October 2009

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The high cost of hiring, and firing, a doctor

in Physician | 6 responses

Originally published in HCPLive.comby Jeff Brown, MDOne area we need to look at is the surprisingly high costs of hiring and firing people who work with us. And as always, I rebuke our training programs for their ostrich-like attitudes, ignoring how important managerial and organizational competence is to the quality of medicine that we practice.The high cost of hiring, and firing, a doctor We know that recruiting ...

My USA Today column on why medical malpractice reform is needed

in Physician | 20 responses

My latest USA Today column was published this morning: Any malpractice reforms should put patients first.My USA Today column on why medical malpractice reform is needed I discuss how the our medical malpractice system poorly compensates injured patients and is ineffective at improving medical practice. These are the most important reasons why malpractice reform is needed. And capping awards is not the answer:

Researchers found that the impact of frivolous lawsuits ...

Both the far left and right agree not to receive the H1N1 vaccine

in Conditions | 4 responses

What can unify Glenn Beck and Rush Limbaugh with the progressive anti-vaccine bloggers of the Huffington Post?Both camps are revolting against the H1N1 vaccine.In a piece from Slate, Christopher Beam notes that "the two sides have finally found common cause," and share a worldview where there's "distrust—of doctors and modern medicine or of government."On the right, Mr. Lumbaugh eloquently told the Secretary of Health and Human Services to "screw ...

Are we underusing aldosterone antagonists in congestive heart failure patients?

in Conditions | one response

Originally published in InsidermedicineAre we underusing aldosterone antagonists in congestive heart failure patients? Less-than one third of eligible patients being discharged from hospital with heart failure are being prescribed guideline-recommended treatment, even though the hospitals are participating in a program aimed at improving compliance with treatment guidelines, according to research published in the latest issue of the Journal of the American Medical Association.id="play_continuous_flvs" classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="385" height="239" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">

Discussing end-of-life care in the ICU and saving Medicare money

by | in Policy | 7 responses

I think by now there is not a person in the US who cannot quote at least approximately how much we spend annually on healthcare. Fewer people appreciate that nearly 1/3 of this $2.2 trillion bill is eaten by hospitalizations, amounting to about $680 billion. Although the data in the diagram below represent a single year, the overall distribution of expenses is remarkably constant over time.Discussing end of life care in the ICU and saving Medicare money

H1N1 rapid tests: Poor sensitivity

in Conditions | one response

Originally published in Journal Watch Infectious Diseasesby Stephen G. Baum, MDRapid tests for seasonal influenza generally have relatively low sensitivity; their sensitivity for detecting the 2009 H1N1 virus seems even worse.H1N1 rapid tests: Poor sensitivityMany respiratory pathogens can produce an influenza-like illness. With a sensitive and specific rapid test for influenza, the onset of outbreaks could be established and patients could receive appropriate antiviral ...

When compassion meets progress in American health care

by | in Policy | 4 responses

Does anyone realize that the chaos of modern American health-care is not a tragedy, but a triumph? We’re so busy trying to fix what isn’t broken and ignoring what is, so busy casting stones and casting doubts that we are blind to what we have.I have practiced medicine in this labyrinth for 16 years. I am an emergency physician. I practice in what may be considered the ‘epicenter’ of modern ...

Why pregnant women should get the H1N1 flu vaccine

by | in Conditions | 18 responses

Doctors are often compelled to make quick decisions in life threatening cases with only limited information. Unfortunately, pregnant women are now going to be put in the same situation.The H1N1 flu has taken an extraordinary toll among pregnant women. A new vaccine is now available. Because of the nature of the emergency, there has not been time to do any long term studies of the vaccine. Yet pregnant women will ...

Doctors spend more time on social work than medicine

in Physician | 10 responses

Originally published in HCPLive.comby Alan Berkenwald, MDWilliam Osler is known as the Father of American Medicine. He was a world class physician, the “Doctor’s Doctor” - as physicians all along the Atlantic seaboard would sent their family members to him.Doctors spend more time on social work than medicine He wrote the first American medical textbook. He was so good, he was recruited from Johns Hopkins (which he had ...

Everybody loses when physician conferences restrict medical news reporting

in Social media | no responses

by Robert Stern, MA, CCMEPAlmost a decade ago, I had a simple idea -- deliver fast, accurate medical news to clinicians in a format that was easily accessible, and turn that news into a "teachable moment." Almost five years ago, that idea became reality with the launch of MedPage Today.Monday through Friday (and if news is happening, Saturday and Sunday, too), MedPage Today delivers on our promise of "Putting Breaking ...

Why doctors should reconsider ordering a CRP to screen patients for heart disease

in Conditions | 5 responses

The CRP, or C-reactive protein, is a test that many doctors use to screen for heart disease.And indeed, studies have associated an elevated level with an increased risk of coronary artery disease. But there is little data showing that reducing the CRP level saves lives. That hasn't stopped both doctors and patients from inappropriately ordering the test.Although not expensive by itself, it serves as a gateway to ...

How to take money out of health care, and is a single-payer system inevitable?

in Policy | 19 responses

by Bruce Douglas, MDI've been practicing my health care specialty for sixty years and have enjoyed almost every minute of it. The minutes I have not enjoyed all have to do with "money."Financial transactions in doctors' offices are the root of most evils in the relationship between doctor and patient. Along with that evil goes an additional detraction from good, humane health care called the fee-for-service system, which ...

Should doctors fire young patients if their parents refuse to vaccinate them?

in Conditions | 17 responses

Originally published in MedPage Todayby Emily P. Walker, MedPage Today Washington CorrespondentIf parents refuse to vaccinate their children, it's ethical and legal to dismiss the child as a patient, a pediatrician told attendees of the American Academy of Pediatrics meeting here.Should doctors fire young patients if their parents refuse to vaccinate them? "In the middle of treatment, you can't just say, I'm done," Gary Marshall, MD, of the University of Louisville ...

How a nursing student got expelled for blogging

in Social media | 12 responses

Here's an example of how health care professionals should not blog.Michelle Fabio writes, in a guest post on Better Health, about the travails of a nursing student, who blogged about watching a patient give birth:

When school officials read [nursing student] Yoder’s post, which included a description of the baby as a “creep” and “a wrinkly, bluish creature, all Picasso-like and weird, ugly as hell, covered in god knows what, ...

What if newspapers reported science the way they cover the World Series?

in Social media | 6 responses

by Larry Husten, Ph.D.October brings the Nobel Prize announcements and the World Series. No one will mistake media coverage of one for the other. Each Nobel Prize will get one article and 10 seconds on the evening news. A soft feature will quote the new Nobel recipient’s complete surprise at the 4 AM phone call.By contrast, baseball, like all major sports, is covered in great depth, by legions of sports ...

When patients receive too much radiation from CT scans by mistake

in Conditions | no responses

Originally published in MedPage Todayby Crystal Phend, MedPage Today Senior Staff WriterReports of stroke patients who were accidentally exposed to eight times the normal radiation dose during diagnostic CT scans at Cedars-Sinai Medical Center in Los Angeles are prompting safety warnings and soul searching among radiologists nationwide.When patients receive too much radiation from CT scans by mistake Over an 18-month period, 206 patients at the center received 3 to 4 ...

How emotional stress affects physician training

in Education | 3 responses

Much has been made of fatigue increasing the number of medical errors doctors make.But what about other factors, like emotional stress?That's a little-reported issue that Pauline Chen addresses in her recent New York Times column. In residency, some doctors-in-training have to care for small children, among other life issues. As Dr. Chen notes, "whenever one of us experienced additional stress apart from our work, the house of ...

Google Android versus the iPhone for medical apps

in Tech | 22 responses

by Jeff BrandtVerizon, Motorola, and Google, along with 9 other cell phone manufactures and countless world carriers, have teamed up to provide a smartphone with the power to deliver useful applications for medicine: the Verizon “Droid” smartphone, based on the Google Android operating system (OS).Google Android versus the iPhone for medical apps The Droid’s processor is the same processor that powers the iPhone. The main reasons this ...

Will co-sleeping with your infant increase the risk of SIDS?

in Conditions | 12 responses

Originally published in MedPage Todayby Todd Neale, MedPage Today Staff WriterJust over half -- 54% -- of sudden infant death syndrome (SIDS) cases in southwest England occurred when the baby was co-sleeping in the same bed as a parent, a case-control study showed.Will co sleeping with your infant increase the risk of SIDS? That compares with 20% of infants among randomly selected families and controls deemed to be at high ...

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