Physician

Aortic dissection symptoms and current treatment options

by Joseph Lombardi, MD

You probably remember the tragic death of actor John Ritter in 2003.

Recently, his family partnered with the Thoracic Aortic Disease (TAD) Coalition to shed light on the condition that took his life: aortic dissection.

In addition to TAD Coalition’s “Ritter Rules,” which focus on recognizing, treating and preventing the condition, the American Heart Association and American College of Cardiology also released new guidelines designed to prevent unnecessary …

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Physicians increase revenue with better appointment analysis

by Nikolaos I. Kakavoulis, MD

Physicians are working harder than ever to generate even a small increase in their income. Despite seeing more patients, average physicians net income between 1995 and 2003 has declined about 7% after adjusting for inflation, according to a national study from the Center for Studying Health System Change.

Why is this happening?

Now more than ever, physicians face an avalanche of complex rules, regulations, and administrative processes needed …

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A DNR order may not always be best for the patient

Doctors are often encouraged to discuss advance directives with their patients.

But sometimes, when it comes to act on a “Do not resuscitate” (DNR) order, the situation can be far from clear.

In a provocative essay from the Washington Post, emergency physician Boris Veysman discusses a case where he successfully revived a man who, unbeknown to Dr. Veysman, had a DNR order.

Despite the temporary nature of the illness, the family honored …

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ER overuse may be a myth

Overuse of the emergency department is commonly discussed during the health care conversation. Especially with the lack of primary care access shunting patients with seemingly routine symptoms to the ER.

But is this a myth?

That’s what two emergency physicians contend in a piece from Slate.

The emergency department is functioning just fine, they say: “Just 12 percent of ER visits are not urgent. People also tend to think ER visits …

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My health reform opinion in AOL News

Thanks to AOL News for publishing my latest opinion piece, Reform’s Great, But We Need More Doctors.

I discuss how health reform’s ultimate success or failure is largely dependent on whether our primary care system can accommodate the millions of newly insured patients:

… having health insurance doesn’t necessarily mean it will be easy to find a doctor. Even before reform, …

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Primary care is the loss leader of medicine

Medicare’s sustainable growth rate, or SGR, has been the bane of doctors for years now.

To encapsulate, this is the reason for Medicare’s annual threat to cut doctors’ fees by 20% or more, only to be staved off at the last minute.

Emergency physician Shadowfax has a nice take on it, explaining why it has devastated primary care:

Primary care has many fixed expenses in addition to those we bear: they pay …

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Primary care is disproportionally hurt by Medicare cuts

Doctors don’t garner much sympathy when they rail against the perpetual threat of Medicare reimbursement cuts.

In a story from CNNMoney.com, a primary care physician provides some stark reality.

In an independent solo primary care practice, employing an office staff and two nurse practitioners for instance, fixed costs add up to $60,000 per month. A 21% cut in Medicare reimbursement, assuming an average sized Medicare panel, can take away …

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Doctors need protected time away from the pager

When nurses sign out during the end of shift, it’s done so in a quiet setting.

Contrast that to medical residents — at least when I was a resident 8 years ago — where pager interruptions during sign out were the norm.

PookieMD compares the situation to the “sterile cockpit” that airline pilots enjoy: “Pilots have the sterile cockpit–a situation in which, if the plane is below 10,000 feet, only conversation …

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ED can predict heart death

Originally published in MedPage Today

by Joyce Frieden, MedPage Today News Editor

Patients with erectile dysfunction (ED) who were treated with telmisartan, ramipril, or both were at greater risk for cardiovascular events than other patients on the same medications, researchers found.

In men who reported ED at baseline, all-cause mortality during a median follow-up of four years was double that seen …

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Palliative care shows the importance of language

by Patrice Villars

The best learning experiences for me have been times when I come away questioning core assumptions about the work I/we do. As palliative care folks, we try to help people understand where they are in relation to their disease and what their hopes and goals are for care. We offer treatments and resources to match those needs through, in part, supportive communication.

What if, in our kind, well-meaning …

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