Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentThe strain of caring for a disabled spouse is associated with an increased risk of stroke, researchers found.
The risk is increased for men, and especially African-American men, according to William Haley, PhD, of the University of South Florida, in Tampa, and colleagues.On the other hand, there was no significant ...
January 2010
All Stories
Can we grow organs instead of transplanting them?
Anthony Atala's lecture at TEDMED 2009, discussing how his state-of-the-art lab grows human organs - from muscles to blood vessels to bladders.Amazing.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">
Should society consider purchasing and selling tissues and organs?
by Michael Kirsch, MDChoose the best answer.To stimulate organ donation, we should provide organ donors with:* Cold, hard cash * Upgrades to business class on any flight within the continental United States for 1 year * College tuition discounts for up to 3 children * Income tax relief * First row Bruce Springsteen concert tickets * A certificate of appreciationThere is a reason that we don’t ask families of kidnapped victims what our policy should ...
How many Americans received the H1N1 vaccine?
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentAs 2009 ended, an estimated 55 million Americans had been infected with the H1N1 pandemic flu and roughly one in five Americans had been vaccinated against the disease, the CDC said. The immunization data works out to about 61 million people, the agency said in an early release issue ...
5 reasons why Apple’s iPad will have trouble in health care
Originally published in HCPLive.comby Colin CrawfordThe Steve Jobs iPad Tablet media show held at the Yerba Buena Center for the Arts in San Francisco was always going to have a hard time living up to the ridiculous pre-launch hype that's been circulating around the Web.
Steve's presentation was more moderate than at previous product launches as he tried to manage expectations ...
How can doctors stop drugs prescribed by other physicians that are no longer effective?
Here are two vignettes illustrating the failure of doctors to master the obvious and maybe a window onto the future struggles to control medical costs.A 90-year old is referred for care due to "end stage dementia." End-stage dementia is medical speak and as such does not really convey the appropriate imagery. It means a skeletal man, in a wheelchair or mostly in bed, with diapers, who has does not know ...
How can doctors make America a better place to live?
What can physicians do to make American a better place to live, die, afford, and receive care? What can we do to bring about practical reform? What can we contribute?These may seem odd questions, After all, we deliver care. Care goes through us. But Medicare, Medicaid, and private third parties are big players. They dictate terms of engagement and payment. But the answers lie at the core of the physicians’ ...
Risks, benefits and efficacy of bariatric surgery
Originally published in InsidermedicineA new model that takes into account the risks of surgery, the risks of obesity, and the efficacy of bariatric surgery helps clarify which patients are likely to live longer as a result of this intervention. The research is published in the January issue of the Archives of Surgery.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">
Will New York’s ban on salt really make patients healthier?
Originally posted in MedPage Todayby Mike HimowitzI have a libertarian streak that compels me to shout “Nanny State!” when local governments put up speed-trap cameras to extort money from otherwise law-abiding citizens who drive a few miles over artificially low limits. Same for legislators who want to make me a criminal for calling my wife on my cell phone to ask her if I should pick up anything at ...
Why are doctors so reluctant to discuss end of life care?
A recent study suggests that doctors may put off holding end of life care discussions that involve subjects like advance directives, hospice or site of death.Recommendations suggest that physicians hold these conversations when patients have about a year to live, but the data shows those guidelines aren't being followed.Why?According to the study's authors, they suggest that doctors "may not be comfortable discussing it,” and, “these conversations are time-consuming and ...
Health care reform requires listening to doctors and patients; my New York Times take
Did President Obama say enough in last night's State of the Union address to improve the perilous state of health care reform?
I discuss what needs to be done to help reform's prospects in a piece from the New York Times' Room for Debate blog:
A recent Gallup poll noted that 73 percent of patients trusted their doctor’s opinion on health ...
Nobody will be held accountable if healthcare reform fails
I must admit I’m a little weary of the entire debate on health-care reform. But something still haunts me. And that something is accountability. Of course, over the almost twenty years that I have borne the title ‘MD,’ I’ve learned a few things about accountability.I understand that, almost without fail, the buck stops with me. The nursing home director knows the elderly lady wasn’t seriously hurt in that fall, but ...
Why antibiotic dosing should be tailored to patients’ physical characteristics
Originally published in InsidermedicineThe dosing of antimicrobial agents should be tailored to patients' physical characteristics in order to achieve maximal effectiveness and safety, according to a Viewpoint argument made in the The Lancet.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">
Apple’s iPad health impact for doctors and hospitals
Apple just yesterday introduced the iPad, essentially an iPhone on steroids that bridges the gap between smartphones and small computers.
Will this be the platform that accelerates eHealthcare on the provider side (hospitals, doctors, medical education, etc.)?I say yes. Here’s why:First of all, the pace at which doctors are using smartphones as part of their practice (and especially iPhone/iPod Touch) ...
Why health IT won’t help with medical risk management
by Satish Misra and Iltifat HusainThe march is on across the American healthcare landscape to implement electronic health records that also function as decision-support systems.These “advanced” electronic health records will both provide centralized records and assist providers in making care decisions such as implementing therapy and utilizing evidence-based practice on the individual patient level. And anyone that has had the opportunity to work with some of the systems out ...
The difference between regret and apologies in health care
I've written recently that "I'm sorry" are the hardest words for doctors to say.Good piece in The New York Times, observing that the health care industry, in general, has a hard time apologizing. In many cases, hospitals and drug companies simply state they "regret" the situation.Is there a difference? Of course there is: "The difference between apologizing and simply offering a 'regret' may seem semantic. Yet ...
How to make your medical grand rounds thrive
Early last year, my boss Talmadge King and I were at an ABIM meeting (we’re both on the board), and the group was debating a controversial topic. Another participant at the meeting, like Talmadge the chair of a prominent department of medicine, said, “We polled 250 people at our grand rounds last week, and they said ‘X’.” The audience gasped – ‘X’ was a completely unexpected ...
How to stop theft from your medical practice
Originally published in HCPLive.comby Ed RabinowitzThere’s a great scene in the movie The Big Chill where the main characters are having a discussion on the topic of rationalizations. One individual comments that he doesn’t know anyone who could get through the day without two or three juicy rationalizations. That may be true. But when a rationalization involves taking things from the office or workplace, and that office just happens ...
How President Barack Obama’s State of the Union speech will impact healthcare reform
Originally published in MedPage Todayby Emily P. Walker, MedPage Today Washington CorrespondentPresident Barack Obama's State of the Union speech Wednesday night will likely focus on job creation and the economy and not -- as many Democrats once hoped -- on congratulations for the passage of healthcare reform. In the week following the election of Republican Scott Brown to the U.S. ...
Doctors who are not on Facebook, Twitter and blogs risk becoming irrelevant; my USA Today op-ed
My latest USA Today op-ed was published this morning: Doctors ignore Internet at their own peril.
I discuss how social media, like Twitter, Facebook, and blogs, have the potential to improve patient-physician communication:
Social media websites that encourage reader interaction are playing an increasingly ...
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....
