March 2010

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Health care reform needs to pass now, and here’s why

by | in Policy | 40 responses

There are certain actions we take even though we know that ultimately we will not be successful. Sometimes we do this out of hope for a better tomorrow (like playing the lottery) or because we are taking a moral stand (like supporting a candidate that has no chance of winning).Supporting health care reform is probably a little of both.Even if any of the currently proposed health care reform plans pass, ...

Autism in children can be missed early in life

in Conditions | one response

Originally published in MedPage Todayby Chris Emery, MedPage Today Contributing WriterThe symptoms of autism tend to emerge in children after six months of age, with a loss of social and communications skills that is more common and more subtle than previously thought, according to a new study that questions previous assumptions about the progression of the condition.Autism in children can be missed early in life At six months, ...

Nurse practitioners will not solve the primary care shortage

in Physician | 65 responses

With health reform possibly passing within the next few months, attention now turns to the primary care doctor shortage.Regular readers of this blog know that there are not enough primary care doctors currently; it's frightening to think what would happen if an additional 40+ million newly insured patients start looking for care.A recent piece from Newsweek nicely encapsulates the problem. It's a good piece, elucidating the myriad of ...

Patient handoffs limit residents work hour cap gains

in Education | 9 responses

by Vineet Arora, MDAnyone affiliated with a teaching hospital knows that the controversy regarding resident work hours is heating up again. It's been over 5 years since the ACGME limited resident hours to 80 hours per week with a maximum of 30 consecutive hours. While this may not sound like 'reform', as someone who trained prior to these rules, it is definitely a change.More recently, the Institute of ...

Help doctors to best care for their patients

by | in Patient | 4 responses

Part four of a series. See also parts one, two, and three.When dealing with your doctor's biases, you have on your side a fact I firmly believe to be true: most doctors want to do a good job and help their patients as best they can. So what exactly can you do to maximize your doctor's ability to help you?1. Position your symptoms and requests carefully. Don't demand medications ...

DVDs don’t help infants learn language

in Social media | no responses

Originally published in MedPage Todayby Kristina Fiore, MedPage Today Staff WriterInfants don't learn a great deal from language-acquisition DVDs, and may in fact be hindered from learning vocabulary, researchers have found.DVDs dont help infants learn language Tots who watched such DVDs over a six-week period didn't have better language knowledge scores than youngsters who didn't watch, and those who first tuned in at a younger ...

Robotic surgery is driven by patient demand

in Conditions | 3 responses

Robotic surgery, which mostly used for prostate surgery, is one of the newer trends that hospitals are embracing.But are the costs, which can reach into the millions of dollars, worth the expense?That's a question discussed in a recent New York Times piece. There's no question that robotic surgery costs more -- almost $2,000 more per patient. And indeed, some patients are more comfortable post-op. But there ...

Primary care needs to be valued first before it can be saved

by | in Physician | 20 responses

I went to my physical therapist yesterday for knee treatment and we talked about the fact that Blue Cross is cutting their reimbursement to the point that the cost of providing care will not even be covered. All I could do was lament with him and listen.One insurer even told him (the owner of the business) to just "make the sessions shorter and don't give as much care."Clearly the insurance ...

Aggressive behavior in children and the family dynamic

by | in Patient | 5 responses

In the Tony award winning play God of Carnage two couples meet in an elegant living room for an ostensibly civilized conversation about the aggressive act of one couple’s child against the other’s. The meeting soon degenerates to reveal the underbelly of conflict in the two marriages. Husband and wife hurl insults, precious items and even themselves with escalating rage. We see, as they attempt in vain to focus on ...

Vaccine safety still concerns parents

in Meds | 4 responses

Originally published in MedPage Todayby Kristina Fiore, MedPage Today Staff WriterVaccine safety still concerns parents Even though 90% of parents believe vaccines protect their children against disease, many are also concerned about potential adverse effects, a new survey found.More than half of survey respondents said they were concerned about vaccine safety profiles, particularly for newer immunizations, Gary L. Freed, MD, MPH, of the University ...

Electronic medical records need to better focus on patients

in Tech | 7 responses

The biggest problem with today's push for electronic medical records is an archaic user interface.Physician Alexander Friedman, writing a scathing essay in The Wall Street Journal, agrees.Today's electronic medical records are written for the benefit of insurance companies, which scrutinize each doctor's note carefully for billing purposes. But, as Dr. Friedman astutely points out, "thorough, efficient billing doesn't translate to better care."It's gotten to a point where some ...

Helping organ donation with donor advocate teams

by | in Physician | 5 responses

One of the joys of practicing at an academic center is that I get to do many different things in my job.The foundation of my work is seeing my own patients in a large group (more than thirty doctors!) primary care practice.Two months a year, I take my turn rotating on the hospital inpatient services, supervising teams of residents and students who are the primary caregivers for patients with illnesses ...

Why physicians are working fewer hours

in Physician | 9 responses

Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentWhy physicians are working fewer hours Physicians are working fewer hours than they once did, the result of a decade-long decline that coincided with lower fees for their services, a study showed.After two decades of stable hours, a steady decrease began in 1997, according to Douglas Staiger, PhD, of Dartmouth College, and colleagues.The decline coincided ...

A hospital benefits when joining a large medical center

in Physician | 3 responses

What if your local hospital went national?In a growing trend, big name institutions are partnering with smaller hospitals nationwide, looking to leverage their reputation.Drew Weilage, blogging at at our own system, highlights a local hospital in Ft. Lauderdale, Florida which signed a partnership agreement with Boston's Massachusetts General Hospital.Indeed, he asks, "Who wouldn’t choose, if they could, the Mayo Clinic for neurosurgery? Or the Cleveland Clinic for heart treatment? Or ...

Evidence and the Eastern paradigm of medical treatment

by | in Conditions | 5 responses

Remember the trial a couple of years ago that showed that group support participation was associated with prolonged survival among women with metastatic breast cancer?I've thought a lot about that over the years. Isn't it interesting that something as simple as a supportive environment can make a difference in what researchers consider to be the hardest endpoint there is: survival? In our dualistic view of the human organism, we think ...

Why rosiglitazone would not have been approved today

by | in Meds | one response

Avandia continues to dominate cardiovascular-related news this week. Recently, the AHA and the ACC issued a highly detailed, thoughtful, though perhaps slightly over-diplomatic science advisory on TZDs and CV risk. Taking a completely opposite tack, GSK, in no mood to take prisoners, and apparently about to nominate itself for a Nobel Prize, issued a 30 page White Paper in response to the Senate report published on Saturday.At the core ...

Using CT scans to diagnose chest pain in the ER

by | in Physician | one response

During residency, there was always a case of misdiagnosed chest pain to discuss in conference.  Incorrectly sending a patient home and missing the diagnosis of cardiac chest pain was an infrequent, but repetitively observed, phenomenon.So as to tread carefully with words, it is sufficient to say that even now, chest pain triage remains a vexing problem.Chest pain diagnosis is like appendicitis; there are always small numbers of unusual cases in ...

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