Top stories in health and medicine, August 14, 2014From MedPage Today:

  1. Beyond Asbestos: Autoimmunity, Pollution, and Particles. Recently, I wrote an article about some interesting research being done by Jean Pfau, PhD, of Idaho State University suggesting that workers who had been exposed to asbestos at the now-shuttered Zonolite mine in Montana were developing an as-yet undescribed autoimmune condition characterized by severe ...

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The number of people engaging in personal health tracking is on the rise, as are the number of devices available for that purpose. By some estimates, around 15% of Americans use technology to track a health indicator for themselves or a loved one. The availability of technology like Bluetooth LE and smartphones have made tracking an ever increasing number of health parameters possible. As we recommend these tools to patients, its ...

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ZDoggMD's Dr. House of Cards  returns, and who does he have in his sights today? None other than Dr. Oz, who recently testified at a Congressional hearing.  See how he fares against Dr. Underwood.

For years, critics of Obamacare (Affordable Care Act), have predicted that it would turn out to be a “train wreck” -- or something worse.  But now we know that by every objective measure, the ACA is working out pretty darn well.  Let’s run through the “train wreck” predictions, and what we now know to actually be the case: Train wreck prediction #1: “Obamacare will lead to skyrocketing health care cost increases and ...

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Recently I attended a national academic conference, and while I'll admit that, having brought my husband and son along for the trip, the balance of time spent was skewed more toward pool and beach activities than academic sessions, I did indeed attend several and overall they were of good quality. One left me somewhat disappointed, though, because although it addressed what I would consider an important topic within my field, ...

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In inpatient settings, family physicians frequently care for patients with progressive, incurable conditions that cause severe pain. Interventions aimed at slowing the progress of a disease often add to patients' physical distress; therefore, pharmacologic management of pain is a key component of end-of-life care, as outlined in an article in an issue of American Family Physician. However, as Drs. Timothy Daaleman and Margaret Helton discuss in an accompanying editorial, providing analgesia is ...

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We are at a pivotal moment in health care. It’s changing so rapidly even the people leading the change can barely keep up. One of the biggest paradigm shifts over the last decade is the focus on quality over quantity. Improving the health care experience and patient satisfaction are also being talked about in boardrooms across the country (largely due to the link with reimbursements, but still unthinkable a few ...

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Are patient portals a gateway or barrier to patient centered care and communication?A guest column by the American College of Physicians, exclusive to KevinMD.com. Patient portals. They have great potential, but is it being met? And are we losing something in return? I ask myself these questions now that my practice offers a patient portal linked to our electronic health record (EHR). I did not expect to feel that way, ...

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Top stories in health and medicine, August 13, 2014From MedPage Today:

  1. CT Images Can Inform Clinical Decisions. The identification of high-risk plaque features using noninvasive CT imaging is a useful and independent predictor of acute coronary syndrome (ACS) in patients presenting to emergency departments with acute chest pain.
  2. Status of Spray Sunscreens Still Uncertain. The FDA has not reached a ...

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After 12 years of blogging, I wonder if I should have titled my blog “unintended consequences.” So many rants focus on the unintended consequences that follow from health care policies. The aphorism (falsely attributed to Samuel Johnson) states, “The road to hell is paved with good intentions.” Too often our policy makers, be they bureaucrats in government, insurance company managers or guideline creators, think like a chess beginner. They see the ...

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There are doctors that patients see. And there are the doctors that patients almost never see. Patients see me, an obstetrician, at prenatal visits, in the ultrasound unit, or on the labor floor. But they don’t see all the wise radiologists reviewing their imaging studies, or the educated pathologist assessing whether their biopsy is cancerous. Some of the most important doctors that our patients don’t see are the ones in the ...

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Today I had a very special experience, one which many of my patients have faced: I was treated like a nobody while at the hospital. Yay me. I went to visit a patient who was admitted over the weekend to see what was going on.  She was a bit upset about the confusion of the hospitalist service and how orders apparently didn't get written for her care by the admitting physician. ...

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She’s 58, but appears maybe three days older than 42. Her eyes are sunken, tearful, worried, anxious.  She tells me about her two grandchildren, and how she just visited them in Michigan.  She came to the hospital, straight from the airport.  She’s worried. She’s worried because her shortness of breath hasn’t gone away for over a month now.  She has had breast cancer, and opted for a more conservative approach: a ...

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As Americans, we love to associate with groups. More than that -- we love to plant ourselves in a group, stand firmly in our decision, and then adamantly refuse to budge or to see the other party’s perspective. Pro-life. Pro-choice. Democrat. Republican. Pro-Obamacare. Anti-Obamacare. I suppose for all of us, myself included, it is easy to identify with our group of choice when we are sitting at home watching or reading our ...

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The doctor who has to do the laundryThe doctor who has to do the laundry An excerpt from So Long, Marcus Welby, M.D.: How Today's Health Care Is Suffocating Independent Physicians - and How Some Changed to Thrive. Ripley Hollister has been president of his county's medical society in Colorado Springs, Colo., and a director of the Colorado Medical Society. He has been a unit commander ...

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Top stories in health and medicine, August 12, 2014From MedPage Today:

  1. Low Obesity Risk Score Can Still Equal Major Health Problems. Young adults who scored slightly higher on an obesity risk assessment scale still had significantly worse dietary habits than those who were at lower risk.
  2. Feds' $10 Billion Search For Healthcare's Next Big Ideas. The Affordable Care Act was ...

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Medical lessons from Robin Williams Dear Robin, You were such an inspiration.  You showed us courage in the face of adversity, making us laugh while your own soul was broken. Even now, at the time of your death, we find ourselves in a recently forgotten place where all people -- regardless of faith, color, or country of origin -- stand united, sending out love to you and your family. You ...

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To be quite blunt about it, Ebola is a very scary disease. Among those infected, the mortality rate is, as is perhaps now widely known, an appallingly high 90%. That would seem a very good reason to keep our borders closed to this scourge -- and the consequences to the poor souls who already have it be damned. That, apparently, was just the kind of thinking behind at least 
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7 ways patients can help reduce medication errors I just got off the phone with a very upset patient who had just discovered that her pharmacy had been giving her the wrong medication for the past 5 months, substituting a similarly spelled antibiotic for her rheumatoid arthritis med. She was tipped off when she realized how bad she had been feeling of late and decided to check the expiration ...

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After more than 40 attempts to pass legislation calling for repeal or significant changes to the health law, opponents of the Affordable Care Act have moved their focus from the House floor to the courthouse. Currently at least four lawsuits are working their way through state and district court -- and one case awaits a nod from the Supreme Court -- that would make it illegal for the federal government ...

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