July 2009

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Fixing malpractice is a vital part of health reform

in Physician | 49 responses

It was gratifying to see President Obama recently acknowledge the role malpractice plays in our failing health system, as well as admitting the presence of defensive medicine.Furthermore, The New York Times, whose editorials I've taken exception with in the past, wrote a reasonable opinion on the issue. As they admit, "The current medical liability system, based heavily on litigation, has a spotty record. It fails to compensate most ...

If health reformers want to emulate Canada and Europe, can we copy their malpractice systems too?

in Physician | 26 responses

Most health reformers and progressive policy experts want our health system to be more like Canada, a single payer system, or Europe, which include hybrid public-private systems.What most fail the mention is that in both these instances, malpractice systems (via DB's Medical Rants) from these countries compensate patients more fairly, and do not expose the physician to the lengthy and traumatizing litigation process that they do in America.Consider ...

Older primary care doctors can’t retire

in Physician | 17 responses

Just when you think the primary care shortage can't get any worse.Not only are there not enough primary care access to serve the almost 50 million uninsured Americans, recent numbers also show that out of 270,000 primary care doctors, almost 5,000 of them are older than the age of 75.They simply can't retire, mainly because of an inability to find a young doctor to take their place within the ...

Why are hospitals offering nurses free plastic surgery?

in Patient | 7 responses

Is there pressure for nurses to look more like models?The answer appears to be yes, in Prague. Citing an article in The New York Times, plastic surgeon Chris Hess (via Better Health) notes that nurses in that region are "under enormous pressure to look good in a society where attractiveness is often as highly prized as clinical skills."And according to this Czech nurse, "We were always taught ...

Shadowfax on the KevinMD Live Q&A: Tuesday, July 14th at 10:30pm Eastern

in Physician | 2 responses

Emergency physician Shadowfax will be my next guest on the Live Q&A.Blogging over at Movin' Meat, Shadowfax is the pseudonym of an emergency physician in the Pacific Northwest. His blog posts are a combination of cogent health care reform analysis and opinion, commentary from the administrative side of medicine, and fascinating ER cases.He recently had a piece on health care reform published in The New York Times' Room ...

Discussing health care reform at the National Press Club, Friday, July 17th at 9am

in Policy | 2 responses

Thanks to Dr. Val Jones for organizing Health Care Reform: Putting Patients First, a panel discussion where health reform will be discussed from a medical blogger perspective.I have graciously been invited to speak and participate in the ensuing discussion, which also includes other prominent primary care and specialist physician and nurse bloggers like Rob Lamberts, Alan Dappen, Valerie Tinley, Kim McAllister, Westby Fisher, Rich Fogoros, and ...

Is it dangerous for a doctor to be online?

in Social media | 7 responses

As more doctors are blogging, using Twitter, or are on Facebook, minding their online reputation becomes more important.I've written and cited several pieces on this issue in the past, and it cannot be stressed enough that what you write or say online stays there forever.Over at his blog at White Coat Underground, internist PalMD writes about the many potential pitfalls of physicians maintaining an online presence.For instance, citing ...

Are drug companies trying to influence health journalists?

in Social media | 2 responses

The pharmaceutical industry has been vilified by its close association with physicians.With reforms having distanced these two groups, it appears they are moving onto trying to influence reporters. As journalist professor Gary Schwitzer writes in a recent blog entry, Pfizer is offering journalism fellowships on cancer issues.The program, not unlike Pharma-sponsored CME for doctors, includes an all-expense paid trip for the 4-day seminar.Professor Schwitzer ...

How soon should patients receive their test results?

in Conditions | 22 responses

And should you assume that no news is good news?The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent.That's almost a quarter of abnormal test results from that center that patients were never ...

ACR: Reducing medical imaging costs requires a short term investment

in Policy | 8 responses

The following is a guest post from the American College of Radiology.by James H. Thrall, M.D.Health care reform cannot be approached with a “one size fits all” cost-cutting mentality. Reducing costs in the long term often requires an investment in the short term — particularly, in regard to medical imaging.Medical imaging saves lives. Imaging also saves dollars through earlier disease diagnosis, less invasive medical procedures, shorter hospital ...

Prostate cancer screening in blacks, and the lack of balanced information

in Conditions | 5 responses

Prostate cancer screening continues to be a controversial issue.Regular readers of this blog know about the risks of cancer screening, especially prostate cancer, which can lead to unnecessary biopsies necessitating invasive procedures that can lead to life-altering side effects. All for a slow-growing cancer that may not have led to death.The problem with prostate cancer is that the current detection methods, like the prostate specific antigen, are not ...

Rationing care is inevitable to control health care costs

in Policy | 17 responses

Those on the left will pretty much sacrifice everything to attain their goal of universal coverage.But, in this well-reasoned piece by conservative economist Tyler Cowen, expanding coverage won't necessarily control costs, which is a more imperative issue. The bandied about means of cost control, such as electronic medical records, cutting provider payments, and preventive care, all will have little nor no impact in controlling costs.Take physician reimbursements, for ...

Should patients care how many times a doctor has performed chorionic villus sampling?

in Conditions | one response

When it comes to procedures, experience counts.In a recent op-ed in the WSJ, maternal-fetal medicine fellow Adam Wolfberg talks about the potential complications of chorionic villus sampling (CVS) (via Suture for a Living). Used to assess the risk of Down Syndrome in the fetus, it involves inserting a 3 1/2 inch needle into the mother's uterus to obtain cells from the placenta. The rate of miscarriage is ...

The games drug seekers play

in Meds | 41 responses

Patients who are addicted to narcotic painkillers reveal methods to try and receive more drugs from an emergency room.In the interview, the patient admits calling 911 and feigning chest pain. Why?

What the caller, and only the caller, knows is that his chest is not throbbing in pain. Actually, his chest is fine. What he has done is just reserve his personal medical limousine for transport to the head of ...

Do doctors set themselves up for physician burnout?

in Education | 19 responses

It's no surprise that doctors are prone to burnout, especially during residency training.But, according to a study cited by Pauline Chen in a recent New York Times column, it's part of the doctor-in-training culture. In fact, residents "from seven different specialties and found that they set themselves up for burnout by accepting, even embracing, what they believed would be a temporary imbalance between the personal and professional aspects ...

How zinc-containing Zicam can harm patients and damage their sense of smell

in Meds | one response

Zicam is becoming an example of the dangers of mass-marketing unproven homeopathic remedies.As MedPage Today reports, the FDA has warned patients to stop using Zicam, as the product can lead to anosmia, or loss of the sense of smell.This isn't a new claim, since, "In 2006, the company paid $12 million to settle 340 lawsuits brought by consumers who claimed the zinc nasal gel adversely affected their sense of ...

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