Matt Steinglass at The Economist has interesting take on tort reform, specifically that limiting physician liability for adverse patient outcomes must come with an equable cost to doctors.In Europe, the costs accrued due to medical errors are covered by the wide-ranging social safety net; the lottery system of massive medical malmalpractice judgments is virtually absent.
It's part of the social contract: doctors accept limited salaries in exchange for limited liability; ...
Welcome readers from CNN.com!"E-patients are an essential part of the health care team, and play an increasingly influential role in the shared decision making process with their physicians."
That's what I wrote in a CNN.com column published this morning, entitled, Will the doctor answer your e-mail?However, doctors aren't given the tools or the time to properly engage empowered patients, despite ...
Several have asked me to comment on the New York Times versus Dartmouth Atlas spat.In summary, the Dartmouth Atlas comprises of studies showing variation in care for Medicare recipients. Their main, take home message is that high-spending areas of the country sometimes had poorer outcomes than lower-spending ones.Their work has been influential with the current administration, and among progressive health reformers. Last week however, the New York Times published a ...
As someone deeply immersed in pharma communications, and especially the newer realm of social networking, I’ve been closely following the ongoing process of the industry/FDA dance, trying to figure out how social media/web 2.0 approaches “fit” with pharmaceutical manufacturers and their various audiences.And I keep wondering if we’re going about the whole thing the wrong way.Think about the fine print PI (Product Information) you see in a magazine, accompanying a ...
Here are the top posts from this past month, based on the number of times they were viewed.1. How to use sex to teach CPR2. Physician assistant name change rubs doctors the wrong way3. Patient wants an apology, not money, after medical malpractice4. Causes of Beau Biden’s stroke5. Why primary care doesn’t appeal to this medical student6. A medical student chooses dermatology because ...
by Joyce FriedenWhen it comes to the healthcare reform law, no provision is more controversial than the individual mandate – the part that requires every citizen to purchase health insurance or pay a penalty.More than 20 state attorneys general are suing the federal government over the health reform law, in large part because of this provision. Several states have already passed laws declaring an individual mandate unenforceable in their state, ...
It’s hard to look at the mug-shot of the 60-year-old woman charged with tampering with forensic drug evidence (basically, stealing police-confiscated cocaine) without wondering how things got to this point. I mean, surely they weed out the felons, and the known addicts, and do a background check, and then make you pee in a cup before they even hire you for a job like this. Right?So just exactly how can ...
As a former New Yorker, the Disease Management Care Blog has always had an abiding respect for the Big Apple's taxi drivers.That increased considerably after it left its wallet in a Manhattan cab and it turned up in Virginia a year later -- in the possession of an individual allegedly involved in organized crime. This and other evidence of the cabbies' shrewd business acumen makes the DMCB wonder why Hizzoner ...
by Tim HarwoodHundreds of thousands of people each year are taking the plunge and choosing to have the life changing procedure that is laser eye surgery.It is currently the most popular elective surgery in the world and the number of people having it done is likely to increase as the procedure becomes safer and more accurate. If you yourself are considering having laser eye surgery, then you will almost ...
by Joyce FriedenPartisan wrangling aside, the Supreme Court will have to address serious constitutional questions about the healthcare reform law, and it's far from clear how the justices will decide the issues, legal scholars say.So far, 21 state attorneys general are suing to overturn the law on constitutional grounds. One of their arguments is that by forcing individuals to either buy health insurance or pay a fine, the law violates ...
The trauma for Artyom continues. After having been given up to an orphanage by his alcoholic mother who lost her parental rights, being adopted by a US family, sent back to Russia alone when his adoptive mother allegedly was unable to cope with his psychological problems, he has now become the object of a tug-of war between Russia and the US over his citizenship. His future seems to hold unimaginable ...
A video excerpt from The Vanishing Oath, a film directed by Ryan Flesher, MD.Medical malpractice is a major issue that divides doctors and lawyers -- with patients often left in the middle. I wrote last year in USA Today that reform is sorely needed, mainly to help injured patients be compensated more quickly and fairly than they currently are:
Researchers from the New England Journal of Medicine found ...
Pharmaceutical companies and their shareholders are always looking for the next "blockbuster" drug, the label given to a drug that generates more than $1 billion of revenue per year.Blockbuster drugs don't necessarily have to save many (or any) lives - slick marketing more than compensates for marginal improvements in treatment efficacy -- but they do need to target conditions that are common enough that millions of patients will buy them. ...
Obsession with medical technologies and machines characterizes American’s cultural expectations. We tend to think of our bodies as perpetual motion machines, to be preserved in perpetuity.If the face of our machines sag, we lift it up. If our pipes clog, we roto-rooter or stent them. If impurities gum up our machinery, we filter them out. If our joints give out or lock up, we replace them. If we want to ...
by John GeverA new FDA program seeks to enlist healthcare professionals in flagging improper sales tactics for prescription drugs.Although the agency calls the program "Bad Ad," its interest goes beyond broadcast and print advertisements to include misleading in-person presentations.Housed within the Division of Drug Marketing, Advertising, and Communication (DDMAC), the program is intended to increase the number of eyes and ears available to monitor pharmaceutical companies' promotional activities -- especially ...
by James Baker, MDUsing the diagnosis "bipolar disorder" for children with problems in mood has been controversial ever since a surge in its use in the mid-1990’s.A recent article in the Los Angeles Times gives the pros and cons on the use of "bipolar disorder" in children through the opinions of two psychiatrists on opposite sides of the controversy.The problem with using "bipolar" is that it requires a too-loose interpretation ...
A recent study from Health Affairs found that people are skeptical about evidence-based care.I'll admit, my first reaction was, "they needed a study for that?"Regular readers of this blog know that I think patients need to share the responsibility with doctors when it comes to embracing evidence-based medicine.According to the study,
... participants also believed that any new treatment is improved treatment. This attitude may help explain the survey finding ...
They say an ounce of prevention is worth a pound of cure, but is that still true in today’s money? Recently I had an illuminating conversation with a patient that got me thinking about how I may try to answer this question. This is the first in a short series on the price of preventive health care.Mr. GR, as I will call him, had recently turned 60 years young. Though he ...
I'm a doctor. We get all the glory. And credit. And guess what? We only deserve part of it.I started out in medicine in the mid-80's, volunteering at an ER. And the biggest shock to me was learning how much of what happens in a hospital is nurse territory. Doctors will see you anywhere from 5 to 30 minutes a day, depending on how sick you are. And the rest ...
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 50-year-old woman is evaluated for a rash on the back of her elbows and knees. A similar rash has occurred in the past, with her first episode as a young adult. She has used over-the-counter hydrocortisone cream without relief. She does not smoke or drink and is otherwise healthy.
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....
