The approval of dabigatran (Pradaxa) has been long awaited in the cardiology community. Although just about everyone agrees that a good alternative to warfarin is highly desirable, there are many remaining questions about the drug as it prepares to enter the marketplace.Here are a few questions raised by electrophysiologist John Mandrola on his blog:
by Danielle Leach, MPA"A true friend walks in when everyone else walks out."I read that on a magnet on my friend’s refrigerator recently and the simple power of that saying brought me to tears. I have learned that lesson of true friends since my son’s diagnosis of cancer in 2007. Anyone who has faced a serious illness as a patient or a caregiver knows that you quickly learn who your ...
Adoption of electronic health records (EHR) systems remains a challenge, both for hospitals as well as for physicians in ambulatory practice. The process of adoption, implementation, and meaningful use of EHRs (let us keep in mind) is actually quite different between those two setting.Much has been written concerning EHR adoption within hospitals. Much of the experience in computerized physician order entry (CPOE) comes from hospital EHR adoption, and many of ...
As I walked into the ED for my shift, the nursing supervisor was fumbling with a syringe attempting to get medication out of a small vial.“Ummmm. Looks like you need to adjust your bifocals,” I quipped. We have a running joke about who is older and bust on each other about our ages every chance we get.When she turned around, the look she gave me signaled that it was no ...
The other day, I happened to be talking to Mark, a sales representative from one of the pharmaceutical companies. He’s the type of rep that many doctors don’t mind seeing – someone who is careful of your time, is happy to hunt down the answers to questions that come up on the medications his company makes, and brings by useful information about new drugs that seem to be practice-appropriate. He ...
The following is a brief list of some of the things I think have been useful and worth their money in my first two years of med school:1. Large, widescreen computer monitor. The volume of information required to internalize during the preclinical years of medical school can’t be compiled and organized on paper. You would end up with bookshelves filled with those gigantic 4″ binders. Therefore, almost everything happens on ...
The Institute of Medicine has been an advocate for clinical guidelines for many years.Although the value of guidelines has never really been established, both clinicians and medical malpractice attorneys often want to ascribe greater credibility to them than they deserve. The issue was raised again in the past few months and I review it briefly here.A few years ago Dr. Robert Ewart discussed the ethics of using guidelines to screen patients ...
US District Judge George Steeh of Michigan ruled last year that the constitution permits the federal government to require individuals to obtain health insurance coverage.This lawsuit was filed by a Christian legal organization called the Thomas More Law Center, as well as others. Other lawsuits are in the works in numerous other states. These suits are filed primarily by Libertarian-types who don’t want to be forced to buy health insurance ...
Every once in awhile amidst the weekly deluge of medical articles comes a show-stopper that has the potential to change the way we practice.Rarer yet is the article that not only changes how we practice, but calls into question why we do what we do.This recent article from the New England Journal of Medicine is just such an article. Before you bolt, let me simplify it for you.
You are a new parent. Your infant is gassy, fussy, spitty, and does not sleep much. In other words your infant is a normal baby. You are stressed, and like any good parent, you want to fix what "ails" your infant. As you stroll down the baby aisle at the grocery store, you see labels that tout words like gentle, comfort, and restful. Formula manufacturers are brilliant. They know their ...
A common complaint about modern medicine is the depersonalization of the patient and the loss of compassion.So let's take a look at compassion.Compassion is derived from the Latin "cum" (together with) and "patior" (suffer). From the perspective of clinicians, compassion is defined by two concurrent emotions: (1) a feeling of deep sympathy and sorrow for another who is stricken by medical misfortune accompanied by (2) a strong desire to relieve that ...
I'll be giving the keynote at the 2011 Texas Medical Association Winter Conference this Saturday, January 29th in Austin, TX.
Entitled Medicine in the Age of Social Media, I'll reflect on my social media journey through the years, and discuss how blogs, Twitter and Facebook will impact patient care and physician practice going forward.The address will be
by Rishi Manchanda, MDAs a primary care doctor for working families, I am interested in anything that can tangibly address my patients' health problems. But how do I prescribe repeal?The House effort to repeal and replace last year's health care law is not just an untested placebo with major potential side effects, like increasing the number of Americans without health coverage. For those of us on ...
Antibodies are complex proteins created by immune cells that are targeted to very specific parts of other large and complex molecules called antigens.Much smaller molecules like nicotine, called haptens, do not normally induce any significant immunologic response so researchers chemically bound several nicotine molecules to a large protein to form an adduct. This combined molecule does induce an immune response, i.e, causes immune cells to produce antibodies targeted to the ...
Did you know that one-third of the country's physicians are over the age of 65?That's right, there's a good chance that your doctor is on Medicare. That's a concern, because physicians aren't immune to the ails of aging, and are just as prone as patients to succumb to the effects of Parkinson's or various types of dementias.Not comforting if you're about to undergo an operation, for instance. And absolutely frightening when ...
This past summer I got a chance to visit Washington DC. While I was there, I saw a Norman Rockwell exhibition at the Smithsonian American Art Museum. As it turned out, the exhibition was the private collection of George Lucas and Steven Spielberg. The exhibition highlighted Rockwell’s masterful storytelling.I didn’t know much about Norman Rockwell before that day. I knew he was a famous American painter and I had seen ...
If you listen to the discussions in health care circles about social media, you get the idea that social media is complicated, time consuming and a liability nightmare.Nah.It’s not that hard and can actually be quite simple if you consider your options carefully and logically.Let’s look at a simple social media plan any health care professional can use.If you’re even considering using social media to market or connect with current ...
There has been an irresistible urge for people — doctors, public health officers, politicians, journalists, the usual pundits — to compare adherence to HIV treatment in resource-rich vs. resource-limited setting.I suspect this is because the whole issue got off to a famously bad start in 2001, when then-head of the U.S. Agency for International Development (USAID) Andrew Natsios said in an interview with the Boston Globe that Africans,
don’t know what Western time ...
Is there anything that we physicians can and should be doing to help with the huge problem of gun violence in America?We all know it is nuts to sell guns and ammo to nuts, yet as a country we do it every day.We all know that, in contrast to rifles and shotguns, the only moving targets for hand guns are people; that the Congress and president in this century legislated ...
An excerpt from White Coat, Black Hat.by Carl ElliottMany of us have a relatively simple, commonsense view of the way that drug development and marketing work.People get diseases; scientists develop drugs to treat those diseases; and marketers sell the drugs by showing that the drugs work better than their competitors. Sometimes, however, this pattern works in reverse. Drug company scientists develop a drug ...
Patient satisfaction is all the rage. Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country...
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
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....
From age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but...
Lately, I get the feeling that I’m doing something wrong. I’m supposed to form a partnership with my patients. My patients are...
There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He...
I have tried to write a letter of thanks but don't know what to say or even how to begin. I don't...
It is said that "turn around is fair play." So if providers (physicians, hospitals and other health care professionals) expect patients to...
Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure...
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
As Americans we believe we have the best healthcare system in the world. But think again, it’s really not the truth. We...
Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently,...
Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no...
We have a real paradox in American healthcare. On the one hand we have exceptionally well educated and well trained providers who...
There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers....
In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over...
We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology. We have firsthand...
Speaker after speaker at the recent Care Innovations Summit in Washington, DC concluded that increasing the quality and decreasing the per-capita cost...
Lots of pressure out there for you to be on Facebook and Twitter, right? The ultimate question, though, is how are you...
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
