So there was a neurosurgeon who called a plumber for a house visit.
The plumber arrived and after spending an hour bestowed the neurosurgeon a bill of $500. The surgeon was stunned; he said, “Even I don’t charge this much after a surgery.” The plumber stood up, gave him a sly look and said, “well that is why I am a plumber now; I used to be a neurosurgeon.”
I mention this …
How a plumber charges more than a neurosurgeon
The official ESC journal Europace publishes an online case report by Dr. Martin Hudec about the extremely rare and spectacular failure of a recently implanted Biotronik 340 VR-T ICD in a 46-year-old man. The battery of the device apparently overheated, causing the device to malfunction and leading to severe internal burning.
On Wednesday, October 6, US electrophysiologist Westby Fisher summarizes the Europace article on his blog and reprints several extremely gruesome …
Suspicious withdrawal of a publication from an academic journal
by Brian Loew
Travelers with medical conditions hope that the TSA pat-down incidents involving bladder cancer survivor Thomas “Tom” Sawyer, at Detroit Metro Airport, and to breast cancer survivor Cathy Bossi, at Dulles Airport, are isolated incidents. But these reports are already creating a chilling effect on air travel for people with medical conditions and disabilities.
This group of travelers could benefit the most from holiday …
Travelers with medical conditions fear increased TSA security procedures
This is a topic close to home.
My wife was diagnosed with stage 3C cancer of the ovary a bit over a year ago. She was a chemotherapy superstar, had few complications, and has been in remission since her treatment finished last October. Still we know her chances of a cure are fairly low.
Understanding statistics is a mixed blessing. Even though her chances of this cancer never recurring are pretty low, …
Living with cancer is different from living after cancer
by Dennis Grace
For years, if you asked for a recommendation for a physician, the answer included some mention of bedside manner.
I mean, we’re human beings first and patients second, so we think it’s great that she’s a brilliant doctor, but is she pleasant? Is she respectful and patient? Nobody wants to work with a know-it-all, especially one who gets to hear about our bowel movements …
Bedside manner may need to include cost of care discussions
There has been significant media attention on a New England Journal of Medicine case report where a surgeon, Massachusetts General Hospital’s David Ring, described how he operated on the wrong hand of a patient.
Here’s a summary of the case:
Ring, along with colleagues at Massachusetts General and Harvard Medical School, detailed the series of missteps that led to the wrong operation in the patient whose ring finger on her …
The malpractice system doesn’t improve patient safety
Antibiotics for viral infections are a big pet peeve of mine. No. Make that a huge pet peeve.
Some doctors prescribe antibiotics for coughs and stuffy noses because the patients want them. If you’re one of those patients who think that antibiotics make your coughs go away, or clear up your stuffy noses, or somehow make your sinus headaches vanish, or if you’re a doctor who prescribes antibiotics for these symptoms, …
Antibiotics need to become controlled substances and regulated
A recent report in the Annals of Internal Medicine on the characteristics of prescriptions that are abandoned at the pharmacy raise the question of (1) how to ensure that people actually pick up their prescriptions, and (2) how to make sure that people actually take the medications that are prescribed.
What role does modern Electronic Health Record (EHR) technology play in this question?
A study by the non-profit New England Healthcare Institute …
Electronic health records (EHR) to improve medication compliance
by Rosemarie Nelson, MS
Everyone is trying to “do more with less” and concerns about the economy add fuel to that fire! But, when done with purpose and thoughtfulness, you can manage vendor relationships so that you’ll deliver successful negotiations that will get the most bang for the buck for any medical practice, small or large, multispecialty or single specialty.
Preparation and setting objectives well before contract …
How your medical practice can manage vendor relationships
Recently, Dr. Scot Silverstein over at Health Care Renewal published this update to the ongoing story of electronic medical records that are so simple, intuitive and easy to use that doctors and hospitals everywhere are being forced to hire “scribes” to run them.
We’d looked at the resurgence of scribes in a previous post, and Dr. Silverstein’s article seems to confirm that the phenomenon is is here to stay for …
Scribes lead to unintended consequences from electronic medical records
I’m not sure about the validity of this study: Free Access to U.S. Research Papers Could Yield $1 Billion in Benefits.
Quantifying how much money will be saved by increased efficiency due to open access seems like fuzzy math at best. However, we do need better access to medical journal articles. As a researcher, I’ve constantly fought the battle against firewalled journals. I am fortunate to be part of a university …
Paying for access to medical journals
Everyone one knows ER docs work shifts. Many places though have each doc doing a set schedule. Such as 1 day, 1 evening, 1 overnight or one week with days, one with evenings, and one with nights.
Others, like my hospital, it is a mass jumble. We work all sorts of random shifts at random times, so long as it evens out at the end of the 6 week block that …
Shifts and making switches in the ER
For five years I worked at GlassHospital’s Student Care Center.
I don’t get no respect, neither.
One of the great things about GlassHospital is that it sits on the campus of a well-known and fairly well-respected former Big Ten university.
Like all colleges and universities, our place acts in loco parentis to the students that grace its campus. This means responsibility for our students’ health and well-being.
I loved working at the Student Care …
Working at the student care center in college
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Viral upper respiratory illnesses, or common colds, are by far the most frequent illness I see in my office.
It is called the common cold because it is, well, common. I typically can make the diagnosis with a high degree of certainty based on the pattern and the timing of the symptoms. Deciphering cold symptoms and knowing when to worry is what a pediatrician does more often than anything else, and …
Colds teach the immune system how to fight future viruses
The New York Times recently ran an article tackling a complex ethical dilemma in cancer care: the withholding of treatment in clinical trials. Because I was treated in 3 clinical trials in the 1990s, the topic is close to my heart.
Scientists have advanced the treatment of disease using the scientific method. By that, I mean they have tested a theory using rigorous methods that give a reliable and reproducible answer. This …
Ethics of placebo in cancer treatment clinical trials
by Stephen R. Blumberg, PhD
If you are like many Americans, you are planning or getting ready to take a summer vacation. Sounds very exciting. Aruba. A cross-country jaunt. Or a short trip overnight to the coast!
What is exciting for the panic-free community can be agony for a panic sufferer. Why?
The core fear is being trapped far from safety
Whether it is traveling on a cruise ship, airplane, highway driving, …
Travel tips for a panic free vacation
Physicians hate acid. But, hey, who doesn’t hate acid? It burns things. It corrodes. It’s that after-pizza punishment.
We prescribe antacid medications by the ton in this country, not because people’s stomachs have developed increased acidity, but because people in our modern society are generally overweight, like to eat large meals, and prefer fatty foods and things like alcohol, chocolate, and tobacco, all of which tend to worsen acid reflux.
Physicians like …
Concerns about long term acid suppressive therapy
No shows. It seems that no matter what we do, we always have them.
Despite the fact that we call every single person on the schedule to remind them of their appointment the day before (the staff personally makes the call. We don’t use an automated system) we found that in 2009, we had 389 no-shows.
Slicing the data
Is 389 a high number of no-shows? I guess it depends on the size …
Should patients be charged for no shows?
Health care is changing at lighting speed. If you don’t know this, or worse, don’t accept it you’re doomed. No. Really. It’s change or close shop. Whether you like it or not, health care reform is going to change the way we practice from now on.
Many physicians are choosing to work for large group practices to buffer themselves from directly dealing with change. Mental health providers could do the same, …
How small private practices can still thrive
by Alexandra Drane and the Engage With Grace team
For three years running now, many of us bloggers have participated in what we’ve called a “blog rally” to promote Engage With Grace – a movement aimed at making sure all of us understand, communicate, and have honored our end-of-life wishes.
The rally is timed to coincide with a weekend when most of us are with the very people with whom we should …
Talk with your family about their end of life wishes
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