2010

Autistic enterocolitis may not be real

May 7, 2010May 7, 20103

by Todd Neale The status of a new inflammatory bowel condition identified in the retracted Lancet paper that linked the MMR vaccine and autism -- autistic enterocolitis -- appears to be in limbo. The 1998 paper by Andrew Wakefield, MBBS,…

by Todd Neale

The status of a new inflammatory bowel condition identified in the retracted Lancet paper that linked the MMR vaccine and autism — autistic enterocolitis — appears to be in limbo.

The 1998 paper by Andrew Wakefield, MBBS, and colleagues was fully retracted by The Lancet in February, although the alleged and repeatedly disproven vaccine link was dropped in …

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A pre-medical student writes to her gross anatomy cadaver

Hana Low

May 7, 2010May 7, 201013

A letter from a pre-medical student honoring her gross anatomy cadaver. Letter to the other side by Hana Low Thank you for donating your body to science and medical education. It's so generous to give yourself to those you will…

A letter from a pre-medical student honoring her gross anatomy cadaver.

Letter to the other side
by Hana Low

Thank you for donating your body to science and medical education. It’s so generous to give yourself to those you will never meet. I hope you’re having a good time, up there or wherever you are.

Working with your body has made me acutely conscious of the dangers in my everyday environment. I have to …

China medical school and residency training

Vineet Arora, MD

May 6, 2010May 6, 20103

My husband and I recently traveled to Wuhan Medical School in the Hubei Province in central China. Our medical school has partnered with Wuhan to help inform their curricular reform efforts. We spent 4 days touring the hospitals and teaching…

My husband and I recently traveled to Wuhan Medical School in the Hubei Province in central China.

Our medical school has partnered with Wuhan to help inform their curricular reform efforts. We spent 4 days touring the hospitals and teaching facilities, meeting students and faculty, going on rounds, and giving talks. Although the language barrier was challenging, we had incredible translators who worked to translate every slide we spoke …

Calorie counts in health reform is significant for patients

Danielle Ofri, MD, PhD

May 6, 2010May 6, 20106

Counting calories as part of health care reform—who knew? But apparently it’s there on page 455 of the health-care reform act, according to Marion Nestle, Professor of Nutrition at NYU, writing in the New England Journal of Medicine. There will…

There are many ways to improve the overall health of Americans, but tackling obesity is surely one of the …

Conditions and diseases

Inhalant abuse remains prevalent in teens

May 6, 2010May 6, 20102

by Todd Neale Although inhalant abuse has become less prevalent since the early 1990s in all age groups, it remains a source of injury and death, particularly among teenagers, researchers have found. From 1993 to 2008, intentional exposure to 3,410…

by Todd Neale

Although inhalant abuse has become less prevalent since the early 1990s in all age groups, it remains a source of injury and death, particularly among teenagers, researchers have found.

From 1993 to 2008, intentional exposure to 3,410 different inhalants was reported to U.S. poison control centers, Toby Litovitz, MD, of the National Capital Poison Center in Washington, and colleagues reported in the May issue of Pediatrics.

The highest rate of …

Social media in medicine

Social networking impact on patients, doctors, and non-profits

David B. Nash, MD, MBA

May 6, 2010May 6, 20104

In its current listing of online social networks, Wikipedia presents 156 major, active websites. A neighboring link to view "now-defunct" sites accompanies the listing -- a subtle reminder of the Internet's competitive and volatile environment where promising endeavors rise and…

In its current listing of online social networks, Wikipedia presents 156 major, active websites. A neighboring link to view “now-defunct” sites accompanies the listing — a subtle reminder of the Internet’s competitive and volatile environment where promising endeavors rise and fall overnight.

But although the popularity of a specific website may fade with time, the practice of online social networking is here to stay.

In its simplest form, online social networking is …

Health technology

How Massachusetts can lead health IT modernization

John Halamka, MD

May 6, 2010May 6, 201010

Although healthcare reform has its supporters and detractors, healthcare IT reform - the use of technology to improve the quality, safety and efficiency of healthcare throughout the country - has broad support from all stakeholders. The passage of last year’s…

Although healthcare reform has its supporters and detractors, healthcare IT reform – the use of technology to improve the quality, safety and efficiency of healthcare throughout the country – has broad support from all stakeholders.

The passage of last year’s $787 billion economic stimulus bill brought with it a healthcare IT modernization program that could inject about $30 billion into the economy. Since Massachusetts is a leader both in the use …

Family comes first for some who have finished residency

Anonymous

May 5, 2010May 5, 201024

I have met several women who have completed residency and maybe even practiced beyond that, but decide to quit and stay at home with kids. I wonder - why would a woman who has gone through all of that training…

I have met several women who have completed residency and maybe even practiced beyond that, but decide to quit and stay at home with kids. I wonder – why would a woman who has gone through all of that training just quit? It would seem like the hard part is behind them and I am perplexed by their decision but, of course, I don’t want to …

How Massachusetts controls health costs should be closely watched

David Williams

May 5, 2010May 5, 201010

A major criticism leveled at the health reform law is that it doesn’t do enough to control costs. Yet experience with a similar breed of health reform in Massachusetts indicates that the cost control issue will come to the fore…

Recent stories have reinforced my conviction about this:

Massachusetts health plans have sued the state and stopped issuing new policies to small businesses and individuals after the …

Maternal death rates improve but hurts fund raising

May 5, 2010May 5, 2010

by Mike Himowitz When you’re advocating for a health cause, can good news be bad news? It’s entirely possible -- when science threatens fund-raising, and at the worst possible time. Consider a study of worldwide maternal death rates by a…

by Mike Himowitz

When you’re advocating for a health cause, can good news be bad news?

It’s entirely possible — when science threatens fund-raising, and at the worst possible time.

Consider a study of worldwide maternal death rates by a team from the University of Washington that appeared online recently in The Lancet.

The group, led by Christopher Murray, of the school’s Institute for …

Quality hospital care deserves to be celebrated

Brian Klepper, PhD

May 5, 2010May 5, 2010

Last week my wife and best friend, Elaine, had massive abdominal surgery. We fully expected her to be an inpatient for a week, but she was home in four and half days. To watch her recover was to see what happens when everything converges: the deep knowledge and skills of excellent, humane physicians; a capable, caring clinical staff; wonderful new technologies; and a lifetime of eating right, being fit and …

Health reform may mean meaningful changes for physicians

Aldebra Schroll, MD

May 4, 2010May 4, 20106

Jim called me late on a fall afternoon to report our mutual friend was in the local emergency room. “It looks like he had a stroke”. I immediately asked to speak to the ER doctor for the results of the…

It has been over two years since my friend died. He was among the millions …

Health technology

Problem list problems with electronic medical records

Hans Duvefelt, MD

May 4, 2010May 4, 20104

In family medicine it has been common to keep a “Problem List” in patients’ paper charts. Usually placed on the left hand side, on top of the Medication List, it has given doctors like me an instant thumbnail sketch before…

A typical Problem List would include diagnoses like diabetes, hypertension, high cholesterol or rheumatoid arthritis. It would list prior surgeries, like …

Malpractice fears influence cardiology decisions

May 4, 2010May 4, 20105

by Charles Bankhead For nearly a quarter of cardiologist respondents, malpractice concerns influenced their decisions to order tests or treatment for hypothetical cases included in a national survey. Almost 30% of cardiologists acknowledged ordering cardiac catheterization because colleagues did so…

by Charles Bankhead

For nearly a quarter of cardiologist respondents, malpractice concerns influenced their decisions to order tests or treatment for hypothetical cases included in a national survey.

Almost 30% of cardiologists acknowledged ordering cardiac catheterization because colleagues did so in the same situation, according to an article published online in Circulation: Cardiovascular Quality Outcomes.

Concerns about malpractice had a significant association with regional use of tests and treatment, Frances Lee Lucas, PhD, …

Avoiding the ER and arranging a direct admit is not easy

Kevin

May 4, 2010May 4, 201016

Are emergency departments solely responsible for the bulk of unnecessary tests? Most would like to believe so, but emergency physician Edwin Leap says that's not the case. He cites an instance involving a primary care doctor and hospitalist: Local physician,…

Are emergency departments solely responsible for the bulk of unnecessary tests?

Most would like to believe so, but emergency physician Edwin Leap says that’s not the case.

He cites an instance involving a primary care doctor and hospitalist:

Local physician, who does not admit to the hospital, sees patient in the office. Patient has uncontrolled hypertension and is having some chest pain and shortness of breath. Local physician contacts hospitalist.

…

Defensive medicine worsens patient care and raises costs

Roy Benaroch, MD

May 3, 2010May 3, 2010

Health care in the United States costs too much, and it doesn’t look like that’s going to change. Recent health care reform legislation doesn’t take any meaningful steps towards reducing or controlling costs. In fact, it explicitly forbids states from…

How does a fear of lawsuits increase costs? The most direct way is …

Residency team changes can improve education and patient care

Robert Wachter, MD

May 3, 2010May 3, 2010

In the early 90s, I had the privilege of directing UCSF’s exceptional internal medicine residency program. It was a time of transition. A decade earlier, residency accreditation requirements (dictated by the Accreditation Council for Graduate Medical Education, ACGME) were fairly benign and largely ignored – marquee programs like ours were generally given carte blanche to organize our residents’ experience as we saw fit.

When I took over our residency in 1992, …

Money prevents patients from seeking timely heart care