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Understand your options before monitoring Internet use

Health Technology

November 10, 2010

As medical practices become more advanced, staff members gain improved access to the Internet during work hours. Cyber-slacking is a well-known problem in corporations; in fact, one study found that over thirty-five percent of employees admit to using the Internet for personal surfing at work.

The New York Times cited that twenty-five percent of Net use on work computers isn’t actually work-related. Although it is unknown how severe the problem is …

Will the new Congress allow the physician Medicare cuts to pass?

Dan McCoy, MD

Health Policy

November 10, 2010

Well it’s that time of year again.

No, not Thanksgiving or Christmas, or even the venerable Interim Meeting of the AMA. It’s the time that physicians nationwide anticipate another mandatory cut in Medicare reimbursement rates.

This time the recurrent temporary fix will result in a cut of 23.6 percent on December 1st. Assuming political gridlock the rate will fall another fraction of 6.5 percent on …

How EMRs are failing nurses

Jared Sinclair, RN

Health Technology

November 9, 2010

Among the litany of complaints about the (un)usability of EMRs, it’s easy to lose sight of the big picture. More than the poor design choices and overall ugliness of existing software, by far the single biggest failure of HIT companies is that none of them has yet to produce an EMR that nurses actually need.

There is a huge opportunity being wasted here. Other industries have been able to incorporate computers …

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How EMRs are failing nurses

Patient safety suffers when doctors are forced to learn multiple EMRs

angienadia, MD

Health Technology

November 9, 2010

As a new intern at a well-endowed medical institution, I was disappointed despite the flurry of excitement that comes with orientation. I was disappointed despite the brand new privilege to save lives and relieve human sufferings. And the disappointment was made clear to me over the past two days.

What has happened in the past two days? As I will be working at two separate hospitals, for the past two days …

Uninsured Americans cannot afford many medications

Brad Wright, PhD

Health Policy

November 9, 2010

I went to the doctor recently and got a new prescription.

The doctor was kind enough to give me some free samples, and a voucher that I could redeem to fill the prescription once at no cost. In the future, it will cost me $50 if I decide to refill it. If I didn’t have pharmaceutical benefits through my insurance coverage, the medication would set me back about $500 for a …

Why patients are leaving our practices

Jordan Grumet, MD

Physician

November 9, 2010

She was like … Superwoman. A strapping medical visionary probably in her forties. Gray long coat falling below the knees. She strode confidently down the hallway towards the elevator, a father hurrying beside her with his young lanky daughter cradled in his arms. The girl’s head nuzzled into her father’s shoulder. She was old enough to walk by herself…but clearly she was sick. Unable.

Undoubtedly they were headed from the medical …

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Why patients are leaving our practices

An ACO may or may not reduce health insurance premiums

Paul Levy

Health Policy

November 8, 2010

Is the move towards accountable care organizations (ACOs) and capitated (aka, global) payments likely to reduce health care costs and insurance premiums, or will it do the opposite?

Being an economist, my answer will be, “On the one hand … On the other hand …”

On the one hand, ACOs offer the potential for a better integration of care across the spectrum of primary care, hospitalization, skilled nursing, rehabilitation, and hospice. If …

Is your child’s behavior due to ADHD?

Orly Avitzur, MD

Conditions and Diseases

November 8, 2010

When my oldest son was 13 he began to do poorly in school. He often forgot to do his homework, or he did it but forgot to hand it in. He had difficulty paying attention during tasks, was extremely disorganized, and his teachers said he was easily distracted. They suggested that his behavior fit with many of the symptoms of attention deficit hyperactivity disorder (ADHD), but since this was mostly …

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Is your child’s behavior due to ADHD?

Primary care private practice will die, will patients benefit?

Kevin Pho, MD

KevinMD

November 8, 2010

Having more primary care physicians doesn’t necessarily improve the quality of care.

That may come as a surprise to regular readers of this blog, but that’s one of the findings that came from a recent analysis of the Dartmouth Atlas.

As reported by the WSJ’s Health Blog,

having regular primary-care visits isn’t a guarantee of receiving recommended care. There was “no relationship” between rates of breast cancer screening for women age 67-69 …

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Primary care private practice will die, will patients benefit?

Coping with frightening circumstances after a cancer diagnosis

Bruce Campbell, MD

Conditions and Diseases

November 8, 2010

For myself I am an optimist — it does not seem to be much use being anything else.
-Winston Churchill

Even before I met him, I could tell that his cancer was extensive. His problems had started several months before with a cough, a voice change, and some trouble swallowing. His primary doctor had not spotted anything but had kept an eye on him. Antibiotics and cough medicine had not helped. After …

Can a social media manager convince doctors to get online?

Kevin Pho, MD

KevinMD

November 8, 2010

A social media manager is becoming an imperative position for hospitals.

Medical institutions are waking up to the fact that they need to engage their patients and physicians online. No where is there more fertile growth than in the various social media platforms that are prevalent today — like Facebook, Twitter, and YouTube.

American Medical News recently profiled the phenomenon, highlighting the position of social media manager, which some institutions pay between …

Alzheimer’s disease: 5 reasons why awareness matters

Kevin

Conditions and Diseases

November 8, 2010

by Dennis Fortier

More so than with any other major disease, our near-term progress in the battle against Alzheimer’s will be determined largely by our ability to improve awareness about several aspects of this encroaching threat.

Summarized here are five reasons why greater awareness about Alzheimer’s disease, and a deeper public understanding of risks and prevention strategies, will play a key role in the nation’s ability to triumph against the prospect of …

Questions about the early diagnosis of Alzheimer’s disease

Juliet K. Mavromatis, MD

Conditions and Diseases

November 8, 2010

Alzheimer’s disease made headlines recently, first with news about a new biomarker test that is able to diagnose the disease with increased accuracy, then with a follow-up story detailing the collaborative model of data-sharing that contributed to the success of recent research.

As I read the news with interest I couldn’t help but feel that in our current climate, the manner in which it was reported was …

Expanding hepatitis B vaccine recommendations for adults

William Schaffner, MD

Physician

November 7, 2010

My colleagues at the Advisory Committee on Immunization Practices (ACIP) are examining a proposed policy for hepatitis B vaccination for diabetic patients. If accepted, this would be the next in a series of baby steps expanding hepatitis B vaccine recommendations for adults. While we are taking these baby steps, HBV incidence rates among U.S. adults remain pretty flat, and they haven’t changed much since 2006.

We know the vaccine works. We …

Why total body scans are a scam

Michael Kirsch, MD

Conditions and Diseases

November 7, 2010

Folks across the country are paying hard cash for total body scans, abdominal aortic aneurysm testing, CAT coronary artery scans and carotid artery evaluations to prevent disease or find important lesions early. It’s a seductive argument, and it’s a scam.

Ordinary patients don’t understand about pre-test probability and positive and negative predictive values. Indeed, all physicians were taught to consider Bayesian theory when ordering diagnostic tests. This is very tough concept for …

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Why total body scans are a scam

Avandia, Actos and behind the scenes of study 175

Matthew Mintz, MD

Medications

November 7, 2010

Though I am not going to say that the New York Times lied, they either purposely and grossly misrepresented the truth or did a horrible job of reporting.

In their article, “Diabetes Drug Maker Hid Test Data, Files Indicate” the Times states that Avandia maker GSK “secretly began” a study which “provided clear signs that it (Avandia) was riskier to the heart.”

In fact, the study in question, called study …

How fear may lead to infidelity

Srini Pillay, MD

Physician

November 6, 2010

When we think of infidelity as “mere cheating” we are often overlooking the many fears that go along with this. Infidelity may be due to fears and fears themselves may lead to infidelity. Why is this, and what can you do about this?

1. Fear of being trapped. One of the greatest fears of commitment is the fear of being trapped. When people feel trapped, their primitive brains start to rebel. …

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How fear may lead to infidelity

How much breast cancer chews up your schedule

Jackie Fox

Conditions and Diseases

November 6, 2010

Whether you’re newly diagnosed with DCIS or a more advanced form of breast cancer, you’ll notice it has a big time impact. One of the things that surprised me was just how much breast cancer chews up your schedule. I had something like 38 appointments in 20 weeks, and this did not include radiation, which was not in my treatment plan.

In case you’re wondering what all those appointments were for, I had two …

Vaccines and the diseases vaccination can prevent

Kevin

Patient

November 6, 2010

by Val Jones, MD

Vaccines have saved more lives than any other medical intervention in history. They are incredibly safe and effective and are well-tolerated by most people. In the US, the Centers For Disease Control and Prevention (CDC) carefully reviews all reports of adverse reactions that could be associated with vaccines. Over decades of review, they have found that the rate of …

Physicians should establish rules with their patients before using a PHR

Glenn Laffel, MD, PhD

Health Technology

November 5, 2010

These days, it seems that for every consumer advocate out there who promotes the personal health record (PHR) as The Patient Empowerment Ubertool, there’s at least 10 physicians worried sick that the technology will further complicate their frazzled work lives.

The fear and loathing derives from an increasingly common and distinctly distasteful experience in which a patient presents the physician with a thumb-drive, computer disk or Web-link to a site containing …

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