by David Alway, MDIn thinking about socialism and medicine in the United States let's adopt socialist point of view and ponder some logical conclusions.Injustice ExistsThe socialist notices that some people are starving, don't have adequate shelter, or are relatively uneducated. He also observes that others are very well off, having access to the finest meals, enough money to buy grand homes and are well-educated. This state of affairs, ...
September 2009
All Stories
Should soft drinks be taxed and be called a public health hazard?
Originally published in MedPage Todayby Kristina Fiore, MedPage Today Staff WriterSoft drinks and other beverages loaded with sugar should be taxed as a public health hazard, much as cigarettes are, a group of prominent medical researchers says.
Since extensive evidence ties sugary drinks to an epidemic of obesity and related health problems, such as heart disease and diabetes, they ...
Why suffering patients find their way to psychiatrists
"Psychiatrists may be the last batch of physicians who are still granted a luxurious amount of time with patients."So says Maria, a psychiatrist who blogs over at intueri.And because time is so undervalued without our health system, some doctors relying on psychiatrists to counsel patients in the hospital. She cites an example with surgeons, saying that "it is entirely unfair to both the patient and the psychiatrist for the ...
Is medical technology making doctors less relevant?
It happens over and over. I call a surgeon about a patient with abdominal pain.‘Well, what’s the white count?’‘Normal.’‘Did you get a CT Scan?’‘Yes, and it was normal. But they just look uncomfortable.’‘Sounds like nothing for me to do. Call the hospitalist.’It happens in other specialties. Cardiologists who aren’t interested in a patient with a normal stress test, pediatricians unimpressed with negative chest x-rays and normal labs. ENT’s unconcerned if ...
Why Howard Dean is wrong on medical malpractice reform
by Jeffrey Segal, MD, JDI am on record saying that some elements of tort reform will be passed by Congress.The most likely reform will be safe harbor immunity for following physician-developed practice guidelines. We believe this is a start.A more robust approach would include qualified immunity for those who consciously deviate from such guidelines because in a specific clinical circumstance, it makes good clinical sense for patients. This balance ...
Why patients will reject evidence-based medicine
Newsweek's Sharon Begley pens an excellent piece on why Americans will reject evidence-based medical decisions.She opens with a vignette, which every emergency physician should be familiar with:
A 4-year-old suffers minor head trauma, perhaps from falling off a swing and hitting her head on the ground. She is dazed, and although she doesn't lose consciousness her worried parents—visions of subdural hematomas and concussion dancing in their own heads—rush her to ...
Medical students using Facebook and Twitter can get expelled
by Chris Emery, Contributing Writer, MedPage TodayA large number of U.S. medical schools say students have posted unprofessional material on Web sites such as MySpace, Facebook, and Twitter, but few schools have adequate policies in place for dealing with such behavior, a new study found. Of 78 U.S. medical schools that responded to a survey, 60% reported incidents of ...
How to protect yourself from abdominal aortic aneurysms
by Mark Adelman, MDWhile diseases like prostate cancer and heart disease have become household concerns, abdominal aortic aneurysms (AAA), the 10th leading cause of death in men age 55 and older, have been overshadowed by more prominent diseases for far too long. It’s time we pull back the curtain and take a closer look at this serious disease and how it can be both detected and prevented.An AAA, which ...
An iPhone or Blackberry for doctors and medical students?
by Tom TharpA recent Manhattan Research study found that twice as many physicians are using Apple's iPhone this year than last, but that BlackBerry is still the most popular smartphone among physicians. The same study found the percentage of physicians in the U.S. using smartphones increased 20 percent from 2008 to 2009.
With more and more physicians looking to the ...
Is the flu a heart attack risk factor?
by Todd Neale, Staff Writer, MedPage TodayFlu appears to act as a trigger for myocardial infarction and cardiovascular death, a review of the literature showed. All observational studies included in the review found an association between times when influenza viruses were circulating and increases in cardiovascular death, according to Charlotte Warren-Gash, MBChB, of University College London, and colleagues.There was ...
Should homebirth advocates continue support a doctor convicted of sexual exploitation?
Amy Tuteur calls sexual exploitation "the most egregious violation of professional conduct that any obstetrician-gynecologist can commit."And in that context, she details an interesting scenario brewing in California. Stuart Fischbein is an obstetrician that's widely hailed in homebirth circles, writing a book and being a foremost advocate of homebirths.Unfortunately for him, he also exercised some poor judgment, as detailed in this newspaper report:
He called her "sweet pea," held ...
Health care reform protests and how fears and beliefs are exploited
by Abraham Verghese, MDThe unfortunate politicians who have braved town hall meetings to talk about health reform seem to have been taken by surprise by the vitriol and volume of the push back. Yes, I know the audiences were marshaled and recruited to shout down the speakers but still the passion on display was genuine and not in the least surprising to me. What the President and our politicians should ...
How eliminating waste and taking fewer steps can improve patient care
Recently I was on a canoe trip in Ontario, Canada with a close friend. As he and I were portaging our gear and canoe between two lakes I was thinking that the uphill path was difficult and wondered how many more steps it would take. The sooner it was done the better.I often find myself counting steps during my daily activities as I know that the fewer physical steps it ...
How will the H1N1 vaccine be distributed to patients?
by Michael Smith, North American Correspondent, MedPage TodayA minimum of 3.4 million doses of vaccine against H1N1 pandemic flu will be available in the first week of October, the CDC said. Those doses -- all in the form of a live attenuated nasal spray vaccine -- may be supplemented by some injectable vaccine, according to Jay Butler, MD, the ...
Why doctors and nurses should engage in social media
Instead, the question should be, why shouldn't you?Kim McAllister, over at Better Health, gives some good reasons why health professionals should start a blog. But it shouldn't just be limited to blogging, but the entire spectrum of social media tools, which give health professionals a powerful way to engage both patients and colleagues.I recently gave a talk to the folks over at the New England Journal of Medicine, ...
How hospitals should deal with disruptive physician behavior
by Mark N. Simon, MDWhat can hospital medical staff leaders learn from University of Oregon football coach Chip Kelly? In the morning of September 4th, Kelly had an opportunity to review video tape from the conclusion of his team’s game with Boise State University the night before. What he saw was his senior running back LeGarrette Blount punch an opponent and then lose his cool with the fans ...
What does bias when analyzing data have to do with slow lines?
Here's an excerpt from a lovely little book by John D. Barrow called One Hundred Essential Things You Didn't Know You Didn't Know; Math Explains the World. This selection has a great lesson about statistical inference. The chapter is entitled, "Why does the other queue always move faster?"You will have noticed that when you join a queue at the airport or the post office, the other queues always seem to ...
Medical malpractice reform by President Obama and the White House
by Emily P. Walker, Washington Correspondent, MedPage TodayThe White House today announced details of a $25 million grant program to test alternatives to the tort system for medical liability cases. In his Sept. 9 speech before Congress, the president announced he would direct Kathleen Sebelius, Health and Human Services secretary, to launch pilot programs meant to cut down on ...
Is an efficient physician necessarily a good doctor?
What makes a good doctor?There are two important characteristics. The first is clinical skill: the ability to find a pattern in the patient's signs and symptoms, the ability to identify the pattern, and the judicious use of medical tests to fill in the blanks of the pattern. The second characteristic is compassion: the ability to care about the patient and empathize with his or her situation.Many doctors have one or ...
Inconvenient truths about our health care system
1. Most physicians do not set their own fees. Medicare, Medicaid, and private health plans set these fees, which often have little to do with the costs of doing business.2. Congress each year sets Medicare fees through a formula called SGR (Sustainable Growth Rate), which this year calls for a 20% reduction in overall physician fees.3. If SGR were to go through as to proposed, surveys indicate at many at ...
Kevin Pho, MD
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How patient satisfaction can kill
Patient satisfaction is all the rage. Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country...
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How I approach ovarian cancer screening with patients
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
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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....
Physician
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The analogy between baseball hierarchy and medical systems
From age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but...
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Saving patients from Internet health information
Lately, I get the feeling that I’m doing something wrong. I’m supposed to form a partnership with my patients. My patients are...
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Understanding what patient centered care really means
There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He...
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A letter of thanks to my organ donor
I have tried to write a letter of thanks but don't know what to say or even how to begin. I don't...
Patient
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Why patient engagement is reciprocal
It is said that "turn around is fair play." So if providers (physicians, hospitals and other health care professionals) expect patients to...
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Question the price of drugs and medical procedures
Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure...
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In love there is a life giving force
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
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How to get ready for death
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
Policy
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America has a medical care system not a health care system
As Americans we believe we have the best healthcare system in the world. But think again, it’s really not the truth. We...
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Reading between the lines of breast cancer treatment studies
Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently,...
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Why are labor and deliveries closing?
Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no...
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America has a health care paradox
We have a real paradox in American healthcare. On the one hand we have exceptionally well educated and well trained providers who...
Tech
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Why physicians don’t want patients to have their cardiac device data
There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers....
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Impersonal communication on the Internet fuels cyberbullying
In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over...
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Health IT and doctors: A framework for successful partnerships
We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology. We have firsthand...
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Break out of the prison of the American health care delivery system
Speaker after speaker at the recent Care Innovations Summit in Washington, DC concluded that increasing the quality and decreasing the per-capita cost...
Social Media
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Why doctors should embrace Google+
Lots of pressure out there for you to be on Facebook and Twitter, right? The ultimate question, though, is how are you...
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Using Twitter to deliver health improvement messages
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
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Addressing comments on your medical practice’s Facebook page
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
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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...
