shutterstock_180109973 There has been concern for several years about commonly prescribed antacid drugs called proton pump inhibitors (PPIs) and the heart.  PPIs are used to treat gastroesophageal reflux disease (GERD), peptic ulcer disease, and other acid-related diseases.  Common drugs in the PPI class are omeprazole (Prilosec), esomeprazole (Nexium), pantoprazole (Protonix), lansoprazole (Prevacid), and dexlansoprazole (Dexilant), among others. Specifically, there is a potential interaction ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old asymptomatic man is evaluated during a routine examination. He has a long history of heart murmur. With normal daily activities, he has not experienced shortness of breath, chest discomfort, or palpitations. Blood pressure is 138/78 mm Hg, pulse rate is 82/min and regular, and respiration rate is 16/min. BMI is 27. ...

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Congress is infected with the budget-cutting bug, and building an effective immune system requires political savvy. Sometimes, it’s simple (“We bomb terrorists” or “We process Social Security checks”), but sometimes an agency struggles. Case in point: AHRQ. A House subcommittee recently voted to eliminate the Agency for Healthcare Research and Quality (AHRQ) as of Oct. 1, 2015, the start of fiscal 2016. If you hadn’t heard the news or aren’t ...

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shutterstock_119953213 Recently I  read an article in the New York Times by Elisabeth Rosenthal. She’s the same author of the enlightening article, “My doctor charged me $117,000 and all I got was this lousy hospital gown.” That may not have been the exact title of the article. Following that article she wrote a follow-up about the long and difficult ordeal it ...

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shutterstock_126678482 Natalie Fuelner created a well-written article in the Bangor Daily News describing some of the tribulations many new parents go through with young children. One weekend, her toddler fell face first onto a metal patio table. Immediately, the toddler’s face is full of blood. The dad panicked. Natalie was a “trembling mess” on the inside. Their physician neighbor wasn’t available to look at the child. ...

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shutterstock_65521543 The latest salvo in the interoperability and information-blocking debate comes from two academic experts in the field of informatics, and was recently published in JAMIA. In the brief article, Sittig and Wright are endeavoring to describe the prerequisites for classifying an EHR as “open” or interoperable. I believe the term “open” is a much better fit here, and if ...

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pnhp-long-setweisbartversion-52-638 In contrast to the expected shortage of tens of thousands of physicians, there appears to be an abundance of health care administrators, at least judging by graph above. The originators of the graph -- economists and physician-activists at Physicians for a National Health Program (PNHP) -- invoke the administrative bloat as reason to promote a single payer system.  With a single ...

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shutterstock_286268375 Flying on a return trip from Chicago to San Francisco, I can’t help but feel a little on edge. It’s not the fear of flying that is leaving me a little less relaxed than the pleasant, middle-aged woman peacefully slumbering in the seat next to me. It’s the possibility of hearing the announcement few doctors are comfortable hearing during travel: “Is ...

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shutterstock_256008637 I had spent medical school and the better part of my adult life in another state by the time I matched into a medical internship back home. Such an opportunity allowed me the opportunity to enjoy a more familiar setting complete with the more bucolic and relaxing lifestyle I had missed for so long. Though not quite in my rural hometown, ...

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How does heartburn turn into a multi-thousand dollar workup?  The simple answer: defensive medicine.  See how this scenario plays out daily in this latest episode from Healthcare Not Fair.

IMG_0785 Sitting in a rickety jeep rumbling through treacherous mountainous terrain, on winding unpaved roads full of blind curves and teetering on the edge of cliffs recently ravaged by an earthquake, I began to question my decision to go along on this trip.  We were about 3 hours outside Kathmandu, Nepal heading to a small village along the banks of the Melamchi ...

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shutterstock_255233311 As a multi-racial and ethnically ambiguous American, 90 percent of the time I walk into a patient's room or show up to help run a clinic I'm asked if I'm a nurse or a translator. Most of my patients simply do not perceive someone who looks like me to be a doctor. This may be because the majority of doctors at ...

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shutterstock_277040312 american society of anesthesiologists A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Summer is immortalized in popular culture for good reasons -- no other season can match it for the variety of fun and exciting activities it brings. Unfortunately, that variety of activities and the large volume of ...

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shutterstock_210047401 In 1735, Benjamin Franklin wrote, “An ounce of prevention is worth a pound of cure.” Now 280 years later, this basic concept of human health has been refined and applied throughout medicine. Recently, the emphasis on prevention has been amplified by the passage of the Affordable Care Act that prioritizes such services. Radiology remains uniquely poised for this change with its ...

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shutterstock_166402376 We are data druggies. We spend our days like desperate junkies crawling the carpet, sifting through the shaggy strands of patient histories with shaky fingers in search of facts. Every word our patients utter we feed to the never-ending demands of the electronic chart. We find a fact and we enter it. The database grows. Someone somewhere adds another question we are supposed to ...

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shutterstock_277885379 Doctors and nurses said patients and their families created the largest obstacles to end-of-life decision making in the ICU, in a large survey published in JAMA Internal Medicine. About 1,300 staff at 13 academic hospitals in Canada rated barriers to end-of-life goals of care on a 1 to 7 scale. Doctors and nurses considered the largest barriers to end-of-life decision ...

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shutterstock_125105294 The feminization of health care is fundamentally changing care delivery in the United States and it is doing so in ways that will accelerate the pursuit of improved quality and affordability. Historically, health care providers and health care leaders have been selected for and nurtured traits that are traditionally seen as “masculine” -- traits such as heroism, independence, and competition. Yet it ...

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shutterstock_139593809 At 3 a.m. last Saturday, I was feverishly devouring medical journal articles on subarachnoid hemorrhages (which I now know are a type of stroke caused by bleeding into the space surrounding the brain), trying to determine just how much I needed to be panicking about the health of a loved one. With every text message update from the rural hospital he ...

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shutterstock_144659519 “Your wife has gestational diabetes.” My heart stopped when my wife’s physician called to tell me this. “I want you to tell her because it’ll be easier to give it some time and let it sink in. Tell her to call me if she has any questions.” But I had questions -- about a million. Let me give some background information. I’m ...

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shutterstock_114519565 How is it that, in this day and age, a talented teenager treated for lymphoma emerges cured but with a life-threatening eating disorder? How is it that, in our nation’s capital, a boy dying at home from neuroblastoma experiences excruciating pain in his final moments? How is that, when we develop new drugs to treat children with cancer, we do not, at ...

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