From MedPage Today:

  1. Congress Grapples With Primary Care Pay. Some Democratic lawmakers have expressed interest in extending the pay increases for primary care physicians in Medicare and Medicaid that are temporarily in effect under the Affordable Care Act (ACA).
  2. Stem Cells as Tx for TB? Bone marrow stem cells were safe to give during treatment for multidrug- and extensively drug-resistant (MDR, XDR) tuberculosis (TB), ...

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From MedPage Today:

  1. Talk to Patients About Alcohol Use, CDC Urges. Roughly 84% of U.S. adults have never discussed alcohol use with a healthcare professional.
  2. Cancer Stats Show Progress, Hint at Challenges. A steady decline in cancer mortality has added up to a 20% reduction over the past 2 decades, the American Cancer Society reported in its annual review of cancer statistics.

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Perhaps you’ve seen some of the media coverage reporting that “an apple a day” would save as many lives as statins do, with fewer side effects. Or perhaps not -- thankfully, this tongue-in-cheek “study” didn’t get the intense coverage received by the new statin guidelines (an issue I Read more...

From MedPage Today:

  1. Bystander CPR Better When More People Help. Cardiac arrest victims were more likely to receive good-quality bystander-initiated cardiopulmonary resuscitation (CPR) if multiple people assisted.
  2. New Guidelines Reflect Gout Evidence. A multinational group of experts has developed a set of 10 recommendations for the diagnosis and treatment of gout, derived from the "3e" initiative -- evidence, expertise, exchange -- and based on ...

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As the year comes to a close, we physicians feel tremendous uncertainty with the rain of change from Washington. As I approach my third decade of medical practice, I feel more distant from the patient who desperately seeks my attention. I struggle daily to reconnect with her, recalling the fading reasons I embarked on this field, trying to resuscitate the patient-physician relationship which is central to our broken medical system. Often ...

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JAMA published the long-awaited Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure-8 (JNC-8) guidelines December 18, 2013. They recommended blood pressure lowering drug treatment for patients ≥ 60-years-old with systolic blood pressure (SBP) ≥ 150 or diastolic blood pressure (DBP) ≥ 90 mm Hg. For patients < 60-years-old, they recommended medications for DBP ≥ 90 mm Hg. They classified both of these recommendations as ...

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The new blood pressure (BP) guideline, released recently in JAMA, has simplified blood pressure management and likely decreased both the number of patients needing treatment and the number of medications they need. Many commentaries have begun to flood the Internet, so of course I must add my thoughts. First, please read Harlan Krumholz thoughts: 3 Things to Know About the New Blood Pressure Guidelines. Here are my main thoughts: 1. This guideline panel ...

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I’m not going to discuss the entire subject of cholesterol in this post, but one part of it: specifically, how to discuss with your doctor how much cholesterol should matter to you. If you have read any health news recently, you know that the American College of Cardiology and the American Health Association issued new guidelines to help doctors advise patients about cholesterol medications. The new recommendations are accompanied by a ...

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Today’s question is a simple one. How many patients can a physician see in one day and still be thorough? Don’t get me wrong; I’m all for efficiency. But we need to recognize when efforts at efficiency become “medical sloppiness” or, frankly, malpractice. With health care policy and insurance reimbursement what they are today, it’s not uncommon to encounter physicians seeing forty, fifty, and even sixty or more patients a day ...

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Last night, I responded to a code blue while working the night float at the hospital. The patient was a relatively young female who had just completed a coronary artery bypass procedure. Per training, I began compressing her chest to induce blood flow to the rest of her body. As I pushed, the incision reopened and blood began spewing everywhere. I could feel her ribs giving and cracking from the force ...

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