Here's the obligatory Tiger Woods post on the blog.Whenever Tiger gets back to the course, some are wondering how his current travails will impact his golf game. NPR's Shots interviewed a sports psychologist about the issue.Gregg Steinberg, author of Mental Rules for Golf, cites the so-called "triad of toughness," - physical, mental and emotional:
For a golfer, says Steinberg, physical toughness means you have components like a great swing ...
The costs of healthcare have been rising exponentially, but people's incomes have not. Despite the biggest economic expansion over the last 50 years, and despite astronomic rise in our productivity, the real wages for the bottom 80% of all earners have not increased one iota since 1975. This means that, while the costs for all products and services have grown at the pace of inflation or more rapidly (as in ...
Originally published in InsidermedicineRepeated use of the club drug MDMA, which is known on the street as "ecstasy" increases the risk of the breathing disorder known as sleep apnea, according to research published in journal Neurology.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">
Originally published in MedPage Todayby Crystal Phend, MedPage Today Senior Staff WriterGains in life expectancy from lower smoking rates over the next decade will be offset, to some degree, by reductions in life expectancy based on the rise in obesity, researchers estimated.
If obesity and smoking rates had held steady, the average 18-year-old would have seen a 2.98-year increase in ...
The Senate health reform bill proposes to add 2,000 residency slots, in the hope to increase the number of primary care doctors and general surgeons.I'm going say right now, that isn't going to work.Similar in concept to building more medical schools, nothing is going to change the skewed generalist:specialist ratio unless the professional incentives of each field changes.And I'm not just talking about money, although that's a huge factor.The ...
Fear is such a powerful emotion, humans will do almost anything to relieve it. The most effective way to control fear is to manage whatever it is we're afraid of. Night lights against the monsters under the bed; locks on the doors and a handgun under the pillow to fend off intruders; annual mammograms and PSAs to keep us from dying of cancer. Although all these things may relieve fear ...
Originally published in HCPLive.comby Alberto Borges, MD
For those interested in health information technology, there is now an excellent, new, powerful article about this topic entitled, "Can Cleveland Clinic Be a Model for Digital Medicine?" where they discuss how this hospital system has failed to recoup their $100 million investment to date.Here is my take on the Cleveland Clinic story, beyond ...
Originally published in MedPage Todayby John Gever, MedPage Today Senior EditorResponding to growing concern over concussions suffered by professional football players, the National Football League may soon require teams to seek opinions from independent neurologists before allowing head-injured players back on the field.League officials have not confirmed the plan, but reports in The New York Times, the Associated Press, FOXSports.com, ...
What are two of the hardest words for a doctor to say?"I'm sorry."Evan Falchuk, speaking from a legal perspective, understands why some defense lawyers counsels physicians not to apologize to patients: "If you say you’re sorry for something, you are implicitly taking some degree of responsibility for whatever has happened. Plaintiff’s lawyers will use a doctor’s apology to the maximum extent possible to show the doctor knew what ...
by Helen Kao, MDAs the health reform debates continue, I am struck by the lack of attention to what seems to be a critical issue in poor health care delivery.With the technologizing of medicine (and more recently the hospitalist "movement"), delivery of health care has come to be centralized around acute care hospitals. Over time, patient care has been divided into acute inpatient care and 'ambulatory' outpatient care. While transitions ...
Originally published in HCPLive.comby Jeff Brown, MDYou might be thinking, "Why should I consider branding or marketing?” And your reasoning might go something like this:1. As a doctor, I already have a powerful, built-in identity; 2. My practice is full; 3. Even if my practice isn't full, Congress is in the process of putting 40 million more insured people into the available patient pool over the next few years.
Originally published in MedPage Todayby Kristina Fiore, MedPage Today Staff WriterRadiologists have rejected revised mammography guidelines from the U.S. Preventive Services Task Force (USPSTF), arguing that they are not backed by scientific evidence and will lead to unnecessary deaths.Under the revised guidelines, "screening will begin too late and its effects will be too little," said Stephen A. Feig, MD, of ...
What if cost cutting measures were put into place, but no one listened?That's the question cardiologist Sandeep Jauhar asks in a recent, excellent, New York Times essay. In the piece, he writes about the problem of Medicare readmissions, a significant cost driver. One of the ways to decrease the frequency is to financially reward hospitals that have low re-admission rates.There's one problem, however. Doctors don't see ...
Originally published in InsidermedicineMore than half of patients in intensive care units (ICUs) worldwide are suffering from infections, which lengthen their hospital stays and increase their mortality rate, according to research published in the December 2 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">
When we talk about efficiency in the business world, we are basically talking about getting as much profit as possible. This profit is wrung out of the system by reducing production costs to the maximum extent possible and by charging the top price that the market allows.Some of the ways in which the US companies have increased their efficiencies over the last 30 years are, 1) by moving manufacturing to ...
Originally published in MedPage Todayby Kristina Fiore, MedPage Today Staff WriterSome women already at high risk of breast cancer should be cautious about having mammography or chest x-rays before the age of 30 because the imaging may increase the risk of developing the disease, researchers here said. Five or more x-rays, or any exposure to ionizing radiation before age 20, ...
There’s no question the deck is stacked against primary care. Its rates are too low, its hours too long, and its prestige too lagging. Yet everybody agrees a vibrant and broad primary care base is essential to a smoothly functioning and effective health system.I’m optimistic about primary care. I believe primary care doctors are capable of pulling themselves up by their technological bootstraps. In Innovation-Driven Health Care, I devoted several ...
by Bruce GoldmanPeople of a certain age have been known to complain that, while they lucidly recall the details of childhood events, they can't remember what they ate for breakfast.As it is with brains, so it may be with immune systems. Older people's immune responses, while generally somewhat sluggish in revving up after, say, a vaccine against seasonal influenza, seem to retain a knack for fending off the current H1N1 ...
Recently, two groups released new guidelines that may affect breast cancer and cervical screening in women.The US Preventive Services Task Force (USPSTF) recommended against screening women in their 40s and to screen women every other year starting at age 50. The USPSTF left room for individualized screening, particularly in the presence of risk factors such as family history. Still, it is ...
Originally posted in MedPage Todayby John Gever, MedPage Today Senior EditorAlmost one-third of doctors in an industry-sponsored survey said they didn't spend enough time with their diabetic patients and blamed low reimbursement rates for diabetes care, researchers said. In a survey of 200 primary care physicians and 100 endocrinologists, 32% reported an inability to provide comprehensive diabetes care, Alyssa Pozniak, ...
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
Are doctors really going broke? According to this piece from CNN Money, some are: "Doctors list shrinking insurance reimbursements, changing regulations, rising...
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned...
Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. ...
As physicians, we are often called upon to be advocates for our patients. Sometimes they have no other person to turn to....
Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for "feeling good", but...
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in...
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a...
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...
So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence. The following passage really caught my attention: "Question is: are...
A social media movement is happening before our eyes with action starting to take shape. The #occupyhealthcare movement has begun within to...
The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering...
The storyline is familiar. An organization is challenged to achieve better results without spending more money. An executive is committed to obtaining...
Why are cancer organizations waiting until it starts to rain before they suggest buying an umbrella? “Join my Medicare Advantage plan and...
How many times as a doctor do you ask the same questions over and over again as part of the routine process...
Many clinical decisions in older persons are dependent on life expectancy. For example, as life expectancy declines, cancer screening is likely to...
“To Err Is Human” is the title of the now famous book from the Institute of Medicine on patient safety published about...
Professor Gunter Dueck, is a calm and eloquent german mathematician who’s also the CTO of IBM Germany. He studied mathematics and philosophy...
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
The physician’s decision to first dive into social media can be stress-inducing. Issues of time management, maintaining professionalism, and determining a return...
The impact of social media on medicine could arguably be compared to the impact of the industrial revolution on the human condition....
