Thanks to the popularity of medical television shows, most people have witnessed hundreds of fictional cardiac arrests in their lifetime. In most of these scenes, the patient loses consciousness, and the medical team rushes to the bedside: “He’s in v-fib.” “Get me the paddles.” The team performs urgent chest compressions for a few seconds.  Then they place the metal paddles on the victim’s chest: “Clear!”  Kathump. The patient’s heart is back to normal again, tragedy ...

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Wendy Davis, gubernatorial candidate for Texas, has a new memoir Forgetting to Be Afraid. In it she describes terminating two pregnancies. One termination appears to have been in the second trimester for fetal indications and the other she describes as an ectopic pregnancy. She writes, “The only medical option was to have surgery to terminate the pregnancy and remove the affected fallopian tube -- which in Texas is technically ...

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August 17, 2010. Maris is a 57-year-old woman in excellent health.  She has not seen a doctor in years. Divorced, she lives by herself, but spends occasional evenings with her daughter and son-in-law.  A successful businesswoman, Maris gardens, serves on the board of a community theater and plays a mean game of bridge. It is 10:11 a.m. when Maris presents to the emergency room. Three hours earlier, her legs became wobbly while ...

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The new VA secretary, Robert A. McDonald, speaking to a room-full of reporters, acknowledged for the first time that the department needed to hire "tens of thousands of new doctors, new nurses, new clinicians." It is now accepted that a shortage of employees directly involved in treating patients was a main driver in the waiting-list scandal that rocked the agency this year. The second, and equally important driver, was the artificially created benchmarks, that ...

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Just a few years ago it seemed that advocates for health care transparency had scored a big victory. The Centers for Medicare & Medicaid Services (CMS) announced that they would rate nursing homes by awarding five stars to the best and fewer stars to lower-quality facilities. Families searching for care for loved ones would have access to a familiar rating system to help them make choices. After all, star ratings for ...

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If you’re a 3rd- or 4th-year resident, chances are you’re no stranger to unsolicited job offers showing up in your email inbox. Maybe it’s a few a week, or maybe it’s a few a day, but they are always there. The emails find you. I’ve been out of residency for years and I’m still getting them. The macro reason for this flood of unsolicited job offers is obvious: You’re in high ...

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Top stories in health and medicine, September 17, 2014From MedPage Today:

  1. Exercise Keeps BP Steady Despite Age. A progressively rising blood pressure trajectory is not an inevitable part of aging in men who remain active and maintain high levels of cardiorespiratory fitness.
  2. AAFP Wants GME $$ Decoupled From Hospitals. Graduate medical education (GME) should mostly take place in the community ...

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Widespread news coverage has heightened concerns by many parents about a severe-symptom viral infection causing respiratory illness in children, predominately in the Midwest. Over the last month there has been a dramatic up-spike in children hospitalized with severe cold symptoms and wheezing. The virus isn’t new, but its effect on children seems to be. The Centers for Disease Control (CDC) has confirmed tests on children both in Kansas City and ...

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“Am I a hypochondriac?” It’s a question I hear with quite some regularity, almost never from people who suffer from bona fide anxiety disorders related to their health. No, the fact that all you have is a simple upper respiratory infection -- the common cold -- instead of a potentially lethal strain of H1N1 avian flu does not qualify. Not when your response to my reassurance is relief. That’s completely appropriate, and ...

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Back-to-school shopping, new sneakers and first-day outfits, sharpened pencils and fresh notebooks in oversized backpacks by the door: As a parent, these are the images I’ve come to associate with the start of every school year. But with my 20-plus-year history as a developmental pediatrician specializing in autism at Albert Einstein’s Children’s Evaluation and Rehabilitation Center, I have an added association with the start of the school year: a particular type of ...

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The joys of September! Parents gleefully shove their reluctant children onto school buses, the palm trees in Los Angeles don’t change color, and everyone realizes that they gained 20 pounds during their summer vacation. It’s time to get serious again about losing weight. But how should you eat to best help you shed the extra pounds? Many people are passionate about their favorite diet, but there is very little data comparing ...

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As a physician who openly despises many aspects of current EMRs (see “How An EMR Gave My Patient Syphilis” or “The Medical Chart: Ground Zero For The Deterioration Of Patient Care” ) I recognize that they are here to stay. And so, since we’re all stuck with these digital middlemen, I have some suggestions (based on popular social media platform functionality) for making them better. 1. Likes. Health care ...

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“Doctor, what do you think of alternative medicine?” a patient with chronic fatigue syndrome asked me the other day. She was interested in doing something more for her severe fatigue. “Would acupuncture help me?” I paused and, as I have done many times before, answered that my training and most of my clinical experience has been in Western, allopathic medicine. (Ironically, the word “allopathic” was first used as a derogatory term ...

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Top stories in health and medicine, September 16, 2014From MedPage Today:

  1. GLP-1 Plus Insulin Betters Glycemic Control. The combination of GLP-1 agonists and basal insulin beat other type 2 diabetes treatments at lowering HbA1c and improving glycemic control.
  2. Obamacare Does Little to Cut Kids' Uninsured Rate. The uninsured rate for kids under age 18 hasn't budged under the health law, ...

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Risk-adjusted 30- to 90-day outcome data for selected types of operations done by specific surgeons and hospitals are now being publicly posted online by England's National Health Service. According to the site, "Any hospital or consultant [attending surgeon in the UK] identified as an outlier will be investigated and action taken to improve data quality and/or patient care." After cardiac surgery outcomes data were made public in New York, some interesting unexpected ...

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On the face of it, the phone call was relatively innocent.  A family member was confused about the test I scheduled.  Apparently the lab refused to draw the blood.  When I inquired why, I was informed that the patient hadn't been fasting.  I calmly explained to the daughter that fasting was not necessary.  Recent studies had shown little effect on lipid panel results and I was using the glycosylated hemoglobin ...

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I don’t remember how many patients I saw at the health fair before George came to me; none of them were as memorable. George was a tall, stooped man with a serious expression. His skin was weathered but he couldn’t be called elderly by any means. I guessed that his age hovered somewhere around forty. He looked serious and spoke quietly. He had no interest in being rude, but no ...

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Everyone involved in health care, and particularly hospital care, has witnessed a sea change over the last decade. Things that were never even thought about, let alone formally taught to frontline doctors and nurses, have now come to the forefront. Chief among these is the drive towards improving patient satisfaction and delivering a more optimal hospital experience. True, a large part of this is due to federal incentives and tying reimbursements ...

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Recently, the Los Angeles Times reported on California pediatrician Dr. Bob Sears’ role as a favorite among vaccine-fearing parents. What he tells them is absolute nonsense that he has freely admitted he made up in a Reddit interview. Now he’s let a little more honesty shine through. He told the reporter: “I do think the disease danger is low enough where I think you can safely raise an unvaccinated child in today’s society,” ...

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Joan Rivers: Pushing the limits of outpatient care There are minor operations and procedures, but there are no minor anesthetics.  This could turn out to be the one lesson learned from the ongoing investigation into the death of comedian Joan Rivers. Ms. Rivers’ funeral was held on September 7.  Like so many of her fans, I appreciated her quick wit as she entertained us for decades, poking fun at herself and ...

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