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Leg and buttock pain can be signs of peripheral arterial disease, especially in patients with diabetes

Kevin

Conditions and Diseases

February 4, 2010

by Michael Jaff, MD

Peripheral Arterial Disease (PAD), a condition commonly correlated with diabetes, also known as a “silent killer,” affects at least one in every three diabetics over the age of 50 and approximately eight million Americans in total over the age of 40. Although PAD is prolific among diabetic and senior populations, current data show that public and physician knowledge of the disease is startlingly low, with only 25 …

Differences between the Senate and House approach to health insurance exchanges

Kevin

Health Policy

February 4, 2010

by Deborah Maggart

It’s a very exciting time to be a part of the health care world.

The U.S. Senate and House were in deep negotiations attempting to reform health care in America by reconciling their separate visions into a single bill and – just as reform was deemed imminent – a special election in Massachusetts complicated matters by ending the Democrats’ filibuster-proof “supermajority” and with it the possibility of strictly partisan …

Why did Canadian premier Danny Williams come to the United States for heart surgery?

Kevin

Health Policy

February 4, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

It is rare that a simple matter of patient choice causes an international flap.

But that’s what happened when 60-year-old Danny Williams of St. John’s, Newfoundland, decided to go to the U.S. for heart surgery.

That’s because Williams isn’t just any old Newfoundlander — he’s the premier of Canada’s easternmost …

Why primary care doctors need to practice insurance free medicine

Matthew Mintz, MD

Physician

February 3, 2010

I never thought I would be in academic medicine for so long.

When I was hired about 12 year ago, I figured I would stay in academics for a few years and then join a private practice Internal Medicine group. Now, I can’t even fathom that idea. One of the reasons I have stayed at my institution for so long is that I love teaching and the academic environment.

However, a second …

Why there are so few leaders in medicine and how to fix it

Kevin

Health Policy

February 3, 2010

Originally published in HCPLive.com

by Jeff Brown, MD

A quick look at a newspaper will tell any doc just how important physician leadership has become, and increasingly so, in having a say in our economic futures. But our titular leaders are in a historically weak system complicated by being only one group of voices struggling to be heard in the rush to deal with national health care reform. There are many docs …

How soon should the dead be buried in Haiti?

Kevin

Physician

February 3, 2010

Originally published in MedPage Today

by Crystal Phend

Aid appears to still be trickling in to Haiti, making little headway against the swelling need for food, water, and medical care after last Tuesday’s earthquake.

With a projected death toll between 100,000 and 200,000, the dead bodies piled in the streets — and reportedly even being incorporated into roadblocks by angry Haitians …

How should pharmacy benefit managers (PBMs) and pharmacies communicate with physicians?

Kevin

Medications

February 2, 2010

by George Van Antwerp

In the pharmacy and pharmacy benefit manager (PBM) business, there are lots of reasons to reach out to a physician:

* Drug-drug interactions
* A chemically equivalent version of the drug prescribed is available
* A therapeutically equivalent version of the drug prescribed is available
* The prescribed drug is not covered
* A prior authorization is required
* The patient is required to try an alternative drug first (step therapy)
* The prescribed …

A comprehensive plan to fight obesity begins at an early age

Kevin

Conditions and Diseases

February 2, 2010

Originally published in HCPLive.com

by Jeffrey Gene Kaplan, MD, MS

In a given year in the U.S., 1/4th of US men and 2/5ths of US women attempt to lose weight, unfortunately, they often fail to keep the weight off.

Sobering statistics that we see all around us, particularly poignant in my office as a pediatrician. Clearly a multifaceted approach is required, but the most …

What doctors need to know about Google Android and Nexus One

Satish Misra, MD

Health Technology

February 2, 2010

The momentum and enthusiasm in the mobile technology world is, these days, clearly with Google.

The question for many people is whether to go with the reigning champion of the mobile device world (arguably Apple) or to take a chance on the challenger. The Nexus One, the flagship of the Android family of mobile devices, was unveiled to much fanfare in …

10 ways an Apple iPad can help doctors improve patient care

Joseph Kim, MD, MPH

Health Technology

February 2, 2010

The current (first generation) Apple iPad probably won’t run a robust electronic health record (EHR).

However, it may run some iPhone/iPod touch EHR/EMR apps. I think most physicians will prefer to use a standard tablet PC instead of the iPad. However, given that a large percentage of physicians are not using the tablet in the outpatient office setting, perhaps …

EMRs can slow medical charting by requiring too much information

Edwin Leap, MD

Health Technology

February 1, 2010

We have a new EMR system. I like it because I type well. I’m facile at using a keyboard and touch-screen. Not everyone in my group is so blessed, and we’ve had some difficulties using the voice-transcription software. Nevertheless, my gut tells me that in a month or two more, we’ll be getting along with our new system swimmingly. It’s the sort of thing I have wanted for a while, …

Why doctors are too quick to prescribe drugs for ADHD

Kevin

Medications

February 1, 2010

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Physicians may be too quick to medicate children suspected of having attention deficit hyperactivity disorder (ADHD).

The etiology of the disease is not well understood, and while some cases may have neurological causes, children may respond to psychotherapy instead, Esther Fine, PhD, a psychoanalyst in private practice in Los Angeles, told …

How the stress of caregiving can lead to stroke

Kevin

Conditions and Diseases

January 31, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

The strain of caring for a disabled spouse is associated with an increased risk of stroke, researchers found.

The risk is increased for men, and especially African-American men, according to William Haley, PhD, of the University of South Florida, in Tampa, and colleagues.

On the other hand, there was no significant …

Should society consider purchasing and selling tissues and organs?

Michael Kirsch, MD

Conditions and Diseases

January 31, 2010

by Michael Kirsch, MD

Choose the best answer.

To stimulate organ donation, we should provide organ donors with:

* Cold, hard cash
* Upgrades to business class on any flight within the continental United States for 1 year
* College tuition discounts for up to 3 children
* Income tax relief
* First row Bruce Springsteen concert tickets
* A certificate of appreciation

There is a reason that we don’t ask families of kidnapped victims what our policy should …

5 reasons why Apple’s iPad will have trouble in health care

Kevin

Health Technology

January 30, 2010

Originally published in HCPLive.com

by Colin Crawford

The Steve Jobs iPad Tablet media show held at the Yerba Buena Center for the Arts in San Francisco was always going to have a hard time living up to the ridiculous pre-launch hype that’s been circulating around the Web.

Steve’s presentation was more moderate than at previous product launches as he tried to manage expectations positioning …

How can doctors stop drugs prescribed by other physicians that are no longer effective?

John Mandrola, MD

Medications

January 30, 2010

Here are two vignettes illustrating the failure of doctors to master the obvious and maybe a window onto the future struggles to control medical costs.

A 90-year old is referred for care due to “end stage dementia.” End-stage dementia is medical speak and as such does not really convey the appropriate imagery. It means a skeletal man, in a wheelchair or mostly in bed, with diapers, who has does not know …

How can doctors make America a better place to live?

Richard Reece, MD

Health Policy

January 29, 2010

What can physicians do to make American a better place to live, die, afford, and receive care? What can we do to bring about practical reform? What can we contribute?

These may seem odd questions, After all, we deliver care. Care goes through us. But Medicare, Medicaid, and private third parties are big players. They dictate terms of engagement and payment. But the answers lie at the core of the physicians’ …

Will New York’s ban on salt really make patients healthier?

Kevin

Conditions and Diseases

January 29, 2010

Originally posted in MedPage Today

by Mike Himowitz

I have a libertarian streak that compels me to shout “Nanny State!” when local governments put up speed-trap cameras to extort money from otherwise law-abiding citizens who drive a few miles over artificially low limits. Same for legislators who want to make me a criminal for calling my wife on my cell phone to ask her if I should pick up anything at …

Nobody will be held accountable if healthcare reform fails

Edwin Leap, MD

Health Policy

January 28, 2010

I must admit I’m a little weary of the entire debate on health-care reform. But something still haunts me. And that something is accountability. Of course, over the almost twenty years that I have borne the title ‘MD,’ I’ve learned a few things about accountability.

I understand that, almost without fail, the buck stops with me. The nursing home director knows the elderly lady wasn’t seriously hurt in that fall, but …

Why health IT won’t help with medical risk management

Satish Misra, MD and Iltifat Husain, MD

Health Technology

January 28, 2010

The march is on across the American healthcare landscape to implement electronic health records that also function as decision-support systems.

These “advanced” electronic health records will both provide centralized records and assist providers in making care decisions such as implementing therapy and utilizing evidence-based practice on the individual patient level. And anyone that has had the opportunity to work with some of the systems out there knows that they can be …

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