Learning how to do a pelvic exam can be uncomfortable for medical students doing it for the first time.There's a trend in medical schools to use "simulators" and mannequins, rather than model patients, to teach students.At the University of Minnesota medical school, tabletop anatomical models have largely replaced humans. Although the school denies costs are an issue, the savings are significant -- currently it costs $150,000 to hire ...
March 2010
All Stories
Health blog posts of the week, March 12-19, 2010
Here are the top posts from this past week, based on the number of times they were viewed.1. Match Day and how each medical school celebrates2. A patient live blogs his hospital stay, looking for a cure3. CRNA salaries surpass those of primary care doctors4. Nurse practitioners will not solve the primary care shortage5. Physical exam evidence and whether it’s still useful
Industry relationships with physicians are coming under fire
Originally published in MedPage Todayby Kristina Fiore, MedPage Today Staff Writer
Earlier this year, Harvard's Partners Healthcare put a cap on payments its physicians can receive for serving on corporate boards at $5,000 a day.Although the cap primarily affects top researchers and executives, it is by far the stiffest limit imposed by any academic medical center, and drives deeper the ...
Healthcare reform is an achievement but isn’t perfect
Heading into the final weekend of Mr. Toad’s Wild Ride, who could have guessed that in a year that brought us Death Panels, Pickup Trucks, “You Lie”, The Cornhusker Compromise, Bart Stupak (boy, that must have been a tough name to grow up with), and the Senate Parliamentarian-as-Rock-Star, we would be on the cusp of passing a perfectly ...
President Obama bets big on health care reform
President Obama has decided to place all his bets on an “up and down vote” on his health care bill.The stakes are enormous and rests on ten risky Obama bets.Bet One – His legacy depends on the outcome. If he loses, he may be a one-term president, and Democrats may lose their majorities in the House and Senate come November.Bet Two - The American people will ultimately recognize this is ...
Flood insurance by the government, but no public option
Originally published in MedPage Todayby John Gever This meditation was evoked by the prospect that my basement could be filled with E. coli-laden mud next week.I live within a few yards of Wheeling Creek, a tributary of the Ohio River that drains about 250 square miles of northern West Virginia and southwestern Pennsylvania. This week has brought temperatures near 70 degrees, ...
Atrial fibrillation as experienced by an electrophysiologist
Middle age introduces itself in many ways; one is atrial fibrillation. Youth, vigor and a medically-problem free life was seemingly right there in the recent past. A rhythm doctor often hears this suddenness of onset described as "Doc, yesterday, I was fine." As is always the case for a first episode of an arrhythmia, yesterday, you were fine, but today is indeed a new day.It happened during a bike ride. ...
Professionalism matters in correctional health care
As correctional health care professionals, there may be times when we are tempted to conduct ourselves in a less than professional manner simply because we can.We may be able to get away with speaking to our patients rudely, using profanity profusely, or wearing inappropriate clothing. After all, we work in jails and prisons. This culture is far from prim and proper. And, our patients are inmates. Many may tolerate misbehavior ...
Medicare rates and capping payments to hospitals
If there is anything about economics that has been proven over and over, it is that price controls do not work. The unintended consequences are usually worse than the problem that led to the solution in the first place.Massachusetts legislators, feeling the frustration of higher insurance premiums, are now considering a bill to limit doctor and hospital reimbursement payments to 110% of Medicare rates, or perhaps some other percentage ...
Coronary angiography is being overused
Originally published in MedPage Todayby Kristina Fiore, MedPage Today Staff WriterFor patients without known heart disease, the diagnostic yield of coronary angiography appears to be low, researchers found.Only about 38% of those referred to the cath lab for the elective procedure had obstructive coronary artery disease, Manesh R. Patel, MD, of Duke University, and colleagues reported online in the New England ...
The personal health record is failing patients
A personal health record (PHR) has been touted as a way for patients to better keep track of their health information. Google Health and Microsoft HealthVault lead the way.But what happens if the company storing your data gets bought, goes bankrupt, or simply decides to discontinue their system?Well, those who stored their data with Revolution Health are finding out first hand.The troubled company, which started off with so much ...
Business model woes traps doctors and impedes health care
If you are a physician, therapist or any other helping professional whose business model relies on third party manged care reimbursement you are engaged in the world's worst business model.Let me start with a story to set the stage.Imagine you are a bright, idealistic college student. You’re good at academics, want to make a difference in the world and have hundreds of career options in front of you.After lots of ...
Dance healed this physician and helped with burnout
Ten years ago, I was an Emergency Medicine Resident and wanted to die. Today, I’m a general practitioner in part-time practice and am in love with life. What made the difference? I signed up for a dance class.Reports on physician burnout list the personality traits that set us up for trouble: we’re excessively conscientious, feel overly responsible, want to please everyone, and function on an extremely high level - even ...
Medicare and how a grandmother worries about its costs
Originally published in MedPage Todayby Liz O'Brien My grandmother and her hospital roommate -- aged, tiny, frail, and sporting matching bright pink hairnets.They looked like twins -- two thin shrubs in winter that had each sprouted an improbable, big pink rose.Although sick and scared, my grandmother had admired the pink hairnet on the lady in the next bed, so my mother ...
Match Day and how each medical school celebrates
by Brian EuleWhile the debate continues to rage over the health care reform bill in Washington D.C., today at Noon Eastern time, the newest class of 15,000-plus graduating medical students will get their marching orders, beginning their lives working in medicine.It’s called Match Day and each year, on the third Thursday of March, the nation’s graduating medical school students gather with their classmates and wait for an envelope with their ...
How CTs and MRIs drive health care spending
It's well known that the use of imaging scans, like CTs, MRIs and PET scans, have been growing at an alarming rate.But a recent study provides some stark numbers.According to a recent CDC report, "MRI, CT or PET scans were done or ordered in 14 percent of ER visits in 2007, the report from the Centers for Disease Control and Prevention found. That's four times as often as in ...
Communication with the patient may not be helped by time
If the lack of time is the chief barrier to poor physician-patient communications, it logically follows that longer patient appointments are the solution. Ok, let's say that I could wave a magic wand and add 5 or even 10 more minutes to the average primary care office visit. Would more time really make a difference?Probably not.A quick examination of just some of the key drivers of physician-patient ...
Medicare doc fix questions and answers
by Vineet Arora, MDA 21% cut for Medicare physician fees is set to go into place soon. This year, fixing physician payment has been overshadowed by all the talk about health insurance reform.In fact, I remember being invited to talk about healthcare reform on a panel for medical students this past fall. As part of my remarks, I mentioned the 21% pending cut in physician payment and recall ...
The Colonoscopy Song, for colon cancer screening enthusiasts
Peter Yarrow of Peter, Paul & Mary has teamed up with CBS to deliver a serious health message to CBS viewers and audiences beyond: be screened for colon cancer.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">(via Clinical Cases)
Taxing junk food may improve your health
Originally published in MedPage Todayby Kristina Fiore, MedPage Today Staff WriterTaxing junk food may help reduce obesity and improve health, researchers have found. Patients got significantly less of their energy (calories) from soda or pizza when there was a 10% increase in the price of either (P<0.001), Penny Gordon-Larsen, PhD, of the University of North Carolina at Chapel Hill, and colleagues ...
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....
