by Paula Hartman CohenHave we overlooked the public health aspect of health care reform?In the health care reform debate, we’ve heard and read how health care reform will or will not work, what it will or will not cost, and how it will or will not impact each one of us as individuals.We’ve also heard from those who have great faith in our current system, and sincerely believe we should ...
October 2009
All Stories
Do HMOs drive blacks to the emergency room?
Originally published in MedPage Todayby John Gever, MedPage Today Senior EditorMany African-Americans in California enrolled in health maintenance organizations (HMOs) appear to prefer getting medical treatment in emergency rooms, researchers said.
One-quarter of African-Americans enrolled in Kaiser Permanente or other commercial HMOs in California, who would therefore have a range of treatment options, sought treatment in emergency rooms in 2007, ...
Does your patient really need another chest CT?
Originally published in Journal Watch Emergency Medicineby Richard D. Zane, MD, FAAEMRepeat chest CT angiography scans have a low yield for diagnosing pulmonary embolism. 
Computed tomography (CT) angiography of the chest is considered the definitive test for pulmonary embolism (PE) in the emergency department. Although CT angiography is readily available, it exposes patients to ionizing radiation and iodinated contrast dye ...
Where’s the money to better pay primary care doctors going to come from?
I've written before that there's a good possibility that tensions between primary care doctors and their specialist brethren will get worse.The issue comes down to pay. Congress, rightly, is trying to find ways to better compensate primary care physicians, but most proposals do so at the expense of specialists.In an article from Investor's Business Daily, most of the bills circulating through Congress call for a 10 percent increase ...
How Google Sidewiki will impact drug company websites
Take a look at the screen shot below, from Pfizer’s homepage. Believe it or not, I, or anyone else, can now leave comments “on” any website (such as Pfizer.com) using a new tool (currently in beta) from Google, called Sidewiki.
Game-changer? You bet.While the use of Google’s Sidewiki has ramifications across the entire web, for every type of site or industry, I’m going ...
Does the seasonal flu vaccine offer protection against H1N1 influenza?
Originally published in InsidermedicineReceiving a seasonal flu vaccine may offer some protection against the H1N1 flu, although it by no means should replace an H1N1 vaccine, according to research published in the latest issue of the British Medical Journal.
Here is some information about the H1N1 vaccine and seasonal flu vaccine:• They are two separate vaccines. A seasonal ...
Why rapid viral testing for kids with URIs may not help in the ER
Originally published in MedPage Todayby Todd Neale, MedPage Today Staff WriterRapid viral diagnostic testing did not reduce the burden of treating children with respiratory symptoms and fever in the emergency department, according to a Cochrane Review meta-analysis. Pooling the results of four trials, researchers found a significant reduction in the use of chest radiography (RR 0.77, 95% CI 0.65 to ...
Reducing the paperwork burden on primary care
Of the many obstacles facing primary care, the sheer amount of paper stands out as one of the most burdensome.There are studies that show that every hour of clinical care generates an additional hour of paperwork. In fact, as Better Health's Val Jones recently notes, one-third of a primary care doctor's income is spent on paperwork.It's no wonder that the PCP burnout rate is so high, and ...
Poll: How effective is the HIV vaccine, and will it affect public health?
Findings released in late September showed potential benefits of an investigational HIV vaccine.16,000 people were involved in the three-year study. Roughly half received the vaccine, and the others received a placebo. 74 participants in the placebo group got infected with HIV, compared with 54 in the vaccinated group. The results suggested that the vaccine was 31 percent effective, and were deemed statistically significant. The National Institutes of ...
Should doctors be paid to e-mail their patients?
by Michael Kirsch, MDThis is a less controversial issue than patients ‘friending’ their doctors on Facebook, which I oppose. Although most physicians’ offices are not e-mailing with patients, perhaps they should. There are several obvious advantages.* Decompress phone lines, which are suffocating nearly every medical practice in America.* Relieve patients of the cruel and unusual punishment of languishing on ‘hold’ listening to elevator music or dead air.* Allow office staff ...
Will riding in a convertible harm your hearing?
Originally published in MedPage Todayby Ed Susman, MedPage Today Contributing WriterCruising down the highway in a sleek convertible, with the wind blowing in your hair, may sound like the ideal road trip -- but it could harm your hearing, British scientists said. In a study conducted on the high-speed motorways of the U.K., doctors found that at highway speeds, ...
Does the Max Baucus health reform plan do enough for doctors?
Max Baucus’ decision to release his solo album—subtitled the Senate Finance Committee’s proposal on health reform—was timed with the precision of a 4th grade marching band.Physicians could live with that, but the bill contained gornisht on tort reform and not much more than that on Medicare reimbursement. Upon seeing that, the Long White Coats reacted as if they’d seen earwax on their stethoscopes."The feeling of most doctors is ...
Will more primary care doctors keep patients out of the ER?
One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I think I know why.Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency ...
Can ventilating patients spread H1N1 flu in hospitals?
Originally published in MedPage Todayby Crystal Phend, MedPage Today Senior Staff WriterPlumes of virus-laden air shooting out from the masks of patients undergoing noninvasive ventilation could put healthcare workers at increased risk for infectious diseases such as the pandemic H1N1 (swine) flu, researchers said. A positive-pressure ventilation mask on a simulated patient yielded a jet of exhaled air extending ...
Does vitamin D reduce the risk of falls in the elderly?
Originally posted in InsidermedicineTaking a high daily dose of vitamin D can help the elderly reduce their risk of falls, according to research published in the latest issue of the British Medical Journal. Here is some information about vitamin D:• It is a vitamin that is present in very few foods but is necessary for development and maintenance ...
When a health care professional gets diagnosed with breast cancer
A social worker at a Boston hospital, who counsels patients with cancer, discovers that she herself has breast cancer.She tells her compelling story to Better Health's Val Jones.classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="430" height="295" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="430" height="295" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
The alternative, complementary, and integrative health obsession with toxins
Everything old is new again and that is certainly true in the world of "alternative" health. One of the axiomatic premises of contemporary "alternative" health puts its believers behind the times ... by approximately 500 years.A fundamental premise held by believers in "alternative" health is that we are swimming in a world of "toxins" and those "toxins" are causing disease. Like most premises in "alternative" health it has no basis ...
AMA: Permanent repeal of the Medicare physician payment formula must be part of health reform
The following is part of a series of original guest columns by the American Medical Association.by J. James Rohack, M.D.All eyes are on the Senate Finance Committee this week as they prepare to vote to move health reform legislation forward. The AMA is committed to health reform, and as the process moves to the Senate floor, it’s crucial that the Senate include permanent repeal of the current Medicare ...
Doctor makes more money on eBay than practicing medicine
It's no secret that more primary care doctors are looking for careers outside of medicine.And no wonder, considering that burnout rates are at all-time highs, compounded by soul-crushing bureaucratic responsibilities.This profiled physician on CNN.com, who works at a community health center, sells clothes on eBay - which is not uncommon on the online auction site. What's impressive, or disturbing, depending on your point of view, is that ...
Has the ban on doctors accepting drug company gifts gone too far?
Select states have taken a hard line against doctors accepting any type of gifts from drug companies.And that includes food of any kind, which makes for some awkward moments at national physician conventions.So, during this week's ACEP Scientific Assembly in Boston, WhiteCoat snapped a picture of this notice, which borders on farcical:
I've heard similar stories from ...
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....
