2010

March 18, 2010Mar 18, 20108

Ten years ago, I was an Emergency Medicine Resident and wanted to die. Today, I’m a general practitioner in part-time practice and am in love with life. What made the difference? I signed up for a dance class. Reports on…

Reports on physician burnout list the personality traits that set us up for trouble: we’re excessively conscientious, feel overly responsible, want to please everyone, and function on an extremely high level – even …

Health policy

Medicare and how a grandmother worries about its costs

MedPage Today

March 18, 2010Mar 18, 20103

Originally published in MedPage Today by Liz O'Brien My grandmother and her hospital roommate -- aged, tiny, frail, and sporting matching bright pink hairnets. They looked like twins -- two thin shrubs in winter that had each sprouted an improbable,…

Originally published in MedPage Today

by Liz O’Brien

My grandmother and her hospital roommate — aged, tiny, frail, and sporting matching bright pink hairnets.

They looked like twins — two thin shrubs in winter that had each sprouted an improbable, big pink rose.

Although sick and scared, my grandmother had admired the pink hairnet on the lady in the next bed, so my mother …

Medical education

Match Day and how each medical school celebrates

Brian Eule

March 18, 2010Mar 18, 201012

While the debate continues to rage over the health care reform bill in Washington D.C., today at Noon Eastern time, the newest class of 15,000-plus graduating medical students will get their marching orders, beginning their lives working in medicine. It’s…

It’s called Match Day and each year, on the third Thursday of March, the nation’s graduating medical school students gather with their classmates and wait for an envelope with their name on …

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Health policy

Medicare doc fix questions and answers

Vineet Arora, MD

March 17, 2010Mar 17, 20103

A 21% cut for Medicare physician fees is set to go into place soon. This year, fixing physician payment has been overshadowed by all the talk about health insurance reform. In fact, I remember being invited to talk about healthcare…

A 21% cut for Medicare physician fees is set to go into place soon. This year, fixing physician payment has been overshadowed by all the talk about health insurance reform.

In fact, I remember being invited to talk about healthcare reform on a panel for medical students this past fall. As part of my remarks, I mentioned the 21% pending cut in physician payment and recall the questions and …

Read more…

Medicare doc fix questions and answers

Patient voices

Taxing junk food may improve your health

MedPage Today

March 17, 2010Mar 17, 201019

Originally published in MedPage Today by Kristina Fiore, MedPage Today Staff Writer Taxing junk food may help reduce obesity and improve health, researchers have found. Patients got significantly less of their energy (calories) from soda or pizza when there was…

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Taxing junk food may help reduce obesity and improve health, researchers have found.

Patients got significantly less of their energy (calories) from soda or pizza when there was a 10% increase in the price of either (P<0.001), Penny Gordon-Larsen, PhD, of the University of North Carolina at Chapel Hill, and colleagues …

Conditions and diseases

Homebirth does not protect against serious maternal infections

Amy Tuteur, MD

March 16, 2010Mar 16, 201011

Homebirth advocates like to tout the many "advantages" of giving birth at home. High on the list is limiting exposure to hospital acquired infections, and since only your "own germs" are in your home, you are protected. Yes, you are…

Homebirth advocates like to tout the many “advantages” of giving birth at home. High on the list is limiting exposure to hospital acquired infections, and since only your “own germs” are in your home, you are protected.

Yes, you are protected from hospital acquired infections, but the most dangerous infectious agents are actually those that live inside the mother, not the ones in the hospital. Consider that for newborns both Group …

Patient voices

Patient costs when making medical decisions

Edward Pullen, MD

March 16, 2010Mar 16, 201013

At my office we provide care for a fair number of patients without medical insurance. Sometimes we are faced situations with no good options. At a patient visit, often times the diagnosis is not clear without doing some diagnostic tests…

At my office we provide care for a fair number of patients without medical insurance. Sometimes we are faced situations with no good options.

At a patient visit, often times the diagnosis is not clear without doing some diagnostic tests other than the history and physical exam. Many of these tests are ordered from sources outside the office, where I have little or no control over the cost of the test …

Health technology

EMR conversion doesn’t always help physician communication

Stuart Sutton, MD

March 16, 2010Mar 16, 20107

Our very large and very integrated health care system is plowing ahead with EMR implementation. All the offices are gradually converting from paper charts and all the hospitals have completed the process. As a member of one of the last…

As a member of one of the last offices to be converted to the EMR, I’ve had the pleasure of patients being assured that the notes were sent to me (albeit via the EMR we are not yet using). …

Conditions and diseases

Physical exam evidence and whether it’s still useful

Zackary Berger, MD, PhD

March 15, 2010Mar 15, 20106

A number of respected physicians have called for a renewed emphasis on the physical exam. Perhaps most prominently, Abraham Verghese has joined with colleagues at Stanford University to publicize the Stanford 25, a list of physical-exam maneuvers that they hold…

These calls reflect in part the fear that checklist medicine will lead to doctors’ obsession with what Jerome Groopman calls the “iPatient” (the …

Health technology

Use iPhone apps for emergency room wait times with caution

Satish Misra, MD

March 15, 2010Mar 15, 20102

Emergency rooms are notorious for their long waiting times – that’s pretty common knowledge. But now the Hospitals of Central Connecticut are looking to a new medical app for the iPhone to help improve their emergency room wait times. Having…

Having spent a fair amount of time recently working in an emergency room, I (and probably everyone with similar experiences) can assure you that no one – physicians, nurses, administrators – want …

Conditions and diseases

PSA for prostate cancer screening is likely to continue

MedPage Today

March 15, 2010Mar 15, 2010

Originally published in MedPage Today by Crystal Phend The ASCO Genitourinary Cancers Symposium met recently, just after the American Cancer Society updated its prostate cancer screening guidelines to emphasize shared decision making and Congress heard testimony over use of prostate…

Originally published in MedPage Today

by Crystal Phend

The ASCO Genitourinary Cancers Symposium met recently, just after the American Cancer Society updated its prostate cancer screening guidelines to emphasize shared decision making and Congress heard testimony over use of prostate specific antigen (PSA) in prostate cancer screening.

Now urology is no stranger to debate. Controversy continues on overdiagnosis, overtreatment, and other issues raised …

Conditions and diseases

PSA screening for prostate cancer debated in Congress

MedPage Today

March 14, 2010Mar 14, 20103

Originally posted in MedPage Today by Emily P. Walker, MedPage Today Washington Correspondent A day after the American Cancer Society (ACS) released updated prostate cancer screening guidelines, the group's chief medical officer was before Congress urging the government to fund…

Originally posted in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

A day after the American Cancer Society (ACS) released updated prostate cancer screening guidelines, the group’s chief medical officer was before Congress urging the government to fund research into alternative screening methods for prostate cancer.

Otis Brawley, MD, an oncologist and chief medical officer for the ACS, told the House Oversight …

Patient voices

Poetry that your patient can appreciate

Danielle Ofri, MD, PhD

March 13, 2010Mar 13, 2010

When I make rounds with my students and interns, I always try to sneak in a poem at the end. I think poetry is important because it helps convey the parts of the medical experience that don’t make it into textbooks. It’s important because it teaches creative thinking—something of immense value to doctors.

It’s important because interpreting metaphors is a critical clinical skill in diagnosis; patients’ symptoms often present in metaphorical …

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Poetry that your patient can appreciate

Patient voices

7 ways inmates can receive quality medical care from doctors

Jeffrey Knuppel, MD

March 12, 2010Mar 12, 20103

Many non-correctional health care providers will also treat inmates from time to time. This may occur in the office or hospital. How can one best approach the challenges of working with the incarcerated in order to deliver the best possible…

1. Treat the patient with respect. Not submissive respect, but mutual respect — the way we all want to be treated. I believe that this principle …

Health policy

Children with special healthcare needs are underinsured

MedPage Today

March 12, 2010Mar 12, 20102

Originally published in MedPage Today by Chris Emery, MedPage Today Contributing Writer Nearly a third of children with special healthcare needs are underinsured, and where a child lives strongly influences whether he or she will have adequate healthcare coverage, a…

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Nearly a third of children with special healthcare needs are underinsured, and where a child lives strongly influences whether he or she will have adequate healthcare coverage, a new study found.

The unadjusted proportion of underinsured special-needs children varied strongly by state, ranging from 24% in Hawaii (standard error=1.75) to 38% …

Health policy

AMA: Health insurance consolidation can undermine physicians

American Medical Association & J. James Rohack, MD

March 11, 2010Mar 11, 2010

The following is part of a series of original guest columns by the American Medical Association. by J. James Rohack, MD Physicians in nearly every area of the country face a David and Goliath scenario when negotiating with entrenched health…

The following is part of a series of original guest columns by the American Medical Association.

by J. James Rohack, MD

Physicians in nearly every area of the country face a David and Goliath scenario when negotiating with entrenched health insurance companies. This is clearly illustrated by a new AMA study showing that competition in the health insurance industry is disappearing as more markets across the …

Health policy

Health care reform needs to pass now, and here’s why

Matthew Mintz, MD

March 11, 2010Mar 11, 201040

There are certain actions we take even though we know that ultimately we will not be successful. Sometimes we do this out of hope for a better tomorrow (like playing the lottery) or because we are taking a moral stand…

Supporting health care reform is probably a little of both.

Even if any of the currently proposed health care reform plans pass, …

Conditions and diseases

Autism in children can be missed early in life

MedPage Today

March 11, 2010Mar 11, 2010

Originally published in MedPage Today by Chris Emery, MedPage Today Contributing Writer The symptoms of autism tend to emerge in children after six months of age, with a loss of social and communications skills that is more common and more…

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

The symptoms of autism tend to emerge in children after six months of age, with a loss of social and communications skills that is more common and more subtle than previously thought, according to a new study that questions previous assumptions about the progression of the condition.

At six months, …

Medical education

Patient handoffs limit residents work hour cap gains

Vineet Arora, MD

March 10, 2010Mar 10, 20109

Anyone affiliated with a teaching hospital knows that the controversy regarding resident work hours is heating up again. It's been over 5 years since the ACGME limited resident hours to 80 hours per week with a maximum of 30 consecutive…

Anyone affiliated with a teaching hospital knows that the controversy regarding resident work hours is heating up again. It’s been over 5 years since the ACGME limited resident hours to 80 hours per week with a maximum of 30 consecutive hours. While this may not sound like ‘reform’, as someone who trained prior to these rules, it is definitely a change.

More recently, the Institute of Medicine issued a …

2010

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