Here are the top posts from the past month, based on the number of times they were viewed.1. Robert Ricketson and the surgical screwdriver medical malpractice case: The medical records revisited2. Medical students want to become primary care doctors, until reality hits3. AMA: A look at the facts on health reform4. Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?5. The consequences ...
September 2009
All Stories
Violence in the emergency department and how to promote ER safety
by Patricia B. Allen, MBA, RNWhat would you differently tomorrow if you had a violent episode in your emergency department today?Violence in the ED is a growing and alarming phenomenon. A recent survey conducted by the Emergency Nurses Association (ENA) revealed that 25 percent of the RN respondents report experiencing physical violence more than 20 times in the past three years and 20 percent of the respondents revealed encountering ...
Op-ed: Why the doctor won’t see you now
The following op-ed was published on August 20th, 2009 in CNN.com.When President Obama recently cited the number of Americans without health insurance, he declared that, "We are not a nation that accepts nearly 46 million uninsured men, women, and children."Uninsured patients often delay preventive care, waiting to seek medical attention only when their conditions worsen. This leads to more intensive treatment, often in the emergency department or hospital where ...
Advice for President Obama’s health care reform plan
by Arthur Chernoff, MDPrior to President Obama's address to Congress on health reform, I asked myself, "What would I tell the President?"First and foremost: go for it. All of it. Health care in America is too important, both economically and morally, to be left adrift in its current state. Its focus is wrong. It costs too much. And not everyone who needs it is able ...
Why health care savings accounts should play a larger role in reform
by Charles W. Patterson, MDHealth care reform has long been one of my main interests and currently, it seems to be everyone else's. The President said he thought a single-payer system would be best, but submitted a proposal he thought could be passed. The outcome is in doubt.Actually, the single-payer system is the second best possible solution. The government would hold the money but would remain vulnerable to political manipulation, ...
An analysis of Barack Obama’s health care reform speech to Congress
by Emily P. Walker, Washington Correspondent, MedPage TodayIn Wednesday's address to Congress and the nation, President Barack Obama made a number of statements about healthcare reform, some involving issues that would directly affect medical practice. MedPage Today examined five of Obama's statements to add context to the sound bytes.
The Statement:"I don't believe malpractice reform is a silver bullet, ...
Are cardiologists going to take their reimbursement frustrations out on primary care residents?
It's no secret that, in an attempt to increase the pay of primary care doctors, Medicare is going to run in serious resistance from the specialists. In this article from Bloomberg, for example, we're seeing backlash from cardiologists.What caught my attention was how cardiologists in residency programs may now harbor resentment against primary care doctors in training. Consider what Ted Epperly, president of the American Academy of ...
AMA: How to prepare for seasonal and H1N1 influenza
The following is part of a series of original guest columns by the American Medical Association.by Nancy H. Nielsen, MDThis year’s flu season promises to be different than in years past. With the potential of both seasonal and H1N1 influenza circulating this year, it is more critical than ever that health care professionals proactively talk to their patients about influenza.Many patients will be confused about who needs the H1N1 ...
A patient dies after doctors fail to communicate in the operating room
by Jerry I. Meyers, Esq.Communication is essential between health care providers but sometimes communication fails because of the arrogance or carelessness of the persons involved in the needed medical communication.Several years ago, a female client about to enjoy an important anniversary was admitted to a University affiliated hospital for the purpose of having a colostomy wound debrided.This was to be a one-day inpatient hospital procedure and was associated with little ...
A routine brain MRI can lead to incidental findings
by Nancy Walsh, Contributing Writer, MedPage TodayAlmost 3% of healthy, asymptomatic people who underwent MRI brain scans showed incidental abnormalities in a recent study, leading researchers to express concern about about psychological and medical fallout from these increasingly popular screenings.In meta-analysis of MRI brain scans, the prevalence of neoplastic incidental findings was 0.70% (95% CI 0.47 to 0.98), while ...
A critically ill baby can lead to post-traumatic stress disorder in the parents
Parents who have a critically ill infant can exhibit symptoms later on similar to those who have been through war.And indeed, this article in The New York Times draws parallels between the neonatal intensive care unit (NICU) and a warzone, "with the alarms, the noises, and death and sickness."Infants in the NICU can cause the parents to experience multiple traumas, starting with a premature birth, where many of the ...
Family caregivers are the unsung heroes of our health system
Long term care is a hot topic. When people talk about long term care, they are generally talking about nursing homes. Policy makers put a lot of attention on nursing homes because they cost so much money. About half of nursing home care is paid out of public dollars. In California, in the setting of our state budget fiasco, the high cost of nursing home care to the state has ...
Does counseling kids to lose weight and increase exercise work?
by Todd Neale, Staff Writer, MedPage TodayOverweight and obese children who received counseling from a family doctor did not lose more weight or get more exercise than youngsters who did not receive counseling, Melissa Wake, MD, of Royal Children's Hospital in Melbourne, and colleagues reported online in the British Medical Journal. Because the screening and counseling are so expensive, ...
Is President Obama trying to do too much with health reform?
by J.E.B. Johnson, MDDear President Obama:We agree that our health care system can use some improvement, but it is difficult to agree on how to accomplish this. It seems as if your desire for a major overhaul is far from certain. Some pundits have suggested this may emasculate your presidency, but I beg to differ on this point. This is not a failure of policy as much as it is ...
Should patient satisfaction influence physician compensation?
One bane of emergency physicians are patient satisfaction scores, which some hospitals use in part to determine physician salaries.Often times, if patients are denied, say, opioid medications, they're more likely to give low scores, which the hospital administration can then use to penalize doctors. Of course, this creates an incentive to give patients everything they want, sometimes to the detriment of good medicine.But Shadowfax, an emergency physician-administrator, delves ...
The value of a cancer diagnosis second opinion
Here are words any patient awaiting cancer surgery would be thrilled to hear: "We are canceling your upcoming operation! It turns out that the suspicious changes we saw on your recent biopsy are completely benign."This happy turn of events happened in my life recently, thanks to a second opinion from a type of physician few patients realize plays a critical role in their care: the pathologist.Pathologists are medical doctors who ...
Do resident work-hour restrictions increase surgical complications?
by Chris Emery, Contributing Writer, MedPage TodayReductions in resident physician work-hours at teaching hospitals in 2003 were associated with an increase in complications related to surgery to repair hip fractures, a new study found. The rates of pneumonia, hematoma, renal complications, and blood transfusions associated with hip surgery rose disproportionally at teaching hospitals compared to other hospitals after resident ...
Rising health care costs and the tax preference for employer-based health insurance
by Robert Berry, MDIn his column, David Brooks of The New York Times effectively compares our rapidly rising health care costs to “a stampede of big ugly rhinos.” What he ignores, however, is the huge elephant in the room that is largely responsible for this rhino stampede – the tax preference for employer-based health insurance.This tax preference – enjoyed primarily by employees of large businesses and government at ...
Should elderly patients always be admitted to the hospital?
95-year old patients who go to the emergency department, more likely than not, will get admitted to the hospital.But is that always what's best for the patient? Emergency physician Graham Walker suggests not. He notes, correctly, that, "the group with the highest odds of having something seriously wrong with them are probably also the most likely to have something go wrong with them while they’re in the hospital."Indeed, ...
Medical bloggers at Blog World Expo, October 15th, 2009
I have been graciously invited to participate on a panel in the medical blogger track at Blog World Expo 2009, held in Las Vegas on Thursday, October 15th.
My panel, entitled, The State of the Health Blogosphere: We’ve Come A Long Way, Baby, will be moderated by Emergiblog's Kim McAllister. I am honored to be joined by Nick ...
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....
