August 2010

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Pharmaceutical sponsored dinners have educational value

by | in Meds | 12 responses

It is insulting to think that doctors who are ostensibly smart enough to save one's life are in fact so stupid, or merely gullible enough, to be swept away by what is in actuality only a very weak potion of sales-presentation intermixed with and embedded within generally informative and pharmaceutical-balanced subject-focused medical lectures.Such lectures occur usually at a private function room at a restaurant or, in conjunction with a served ...

Notes in the chart are helping patients less

by | in Physician | 17 responses

What is the purpose of the note in the patient chart?Depends who you’re asking.The best guidance I ever received on how to write a good note came from my residency program director, who told us that a note needn’t be encyclopedic to be excellent; in fact, he urged us to get away from the “second-year medical student” style, which typically includes absolutely everything.Instead, he urged us to write, as concisely ...

Bacterial resistance to chronic antibiotics, and why it’s a problem

by | in Conditions | 11 responses

Unlike climate change, where there’s a large contingent of denialists who spread doubt about the scientific evidence, no one denies that antibiotic resistance is a problem. There is controversy, however, on the question of just how much the widespread use of antibiotics contributes to the problem.The mechanism is not in dispute: If you expose bacteria to antibiotics, they will mutate to become resistant. But “overuse” of antibiotics is not the ...

Minimize patient waiting after a potential cancer diagnosis

by | in Conditions | 2 responses

I received a very troubling phone call from a close friend recently. He underwent a study, at the age of 40, and the physician came out of the procedure and said, "you have a large tumor, do you want me to call a surgeon for you."The purpose of this post is not to comment on the physician's behavior or delivery techniques, but to define this very precarious and anxiety producing ...

Obesity in American children and adults continues to grow

in Conditions | one response

by Emily P. WalkerThe number of obese adults in the U.S. continues to rise, despite a growing number of federal anti-obesity initiatives in the past two years, according to a new report.The seventh annual "F as in Fat" report, released Tuesday by the nonprofit Trust for America's Health and the Robert Wood Johnson Foundation, found that obesity rates continued to rise in 28 states from 2007 through 2009.Nationally, two-thirds of ...

Breathe properly at night and learn to sleep better

by | in Conditions | 6 responses

Every time you see a depiction of someone sleeping on TV or in the movies, you'll see the person sleeping on his or her back, and oftentimes, snoring.The lay public, doctors, and even alternative and complementary practitioners naturally assume that you're able to breathe properly at night. This couldn't be further from the truth.Evolutionary biologists and comparative anatomists have stated that speech and language development was ultimately detrimental to humans. ...

Physician social networks and liability risk

by | in Social media | 10 responses

I recently wrote about the hidden dangers of physician social networks, and how private posts can potentially become public at a later date.With the recent controversy surrounding former Washington Post blogger Dave Weigel and Journalist in mind, I commented that,

passionate, controversial debate is frequent on Sermo, along with discussion of patient cases. Part of what makes the site so provocative and insightful is the fact that the conversations ...

Android and iPhone pros and cons for healthcare

in Tech | 18 responses

by Jeff BrandtI wrote an article for KevinMD.com several months ago discussing the benefits of Android for the healthcare market. I also compared Android with the iPhone.   I listed the iPhone's technical shortcomings and really angered the “believers of all things Apple”.  That was not my intent.Apple's latest release of iPhone 4.0 and their new operating system (OS) 4.0 corrects many of the ...

How to say goodbye to patients

by | in Patient | 3 responses

OncRN is a wonderful blog written by an anonymous author sharing stories and insights in her line of work that many times speak to palliative themes.  S/he says it best in her blog description,

my life gets intermittantly (sic) rocked by the wonders/horrors of being an oncology nurse. i just need to talk it all through sometimes.
A recent post is about how to say good-bye to our patients, particularly ...

Unread echocardiogram fallout at Harlem Hospital Center

by | in Conditions | 3 responses

Recently, the New York Times reported that Harlem Hospital Center had finally completed its investigation into thousands of echocardiograms that after receiving an initial reading by a technician had never been read by a physician.It turns out that out of 7,000 tests that went unread, only 14 patients “might have been misdiagnosed because their tests had not been handled properly,” according to the hospital spokeswoman quoted in the story. ...

Create a family practice mystique in medical school

by | in Physician | 21 responses

For at least the last 20 years, graduates of U.S. medical schools have resisted pleas from organized and disorganized medicine to become primary care physicians (PCPs). Since there is already a severe shortage of PCPs, pundits are wondering who is going to take care of the hordes of newly insured by 2014. Many have speculated about the possible reasons for this dilemma such as the relatively paltry earning potential of ...

Was JUPITER trial data influenced by AstraZeneca to favor Crestor?

in Meds | 5 responses

by Charles BankheadReanalysis of a landmark cholesterol-lowering trial of people typically considered at low risk for heart attacks indicated that the results are flawed -- and do not support the primary-prevention benefits that made headlines, authors of the review asserted.The reanalysis of the massive JUPITER trial involving almost 18,000 people with low or normal cholesterol but elevated levels of the inflammatory biomarker C-reactive protein (CRP) -- turned up no evidence ...

Medications that increase the risk of photosensitivity

in Meds | 2 responses

by Marianna Rakovitsky, RPhOh, Summer! The weather is warm, the sun is shining and it is the time when we try to get outside as much as possible. Summer is my favorite time of the year. I love the beach, days that are filled with light and sunshine,  trips to the orchards and hanging out in the backyard. The sunshine that makes the summer such a ...

Every patient deserves a death with dignity and without pain

by | in Physician | 4 responses

Death is not the enemy. We all die.The enemies of patients and physicians are premature death, disease, disability, pain, human suffering.I believe that all people deserve a death with dignity and without pain. Palliative care is the right mode for as many as 80% of all Americans who will die of chronic progressive incurable diseases. Eighty percent of those state that they do not want to die in a hospital ...

Pay specialists less to save primary care

by | in Policy | 59 responses

Since 1997 the number of US medical students choosing to go into primary care has decreased by more than 50%.It seems that sources as diverse as the Obama Administration and the Wall Street Journal think that we should find a way to encourage medical students to choose primary care specialties in order to allow Americans to have the best and most cost effective care. This is very problematic when primary ...

The difficulty of regulating x-ray radiation in the ER

by | in Conditions | 19 responses

A recent article in the New England Journal of Medicine touched off another salvo about how non-clinicians have no problems judging the abilities of clinicians in the world of medicine.The article begins by presenting the case of a woman who awoke with facial paralysis and then went to the emergency department. On arrival, she received CT scans and MRI scans of her brain. When those were normal, she was diagnosed ...

Why health plans who rate physicians should be supported

by | in Physician | 4 responses

Some physicians and physician groups are quite upset about insurers' recent moves to offer employer customers tight, small networks of providers based on quality and cost criteria. In an effort to block these new plans, the AMA and other groups are focusing on the few problems with ratings and avoiding the larger issue - some physicians are just bad actors.What they should be doing is working closely with health plans ...

Caring for dying patients needs better physician communication

in Patient | no responses

by Michael SmithClinicians treating dying patients did well in managing pain but fell short on communicating with patients and their loved ones, researchers said.The findings, from a single-institution study, suggest that those who care for terminal patients also often failed to assess shortness of breath in a dying patient whose mechanical ventilation was withdrawn, according to Anne Walling, MD, of the University of California Los Angeles, and colleagues.But overall those ...

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