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, and also, ...
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 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...
