Posts tagged as:

primary care

Primary care disrespect starts early in medical school

November 20, 2009

In medical schools, primary care continues to be among the least respected fields a student can choose.
No where is that more starkly illustrated than in Pauline Chen’s recent New York Times piece, where she tells a story of a bright medical student who had the audacity to choose primary care as a career:
Kerry wanted to [...]

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Can less aggressive cancer screening recommendations be better for patients?

November 19, 2009

by Amy Tuteur, MD
Doctors have understood for some time that it was inevitable. The American Cancer Society has acknowledged that cancer screening has been oversold.
It seems like every day you read in the newspaper that what was standard medical care yesterday is now no longer recommended. Don’t doctors know anything? Well, actually they do. And [...]

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How to choose the right electronic health record (EHR) consultant

November 19, 2009

Originally published in HCPLive.com
by Jonathan Bertman, MD
You may have seen advertisements, or may already have been contacted by people who’ve promised to help you figure it all out so you can get your share of the stimulus money. Be wary. The truth is that the Obama administration is still defining many essential elements of the [...]

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Why health reformers should be worried about the breast cancer screening backlash

November 19, 2009

What if a non-partisan, authoritative entity wrote a robust, evidence-based guideline, but nobody followed it?
That is precisely what’s happening with the USPSTF’s recent revision of their breast cancer screening recommendations. The change most find problematic is their recommendation that women younger than 50 not undergo any breast cancer screening, such as with a mammogram.

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Can family doctors do safe first trimester abortions?

November 18, 2009

Originally published in MedPage Today
by Chris Emery, MedPage Today Contributing Writer
Complications from first trimester abortions performed by family practitioners are rare, and family doctors could help address abortion provider shortages across the U.S., a new study found.
Among more than 2,500 abortions performed by family physicians, abortion was successful without complications in 96.5% of patients [...]

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A lack of computer skills will make a doctor unemployable

November 18, 2009

How important is it for doctors to have computer skills?
It’s imperative.
Emergency physician Shadowfax is recruiting doctors for his hospital, and balances the typical choices one must make balancing clinical knowledge versus interpersonal skills.
One deal breaker, he notes, is the lack of computer skills:
Unfortunately, in this modern age, if an employee can’t use a computer effectively, [...]

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Why doctors are doing so many unnecessary Pap smears

November 17, 2009

by Matthew Mintz, MD
The Wall Street Journal and other sources reported on a study from the Annals of Internal Medicine that showed that most US doctors don’t know the guidelines of how often women should get a pap smear. More importantly, doctors were doing a lot of pap smears on women who didn’t need them. [...]

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Will patients accept the new, evidence-based, breast cancer screening guidelines?

November 17, 2009

Breast cancer screening has been scaled back, according to the recent recommendations of the USPSTF.
That’s the right move. Although women aged 50 to 74 years should receive a mammogram every 2 years, evidence of breast cancer screening in other age groups has been marginally conclusive at best, and non-existent when it comes to clinical [...]

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Can primary care doctors actually increase health care costs?

November 17, 2009

Poor McAllen, Texas.
The much maligned city has been in the health policy crosshairs ever since Atul Gawande’s seminal New Yorker article on health costs.
Now, it has the added distinction of being the worst place in the country to live with allergies.
The reason? Apparently, there’s one allergist for the entire city. One. And [...]

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Learn how to conduct a family meeting by using a structured approach

November 16, 2009

by Alex Smith, MD
On my last day of ward attending, I handed out an EKG that resembled the Dow Jones industrial average over the last 10 years (not pictured). The normal pattern of an EKG was completely disrupted: ST segments were markedly elevated, P waves were hidden, and beats were grouped in odd patterns. My [...]

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Why you should stop taking Vytorin for high cholesterol

November 16, 2009

by Matthew Mintz, MD
At the American Heart Association meeting in Orlando, the results of the ARBITER 6-HALTS study were released. No Vytorin was used in the study, but I am sure that all the headlines will mention Vytorin.
The actual study published ahead of press online in the New England Journal of Medicine. Essentially, they enrolled [...]

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Poll: Should obese patients pay more for ambulance transport to the hospital?

November 16, 2009

Nearly one-third of the American population is obese, and 5 percent is classified as morbidly obese, defined as more than 100 pounds overweight.
The obese are more likely to have health issues, and, subsequently require more frequent trips to the hospital. Ambulance workers say that patients weighing over 350 pounds present additional challenges to transport, [...]

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Who’s dying from the H1N1 flu pandemic?

November 15, 2009

Originally published in MedPage Today
by Michael Smith, MedPage Today North American Correspondent
Although the pandemic H1N1 flu tends to strike younger people, it can be life-threatening when older people are infected, California researchers said.
In the first four months of the pandemic, 1,088 people in the state needed inpatient care or died of the pandemic flu [...]

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Medicine needs to get back to hands-on basics, rather than focusing on technology

November 14, 2009

by Rahul Parikh, MD
There is plenty to criticize in our bungling trek toward health reform. Leaders on the right, left and at 1600 Pennsylvania Avenue have sidestepped the crucial conversation of controlling the cost of care, in favor of partisan rhetoric about “death panels” and “rationing care.” Worse, the entire focus [...]

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Does television make toddlers more aggressive?

November 13, 2009

Originally published in Insidermedicine
Both watching television and having a television on in the household are associated with a higher level of aggression in three-year-olds, according to research published in the latest issue of the Archives of Pediatric and Adolescent Medicine.

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