Curb prescription drug abuse by following Mayor Bloomberg A version of this column was published in USA Today on April 1, 2013. Prescription drug abuse is a growing national tragedy. One of the biggest culprits is opioid painkillers, such as Oxycontin and Percocet. Shockingly, more than 200 million of these types of drugs are prescribed annually, and they account for more than 16,000 deaths a year.  And for every death, significantly ...

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Health reformers should learn from doctor owned hospitals As part of the health reform movement, hospitals that meet various quality measures, like reduced readmission rates or improved patient satisfaction measures, get financially rewarded.  Those that don’t will be penalized. How’s it going so far? Well, it appears that safety net hospitals that can least afford a financial hit are getting dinged, while doctor-owned hospitals are getting rewarded. Oops. According to Kaiser Health ...

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Boston rises in the wake of tragedy “Daddy, a bomb blew up in Boston!” That was how my 4-year old greeted me when I came home this evening. Of course, I already knew about the horrific attacks during the Boston Marathon, first on Twitter, then realizing the gravity of the event as mainstream media caught up. I practice in Nashua, NH, which is about 45 minutes north of Boston.  But ...

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Health reform faces tension with integrated health systems The following column was published on March 26th, 2013 in the New York Times’ Room for Debate blog. In the coming years, health care reform will drive consolidation in the industry. Reformers, including the president himself, point to integrated health systems like Kaiser Permanente as the future of health care delivery. While this movement may improve patient care, whether it will shield ...

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Walgreens moves into primary care, and its our own damn fault Will your next primary care appointment be at a drugstore? Yes, if Walgreens can help it. It was recently announced that the drug chain will have its nurse practitioners and physician assistants begin to diagnose and manage chronic conditions, such as hypertension and diabetes. "We're not trying to take over primary care, but we think we can help support physicians and transform the ...

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The KevinMD toolkit: Speaking Part of the KevinMD toolkit series. A lot of people ask me, “What tools do you use for blogging, speaking, when you’re on the road, seeing patients etc. ...” So I decided to start a series that describe what tools I use, and why. First in this series are tools I use for my social media keynote presentations. ...

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The Boston Globe recently had a front page story on how a neurosurgeon sued a patient’s husband for a blog critical of the physician. According to the story, the patient underwent a complicated back operation as a result of her bone cancer. She tragically had a stroke post-operatively, and that’s where the situation between the family and doctor deteriorated. On the advice of his psychiatrist, the patient’s husband wrote a ...

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Solving the issue of tired doctors: My radical idea The problem of medical resident work-hours has vexed medical educators for decades.  The traditional model of sleep-deprived residents led to highly publicized medical mistakes, most famously the Libby Zion case in 1984. Nobody wants tired doctors caring for them. In response, various restrictions have been placed on how many hours medical residents are allowed to work.  Since 2011, for instance, medical residents were ...

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Doctor ratings need to be physician driven In the new book, Establishing, Managing, and Protecting Your Online Reputation, physician ratings are highlighted.  This is a topic that gives many physicians some pause, and for some, causes tremendous anxiety. Whether doctors know it or not, they already have online profiles. Third-party rating sites, like Vitals or Healthgrades, already have web pages of most physicians, and they ...

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Health reformers fail to hold patients accountable for health costs To cut costs in our health system, reformers target the massive of waste.  One way to reduce waste is to change the way doctors are paid.  The fee for service payment system, they say,  encourages doctors to prescribe more expensive care, which lines their pockets and drive up the cost of care. To combat this trend, reformers often have providers in their crosshairs, ...

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