Traditionally, the patient chart stayed in the doctors office and rarely did a patient get a glimpse of anything in the record. Photocopying the chart is expensive and no physician would let a chart leave her office because the record must be held safely for a minimum of 7 years. Now more and more offices are doing away with clunky paper charts and electronic medical records are becoming the ...
Toni Brayer, MD
Physicians need to understand subtle marketing manipulation
There is do doubt that the way pharmaceutical companies market drugs to both doctors and consumers sways prescribing and drives up health costs. Prescription drug costs have outpaced other health care spending and are predicted to exceed the growth rates for hospital care and physician services going forward from 2010-2019.Two researchers (Howard Brody, MD, PHD, University of Texas Medical Galveston and Donald Wright, PhD, University of Medicine and Dentistry ...
Physical activity level in patients with osteoarthritis
When we think of osteoarthritis (OA), we think of chronic "wear and tear" on a joint that has just plain worn out. Many patients with arthritis become less and less active and that is actually the worst thing for an arthritic joint.A study published in Arthritis and Rheumatism looked at the functional performance in 2589 adults with knee OA and found that ...
Why powerful men risk their family and career
Arnold Schwarzenegger's revelation about his long-term affair with his household employee that involved a child being born is the latest in a string of powerful men with career ending flaws. Add to that the shocking arrest this week of powerful Dominique Strauss-Kahn for allegedly raping a hotel maid and we must ask, "What the heck is going on with these guys?"I can't count the number of heartfelt apologies that ...
How high blood pressure in the office can be white coat hypertension
"But doc, my blood pressure is always normal at home." I wish I had a dollar for every time I have heard that line and I know it is true.When some patients come to see me, their blood pressure is abnormally high (above 130/90) and this is known as "white coat hypertension." Although it has been thought to be from anxiety about seeing the doctor, even long established patients who ...
How the vaccine and autism scare was a fraud to make money
Most parents and all pediatricians are aware of the 1998 study published in The Lancet by Dr. Andrew Wakefield that mentioned a causal link between measles, mumps, rubella (MMR) vaccine and the increased incidence of childhood autism. It shook the medical community and created an international movement of parents questioning the extensive combination of immunizations that are given to children. Could these immunizations be the cause of the increase in ...
Extra fees may save private practice primary care
I was interested in an article in USA Today about the growing number of physicians, especially primary care doctors, who are boosting their revenues by requiring patients to pay new fees for services that insurance doesn't cover.No longer is your insurance payment "all-inclusive". These fees can include annual administration fees, no-show fees, medical report fees, and extra fees for email or phone consultations. If private practice medicine is going to ...
Primary care shortage solutions after health care reform
The new reform law which is called the Patient Protection and Affordable Care Act (PPACA) will be a huge disappointment to the millions of previously uninsured people who finally purchase insurance policies when they try to find a doctor.Primary care physicians are already in short supply and the most popular ones have closed practices or long waits for new patients. Imagine when 2014 hits and all of those patients come ...
Health costs are high, and here’s why
Health costs are high because the body is complicated and doctors and patients hate ambiguity. The cost is high because a missed diagnosis can lead to death and a large lawsuit. The cost is high because we have many specialists that view the body in tiny pieces and want to feel 100% correct about their piece.Let me give you a real life example.My patient, Rick, is a brilliant attorney. He ...
Primary care needs to be valued first before it can be saved
I went to my physical therapist yesterday for knee treatment and we talked about the fact that Blue Cross is cutting their reimbursement to the point that the cost of providing care will not even be covered. All I could do was lament with him and listen.One insurer even told him (the owner of the business) to just "make the sessions shorter and don't give as much care."Clearly the insurance ...
Hospitals and doctors should still pay attention to word of mouth
The organizations that rate hospitals and doctors have proliferated as the internet has become mainstream over the past 5 years. I'm sure you have seen some of these: U.S. World & News Report, Consumer Reports Health, Health Grades, Leapfrog, Hospital Compare, Americas Best Doctors and 100 Best Hospitals.My local magazine lists the "top doctors" along with full page paid ads and promos that are very compelling. The questions is, do ...
How fame has corrupted Dr. Mehmet Oz
The newest media doc on the block is Dr. Mehmet Oz. When he was first seen on Oprah, he seemed engaging and answered some interesting questions in a real and professional way. The audience loved his blue scrubs and boyish clean cut open style.That was then.Let’s face it . . . the media spotlight seems to corrupt even the best physicians. Dr. Oz now has his own show and ...
Why the Mayo Clinic is refusing to see Medicare patients
Medicare, the government insurance company for everyone over age 65 (and for the disabled) pays fees to primary care physicians that guarantee bankruptcy.Additionally, 70% of hospitals in the United States lose money on Medicare patients. That's right, for every patient over age 65, it costs the hospital more to deliver care than the government reimburses. That is why Mayo Clinic has said it will not accept Medicare payments for primary ...
Radiation exposure from excessive imaging tests after a heart attack
Hopefully, by now, people are realizing that more is not necessarily better. A new study reported at the American Heart Association 2009 Scientific Sessions showed that patients with acute myocardial infarction (AMI) receive large doses of ionizing radiation per hospital admission.They looked at patients treated at 55 academic hospitals and found, on average, each patient received seven studies per AMI admission. The studies included chest X-rays, chest CT, head CT, ...
Are nurse unions using the H1N1 flu pandemic as a bargaining ploy?
Only in the United States could a virus like H1N1 bring out the worst in medical politics and greed. We are facing a pandemic that requires coordination, communication and the best of medical practice. But what are we getting? Strikes, lawsuits and anything but putting patients first.The California Nurse Association (CNA), is taking this opportunity to call a strike on three large Catholic hospital chains (which comprise a total of ...
How teamwork can improve patient care
I spent the entire day in meetings today. One would think that is a boring or unproductive way for a physician to spend time, however these meetings made me proud to be a doctor and proud of my colleagues in medicine.The morning was spent with nurses, respiratory therapists and quality experts who came together to celebrate success with patient safety and quality initiatives that have saved at least 151 patient ...
