Contrary to popular belief, those without health insurance are not flooding emergency rooms as a consequence of being cut off from routine and preventive care. Actually, frequent visitors to the local ER are far more likely to have insurance according to a new review of 25 studies on ER use published since 1990.
Frequent users account for about 8% of ED patients but 28% of visits. Although frequent …
Health reform won’t help the ER
I consider my most successful cases to be the ones that do not seem me any more. Not that they are “better”, but they and their families have come to realize the full complexity of the problems they are struggling with, and are getting appropriate help.
I inherited my “ADHD practice” from another pediatrician. He was wonderful man, a larger than life, toss babies in the air pediatrician with a hearty …
ADHD needs more than drugs to appropriately treat
by Marianne Mattera
President Obama is planning to appoint Don Berwick — the Harvard pediatrician, recognized health policy expert, and head of the Institute for Healthcare Improvement (IHI) — as the new head of CMS.
Berwick’s nomination has been heralded by many as a terrific choice.
Our own health policy columnist, David Nash, said that “Berwick’s global following is a powerful political force …
Don Berwick and whether he can change Medicare and Medicaid
The National Center for Health Statistics recently released a new report, Recent Trends in Cesarean Delivery in the United States. The report is most notable for a startling statistic; the C-section rate has reached the astronomical level of 32%, an increase of more than 50% since 1996. This is disturbing news.
Why is the C-section rate sky high?
The pervasive nature of the increase may hold some clues. The increase has …
C-section rates and its association with lawsuits
by Marie Cooper
St. Vincent’s Medical Center in Greenwich Village was founded in 1849, making it the third oldest hospital in New York City. It has been an occasional scene of notoriety but mostly it has witnessed countless episodes of anonymous compassion and care. My two sons were born there. As a major teaching hospital, it has over 1000 affiliated physicians. It is where generations of …
St. Vincent’s Hospital closes, but who’s to blame?
by Todd Neale
The greater burden of colorectal cancer in the black community appears to be related to healthcare utilization, and not biology, researchers found.
Similar proportions of black and white patients had polyps or masses detected by flexible sigmoidoscopy, but black patients were less likely than whites to have the recommended follow-up colonoscopy (62.6% versus 72.4%), according to Adeyinka Laiyemo, MD, MPH, of Howard University in Washington, and colleagues.
After adjustment for …
Colorectal cancer in blacks is affected by healthcare utilization
The following op-ed was published on March 30th, 2010 in AOL News.
Health reform has passed, and the United States is poised to join the rest of the industrialized world in providing most of its citizens with affordable health coverage.
But having health insurance doesn’t necessarily mean it will be easy to find a doctor. Even before reform, reports projected a shortfall of 40,000 primary care physicians over the …
Op-ed: Health insurance doesn’t mean doctors will be available
Bret Michaels is in critical condition from a subarachnoid hemorrhage.
I’ve been watching Celebrity Apprentice recently, and he comes across as a genuine person who, of course, has been raising awareness for Type 1 diabetes. As most people know, he has battled various diabetic complications on the show, and recently underwent an emergency appendectomy.
What’s his prognosis like?
Not good, I’m …
Bret Michaels has a subarachnoid hemorrhage, and what that means
Dr. Desiree Pardi was the palliative care medical director at Weill Cornell Medical Center in New York. She died of metastatic breast cancer in 2009 at the age of 41.
Her story provides palliative care clinicians an opportunity to reflect on how our own personal mortality interacts with our professional lives.
I did not personally know Dr. Pardi. I write this post knowing that many readers did indeed know her, some …
Palliative care physicians confronting their own mortality
Across the country, state Medicaid health insurance programs serving low-income children and families, people with disabilities, and older adults are struggling in an environment of chronic underfunding.
Consider that, nationwide, at least one child in four relies on Medicaid for health coverage. Medicaid funds healthcare services for two out of every five births and fills in gaps in Medicare coverage for the elderly and disabled.
But inadequate payments and outmoded methods of …
Medicaid physician payment rates hurts primary care doctors
Frequently in preventive health we ask patients to take medications that will reduce the risk of a certain bad medical outcome years down the road: cholesterol-lowering agents that lower the risk of a heart attack, blood pressure-lowering agents that reduce the risk of kidney disease, glucose-lowering medications that reduce the risk of diabetes-related complications.
Sometimes these medications make patients feel better — for example, insulin in patients with symptomatic diabetes or …
Patient adherence to drugs is low and what doctors can do
Our state of South Carolina is a delight. From wonderful people to beautiful landscapes, from a vibrant Southern culture to excellent food like shrimp and grits, it’s a place I’m thrilled to live. But we do lack a few things. And one of the most striking is adequate mental health care.
The state budget, like so many state budgets, has been trimming anything and everything. And of course, mental health coverage …
Psychiatric patients detained in the ER
by Emily P. Walker
My grandfather recently died of pancreatic cancer.
My grandpa was a WWII veteran, a nature enthusiast, an animal-lover, a chiropractor until the 1980s, and a firm believer in natural medicine. He helped my grandmother give birth to five children in her bed, and neither of them had ever taken any drugs except when both were hospitalized one winter with pneumonia.
As someone with a major respect for medical doctors …
Dementia affects the entire family
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Patient satisfaction, as I wrote previously, is being increasingly focused upon.
Doctors are often pressed for time, and appear rushed — which can potentially lead to unhappy patients.
I saw this small study showing that the simple act of sitting down while talking to patients can have a profound effect. Many doctors I know already do this, but now there’s some data to support sitting.
According to the study, performed at …
Patient satisfaction scores improve when doctors sit
When her gynecologist told her she had high blood pressure, Marie had a simple solution: switch doctors. After all, she had gone to him for a different problem, and this was the first time he had ever checked her blood pressure.
“He said, ‘Oh my God, you’re like a bomb waiting to explode.’ I said, ‘I didn’t come here for that, I came here for something else,’” she explained.
Two years later, …
High blood pressure treatment that patients need to know
I’m sure you’ve read through top doctor rankings and online physician ratings. It is only human to seek perceived leaders. But as sometimes seen in politics, those who have reached the pinnacles are often motivated by ambition, charisma, and gamesmanship instead of altruism, sincerity, and merit.
Beware the top doctors issues found in magazines and newspapers.
Some of these doctors are excellent, but many are simply “notable.” They may be well-connected, in …
Top doctors may not always be the best physicians
by Kristina Fiore
If you’re surrounded by heavy drinkers, you’re more likely to become one, new research shows.
An analysis of data on alcohol consumption and social networks found that people are 50% more likely to drink heavily if someone they’re directly connected to does so, Nicholas Christakis, MD, PhD, of Harvard University, and colleagues reported in the Annals of Internal Medicine.
“We’ve found that the influence of your friends and people you …
Social networks affect alcohol drinking patterns
Illness might be the most isolating and alienating experience a person can know. Lots of well people simply have no clue how to relate to someone with a chronic and catastrophic illness. That sort of thing is scary even just to witness. They hope (or assume) you’ll get better, and then they won’t have to deal with whatever you’re going through – but when that takes too long, they drift …
Sick friends could use your help
I was consulted recently about an elderly woman who refused surgery for a large bowel obstruction from a colonic mass, likely cancer. The inpatient team asked me to help with the transition to hospice and to help make her comfortable.
I went to see her. She had a nasogastric tube sucking up brown material from her stomach. Her abdomen was swollen and uncomfortable. Her primary goal was to return to walking …
Palliative care needs a simple and consistent message
by Michael Smith
It’s possible to reduce the burden of drug-resistant pathogens in hard-hit hospitals — all it takes is consistent effort over time, French researchers say.
That’s the conclusion after a 15-year, intensive program aimed at reducing the impact of methicillin-resistant Staphylococcus aureus (MRSA) on Parisian hospitals reported in the March 22 Archives of Internal Medicine.
The program started in 1993 in the 38-hospital, 23,000-bed Assistance Publique-Hôpitaux de Paris, the largest …
MRSA control takes consistent time and effort
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