Last week, the Office of the National Coordinator for Health Information Technology (ONC) released criteria that will be used to certify EHRs as appropriate support tools for providers who want to qualify for Bonanza Days.The criteria are subject to a 60-day comment period before being finalized.I congratulate ONC on its elegant piece of rule making. Its so-called Interim Final Rule (IFR) provides a foundation that can support years of progress ...
January 2010
All Stories
Obese college students are reading health related spam e-mails
Most people automatically filter out spam e-mails, or delete them without ever opening them up.But a surprising number of people actually take the time to read them, which is probably why annoying spam will continue unabated. From the New York Times' Well, Tara Parker-Pope writes points an interesting study looking at who actually read health-related spam e-mails.Looking at college students who were overweight, a study showed that an ...
Primary care needs a face lift, and a better agent
General medicine is not sexy. Less than a fourth of the doctors in the United States are currently primary care providers like Pediatricians, Ob/Gyns, and Internists. According to a recent study published by the Journal of the American Medical Association, only 2% of medical students intend on pursuing a career in general internal medicine. So when health-care reform becomes a reality, and the 46 million uninsured men, women, and ...
How PET scans can help find the cause of Parkinson’s disease
Originally published in InsidermedicineAn image-based classification system based on positron emission tomography (PET) scanning can accurately differentiate underlying causes of parkinsonism, according to research published online ahead of print in The Lancet 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">
Primary care doctors should discuss organ donation with patients
Originally published in MedPage Todayby Charles Bankhead, MedPage Today Staff WriterPrimary care physicians rarely discuss organ donation with patients, even though most of the doctors believe organ donation is within the scope of their practice, a survey of primary care physicians showed.
Fewer than 4% of physicians said they discussed organ donation with patients, compared with 30% who discussed end-of-life issues. ...
How ideology is shaping health care reform
I’m an ideological pragmatist. I believe in what works and what suits the temperament of American people, rather than what is politically correct or what passes some moral litmus test.Whatever reform measure passes, it will be a public-private mix and will superimpose more government regulations on our private system. It will have uneven effects. It will cost more than the status quo. And it will expose the reality, that when ...
Were hospitals responsible for patient deaths during Hurricane Katrina?
A jury is about to decide how far hospitals have to go to protect themselves against natural disasters.It all starts in New Orleans, during the Hurricane Katrina disaster. Hospital generators were not protected against floods, and predictably, that contributed to the loss of power during the category 5 hurricane. If all hospitals were to protect their generators appropriately, it's estimated that it would cost millions to do ...
How to prevent diabetes with diet and exercise
By all accounts, Frances Vasquez ought to be a diabetic. Raised on a diet of fried steak, fried pork chops and lots of rice, her father, mother, and two sisters suffered from the disease. At age 47, Frances was overweight and already experiencing high blood sugar.But over the past 11 years, Frances has been able to avoid diabetes, and her sugars are now normal. By participating in a ground-breaking, government-funded ...
How carriers of Staphylococcus aureus do worse in the hospital
Originally published in InsidermedicineInfections with a type of bacteria known as Staphylococcus aureus, or S. aureus, can be diminished by identifying and treating those who carry it in their nasal passages, according to research published in the New England Journal of Medicine.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">
Why scaring patients to quit smoking may not be effective
Originally published in MedPage Todayby Crystal Phend, MedPage Today Senior Staff WriterTelling people about the benefits of quitting is more likely to help smokers break the habit than scaring them with the dangers of continuing, researchers found. Callers to a tobacco quitline were nearly twice as likely to stop in the short term when they got positive messages rather than ...
Did Martha Coakley kill health reform, and what Senator Scott Brown means for healthcare
In case you haven't heard, in a stunning result in yesterday's special election in Massachusetts, Republican Scott Brown won the Senate seat previously occupied by the late Edward Kennedy.Needless to say, pundits are going crazy analyzing the results, and its implications on health reform. I'll leave the political commentary to them, but I'll comment on what this means for health reform's future.In essence, what turned into a 95% likelihood ...
How doctors suffer during medical malpractice litigation
There are no winners in medical malpractice cases.Patients, of course, suffer the most. But doctors aren't spared either. It's been written previously that doctors suffer significant emotional turmoil after being sued, and in fact, a good percentage even contemplate suicide.In a recent New York Times essay, physician Joan Savitsky talks about her own ordeal. She discusses how being sued affected not only her, but other ...
A doctor writes about his first day in Haiti
by Jonathan Crocker, MDFrom Cange, Central Plateau Haiti 01-18-10We arrived at Cange, in the Central Plateau, the heart of operations for Partners In Health/Zamni Lasante, yesterday. As we expected, things are incredibly busy. People are still arriving from Port au Prince. Those who have been fortunate enough to survive their injuries this long are now running into complications of wound infections, some of which have turned septic, and venous blood clots (from ...
ACP: 10 major challenges that confront medical education over the next decade
The following is part of a series of original guest columns by the American College of Physicians. by Steven Weinberger, MD, FACP
At times of calendar transitions, e.g., at the onset of a new year or a new decade, the popular press often takes a broad view in looking retrospectively at the outstanding or defining events and people of the past ...
Tips for doctors who negotiate reimbursement rates with insurance companies
Originally published in HCPLive.comby Ed RabinowitzWhen it comes to negotiating fees with health plans, practices and physicians have more leverage than they realize. The problem, says John Schmitt, a managed care expert with EthosPartners Healthcare Management Group, is that practices often don’t even try. “Groups negotiate an agreement with a payor and then, for whatever reason, just fi le it away. Most medical groups do not have a good, ...
How many more doctors are using electronic medical records?
Originally published in MedPage Todayby Emily P. Walker, MedPage Today Washington Correspondent,Just over 40% of office-based physicians reported using electronic health record (EHR) systems in 2008, more than double the percentage at the start of the decade. From 2007 to 2008, usage of EHRs increased by nearly 19% according to the National Ambulatory Medical Care Survey (NAMCS), conducted by the ...
How root cause analysis can improve patient safety
Hospitals face so many urgent tasks in safety – computerize, promote teamwork, implement evidence-based safety practices, discover unsafe conditions – that it’s hard to know where to start. If you’re struggling, I recommend that you put your Root Cause Analysis enterprise on steroids. This is what we did at UCSF Medical Center, and it was the most important change we’ve made in our safety journey. Here’s the story, ...
Why are so many patients referred to specialists?
Do generalist doctors refer to specialists too much?Jeffrey Parks, otherwise known as the Buckeye Surgeon, has written numerous times on the issue, and his feeling is, yes, they do.And he's right. There are many physicians, along with mid-level providers like nurse practitioners and physician assistants, that refer to a spectrum specialists for routine conditions, especially in the hospital setting.Dr. Parks asks, "shall we continue with the status quo ...
Why doctors fail to embrace Health 2.0
Originally published in HCPLive.comby Gwenn Schurgin O'Keeffe, MD, FAAPNew technologies can make healthcare more personalized, strengthen the patient–physician relationship, put the right information in the right hands at the right time, and potentially improve outcomes and efficiency across the healthcare spectrum. So why are so many physicians reluctant to embrace these changes?
Wikipedia defines Health 2.0 as “the use of ...
Scenes from Haiti before the earthquake, and what the future holds
Originally published in MedPage Todayby Michael SmithI remember walking through the squalid downtown of Port-au-Prince and coming across a woman sitting by the roadside selling carefully washed tin cans. That was how she made her meager living.There were scenes that were more appalling -- a man on a street corner with his head split open by a machete, a corpse ...
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....
