“Dr. Vashist, I’m sorry to bother but you really need to look at this medication being taken by our patient.” My hospital pharmacist gently prodded me as he handed over the patient’s medication list along with cost information and side-effects of the offending medication. The issue with the list was a subcutaneous injectable form of calcitonin, Miacalcin, costing approximately $11,300 per day of treatment. The patient had been admitted about 11 days back ...

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My oldest son is almost a second grader. He attends a public elementary school in town, and very soon, he will start preparing for an exam known as the STAAR test. The STAAR test is an “assessment of academic readiness.” In my state, it gets administered to publicly-funded school children. Students must pass the exam to continue progressing in school, and ultimately, students must master the exit level test to graduate high school. There’s good ...

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I was incredibly impressed by the announcement that three top U.S. health systems -- Dartmouth-Hitchcock Medical Center, Johns Hopkins Medicine, and the University of Michigan Health System -- will be enforcing standards that prevent low-volume hospitals from performing certain surgeries. This comes on the heels of a major US News story which showed that patients who had surgeries at low-volume hospitals faced significantly higher risks of complications ...

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Dr. Atul Gawande is an American surgeon and public health extraordinaire. He is one of the most successful physician authors of this century, and he writes routinely for the New Yorker. His most recent article discussing unnecessary health care is, as expected, a good read. I applaud Dr. Gawande’s passion towards advancing medicine. And, yes, there is universal agreement that we need to be better in America at providing high-quality low-cost health care. ...

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american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Earlier this year, I spoke to an audience of physician anesthesiologists about setting up a basic quality assurance (QA) program within their departments. At the end of the presentation, one physician anesthesiologist stated that his group “will not let anyone out of the operating room ...

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shutterstock_116371780 The war on medical error was officially launched in 1999, when the Institute of Medicine (IOM) published its landmark report To Err is Human, alleging that up to 98,000 yearly deaths in US hospitals were due to human missteps. Despite significant ambiguities in the definition of a medical error, numerous militias known as patient safety organizations ...

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shutterstock_139099055 I'm usually a huge fan of Dr. Ezekiel J. Emanuel's writing -- whether it's his controversial piece on health care resources at the end of life or his book describing the tumultuous health care policy that led up to the Affordable Care Act, I generally enjoy reading his editorials and vehemently agree with many of his opinions. This being said, when I saw that ...

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shutterstock_134719667 Some months back I read an interesting interview with Jonathan Skinner, a researcher who works with the group at the renowned Dartmouth Atlas of Health Care. More than anyone else I can think of, the people at the Dartmouth Atlas have studied and tried both to understand and to explain the amazing variations we see in how ...

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big-fish Health care consolidation affects every area of health care.   What does this radiologist-illustrator think about it? I think it speaks for itself. James Chang is a radiologist and author of Oh Doctor, The Places You Will Go… He blogs at Poor MD and can be reached on Facebook.

shutterstock_246706588 Imagine a surgeon removing a gallbladder miles away from where he or she actually is. Imagine when you are ill, a physician has the ability to diagnose you from your living room. Telemedicine. Telemedicine itself is not a concept that is all that new. In the 1930’s, Italy used telemedicine to communicate with ships at sea, while in the United States, NASA ...

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