Ten years ago, I wrote the Pew Internet Project’s first report on the impact of the internet on health care, calling it “The Online Health Care Revolution.”
Back then, the idea that people were searching online for health information was revolutionary. All of a sudden, regular people had access to medical information that had always been locked up and out of reach.
Ten years later, I am ready to declare the access …
As a primary care doctor, I have figured out many tricks for helping patients save money on prescriptions. Some of them I am sure you have never heard of, and others , well — you might have, but they bear repeating.
All of the prices quoted here are from Costco, unless otherwise specified.
1. Price compare between pharmacies. Can’t stress enough the potential differences in medicine prices between pharmacies. Generic medicine prices vary more than …
by Walter van den Broek, MD, PhD
Video podcasts are not ready to replace lectures.
This disappointing result is recently published online.
Teachers are eager to use new information technology to teach. When I’m doing a lecture at our medical school, these lectures are made to podcasts and posted on blackboard. Together with the slides, students can rehears or listen to the lecture afterwords when not present. …
Many healthcare organizations are contemplating making dramatic changes in the way they do business and treat patients. Some of these are driven by the recently passed Accountable Care Act and the Tarp Bill. They are planning on adopting electronic medical records, becoming Accountable Care Organizations or becoming Patient-Centered Medical homes.
Unfortunately, like many businesses, they will undergo a lot of stress and loss of resources in time and money in making …
Are patients better off than they were ten years ago?
Just over a decade ago the Institute of Medicine (IOM) released its celebrated report on patient safety, To Err is Human. Many credit that report, which was released with great fanfare, with launching the patient safety movement. So it’s appropriate to assess the movement’s impact eleven years later. How did we do?
On November 25 the New England Journal of Medicine published …
by Diana E. Lee
It sounds like NFL Wide Receiver Percy Harvin (Minnesota Vikings) is one of the luckier chronic migraine patients out there.
He was actually able to identify a specific reason for his drastically increased number of migraine attacks (sleep apnea) and implement a treatment that seems to be helping (CPAP). He is performing solidly and confidently and taking contact without any issues.
I know a …
The growing criticism of industry funded continuing medical education (CME) over the past several years has had a number of significant effects on the CME community. As the Accreditation Council of Continuing Medical Education (ACCME) annual report showed, from 2007 to the present, commercial support of CME dropped 29.3%, and the number of directly sponsored CME activities decreased over 7% between 2008 and 2009.
CME funding is extremely important …
In 1905 William Osler gave his farewell address as he prepared to leave Johns Hopkins for Oxford and England. After speaking to the assembled medical students about the tragic side of medicine he said:
The comedy, too, of life will be spread before you, and nobody laughs more often than the doctor at the pranks Puck plays upon the Titanias and the Bottoms among his patients. The humorous side is really …
A response to my recent post, The malpractice system doesn’t improve patient safety.
by Brian Nash
In his blog, Dr. Kevin acknowledges that in the “world of medical error, truth is often clouded in secrecy.” He then points out that “… taking the bold step of publicly describing your mistake is a brave one. Some would say it’s long overdue.”
Well so far, Dr. K, we’re on …
The September issue of Journal Watch General Medicine included an article from the American Academy of Pediatrics about new criteria for diagnosis and management of concussions in children and adolescents.
Shortly after this issue was published, a segment aired on ESPN regarding a confrontation between the head football coach at Texas Christian University and its team physician over holding a player out of the game due to a concussion.
As a sports …
Reading the newspapers and watching the news lately would lead you to believe that screening for cancer is largely a waste of time.
Yet, in the same week that the NEJM published Norwegian data showing a remarkably small survival benefit of 2% associated with screening mammography, HealthDay reported a decrease in cancer incidence of almost 1% per year from 1999 to 2006 and a decrease in cancer deaths …
Medical errors have been in the news lately. An Ontario provincial review probing unnecessary surgeries at a Windsor hospital found significant concerns with the work of a pathologist involved in a mistaken mastectomy case.
In the US, avoidable medical errors added $19.5 billion to the nation’s healthcare bill in 2008, according to a claims-based study conducted for the Society of Actuaries (SOA). The report lists the 10 most expensive errors in healthcare settings.
Here …
Temperament is generally defined as innate early emotional and behavioral characteristics that precede puberty and adult development. Felt to have significant genetic components, temperament is also potentially influenced by environmental factors.
There are a variety of temperament domains that have received significant attention in childhood, adolescent and adult populations.
Some of the most commonly studied domains include:
The …
by Steve Sanders, DO
“What am I going to do now Doc?” asked Mike, a down on his luck, 29 year–old recently unemployed truck driver, as he handed me his hospital bill.
Mike was seen at our local emergency department on a Friday evening with complaints of indigestion. Earlier that day he and his wife Susan celebrated their second anniversary by splitting a store bought pepperoni pizza. …
I told a friend what I did recently to get in to see a dermatologist and she was shocked.
“You wrote a letter asking her to take you as patient?” “Wow!” “Yes,” I admitted. “I’d called her office for an appointment; she wasn’t taking new patients; I needed to resort to an over-the-top approach.”
You see, I’d researched her (ok, I Googled her) and after reading her background, schooling, and patient reviews, …
From its inception, Medicare has been agnostic about the effectiveness of different treatments when it sets payment rates. Once a treatment is found to be “reasonable and necessary,” Medicare establishes a payment rate that takes into account complexity and other “inputs” that go into delivering the service. But it is prohibited by law from varying payments based on how well an intervention works.
This would change under a “dynamic pricing” approach …
Recently, I had a patient visiting me for the first time. He basically a “syndrome X” type of guy: middle-aged, overweight, high cholesterol, high blood pressure. He’s not the most personally careful individual, with a history of domestic altercation, some prison time. Almost goes without saying he drinks too much and smokes cigarettes.
Well, he wanted his cholesterol medication restarted since he has just now started receiving “insurance”, MassHealth, Massachusetts’ state …
B12.
Sounds simple, huh?
1 letter, 2 numbers. One of the B vitamins. It’s important in a number of body functions, particularly the nervous system and blood cell production. It’s in pretty much all meats and vegetables, and multivitamins you can buy.
To me, it’s also a good example of what’s wrong in health care.
Let’s take Mrs. Olde.
She goes to her internist, and is complaining of feeling weak and tired. So he checks …
Here are the top posts from this past week, based on the number of times they were viewed.
1. How a plumber charges more than a neurosurgeon. So there was a neurosurgeon who called a plumber for a house visit.
2. A neurosurgical resident’s typical day. I’ve made some fairly outrageous claims about the workload of a neurosurgical resident recently. Seems like a reasonable time to lay out exactly …
“Instead of focusing on treating him, an employee said, St. Mary nurses and other hospital staff did the unthinkable: They snapped photos of the dying man and posted them on Facebook.”
What can you say about an article like this? I bet there is not a single physician or nurse who are not reasonably conversant about the basic tenets of the health care privacy laws under which they practice.
Stupid is as …
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