"Do patients care about how much money their doctors make?" This is the headline of a recently published post by Trudy Lieberman, and was written in response to the recent New Your Times' coverage of Medicare disclosing payments to individual providers. Now, I found the Times story fascinating on many levels, but I'll admit it hadn't occurred to me that the main value of this data release is that patients can ...

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Apps used to monitor blood pressure need better design Here's a design approach that I really, really dislike: the scrolling wheel that is often used for number entry in iOS apps. I find that the scrolling wheel makes it very tiresome to enter numbers, and much prefer apps that offer a number pad, or another way to touch the number you need. (Or at least decrease the number at ...

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When it comes to high blood pressure treatment in the elderly, the plot continues to thicken. Last December, a minor controversy erupted when the JNC hypertension guidelines proposed a higher blood pressure (BP) treatment target (150/90) for adults aged 60+. And now this month, a study in JAMA Internal Medicine reports that over 3 years, among a cohort of 4961 community-dwelling Medicare patients aged 70+ and diagnosed with hypertension, those on blood pressure medication ...

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When it comes to the health care of a frail older person, families really need a good personal health record (PHR) system. So I am once again preparing to take a look at what’s available, in hopes of finding something that I can more confidently recommend to the families I work with. (To see what medical info I urge families to track, see this Geriatrics for Caregivers post.) I have -- ...

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Why aren’t people in hospitals more attentive to the needs of patients? In a post, Dr. Ashish Jha raises this issue as he relates his own story of coming to an ED with a very painful dislocated shoulder. Unsurprisingly, prompt treatment of his pain was deferred while staff diligently completed registration, sent him for an x-ray, and waited for a physician to see him. On the bike path where Jha ...

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I assume by now that you’ve heard the news: Google wants to tackle aging. Specifically, they announced the launch of Calico, “a new company that will focus on health and well-being, in particular the challenge of aging and associated diseases.” Because, says Larry Page, with some “moonshot thinking around healthcare and biotechnology, I believe we can improve millions of lives.” “Can Google Solve DEATH?” shrieks a TIME cover. Google’s goal, it seems ...

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What is patient engagement? Everyone agrees that it’s a good thing, and that we healthcare providers should be fostering it. How to do so, however, depends on just what you believe patient engagement means. As Dan Munro recently pointed out, the term “patient engagement” is a hot buzz phrase, and -- in the best tradition of such phrases -- it’s amorphous enough and appealing enough to mean just about anything. Provided that it ...

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In a recent post, Dr. Ashish Jha raises this issue as he relates his own story of coming to an ED with a very painful dislocated shoulder. Unsurprisingly, prompt treatment of his pain was deferred while staff diligently completed registration, sent him for an x-ray, and waited for a physician to see him. On the bike path where Jha took his initial tumble, people went out of their way to ...

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Recently, the New York Times featured a post about me and my practice. Titled "Walking Away from Medicare," it describes my decision to opt-out of Medicare and create a different kind of geriatric practice. It has generated quite a lot of comments. Most of them judge me pretty harshly. It seems that many people feel that I'm doing this for the money. And that I don't care about society ...

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Shouldn't everyone get an individualized assessment of likely benefits, burdens, and risks before making a big medical decision? I was asked this question recently, during an interview for an Internet radio show on aging. Per my host's request, I'd been explaining the practice of geriatrics, and talking about the geriatric approach to addressing the medical needs of older adults. Since I'd mentioned that aging often brings on greater risk of side-effects or ...

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