Remember when I wrote, way back when, that expanding health coverage without a concurrent increase in primary care access will only worsen emergency room waits?For instance, consider this, from CNN.com:
What good is having health insurance if you can’t find a doctor to see you? ...... The Massachusetts Medical Society reported that the average wait time for a new patient looking for a primary care doctor ranged from 36 to ...
Many prescription medicines are actually two or more medicines combined into one pill or package. True, this packaging is convenient-- but you can often save money by buying your medicine as its separate components. Let's look at some examples:Lotrel blood pressure pills. This is actually a combination of two blood pressure medicines: amlodipine and benazapril. Lotrel, the combo pill, is available in a generic form, as are it's two individual ...
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 68-year-old woman is evaluated in the emergency department for difficulty seeing out of her left eye.
The symptoms were first present upon awakening 45 minutes earlier. She describes her vision as “looking through a dark veil.” Her right eye is unaffected. There ...
by Diana E. LeeAt an appointment with my local neurologist I showed up feeling bone tired and mentally drained.Next thing I knew I was going back on a medication I had deliberately chosen to stop taking just because a doctor told me I should be taking something.When the doctor finally came into my exam room he looked over the list of medications I was taking and declared that Lyrica alone ...
by Brett Einerson and Iltifat HusainHealth care professionals and students using Android are probably wondering what free Android apps may be helpful in the health care setting.Android developers continue to add more apps to the Market that relate to health and medical practice. While the field of apps relevant to health care professionals on Android lags far behind the iPhone OS platform, there are several apps worth noting.Here, we ...
As a young medical student I remember the arrival of the first video arcade games very clearly: Asteroids, Space Invaders and Pacman.I spent whatever spare cash I had on them, never playing long enough to be any good, or rich enough to get any better. When I bought my first computer in my late-twenties, I relived my excitement with the newest computer games, spending a disproportionate amount of time long ...
Selecting an EHR is not just about the demo. But those EHR vendors sure do put a lot of focus on that demo! You need to get beyond the smoke and mirrors and consider how to use that focus to evaluate the solution as it meets your needs and requirements.Before you even schedule any vendor demonstrations, write down your "must haves." Can you identify your top 10 requirements?For example, in ...
In May, I spoke at the Chronic Care and Prevention Congress about my most recent report, “Chronic Disease and the Internet.”I talked about the social life of health information and the internet’s power to connect people with information and with each other. Living with chronic disease is associated with being offline – no surprise. What’s amazing and new is our finding that if someone can get access to the ...
Should doctors face consequences if they run late?From the New York Times' health blog, Well, comes a story where a medical group promises, “same-day appointments and longer, more personalized visits that start on time.”Sounds good, right?But it comes with a caveat, namely, a $199 annual membership fee. A tremendous amount of primary care can be bought with that amount of money, and if patients were willing to pay that, ...
The following op-ed was published on June 7th, 2010 in CNN.com."I read all about my condition on the Internet," a recent patient proudly told me. Like other doctors, I'm seeing more patients research their symptoms thoroughly before setting foot in the exam room.Patients are using the Web in unprecedented ways for their own health empowerment. According to the Pew Internet & American Life Project, 61 percent of American adults ...
Social and language issues dominate most of the discussion about the features of autism spectrum disorder (ASD).A neglected area of study are the physical feature characteristics that have been known to be associated with ASD. Unlike some of the diagnostic physical changes in disorders such as Down Syndrome, physical features found in ASD are often subtle and missed by most clinicians.Ozgen and colleagues from the Netherlands, UCLA and the UK ...
by Cole PetrochkoLast week, I was sick, the kind of sick where you're not well enough to leave the house and be productive, but not sick enough to successfully sniffle in bed and subsist entirely on chicken soup and the wishes of family. My existence during that time could have been summarized as, "Periodic bouts of achy consciousness followed by extended fever dreams about King of the Hill characters."Most of ...
As I've watched all of the media reports and videos of the oil uncontrollably gushing into the sea, the decaying marshlands, and the suffering or dead wildlife, the profound sense of sadness, anger, helplessness, and disappointment that I felt after 9/11 returned.I don't feel it all the time—it's not clinical depression. It's just strong negative emotion associated with the fact that both 9/11 and the oil spill were man-made disasters ...
Should drug and device makers fund continuing medical education courses?That's a question medical schools and academic medical centers have recently been grappling over.Now, the University of Michigan has taken the controversial step to completely divorce the industry from physician education.According to the New York Times,
the University of Michigan Medical School has become the first to decide that it will no longer take any money from drug and device makers ...
by Joseph W. Stubbs, MD, FACPThe eighth paragraph of the modern Hippocratic Oath reads: “I will prevent disease whenever I can, for prevention is preferable to cure.”Support and encouragement of prevention are deeply rooted among physicians. Intuitively, to prevent a deadly or disabling disease from occurring or stop it at an early stage seems like a bread-and-butter concept with obvious health benefits.But it should also accrue cost savings by avoiding ...
Here are the top posts from this past month, based on the number of times they were viewed.1. Why patients don’t value primary care doctors2. Vitamin D myths and advice for patients3. Obese patients present challenges in the ICU4. Why Obamacare scares this cardiologist5. How EMR and EHR systems can kill patients
by Kristina FioreAfter combat duty in Iraq, members of the National Guard appear to have higher rates of mental health problems than soldiers in the Active Component, researchers have found.Rates of post-traumatic stress disorder (PTSD) with serious functional impairment increased from about 7% to more than 12% over a nine-month period, compared with only about a 1% increase among those in the Active Component, according to Jeffrey L. Thomas, PhD, ...
As a typical guy, there are several painful illnesses that can hit our brotherhood in an instant. No warning given. No "Get out of jail free" pass, either. Just cruising along, having another fine, healthy day and baam!--suddenly you are lying on the floor in severe distress.The most feared? A testicular torsion. It can happen spontaneously. It can happen suddenly. And if you are the owner of a testicle or ...
In Journal Watch AIDS Clinical Care, we published a simple case: Clinically stable HIV+ gay man, on HIV treatment; anal pap comes back with “atypical squamous cells of undetermined significance” (ASCUS).What to do with this result? Two experts weighed in, Howard Libman and Joel Gallant. In Howard’s thoughtful response, he acknowledges the limitations of the data thus far, but said he would refer the patient for high-resolution anoscopy (HRA) and ...
by Todd NealeChildren whose mothers reported chronic abuse at the hands of an intimate partner were more likely to be obese at age 5 than those from violence-free families, researchers found.After controlling for several potential confounders, including maternal obesity and depression, children whose mothers reported chronic violence had 1.8 times the odds of being obese, according to Renée Boynton-Jarrett, MD, ScD, of Boston University, and colleagues.The association appeared to be ...
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....
