloads on the initiative, noting that it costs pharmacies 30 cents to receive each electronic prescription. Multiply that by the thousands of requests they process, and it adds up. Furthermore, despite the marketing hype, ePrescribe "provides absolutely no cost ...
The media influence on patients and medical stories
Does the media accurately report medical news?According to a poll from the ACP Internist, most respondents don't think so. Some of the problems come from the academic medical center PR departments, which either "overstate results or don't include important caveats when pitching study results to the media." Often times, these press releases make their way into the media and disseminated to patients.In today's competitive environment where newspapers ...
Does Avandia cause heart attacks, and why the RECORD study is important
The diabetes drug Avandia's fate hangs in the balance tomorrow.It's a much maligned medication, with famed cardiologist Steven Nissen gaining publicity for its possible association with heart attacks.Tomorrow, during the American Diabetes Association annual meeting, the final results of the RECORD study is due to be released. This is a study that was designed to answer the questions surrounding Avandia's cardiovascular safety profile. Interim results had ...
10 Medicare posts you may have missed
With entries dating back to 2004, here are 10 classic blog posts on Medicare:1. Hospitals lose money by preventing patient re-admissions2. Covering a virtual colonoscopy, or not, will test the cost-cutting will of Medicare3. Medicare now requires physician essays for hospice care, as if pre-authorizations weren’t bad enough4. Why hospitalized Medicare patients get re-admitted so frequently5. Once you hit Medicare age, good luck finding a ...
The benefits of scanning war corpses
The military is learning from the dead.In the past five years, every soldier who was killed in Iraq and Afghanistan has been given a CT scan. Why? In the hopes of creating a database of war injuries, which can be used to better equip and treat future soldiers.The effort has already paid dividends. While examining the data, it was noticed that chest tubes used to treat pneumothoraces ...
Creative thyroid cancer screening ads
With the USPSTF in the midst of updating their recommendations for thyroid cancer screening, this advocacy organization is coming out with some seriously creative ads.
"Thyroid cancer is growing 7 times faster than breast cancer. Ask your doctor to check your neck. It could save your life."
A doctor is sued, and blogs his malpractice trial
An emergency physician recently concluded his malpractice trial, and is blogging about it.Sound familiar? Well, this isn't the first time it happened. In 2007, pediatrician Flea live-blogged his malpractice trial, which wasn't a good idea for him, and indeed, became a media circus.Prominent emergency physician blogger WhiteCoat is diving into the same waters, albeit with a disclaimer saying that the trial has already ended, ...
Lung cancer CT screening produces false positives and isn’t ready for prime time
Controversy continues to swirl over chest CT scans to screen for lung cancer.MedPage Today reports on a recent study that continues to suggest that it isn't ready for general use yet. Not surprisingly, CT scans had more false positives than traditional chest x-rays when used to look for pulmonary masses.The probability of a false positive was 21 percent after one scan, and 33 percent after two. This is ...
Physician apologies, and does saying you’re sorry mean it’s your fault?
There's a movement afoot to make physician apologies inadmissible in court for cases of adverse patient outcomes.Hospitalist Chris Rangel notes the absurdity of the situation, and says that expressing sympathy shouldn't always imply causation in the first place. After all, saying sorry and expressing sympathy is the right thing to do in these difficult circumstances.But not everyone supports such a move. For instance, Massachusetts is considering such a ...
A referral to a specialist turns patients into currency
Most insurance plans require primary care doctors to refer patients to specialists, like surgeons, cardiologists, and dermatologists.Without a primary care source of patients, specialists will be without patients, and like any business, their practice will suffer as a result.In a recent essay, cardiologist Sandeep Jauhar talks about this system. He writes of an ironic paradox where primary care doctors yield a rare display of power: "Specialists are better ...
How to get doctors to embrace health care reform
Doctors still wield tremendous influence in the health care debate, since they still have the confidence of most patients.If Congress and the Obama administration can convince doctors to support health care reform, it can be, as the ACP's Bob Doherty notes, "decisive in determining if the public will be behind the effort, because voters are much less likely to support health care reform if told that it will result ...
Is rationing health care impossible in the United States?
As long as as 911 and EMTALA remain, the answer appears to be yes.EMTALA is the flawed, unfunded, mandate forcing hospitals to provide a medical exam to anyone who presents to the emergency department. Emergency physician White Coat envisions a scenario where a family who is denied care can simply call emergency services, or show up in the ER, to get the care they want.For instance, what if ...
What is the occupational risk of being a health care worker?
Turns out, we don't know for sure."Despite the very real risk that exists for all health care workers," writes surgeon Pauline Chen in her recent column, "the actual number of deaths from occupational injuries or infections is unknown. Unlike policemen and firefighters and other high-risk occupations, health care workers have no national registry to track deaths caused by infections or injuries acquired on the job."We can only extrapolate from ...
Physician payment reform is the key to fixing the health care system
Changing the way doctors are paid is more important than the debate over the public insurance option, or the arguments over whether we should adopt a single-payer system or not.Atul Gawande's recent New Yorker article is a tour de force, and gets down to the core of why American health care is so expensive. I won't bother summarizing it here - it deserves to be read in its ...
ACP: A practice model for increasing the appeal of General Internal Medicine
The following is the first in a series of original guest columns by the American College of Physicians. by Steven Weinberger, MD, FACPMuch is written and discussed these days about the importance of care coordination by a primary care physician, not only to facilitate patient-centered quality of care, but also to curb the unsustainable growth in the nation’s health care tab. Yet, we hear that the current shortage of ...
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....
