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 ...

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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 ...

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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 ...

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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 ...

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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 ...

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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 ...

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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 ...

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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 ...

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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 ...

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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:

  • neuroticism
  • harm avoidance
  • novelty seeking
  • reward dependence
  • perfectionism (subdomains have included: concern about mistakes, personal standards, doubts about actions, organization
The ...

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