shutterstock_153098018 With much hype and fanfare, the independent investigative journalism outfit, ProPublica recently released their Surgeon Scorecard, assessing individual specialist surgeons who perform elective knee and hip replacements, spinal surgery, prostate surgery, and gallbladder removal surgery. I had blogged about the impending release.  My trepidation about the idea of a non-medical, non-scientific organization analyzing complex surgical data concerned issues such as ...

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lionel-messi-2013-hd-wallpaper-2219075 Quintessential Messi. One moment he is standing over the ball, in a seemingly harmless position at midfield, the next thing you know you are picking the ball out of the back of the net. How did this come to pass? How did things change so rapidly? When you watch it the first time, it's disorienting. It makes no sense. How does ...

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shutterstock_122181037 JAMA published an opinion piece about the controversial issue of patients secretly recording their physicians during encounters.  We live  in the era of the smartphone.  Everyone has one -- soccer moms, teenagers, young kids who can't even read yet, elderly nursing home patients who can't safely feed themselves.  Everyone.  And these devices have amazing powers of audiovisual capability.  We all know this.  ...

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shutterstock_147929984 A few months ago, I was seeing an elderly man in the hospital with a sigmoid mass seen on his colonoscopy that day. He had presented to the hospital with fatigue and anemia, and the long meandering workup eventually zeroed in on this malignant appearing mass as the source. His daughter was in the room while I discussed the results, the ...

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shutterstock_226013521 Aaron Carroll, a pediatrician who blogs at the Incidental Economist, had a piece published a few weeks ago in the New York Times concluding that adolescents and college kids would be better off -- given a choice of illicit substances -- opting for marijuana over alcohol.  Of course, he would prefer that his kids chose neither.  But he is a ...

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Like most of my age cohort, I was brought up to believe that the great Satan threatening to undermine the bloated American health care system was our broken-down, antiquated, self-interested model of reimbursement for care provided called "fee-for-service."  Being a professional who, to the best of my ability, tries to maximize the value of the care I provide to my patients, I subscribed wholly to the notion that the cause ...

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One of the obligations of a medical or surgical specialist is to communicate with the referring primary care provider.  This can take many forms: a phone call, texting via smartphone, email, messages sent via EMR, and dictated letters.  The format is pretty standard no matter what medium is chosen.  You thank the referring doc for the consult request, you give some brief background info about the patient in question, and ...

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Recently, Ohio became the 20th state to pass a law mandating that hospitals and clinics performing mammography screening to notify a patient in writing if results suggest something known as "dense breast tissue."   Standard mammography creates a 2-D image of breast tissue.  In general, this is sufficient for screening purposes.  However, especially in younger patients, the presence of dense breast parenchyma can lead to higher false negative readings and ...

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From my interview with Andrew Thompson the other day, the issue of a medical malpractice crisis was raised.  Mr. Thompson averred that such a concept is pure myth, a spook story older docs tell young interns around the campfire at night.  And he may be right. In a paper from the Journal of Healthcare Quality, researchers at Johns Hopkins demonstrated, using data from the National Practitioner Data ...

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My interview series continues, this time with local litigation attorney Andrew Thompson, Esq. The topic this time is medical malpractice. I asked him a bunch of questions. He answered. See what you think. 1. In your opinion, is there a medical malpractice crisis in this country? No. This is not even a close issue. The concept of a “crisis” or dramatic increase in the number of medical malpractice cases is ...

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