Top stories in health and medicine, September 30, 2014From MedPage Today:

  1. Data Confirm Anti-ALK Activity in Rare NSCLC. Objective responses occurred in 72% of patients with mutation-specific non-small cell lung cancer (NSCLC) treated with crizotinib (Xalkori).
  2. Case Reports: PET Imaging in Dementia. In two cases of progressing dementia, PET imaging with amyloid and tau tracers helped to clarify the diagnosis ...

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I’ve been toiling in the field of connected health for 20 years now, watching for signs of adoption that will move us into the steep part of the curve.  I have to wonder, with announcements from several huge consumer companies recently, if that time is coming. By now you’ve heard about Apple’s HealthKit announcement, which involved not only Apple, but Mayo Clinic and Epic. Samsung is not sitting still, having released increasingly ...

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When I was in high school, a national hardware retailer opened a new franchise down the street from the mom-and-pop hardware store that had served my neighborhood for many years. Since the new store had the advantage of larger volumes and lower costs, it seemed to be only a matter of time before it drove its smaller competitor out of business, the way that big bookstore chains and fast-food restaurants ...

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The outrageous $117,000 bill from an assistant surgeon Recently, I wondered why Medicare could not control its costs using the investigative power of the federal government instead of releasing physician payment data and relying on journalists to do the work. Two stories that appeared within days of each other raise a similar question about the private insurance industry's methods. An article in Modern Healthcare described the impending closure of ...

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What is going on with generic drug prices? Fran Barker called today. She was in a panic because the cost of her monthly prescription of 150 mg amitriptyline tablets had gone up to $130 from $13 the month before. Amitriptyline has been available in this country since 1961, and the 100 mg strength was on Walmart’s list of $4/month drugs the last time I looked at it a few months ...

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Joan Rivers death: What went wrong? The ear, nose and throat specialist who treated comedian Joan Rivers on August 28 has been identified as Dr. Gwen Korovin, a prominent New York physician who is known as a voice doctor to many entertainers and Broadway stars including Hugh Jackman and Julie Andrews. With a physician who is an expert in airway anatomy at her side, and all the technologic advantages ...

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Part 2 of a series (read part 1). I realized I was entering into a process the rules of which were entirely separate from normal human interaction when it hit me that news of the lawsuit was in the newspaper before anyone had had the decency to contact me. What kind of people act like that? Civilized behavior, respectfulness -- in short, all the ways in which you'd think nice ...

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Top stories in health and medicine, September 29, 2014From MedPage Today:

  1. Plans Wrestling With Narrow Networks, Accurate Doc Lists. Narrow provider lists are only one of several network adequacy issues that insurers and regulators are grappling with.
  2. Ebola: 'Magic Bullets' or Current Tools? European health authorities want to compile an overview of all the available data on experimental medications for ...

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One hundred forty-nine messages. This is what I return to on my first day back from vacation. Many of them were marked with a little red arrow, indicating a high-priority phone message. Recharging with a little time off is a darn good thing, something we all need, and something which has been shown to help all of us be better at what we do. All of us, no matter what our jobs are. ...

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The recent arrest of Minnesota Vikings star running back Adrian Peterson on child abuse charges has sparked a national conversation on the manner in which parents should discipline their children. Allegedly, Adrian Peterson injured his 4-year-old son by spanking him with a thin tree branch (“a switch”) and leaving cuts and bruises all over his body. After learning of Adrian Peterson’s indictment, Peterson’s mother, Bonita Jackson, was interviewed by the ...

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Where is compassionate end of life care for the elderly patient? When my 82-year-old uncle had a heart attack in the kitchen of his home, I was on the next plane to the East Coast. No one knew how long his brain had been deprived of oxygen before he’d been resuscitated. As I stood next to his bed in the hospital’s ICU, I feared that my uncle would not make it. I ...

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Around the country, doctors are leaving independent practice and joining large groups owned by health care systems. It’s a trend: the recruiting firm Merritt Hawkins predicts that if current growth continues, over 75% of newly hired physicians will be hospital employees within two years. There seem to be a number of reasons for this consolidation of physicians and hospitals into islands of care. One is the desire for larger groups to have ...

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American health care has become a gigantic game board with players of all sorts strategizing to win. Winning, of course, means getting more money from payers: government or private. It turns out this medical marketplace game is not all that new. It's just become wilier, as I have shared in a couple of posts over the summer. An obituary last week for Dr. Rashi Fein, an influential economist with a progressive stripe ...

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Estrogen therapy and breast cancer: The pharmacist said no It’s not often that I find myself speechless. I have heard all sorts of stories in my office -- as a sexuality counselor, I am often humbled by the trust that people place in me and how much they disclose about their private lives. But one conversation I had with a patient literally made my jaw drop. The patient is a ...

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There’s been a lot of controversy recently about workplace wellness programs: Do they save money for employers on health care costs? Can they produce measurable benefits for employee health? Do they unfairly punish people who are unable to participate? Are these programs just a ploy to shift medical costs to unhealthy employees? Recently Austin Frakt and Aaron Carroll revisited these questions in a piece for the New York Times’ Upshot column, “
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Michelle wrote in: “We trained my 3-year-old son approximately 3 months ago, and it’s been great. He’s been having virtually no accidents. The problem is that he’s terrified of making ‘dirty’ on the toilet. He does it in his pamper at night when he’s sleeping. He’s very verbal about it, and tells me that he’s scared to let the dirty come out. It’s really difficult to deal with because there ...

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I have been following the progress of bedside ultrasound (using ultrasound as a diagnostic tool during my physical exam of patients) as it gets a foothold in standard medical practice since I first started learning to do it about 3 years ago. Every so often a study comes out which warms my heart as it proves that less (radiation, expense) is more in treating patients. An article came out in the ...

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She was sick.  Not sick like a high fever, body aches and a runny nose.  Sick like she had spent the last half a decade in nursing homes as most of her internal organs failed.  There was oxygen, and dialysis, and a colostomy.  She propelled herself vigorously through the crowded halls in the custodial wing of the nursing home, her wheelchair a natural extension of her body thoroughly unhampered by ...

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If you are a physician like me who performs procedures, then rarely you will cause a medical complication. This is a reality of medical life. If perforation of the colon with colonoscopy occurs at a rate of 1 in 1,500, and you do 3,000 colonoscopies each year, then you can do the math. Remember that a complication is a blameless event, in contrast to a negligent act when the physician is ...

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“Mr. Jones’ chest x-ray looks normal,” the intern said to me on morning rounds. Mr. Jones just had a transhiatal esophagectomy (THE).  The esophagus is the muscular tube that connects the back of one’s throat to their stomach.  It can develop cancer or become completely dysfunctional because of benign processes, and therefore need to be removed. A THE involves cutting out the patient’s esophagus, in Mr. Jones’ case for cancer, bringing the stomach up ...

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