Originally posted in MedPage Todayby Emily P. Walker, MedPage Today Washington CorrespondentIn its much-anticipated cost estimate, the Congressional Budget Office (CBO) said the Senate Finance Committee's healthcare reform bill would cost $829 billion over 10 years and begin to drive down the federal deficit after that first decade.
The price tag is lower than Sen. Max Baucus' (D-Mont.) previous ...
October 2009
All Stories
When political discourse is like borderline personality disorder
When I was a kid in Odessa my Dad and I went to see The Sound of Music at least 17 times in the span of 3 months. Remember that song sung by the nuns when Maria is late for the vespers, "How do you solve the problem like Maria?" One nun says "She's an angel", another one counters "She's a demon", when the voice of reason from Mother Superior ...
Doctors and nurses need the H1N1 flu vaccine, and recent media mentions
Doctors and nurses should receive the H1N1 vaccine.
That's the take-home message from my latest opinion piece in The New York Times' Room for Debate blog, published earlier this week:
There are over 11 million health care providers working in our hospitals, nursing homes and medical clinics. And with studies suggesting that 70 percent of doctors plan to continue working ...
Is a cocaine abuse vaccine coming soon?
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentA vaccine against cocaine was effective in nearly 40% of users of the drug, researchers said. In a randomized, placebo-controlled study, volunteers who reached a high level of antibodies after vaccination used less cocaine than those whose response was lower, according to Thomas Kosten, MD, of Baylor College ...
Should children with autism be diagnosed at home?
A company is selling a test to detect early signs of autism at home.For $200, parents receive an iPod-like device to attach to their 12 to 24-month toddler and record what they say for 12 hours. The data is then shipped back for analysis, where "acoustic algorithms . . . compare the child's vocalizations to those of other children." The interpretation is then mailed to parents, who presumably ...
Is incident reporting effective in reducing medical errors and increasing patient safety?
When the patient safety field began a decade ago with the publication of the IOM report on medical errors, one of its first thrusts was to import lessons from “safer” industries, particularly aviation. Most of these lessons – a focus on bad systems more than bad people, the importance of teamwork, the use of checklists, the value of simulation training – have served us well.But one lesson from ...
Is clinical breast examination, added to mammography, worthwhile?
Originally published in Journal Watch General Medicineby Allan S. Brett, MDCBE was associated with 55 additional false-positives for each additional breast cancer detected.
Whether patients benefit when clinical breast examination (CBE) is added to screening mammography is unclear. Canadian researchers addressed this issue in an analysis of data from the Ontario Breast Screening Program, a ...
Does Chantix increase suicide risk?
Originally published in MedPage Todayby Kristina Fiore, MedPage Today Staff WriterContrary to information that led the FDA and other regulatory agencies to release warnings about varenicline (Chantix), a new study has found "no clear evidence" of a relationship between the risk of suicide and the smoking-cessation drug.Both varenicline and bupropion (Zyban), another drug used in smoking cessation programs, were ...
How House, M.D. is affecting patients’ expectations of medical care
More patients are expecting doctors to be more like Gregory House, the fictional doctor of Fox's House, M.D.But when you consider how much unnecessary testing is already going on, can this be a good idea?
Well, no. But that doesn't stop a handful of patients with rare diseases to implore that their doctors do more testing: "Doctors ...
Flu and H1N1 influenza vaccine recommendations for doctors and health care workers
The following is part of a series of original guest columns by the American College of Physicians. by Steven Weinberger, MD, FACPIn the Fall of 2009, we physicians should perhaps change the Biblical phrase, “Physician, heal thyself” to “Physician, immunize thyself” and then follow the phrase twice – once for seasonal influenza and once for H1N1. To date, physicians and other health care workers have too often been lax ...
Are surgical masks as effective as N95 respirators to prevent influenza?
Originally posted in InsidermedicineNurses are as well protected from influenza with a standard surgical mask as with an N95 respirator while caring for febrile patients, according to a randomized trial published in the November 4 issue of the Journal of the American Medical Association.
Here are some guidelines for infection control among hospital patients with confirmed or suspected H1N1 ...
Did the 1918 flu pandemic increase the risk of heart disease?
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentMen who were in utero during the peak of the 1918-1919 flu pandemic were at increased risk of heart disease when they reached their 60s, 70s, and 80s, researchers said. In those men, the rate of heart disease was more than 23% higher than among those whose mothers ...
How work-hour restrictions harms resident surgeon training
Controversy persists about limiting the work hours of resident physicians.No where is it more prevalent than in surgery, where proficiency depends on the number of times a trainee physician performs a procedure. In a recent study from the Journal of the American College of Surgeons, 43 percent of surgical residents want to work more than the allotted 80 hours per week, and 41 percent felt the work-hour restrictions ...
10 top medical blog posts, September 2009
Here are the top posts from the past month, based on the number of times they were viewed.1. An analysis of Barack Obama’s health care reform speech to Congress2. A patient dies after doctors fail to communicate in the operating room3. Medical students using Facebook and Twitter can get expelled4. How long are you contagious after being infected with H1N1 influenza?5. The ultrasound that saved ...
How should doctors handle the difficult patient?
by Toni Brayer MDI am willing to bet that patients do not know that the medical community talks formally about "The Difficult Patient". Courses are taught on how to handle these patients and there is even an ethics study on Medscape about it. So what is the difficult patient?Every practice encounters them and they come in many varieties. They are the patients who abuse the staff, miss appointments repeatedly, "lose" ...
Analysis of the Senate Finance Committee health care reform bill
Originally posted in MedPage Todayby Emily P. Walker, MedPage Today Washington CorrespondentThe Senate Finance Committee finished work on its healthcare reform bill in the wee hours of Friday morning, paving the way for a committee vote next week. After considering hundreds of amendments, the committee is now waiting for a cost-estimate from the Congressional Budget Office (CBO) before it ...
Health care reform analysis from a former insurance and hospital executive
by Marie CooperI have been in senior executive management in both managed care and a major hospital system. I find the hysteria over "reform" bitterly amusing because it is so misdirected.The real problem with health care in America? Greed, indifference and incompetence, pure and simple. But not in the places everyone is pointing.Insurer sideInsurance companies have to maximize their revenue because they answer to their boards. They ...
What the United States health care system can learn from Mexico
by Esther Buddenhagen, MSWI write as a lay person concerned about the gap between what many people should receive and what they actually receive. The question of good medical care for ordinary people is being buried not only by insurance issues but by failure to come to terms with what primary care should be about.Even Atul Gawande, who is particularly good at making distinctions between good and ...
Do electronic medical records increase physician communication of critical test results to patients?
Originally posted in InsidermedicineAdvanced electronic systems that alert physicians when outpatients receive critical abnormal test results do not appear to reduce the rate at which these results are overlooked, according to research published in the latest issue of the Archives of Internal Medicine. Here are some ways you can ensure that abnormal results of medical testing that you undergo ...
Not all doctors discuss the risks and benefits of prostate cancer screening to patients
Originally published in MedPage Todayby Todd Neale, MedPage Today Staff WriterMen might not be getting the information they need to make an educated decision about prostate cancer screening, two new studies suggest. Among 375 men surveyed by telephone, only 69.9% had discussed a prostate-specific antigen (PSA) test with their physician before making a decision about screening, according to the ...
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....
