August 2009

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How to fix the primary care shortage

in Physician | 43 responses

by John Horstkamp, MDThe primary care physician (PCP) shortage has attracted a lot of attention recently, and for good reason. Individual Americans are concerned that they will not have timely access to needed medical care, and policy makers are concerned that our specialist-heavy medical system is failing, giving us expensive but disjointed, poor quality care. Many experts rightly think that a robust primary care system would give us ...

Health care policy experts versus the public, an obstacle to reform

in Conditions | 9 responses

I've often written that the public's appetite for excessive medical testing is difficult to overcome.Kent Bottles finds the same thing. Indeed, he writes that, " One of the obstacles to achieving health care reform is the enormous gap between what the health care experts believe and what the general public believe about staying healthy."For instance, according to the Kaiser Family Foundation, "the experts believe that 30% of care ...

Poll: Should doctors be compensated for responding to in-flight medical emergencies?

in Physician | 22 responses

When an airline passenger has a medical emergency mid-flight, a call normally goes out asking for a doctor among the passengers to help. One study has estimated 350 such emergencies in the air every day, worldwide.Airlines appeal to a doctor's sense of duty when asking for their help, and generally don't provide anything more than a token gesture of appreciation. But should physicians who respond to the call be financially ...

Should you follow medical advice from The Huffington Post?

in Social media | 5 responses

The Huffington Post is one of the most prominent, and fastest growing, news sites, and as pediatrician Rahul Parikh puts it, "one of the most valuable pieces of real estate on the Internet these days."They have a prominent health and wellness section, but as you can read from Dr. Parikh's piece, The Huffington Post is crazy about your health, readers be warned.As with their approach to other topics, The ...

Do lacrosse players have a higher rate of sudden cardiac death?

in Conditions | one response

Surprisingly, lacrosse is the fasting growing youth sport in the country.MedPage Today reports a recent study from Pediatrics that showed that lacrosse players have a disproportionally higher rate of commotio cordis, which is ventricular fibrillation caused by blunt chest trauma.43 percent of lacrosse deaths can be attributed to the condition, compared to 27 percent in hockey, and 24 percent in baseball.What to do? Researchers are looking at ...

Should doctors friend their patients on Facebook?

in Social media | 23 responses

As more physicians are on social networking sites. that's an issue that some are grappling with.The NEJM has a nice perspective piece on the issue. After realizing that a recent friend request came from a former patient, Sachin Jain thinks about the ramifications.Dr. Jain writes that, "In confirming this patient as my "friend" on Facebook, I was merging my professional and personal lives. From my Facebook page, Ms. ...

A borderline admission from the ER, or not

in Physician | 11 responses

A woman on Medicaid is newly diagnosed with lung cancer in the emergency department. Although medically stable, should she be admitted to facilitate the coordination of the care she will require?That's a question emergency physician Jesse Pines asks in a recent WSJ op-ed. In the end, despite the resistance of the admitting hospitalist, he admitted the patient. Dr. Pines writes that, "Without expert help, arranging a ...

KevinMD health reform Virtual Town Hall: Thursday, August 13th at 12:15pm Eastern

in Conditions Policy | 5 responses

In the spirit of the vigorous town hall meetings across the country discussing health care reform, I'll be taking your questions on the topic today at 12:15pm Eastern.I'll open up the forum a few hours before; just click on the Live Q&A window below.You can ask your question when the Q&A opens, in the comments of this post, or Tweet them to #kevinmdqa. I'll try, but cannot guarantee, ...

What do primary care physicians and cardiac surgeons have in common?

in Physician | 5 responses

They're both going to be scarce.Along with primary care, cardiothoracic surgeons are projected to be in short supply, according to a report in MedPage Today. A study found in Circulation suggested that fewer medical students are pursuing the field, leading to a "shortage of at least 1,500 surgeons or 25% of the likely projected need."Lifestyle issues are cited, as it takes over 8 years of post-graduate training ...

Should advance directives be stored online on Google Health?

in Physician | 10 responses

It was recently announced that Google Health, a popular personal health record, will allow patients to store their advance directives.Emergency physician Graham Walker calls the initiative an "epic fail," and illustrates some real-life problems of the idea.While it is generally thought that making one's health information available electronically to medical personnel is a reasonable idea, doing so with advance directives may not be. Especially in the emergency department where ...

Can you escape a family history of heart disease?

in Conditions | 5 responses

With the new treatments and medications available to treat heart disease, it sometimes appears that a strong family history of heart disease can be overcome.That's not always the case.In this piece from The New York Times, Michael Winerip does all the right things, including exercising, closely following up with a cardiologist, and undergoing stress tests and angiograms, but still was diagnosed with significant heart disease at the same of ...

Robert Ricketson and the surgical screwdriver medical malpractice case: The medical records revisited

in Physician | 55 responses

Robert Ricketson is a spine surgeon who was involved in a high profile 2003 medical malpractice case in Hawaii where a surgical screwdriver was implanted into a patient's back. This is his account of the ordeal. by Robert RicketsonI am writing today out of frustration and anger, as I am frankly quite tired of passively going along as my name appears year after year in malicious "medical blogs" and ...

Has Wikipedia ruined the Rorschach test?

in Conditions | 10 responses

A physician recently uploaded 10 of the original Rorschach plates to Wikipedia, and psychologists are angry about it.Has Wikipedia ruined the Rorschach test? The Rorschach test is commonly used by psychologists to assess personality and emotional responses. By uploading the images, as well as common responses, they fear that patients can "game" the test, and in effect, render the results useless.They say that, "the ...

Medical students want to become primary care doctors, until reality hits

in Education | 19 responses

According to the Journal of the American Medical Association, only 2 percent of medical students are entering primary care internal medicine.A fourth year medical student gives some reasons why in a Baltimore Sun op-ed:

Like many medical students, I proudly wear Obama T-shirts and yearn to reform medicine. While watching the president speak, I envision myself working in primary care, on the vanguard of health care reform.Then, a little later, ...

Joe Jurevicius sues the Cleveland Browns’ team doctors, would an apology have helped?

in Physician | 3 responses

Maybe.Joe Jurevicius is a former Cleveland Browns wide receiver who contracted an MRSA infection while playing for the team. He has had multiple procedures to clean out the infection, and this past March, the Browns terminated his contract.Jeffrey Parks, also known as Buckeye Surgeon, has been keeping a close eye on the case. He writes that the case isn't necessarily about negligence, but instead, "what it represents ...

Op-ed: Wikipedia isn’t really the patient’s friend

in Patient | 23 responses

The following op-ed was published on July 15th, 2009 in the USA Today."I researched my condition on Wikipedia." That's what more doctors, myself included, are hearing from patients every day.Wikipedia is the Web's most popular online encyclopedia. Its more than 13 million articles cover almost every topic imaginable. It is among the most visited sites primarily because its articles routinely show up near the top of search engine results, like ...

Should Singulair be sold over the counter?

in Meds | 9 responses

The WSJ Health Blog wrote that Merck is considering selling their asthma medication Singulair over the counter.It's Merck's best-selling drug, with revenues in excess of $1.3 billion. But internist Matthew Mintz has some reservations about the proposal.His issue is that Singulair merely treats the symptoms, rather than the problem that can exacerbate asthma:

Singulair works in the same way that antihistamines work: by treating the symptoms. Inhaled corticosteroids ...

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