by Monte Ladner, MDThe August 17, 2009 issue of TIME magazine ran a cover story entitled “The Myth About Exercise” with a subtitle claiming it won’t make you lose weight. The author of the article cherry picked bits of data from several scientific studies to make the case that exercise won’t help with weight loss, and might even lead to weight gain by causing people to eat more.The ...
September 2009
All Stories
Is the public plan option supported by doctors?
by Emily P. Walker, Washington Correspondent, MedPage Today A solid majority of physicians favor creating a new public insurance option that would operate alongside existing private plans, according to a survey published online in the New England Journal of Medicine.
About 63% of doctors, across a smattering of specialties and in various geographic regions, support a public insurance option. That ...
Is the doctor or patient responsible for celebrity drug overdoses?
When it came to Michael Jackson, I argued recently that the singer himself had to share some of the blame.An op-ed in the Houston Chronicle places more blame, however, on a celebrity's enablers, be it a personal physician or part of their entourage with access to a doctor.By enabling a celebrity's dependence to drugs, the piece, citing the case of Anna Nicole Smith, says, "facilitation of Smith's prescription drug ...
Data entry in EMRs, and why doctors are slow to adopt information technology
by Winslow W. Murdoch, MDThe Obama healthcare plan hinges on savings achieved through the implementation of electronic medical records (EMRs) and pays doctors $44,000 over 5 years for hardware and software to embrace this evolving technology. Let us not forget however, that garbage in produces garbage out, for instance, information not suitable for medical decision making.In reality, data entry is daunting and by far the most expensive aspect of converting ...
The Patients’ Bill of Responsibilities
by Susan H1. I acknowledge and believe that I will die someday. Everyone I love will also die. That inevitable outcome will be factored into all my personal health care decisions.2. I acknowledge that just because a paid professional might be found to assert that he would have performed differently under similar circumstances, doesn't mean a doctor or nurse committed malpractice. Judges who are overturned on appeal ought to ...
Analysis of the Max Baucus health care reform plan
by Peggy Peck, Executive Editor, MedPage TodayIn an important step toward moving healthcare reform legislation through Congress, Sen. Max Baucus (D-Mont.) introduced his much-awaited bill today after months of working to gain bipartisan support. The chairman of the powerful Senate Finance Committee released a summary of legislation that would not create a public insurance option and would cost $856 ...
Should we pay American doctors less money?
That's a sensitive topic that progressive reformers often bring up as one way to control health spending.Over at Slate, Christopher Beam takes a balanced look at the issue. He acknowledges that, yes, American physicians get paid proportionally more than the average employee when compared to other countries.But that should always come with the caveat that other countries, like Great Britain and France, heavily subsidize medical education, while the average ...
A personal health record and using the PHR on a mobile smartphone
by Jeff BrandtThere is much confusion about Personal Health Record (PHR) in the market today.PHRs are divided into three groups; Mobile SmartPhone (mPHR), Cloud Apps, and other devices such as USB and Smartcards. Each type of PHR serves a different purpose and provides a useful and needed service. I will speak to the strengths and weaknesses of each of them.Web Apps/Cloud PHRThese are browser based systems that need to be ...
Citizens, not lobbyists, must reform health care in the United States
by Gary R. Gibson, MD, FACPWe can deliver better health care to every U.S. citizen at less than one-half of 2.1 trillion dollars per year with constructive reform, a system wherein people receiving and providing care would feel greater satisfaction and dignity. Through courage and perseverance, we must identify and minimize waste, eliminate corruption and modernize our system. In a competitive world economy, we must reform health care ...
How long are you contagious after being infected with H1N1 influenza?
by Michael Smith, North American Correspondent, MedPage TodayPeople infected with the H1N1 pandemic flu strain continue to shed virus after the point where current recommendations say they can go back to work or school, two studies here suggested. The question, experts said, is whether those people are still contagious and whether a longer stay-at-home period would prevent enough additional ...
Do physician apologies make it less likely for patients to sue for medical malpractice?
Not necessarily.That's the finding from a recent study in the Journal of General Internal Medicine.What the researchers did was simulate three scenarios of medical mistakes, "a year-long delay in noticing a malignant-looking lesion on a mammogram, a chemotherapy overdose 10 times the intended amount and a slow response to pages by a pediatric surgeon for a patient who eventually codes and is rushed to emergency surgery."Varying degrees of physician ...
Cutting health care costs means reducing utilization
by Mark CoyneThe core of the health care debate revolves around the perceived spiraling cost of health care in America. There are many quotes in the media, and from politicians, that health care costs are increasing by more than 10 percent a year, and consistently increasing by more than wage growth – which is unsustainable in the long term. The basic point being made is correct, the overall ...
Why price transparency won’t affect health care costs
by Kumud B. Jindal, MD, MPHMany patients and self-appointed health care experts view medical services as commodities, and openly express frustration with seemingly opaque pricing for a visit to the doctor’s office. “Doctors should publish their fees so we know what we’re paying!” The idea that this matters significantly with regard to health care costs is a terrible myth, one that deserves much closer scrutiny.The health insurance industry and ...
Don’t wait for the H1N1 vaccine before you get your flu shot
by Cole Petrochko, Staff Writer, MedPage TodayDon't wait for the pandemic H1N1 vaccine to become available before getting an inoculation for seasonal flu, the National Foundation for Infectious Diseases warned. Putting off routine flu shots in hopes of one-stop-shopping would defeat the primary line of defense against a proven threat, according to a panel representing some of the nation's ...
Does preventive medicine save money or cost more in the long run?
It depends if you see the glass half empty or full.I've written on several occasions that there is little evidence that preventive medicine saves money, despite what some politicians say or believe. A recent study from Health Affairs provides more clarity, as it related to the long-term implications of diabetes.There are two decidedly different takes on the article. First, according to The New York Times' Prescriptions, it ...
Dean Ornish injects himself in the health reform debate
by Rahul Parikh, MDIt looks like The Huffington Post's honorary Medical Editor, Dr. Dean Ornish, walked into the same trap that Whole Foods CEO John Mackey did.Mackey got a lot of flack when he wrote an op-ed in the Wall Street Journal on health care reform, one in which he emphasized the need for personal responsibility for our health.Ornish, in an effort to inject himself into the current debate, blogged, ...
What does Tiger Woods have to do with medical futility and end-of-life care?
by Michael Kirsch, MDConsider this hypothetical vignette. Tiger Woods accepts my challenge to play 18 holes. Obviously, the gallery would be packed with golf enthusiasts who would cancel job interviews, vacations and even worship services in order to witness this historic competition. Spectators would be permitted to place bets at even money. Perhaps, my mother would bet on me, but no other sane person would. They would properly conclude that ...
How comfortable are compression stockings for post-surgical thromboprophylaxis?
by Crystal Phend, MedPage Today“Every 10 years a doctor should be the patient,” said my doctor, squeezing me into pair of compression stockings that would make a sausage casing seem spacious by comparison. “Seems like a good idea,” I thought, as I lay there on the table feeling optimistic about the opportunity for first-hand experience.It was my first minor ...
Are Liberal or Conservative ideas right for health care?
How about a little of both?I don't see, for instance, why we can't have universal coverage and malpractice reform. In a similar vein, MIT's Jonathan Gruber writes a great op-ed in the Boston Globe recently, about controlling health spending.One one side, progressives generally want to reform the supply side spending of medical care, which means pressuring the payments made to doctors and hospitals. On the other, conservatives ...
Poll: Can house calls provide better medical care at lower costs?
An article that appeared in the Los Angeles Times in late August looked at the idea that one of the keys to providing better medical care at lower costs may be house calls.Should we bring house calls back?There is some compelling data — like an in-home doctors’-visit program for Medicare patients at the Virginia Commonwealth University Medical Center that cut the length of hospital stays and saved the hospital millions ...
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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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...
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The problem of insurance gaps in cancer patients
Why are cancer organizations waiting until it starts to rain before they suggest buying an umbrella? “Join my Medicare Advantage plan and...
Tech
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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...
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Google knows more about certain diseases than physicians ever will
Professor Gunter Dueck, is a calm and eloquent german mathematician who’s also the CTO of IBM Germany. He studied mathematics and philosophy...
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....
