The Justice Department decided to weigh in on the topic of clinical guidelines.As if to underscore Dr. Rich’s assertion that “guidelines are no longer guidelines," the Federal government has raised the prospect of fining your doctor and/or sending her to prison for the crime of not strictly following guidelines of care.As reported by MedPage Today:
“Federal prosecutors are looking into physicians’ prescribing practices relating to implantable ...
Boston Emergency Medical Services recently debuted an ambulance with a mini-crane and reinforced stretcher to transport patients weighing up to 850 pounds. It cost $12,000 to retrofit the ambulance.My problem is this: I think we need to do our best to provide medical care to all patients. But patients need to take some basal level of responsibility for their own health. If you’re saying that you got to ...
by Aldebra Schroll, MDThe Patient Protection and Affordable Care Act is in the process of being rolled out, however many questions remain.Will it guarantee universal coverage? Will it stand up to the many court challenges? The private insurance industry will receive an estimated 400 billion in taxpayer money to subsidize the purchase of these plans. Is this the best way to spend our money?Many of us in the health ...
Bryan Vartabedian, MD blogs at 33 Charts about the convergence of medicine and social media. A post last year gives a vision of how current social media concepts will merge with existing electronic medical record (EMR) technologies to produce a fully integrated communications system for health professionals.The picture Dr. Vartabedian paints is a dream for those of us who extensively ...
I am all for breastfeeding. Without doubt, breast milk is incredible stuff. And it's free. Who complains about free?Nevertheless, somewhere along the way, the campaign for breastfeeding has spun out of control. The topic has morphed into yet another competition in the arena of parenthood. Mothers boast about breastfeeding. Mothers compare how long they nurse. Mothers compare how much milk can be pumped in one sitting. Mothers are made ...
Below are the rates for my student health insurance coverage for the coming year.I’m newly married, so my spouse and I will be enrolling together. That means that the total cost of health insurance for our family of two will be $7,522. Even though I’ve been paying $3,000 a year for my own insurance, $7,522 inspired some sticker shock. Our care is pretty heavily “managed” in this plan, allowing only ...
Every now and then a tonsillectomy patient bleeds after arriving back on the ward after surgery. On this occasion, there was nothing remarkable in the event itself. What was remarkable was the efficiency of the response.
Although the famous clip from Jerry Maguire is about a sports agent trying to negotiate a new contract for an entitled egotistical football player, every time I see it, it reminds me of work. Put a white coat on Tom Cruise, and transplant them from a shower room to an exam room, and it becomes a pretty accurate portrait of my daily conversations with patients.In fact, when I was on ...
Over the past year I have been involved in many discussions with doctors, healthcare executives, elected officials, plaintiff and defense attorneys and others about healthcare reform. Bottom line: There is no consensus what the future holds.There is no question that reform is necessary to avoid absolutely bankrupting the country. However, the recent legislation is a work in progress, not yet an achievement. A change in congressional leadership could derail, ...
by Francine Gaillour, MDA piercing and entertaining article in Harvard Business Review online, "People Are Not Cogs," by Nilofer Merchant, author of The New How, offers keen insights worth considering by healthcare executives and physician leaders.Merchant makes some incisive points about how industry has traditionally measured productivity and hence factored in the value of the individuals on the production line:
In spite of a forest’s worth ...
I rarely get sick and have no known disease. I’m fit as a fiddle for an aging male. I jog four times a week and have strong vital signs (blood pressure is 120/70). I have no family history of heart disease.Besides complying with adult screening recommendations and vaccines, I only see a doctor when I have a persistent cold or sore throat. I fear going to a doctor because ...
by Mona Mangat, MD"We take our children to pediatricians for medical care — not moral judgment, not privacy intrusions."This quote by an NRA lobbyist troubles me. The statement reveals degradation in a sacred relationship – the physician-patient relationship.This sentiment was prompted by a Florida pediatrician that refused to continue seeing a child after the parents refused to answer whether they kept firearms in the home. Governor ...
I had an interesting exchange with one of our nurses recently about a long-term patient of ours.The e-mails went something like this:
Got a fax from —-’s insurance that his Lipitor won’t be covered anymore. They will cover simvastatin, lovastatin, and pravastatin. Let me know what you want to do. Charlie
He’s on darunavir, and all three of those statins are contraindicated because of drug-drug interactions. Rosuvastatin? Paul
Checked with them — rosuvastatin needs ...
All thoughtful physicians I know consider the historical theory and philosophy of homeopathy to be rubbish, balderdash, preposterous, BS, or, politely, NOT PLAUSIBLE; thus, not even worth testing for safety and efficacy.Then, why, when one asks Mr. Google by entering ... Homeopathy ... and clicking, does one receive 9.9 million results?And, why does the National Health Service of the U.K. continue to fund homeopathic hospitals, clinics, and treatments?And why are ...
As undergraduate premedical students, we learned about narrative medicine by chance in a New York Times article titled "Learning to Listen."After exploring the research of Dr. Rita Charon, we were both drawn to the new field and what it had to offer us as future medical professionals. The Times article explains, "Through literature, [Dr. Charon] learned how stories are built and told, and translated that ...
Though there are few subjects as immediate to my experience as that described in Gardiner Harris's article in The New York Times, "More Doctors Say No to Endless Workdays," perhaps the truest indication of my opinion on the matter may be the fact that, upon first glance at the headline, I didn't feel much need to read the rest of the article. More doctors say no to endless ...
How and when do new medical technologies become the standard of care?A recent study showed that the use of CT scans in hospital emergency departments rose sixteen percent between 1995 and 2007.
When Professional Responsibility class began, I was most excited at the idea of not having to sit through another lecture on proteins and cell transport.I was also looking forward to the class where we would be using clickers from the Library to poll audience responses during the lecture, as doing something while listening to someone talking has a much higher success rate in getting ...
Should all health care professionals have a social media presence?No, not necessarily.Did I surprise you? Here I am rattling on and on about how health care professionals should all have a blog, tweet, link up and now I’m saying not everyone needs to hop onto social media.Let me explain the apparent contradiction.If you are a solo provider and hope to stay financially solvent, you need to market online. All ...
At some point the novelty of a new baby wears off.Waking up at two in the morning loses some of its appeal. Parents often tell me that their baby does not sleep well. I tell them how they can get their child to sleep through the night in just three nights. I explain that learning to sleep is a training process, either the parents train the infant or the infant trains ...
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...
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...
William Osler famously said (among other things): “Listen to the patient. He is telling you the diagnosis.” I was doing my obstetrical...
The little boy, who looked to be about two, darted away in a fit of giggles. His young mother, who seemed thoroughly...
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...
People often ask me how I became a hospice volunteer. For the record, nobody is more surprised than I am. You know...
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...
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...
Robotics has the potential to revolutionize the delivery of healthcare. It can help extend the delivery of information, expertise and clinical care...
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....
