Physician

Don’t let a doctor make you feel uncomfortable

by Diana E. Lee

One member of my health care team is a migraine specialist in another state. Since we don’t have many opportunities to work together in person, we generally try to pack a lot into my periodic two-day visits.

Last time I was there I had an experience that has left me feeling guilty all these months later.

My doctor, who I respect and admire greatly, asked if I was interested …

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Can chest pain patients be evaluated in the ER waiting room?

by John Gever

Emergency department patients with chest pain may safely be evaluated in the waiting room when necessary, researchers said.

Among 303 patients triaged to waiting-room evaluation in a prospective study, no acute coronary syndromes were missed and adverse event rates overall were lower than among 804 patients who were assessed in conventional monitored beds, reported Frank Scheuermeyer, MD, of St. Paul’s Hospital in Vancouver, British Columbia, and colleagues online in …

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Residents who specialize in surgery are influenced by family

by Chris Emery

Single and childless surgical residents in the U.S. are more likely to pursue specialized surgical fellowships, and a majority of surgical residents believe a successful career depends upon specialty surgical training, a new survey found.

Of residents who responded to the survey, 28.7% believed general surgery is becoming an obsolete career path (30.1% of men and 25.9% of women, P=0.004), and 55.1% believed specialty training is necessary for career …

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Why pediatricians and other primary care doctors leave medicine

There’s little question that the workplace environment for doctors is deteriorating.

Especially in primary care, where physicians are arguably needed the most.

That’s why is so disheartening to read this Newsweek essay from pediatrician Karen Li, explaining why she left the field.

Much of her piece can be attributed to the bad old days of managed care, where doctors were frustrated by the bureaucratic impediments placed before them:

Why would a businessman or, worse …

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Interruptions in the emergency department can lead to errors

by Nancy Walsh

Busy clinicians in the emergency department reduce the time they spend on clinical tasks when interrupted, working faster and possibly cutting corners, a prospective observational study found.

Overall, clinicians were interrupted 6.6 times per hour, and 11% of all tasks were interrupted, according to Johanna I. Westbrook, PhD, of the University of Sydney, in Australia, and colleagues.

The mean “time on task” for uninterrupted tasks was 1 minute and 26 …

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Never events need to account for pre-existing medical conditions

Expanding never events to include conditions that may not be totally preventable is bound to invite controversy.

I wrote about the issue previously in USA Today, saying, “despite impeccable care, some hospital complications cannot be prevented.”  I cited the facts that no studies exist that show how infections can be cut to zero, and even the government acknowledges that there are few effective guidelines to reliably halt the onset of …

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Choosing between Lasik and Lasek eye surgery

by Tim Harwood

Hundreds of thousands of people each year are taking the plunge and choosing to have the life changing procedure that is laser eye surgery.

It is currently the most popular elective surgery in the world and the number of people having it done is likely to increase as the procedure becomes safer and more accurate. If you yourself are considering having laser eye surgery, then you will almost …

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Medical malpractice from both a doctor and lawyer perspective

A video excerpt from The Vanishing Oath, a film directed by Ryan Flesher, MD.

Medical malpractice is a major issue that divides doctors and lawyers — with patients often left in the middle. I wrote last year in USA Today that reform is sorely needed, mainly to help injured patients be compensated more quickly and fairly than they currently are:

Researchers from the New England Journal of Medicine found that …

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BMI should be routinely measured in pediatric patients

by Emily P. Walker

Physicians should record body mass index (BMI) of their pediatric patients during routine offices visits, according to a sweeping new plan laid out by a White House task force on ways to shrink childhood obesity rates over the next 20 years.

The inter-agency President’s Task Force on Childhood Obesity was formed three months ago as part of the Let’s Move! initiative and was given 90 days to draft …

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Why stress in doctors needs to be recognized and treated

Do doctors take care of themselves?

Sometimes, patients may better follow the advice of physicians that are not obese and don’t smoke. That was a question asked in a post last year, entitled, When fat doctors talk to obese patients.

According to studies, as reported in the Wall Street Journal, it’s a mixed bag:

Physicians as a group are leaner, fitter and live longer than average Americans. Male physicians keep …

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Working overtime can increase coronary artery disease risk

by Todd Neale

British civil servants working three to four hours longer than usual per day appear to have an increased risk of having a coronary heart disease event, a prospective cohort study showed.

After accounting for traditional cardiovascular risk factors and other variables, those working 11 to 12 hours per day had a 56 percent greater risk of coronary death, nonfatal myocardial infarction, or angina than those who worked normal hours, …

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Some patients think primary care is worthless

How much is a primary care appointment worth?

Not much, it appears.

Physicians in California decided to embark on an innovative idea, asking patients to simply pay them what they thought the visit was worth.

Here’s how it worked:

On the day of the events, no insurance was accepted. Care was provided only to the uninsured, who were asked to pay what they could afford. Laboratory tests were provided at cost, and patients who …

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Cholesterol can be improved by eating nuts

by Todd Neale

Eating nuts improves blood lipid levels, which may help stave off heart disease, researchers found.

In a pooled analysis of 25 intervention trials, eating an average of 67 grams of nuts a day (2.4 ounces) reduced total cholesterol by 5.9% and LDL cholesterol by 7.4% (P<0.001 for both), according to Joan Sabaté, MD, DrPH, of Loma Linda University in California, and colleagues.

The ratios of total to HDL cholesterol and …

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