In his popular tome, The Innovator’s Prescription, Clayton Christensen proposes several cures to health care’s cost disease, known as disruptive innovations. One is the replacement of physicians by advanced practice clinicians (APCs). That is, by nurse practitioners and physician assistants. APCs meet the requirements for Christenson’s disruptive innovators: They cost less (than physicians) and are good enough. There is little doubt that APCs are good enough to deal with common clinical presentations. ...

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To critics who admonish emergency physicians like myself for our excessive use of CT scans, I’ll ask them to consider the leaf blower. I’m sipping my morning coffee on our front porch, a bright, idyllic autumn day in New England, the tranquility ripped apart by the landscapers across the street. For many jobs, a powerful leaf blower might prove superior to a rake or broom. But in my neighborhood known ...

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shutterstock_217177708 Radiologists discussing test results with patients, a subject that has been lurking under the radar for a while, recently came to light because of an article in the New York Times. The idea is that patient anxiety while waiting to find out a test result could be alleviated by an immediate discussion with a radiologist. That would be very nice, but there are ...

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medpagetodayFrom MedPage Today:

  1. Duplication Error May Make Giants. A duplication in a short stretch of the X chromosome may be responsible for a specific type of gigantism seen in children.
  2. Lab Work Moves More Quickly to Clinical Setting. A second investigational drug in the isocitrate dehydrogenase (IDH) inhibitor class has demonstrated activity ...

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shutterstock_156020384 How often do we have this interaction: "My wife was here yesterday for belly pain.  That doctor didn’t do nothing! Told me she just needed to get over it. I am not happy and something needs to be done about this!" (Frequently spoken by spouse.) Records are reviewed.  Treatment:  Included numerous doses of morphine and phenergan, as well as fluids and Zofran.  Frequent warm blankets were ...

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shutterstock_202560031 Each year, over 20,000 U.S. students begin medical school.  They routinely pay $50,000 or more per year for the privilege, and the average medical student graduates with a debt of over $170,000.  That’s a lot of money.  But for some who pursue careers in medicine, the financial cost has been considerably greater.  Melissa Chen, 35, a final-year radiology resident at the ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 66-year-old man comes for a preoperative evaluation before total joint arthroplasty of the left knee. He has a 25-year history of rheumatoid arthritis. He has had progressive pain in his left knee with activity, which limits his ability to hike. The patient has similar pain in the right knee, but it ...

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shutterstock_19241515 "Traditionally, doctors used to be called in when needed. But this is now changing. Increasingly it is the doctor who calls the person in by issuing an invitation. Healthy people are asked to visit the surgery for a 'check-up,' or 'screening,' when their computerized records show they are 'due.' Non-attendance is known as 'non-compliance,' indicating an element of recklessness and irresponsibility." - Petr ...

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shutterstock_118491940 From seeing elegant pictures of our brain and spine, to definitely characterizing masses in the liver and guiding management of orthopedic issues, MRI has an established role in the delivery of optimal care. MRI is an amazing tool that allows us to see inside our bodies and helps us get answers about a wide variety of medical conditions.  As a radiologist ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 59-year-old woman is evaluated for a 1-week history of increasing pain of the right foot. She recalls stepping on a nail about 1 month before her symptoms began. The patient has a 5-year history of heart failure secondary to idiopathic dilated cardiomyopathy. She has an implantable cardioverter-defibrillator, and her current medications ...

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