Why does treating heart attacks cost so much money? An article from the JAMA has been gnawing at my consciousness for the last couple of weeks. Dr. Prashant Kaul and colleagues out of the University of North Carolina reviewed records from hospitals in the state of California from 2008 through 2011, looking for patients who had been hospitalized with heart attacks. Specifically, they were looking for patients with ST elevation ...

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Social media and the Internet have often been compared to the Wild West at times when it comes to the posting of ideas, opinions and beliefs.  There has been very little regulation of what is posted and how it is utilized -- which may actually be a good thing. However, many of us have learned (often the hard way) that posts on Facebook, Twitter or other social media sites can be ...

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The cherry trees are still there, blossoming every spring, on a patch of land near Stanley Park in Vancouver. They were planted in 1985 by a group of volunteers from AIDS Vancouver, to honor the memory of three Canadian sons who were among the early victims of AIDS. One of these men was Gaetan Dugas, who died in 1984. During this same period in San Francisco, Randy Shilts, a reporter ...

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80 percent of prescriptions in the U.S. are for generic medications. Generics are supposed to be less expensive alternatives to brand name drugs. However, prices for certain generics are rapidly increasing. 50 percent of generic medications increased in price in the last year and 10 percent more than doubled in cost during the same time period. Among them are thyroid replacement hormone, doxycycline, digoxin and other heart medications, tetracycline, albuterol ...

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As the PBS Newshour recently reported, Westminster, Massachusetts could be the first town in the United States to ban the sale of tobacco. As I watched the debate unfold among neighbors, I was shocked at the level of intensity with which citizens stepped up to defend the sale of tobacco in their town. At one point an elderly gentleman dependent on nasal oxygen due to years of smoking-related pulmonary disease states ...

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I chose to become an OB/GYN because I love delivering babies and bringing joy to expectant parents. It is by far the most rewarding part of my job. Seeing the sense of pride on a new dad’s face, the joyful tears in a happy mother’s eyes, or the inquisitive look of a young big brother or sister is priceless and makes my “job” feel more like a privilege. Bringing a new ...

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Before starting third year, we had a week-long course that taught basic skills not learned in our first two years of medical school: suturing, knot tying, injections, note writing, etc.. One critical skill they left out was how to use a fax machine and how to deal with medical record offices. To outsiders, it probably seems pointless to learn how to operate an archaic communication tool like a fax machine in ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated for a mass in his right neck that he first noticed 2 weeks ago while shaving. The patient also reports experiencing a pressure sensation when swallowing solid foods for the past year and daily diarrhea for the past 2 months. His personal medical history is unremarkable. His ...

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3 guaranteed ways to improve patient satisfaction With roughly 1 billion in Medicare reimbursement dollars being tied to patient satisfaction, it’s no wonder the focus on patient experience is swelling. Of course there are other factors fueling the focus -- the proliferation of online physician ratings websites, ACOs, and CG-CAHPS to name a few. Over the past decade I have visited 100+ different inpatient and outpatient ...

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Any health care provider can tell you that clinical knowledge isn’t the only thing that determines how well you care for your patients.  We’ve all seen -- many times -- the patient that can’t afford the correct antibiotic, doesn’t get preauthorization for the necessary CT scan, and can’t find a specialist who will take his or her insurance.  Making the correct diagnosis is only the first step in helping a ...

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Standing in front of my patient’s home, I reach out to ring the bell. On the other side of the door live a man and his wife, who have been waiting patiently for my arrival. I hesitate for a moment before pressing the button. As I wait uneasily for the door to open, I think to myself that this is the first time I make a house call on my patient ...

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On September 4th, 2014, iconic comedian and TV personality Joan Rivers passed away due to complications following what seemed to be a routine visit to her gastroenterologist. Up until now, a wave of speculation and mystery has surrounded her case with a trove of unanswered questions. What happened on that tragic day? What kind of procedure did she have? Was it a dangerous surgery? Who was in the room? On October 16th ...

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Ferguson: What should physicians do? There is little to say once you’ve said this before. Although the sadness brings fresh tears, they are also old tears. The grief becomes familiar and so too the inevitable resumption of everyday life. The pain bores to the soul but settles in the subconscious, where it rests, privately born and quietly hidden, lest 
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While millions of Americans are re-enrolling in Obamacare, signing up for health insurance for the first time, or double-checking the plans their employer offers, many will undoubtedly ask what’s affordable for them. Good luck defining affordability. Like beauty, it’s in the eye of the beholder. To better understand what affordability in health care means from the vantage point of the ‘kitchen table,’ the National Quality Forum, with support from the Robert Wood ...

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Top stories in health and medicine, December 5, 2014From MedPage Today:

  1. Duplication Error May Make Giants. A duplication in a short stretch of the X chromosome may be responsible for a specific type of gigantism seen in children.
  2. Lab Work Moves More Quickly to Clinical Setting. A second investigational drug in the isocitrate dehydrogenase (IDH) inhibitor class has demonstrated activity ...

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The food stamp program helps over 40 million Americans pay for groceries. Unlike other forms of economic assistance, this program, called SNAP (the Supplemental Nutrition Assistance Program), only pays for food, thereby constraining how recipients make use of the aid. But are food stamps constrained enough? SNAP recipients experience higher rates of obesity and diabetes than the general  population.  Experts estimate that SNAP recipients consume almost twice as many calories ...

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In a controversial study, Tufts University’s Center for the Study of Drug Development estimates that the cost to bring a new drug to market exceeds nearly 2.6 billion dollars.  The study, which was 40 percent funded by industry has been criticized for over estimating these costs in favor of industry and misrepresenting some cost estimates.  While we will not know fully the extent of the methodology of the study ...

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The recently released report, Shooting at Sandy Hook Elementary School, from Connecticut's Office of the Child Advocate offers a searing in-depth account of the holes in our mental health care system. The report is careful to point out that no causative link exists between their findings and the events at Sandy Hook. However, this in-depth investigation offers an opportunity, if we are able to hear and take action on its ...

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Recently, the Centers for Medicare & Medicaid Services (CMS) officially proposed coverage for annual low-dose computed tomography (LDCT) screening for lung cancer in current or former smokers age 55 to 74 years with at least a 30 pack-year history. In doing so, CMS followed the lead of the U.S. Preventive Services Task Force, which had previously given a "B" grade recommendation for screening in a similar population through age 80 ...

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Get help: Most physicians are not good at business We’ve all heard or used the phrase, "Leave it to the professionals." It certainly applies to me as the only tools that I can use with competence are the scopes that I pass through either end of the digestive tunnel. Yeah, I have a toolbox at home, but it is stocked similarly to the first aid kit that your new car ...

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