As most of the electrophysiology (EP) community is aware, device and lead recalls are a reality in today’s EP practice. In the last 5 years, both Medtronic and St. Jude Medical have had significant lead failure issues. The public responses to these recalls have been varied and quite different. As physicians who care for device patients, we must learn to quickly sort through the rhetoric put forth in the New ...
Patients have been arriving at the doors of emergency departments in increasing numbers over the past decade, and this trend will only grow in the future. I believe there are five key factors that suggest every ED should brace itself for a never-ending rush hour.As the CEO of a physician group that provides medical care to over 4 million patients per year, I have the opportunity to study in great ...
In our world of 24/7 media, where we seem to hear about the next big cure, important dietary change or very dangerous drug virtually every day, it is hard to believe that the news people, tweeters and bloggers could miss anything that is going on in health care today. However, it appears most everyone missed a big one. This might be one of the most important stories in health care today, that no one ...
This series is brought to you by MedPage Today.1. Lung Cancer Survival Better for Hispanics. Hispanics living in the U.S. who are diagnosed with non-small cell lung cancer (NSCLC) have a lower risk for overall mortality than other ethnic groups.2. Obesity, GI Issues May Take Root in Gut Flora. Manipulating the microbial flora within the intestine offers great promise for preventing or ...
I am on my last rotation for medical school. It is a “rural selective”, which is a required elective at a rural or underserved location. I am fulfilling it at a local community health center in the women’s health department. Fun!I am taking part in a day long orientation today. In one of the presentations, the speaker had a point on one of the slides about mandatory reporting, and included ...
Medical residents have fewer labor protections than Chinese factory workers. While labor abuses at Apple’s factories make headlines, few people are as concerned about the lack of protections for doctors and medical students here in the United States. As a resident, I was subject to some of the worst abuses – intentionally misreported time sheets and gender-based discrimination – and after I complained, I was fired, so I sued the ...
The following column was published on March 25, 2012 in the Nashua Telegraph.Medical malpractice historically has been a contentious issue. Doctors have argued that the system is broken, promotes multi-million dollar awards disproportionate to the injuries suffered, and encourages the ordering of unnecessary tests to avoid being sued, a practice known as defensive medicine. Trial attorneys, on the other ...
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal level and also learn how to operate our medical practices with the same transparency as any other small business.Our patients (and our prospective patients) now define “great” doctors as those who are willing to display transparency, that is, doctors must be willing to show a human side.For us ...
This series is brought to you by MedPage Today.1. Obesity, GI Issues May Take Root in Gut Flora. Manipulating the microbial flora within the intestine offers great promise for preventing or treating obesity and bowel disorders, but the precise means are not yet available.2. Smoking Cessation Worth It Despite Dim Outcomes. Drugs and counseling to help patients stop smoking typically double the ...
Based upon the past and the current state of affairs in healthcare, healthcare reimbursement will change dramatically in the future. I believe that reimbursement based upon fee-for-service will gradually disappear and be replaced by models based upon the ability to better manage patient diseases and conditions. That is, reimbursement will be based upon the quality of service delivered by the provider. For insurers, whether private or governmental, I believe that ...
The phone conversation, as my dad, in the bed next door, recalls it, went something like this.“Hello?”“Hi, is this Jim? Where are you?”“No, it’s not Jim. I’m John, and I’m in hospital.”“Oh sorry, John, I was looking for Jim the refrigerator mechanic. Wrong number. Hope you’re okay!”“I’m not okay. Just had both my knees replaced and I’m very sore.”“John, I’m sorry. I got problems too. I run an ice cream ...
The United States of America is an immigrant country. It is a melting pot of many peoples and has basically been so since before the Mayflower passengers laid foot on New England soil. Promise of equality, success, quality of life and freedom have drawn multitudes of professionals from all over the world to try to make it in the US. Some of these professionals are doctors.A doctor that wants to ...
How can you determine whether you are in a "developed" or a "developing" country? We used to call these latter "un- or underdeveloped" or "3rd world" countries, but those terms are no longer politically acceptable, considering the tinderbox of feelings about this topic.If one objectively examines all 20 dozen or so of the world's countries, a geographer would divide them into either north or south of the Equator. And if, ...
An IOM report makes recommendations that aim to ensure that progress in omics-based test development is grounded in sound scientific evidence and is reproducible, resulting in improved health care and continued public trust in research. Another new IOM roundtable workshop report discussed the differences in evidence required for clinical use, regulatory oversight, guideline inclusion, coverage, and reimbursement of genomic ...
Amid all the political rancor and media hoopla currently surrounding the American healthcare system and the clamor for reform from all sides, one question has gone unasked; what exactly is this thing we call healthcare? Is it the local hospital with its giant façade and ambulances coming and going all hours of the day and night? Is it the clinic where you sit and wait to have your blood pressure ...
Hospitals commonly espouse a commitment to patient-centered care (PCC). Most fail to achieve it. Causative factors are legion. PCC is often considered a strategy or a tactic, for example, when it really should be integral to an organization’s culture, and enabled by a supportive vision. Some organizations appreciate this, yet still struggle. This is understandable. Today’s health care providers were not trained to provide PCC. They lack the requisite skills, ...
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 78-year-old woman has a 3-month history of increasing fatigue. She has no other medical problems and does not take any medications.On physical examination, temperature is normal, blood pressure is 130/80 mm Hg, pulse rate is 72/min, and respiration rate is 16/min. The patient appears ...
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like crazy; being responsible for the sickest of the sick that rolls through our doors is a daunting task, especially since we were the local trauma center.The shift was going relatively well, and with only a few hours left I was beginning to breathe a sigh of relief.BEEP!There is ...
The fundamental challenge in any high-risk industry is balancing “productivity” versus “safety.” The term “protection” is frequently used within the scientific literature to express the role of safety departments within an organization. Described this way, it might sound as if the safety experts are framing the debate to suggest “the evil factory bosses are continually speeding up the assembly line, while the righteous safety-folks are yelling ‘slow down!’” This essential ...
For various reasons our nation’s public health programs have been decimated. This comes at a time when the number of unemployed and health uninsured are at a record high number. Additionally, we are seeing individuals live longer and experience more chronic debilitating illnesses and conditions that stretch the resources of an already under manned and under funded health system. Emphasizing prevention and healthy living should be a lifetime necessity for ...
Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from...
In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men. Case closed, right? Hardly. The prostate...
When it comes to medicine and social media, much of the attention is negative. Doctors losing their hospital privileges because of Facebook....
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
I was appalled recently by the coverage of radiology “test recalls” by CNN, amplified by Dr. Gary Becker of the American Board...
I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the...
As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during...
He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I...
I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law...
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the...
"It was the best of times, it was the worst of times ..." So begins a story called A Tale of Two...
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
Propaganda and non-truths abound all around the Internet saying that mobile health apps are everything from a threat to Big Pharma to...
The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above...
Every month, hundreds of thousands of people look for a doctor on Google. As an amazing practitioner, your site deserves to be...
The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with...
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
