Top stories in health and medicine, August 12, 2014From MedPage Today:

  1. Low Obesity Risk Score Can Still Equal Major Health Problems. Young adults who scored slightly higher on an obesity risk assessment scale still had significantly worse dietary habits than those who were at lower risk.
  2. Feds' $10 Billion Search For Healthcare's Next Big Ideas. The Affordable Care Act was ...

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We rely on the FDA to protect public health “by assuring the safety, efficacy, and security” of medical drugs and devices. The FDA takes its marching orders from Congress via the legislative process. One such law is the Compounding Quality Act of 2013, passed in response to a series of fatal infections due to improper compounding pharmacy processes. While such oversight is important and well meaning, the unintended consequences may be ...

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For days, I have been trying to get long-term patient, Stan, on the phone; his blood work came back abnormal, and we need to repeat it.  I called the number in our file a bunch of times. The odd thing is that sometimes it rings without stopping, sometimes it is answered by a machine, which immediately beeps and disconnects, and at least once it sounded as if the receiver was ...

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On a cold, blustery Cleveland day when I was a resident, a forty-year-old man walked into our infectious disease clinic at the Cleveland Clinic. The patient was undergoing routine visits in preparation for a kidney transplant. This poor man had been hospitalized six months earlier at another hospital where he caught a terrible infection and was readmitted in septic shock and multi-organ failure. Luckily he survived, but in the process ...

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Apparently all doctors must practice medicine until the day the die.  Or so says Gordon Marino in a New York Times piece called “A Life Beyond Do What You Love.”  This article caught my eye, since I am currently trying to do “what I love,” having already lived a couple of lives doing “what I think I should love.”  I didn’t agree with everything the piece said about doing what ...

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He was a 24-year-old African American man with no history of medical or eye problems.   On an ordinary Thursday evening at 8 p.m., he arrived into the emergency department complaining of a sudden loss of vision in both eyes. “He couldn’t see a thing on our chart.  Vitals are fine, pupils are equal and reactive, and the rest of the neuro exam is unremarkable,” the emergency room attending briefly explained.  “Can ...

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Better outcomes and lower costs: The perioperative surgical homeWhether it’s a knee replacement avoided for years or an urgent life-saving tumor removal, when the decision for surgery occurs, too often the patient begins a journey into a complex system of fragmented medical care. Perioperative care, which generally refers to the three phases of surgery -- preoperative, intraoperative and postoperative -- can be variable and fragmented. ...

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A mission trip to Kenya: Challenge, success and heartbreak A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Mission must have always been in my blood, but it took me a while to discover it. I considered going on a mission trip to Bungoma, Kenya, in 2009, but the timing coincided with one of the major conferences at the New York State Society of ...

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Medicine has always had it regulatory fiefdoms, but in 2002 they were greatly expanded. At that time, a charter on "medical professionalism" was published by the American Board of Internal Medicine, the American College of Physicians, and the European Society of Internal Medicine in the Annals of Internal Medicine that touted three fundamental principles:

  1. the principle of primacy of patient welfare
  2. principle of patient autonomy
  3. principle of social justice
The first set of professional responsibilities for physicians was ...

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Medical scribes are a burgeoning field with many institutions and practices exploring their use while the many commercial enterprises who lease out scribes are pushing for their widespread acceptance. There is no accepted definition of what scribes do or what their background or training should be. There is no mechanism for licensure of them in any state. They are poorly defined medical assistants. The field is in its infancy and ...

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