This has to be a very difficult time for insurance companies in Massachusetts. Notwithstanding that they are non-profits, they are under a lot of scrutiny with regard to reserve margins and profitability. Much of this is unfair, but I think that is just a sign of the times. Hospitals face a similar issue, too. Doctors are certainly next in line. But the Massachusetts insurers have an additional problem. They have been ...

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Grandmother Pat LaColla, 82, was lured by the hype—"get in shape without setting foot in a gym"—when she bought a pair of Skechers last year, wincing at the $100 price tag. Toning shoes like those she bought are the newest craze in athletic footwear, projected to grow 500 percent to become a $1.5 billion market this year. Although the designs vary, toners typically have strongly curved, thickened soles. From the moment ...

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by Kristina Fiore Jennifer Goodman Linn, 39, has been through five surgeries and six rounds of chemotherapy since 2004, trying to control the sarcoma that keeps growing in her abdomen.

Goodman Linn has what her doctors call a rare form of a rare cancer -- an MFH sarcoma, also known as an undifferentiated high grade pleiomorphic sarcoma. It's remained confined to her retroperitoneal ...

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An excerpt from Treat Me, Not My Age: A Doctor's Guide to Getting the Best Care as You or a Loved One Gets Older. by Mark Lachs, MD Over my twenty-five-year medical career, the route by which people are admitted to the hospital for an overnight stay has subtly evolved in ways that most patients (and even many doctors) may not realize. Specifically, the proportion of patients who ...

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My father passed away about two weeks ago after battling a brain tumor for some time. Initially diagnosed with an extensive inoperable mass one and one-half years ago, upon presenting with a focal seizure, he did well with only one medication for seizure control for about ten months. Around Christmas of 2009, however, he landed in the hospital in status epilepticus that took three days to control. After these days of ...

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Congratulations to the Placebo Journal's Doug Farrago, recently profiled in the New York Times. The piece highlights his work at blending humor and medicine, as well as his attempt at getting a family physician-based reality show off the ground.  A Supernanny, of sorts, for primary care. Here's a demo for the show, called Tough Medicine.  Enjoy, and best of luck Doug. classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="425" height="344" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
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We say we exchange words when we meet. What we exchange is souls. -Minot J. Savage It was Monday evening. The shelves in the electronics department overflowed with different styles, prices, and brands of headphones, all displayed in sealed plastic cases. I was in the mood to buy but was baffled by the array of options in front of me. This was not going to be as simple as I had thought. A young ...

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Skin cancer is the most common form of cancer diagnosed in the United States. There are three major types: basal cell, squamous cell and melanoma. Of those, basal cell and squamous cell are most common, accounting for about 3.5 million cases in the United States per year. Although, these types typically do not metastasize, they can be quite disfiguring, particularly after resection when they occur on the face. On a population ...

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You probably saw the July press reports: balmy tropical breezes, azure surf, cerebral plaques and tangles, and new criteria for Alzheimer's. Who could deny an opportunity to spend some time at the best non-oil-spoiled beaches for those who toil at the benches and bedsides for Alzheimer's victims -- and on taxpayer money yet. It seems to me like, just as human hip and knee joints and premolars and molars are not preprogrammed ...

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On September 16, 2010, I attended Fact or Fiction: ADHD in America, a Capitol Hill Forum, along with Val Jones of Better Health and Rob Lamberts of Musings of a Distractible Mind. The event, coinciding with ADD/ADHD Awareness Week, was a panel discussion discussing the impact ADHD has on our society. It was sponsored by Shire, in partnership with the Entertainment Industries Council (EIC) and the Lab School of Washington [Disclosure: ...

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shutterstock_212802112 If you’re relatively young and healthy, gynecologic cancers probably aren't on your radar. But they should be. This year, more than 80,000 women in the United States will get a gynecologic cancer, such as endometrial (a.k.a. uterine), ovarian or cervical cancer. In general, gynecologic cancers occur more frequently in women after menopause, although they can occur in younger women. While all women ...

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As part of the new health care legislation, the government has instituted Medicare's Physician Quality Reporting Initiative (PQRI) in an attempt to motivate health professionals to do the right thing. According to the legislation, PQRI asks physicians to report how the care they furnish aligns with evidence-based clinical guidelines for a variety of medical conditions, such as diabetes or heart disease. In 2010, physicians who successfully report these measures will receive ...

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Should the public be shielded from medical information that can mislead it? Many argue against direct-to-consumer (DTC) advertising, which is omnipresent in print and on the airwaves. Opponents of this practice argue that it promotes the use of expensive medications when patients ask their doctors if the "drug is right for them," the tag line that appears at the end of every ad. This phrase is the drug company’s limp disclaimer ...

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I have a lot of diabetes patients and have been an avid user of the thiazolidinediones (TZD) class. There are many reasons to like the TZD's:

  • The older, generic medicines like metformin and sulfonylureas are known to fail over time. After 3 years, most patients on one of these drugs lose control of their blood sugar. In contrast, patients on TZD's maintain glycemic control (at least up to 4-5 years which ...

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An excerpt from The Night Shift: Real Life In The Heart of The E.R. ©2010 by Dr. Brian Goldman. Published with permission from HarperCollins Publishers Ltd. All rights reserved. Fear and Loathing 12:47 a.m. Two police detectives were waiting for me near the main triage desk; one was a tall male in a sleek black suit, probably in his early forties. He was ruggedly handsome in the manner of Jean-Paul Belmondo, the French ...

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For years, we have heard (and I have often said) that an average of 36,000 Americans die from influenza annually. This figure is based on data from 1990-1999. Now the CDC is telling us that the range of annual deaths is too wide to continue using that single number. Based on a lot more seasons (1976-2007), the average is closer to 24,000 with a range of about 3,300 to ...

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What's one of the biggest culprits for the rise of unnecessary medical testing? Preoperative evaluation. Before most patients undergo surgery or an invasive procedure, they are normally sent to their primary care physicians for a "preoperative evaluation."  This is a visit to determine if they are medically stable enough to undergo the operation. Tests like bloodwork, an EKG, or a chest x-ray are frequently ordered.  For those with suspicion of coronary artery ...

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A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP The Annals of Internal Medicine recently published an article by Mullan and colleagues on the social mission of medical schools. In the article, medical schools were ranked on their record of educating and training physicians to care ...

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The most visible impact of Affordable Care Act is surely the expansion of health insurance coverage to 30 million uninsured Americans, but a lesser known provision in the overhaul will have far-reaching implications as well. The provision catapults the US Preventive Services Task Force (USPSTF) from an obscure agency that produced unenforceable guidelines about screening and preventive services into one whose recommendations directly impact reimbursement. According to the terms of the new ...

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I just don’t understand how someone can live in this day and age and deny the effectiveness of scientifically sound medical treatment when dealing with breast cancer. I was completely flummoxed when I came across the in-depth and thoughtful post “A horrifying breast cancer ‘testimonial’ for ‘holistic’ treatment” on Respectful Insolence, written by a surgeon and scientist who uses the pen name Orac. Like others who came before and surely will come after ...

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