2010

February 5, 2010Feb 5, 20102

Early in my training as a glider pilot my instructor showed me an excellent but simple analogy for ensuring my safe performance as a pilot. I have always remembered this lesson, which he called the ‘accident slope’, and have tried to apply it to my method of practicing medicine, as well as the other ‘dangerous’ activities for which I have an affinity.

“Accidents and mistakes are seldom the result of one …

Conditions and diseases

The specialty of underwater medicine, and an interview with a dive physician

MedPage Today

February 5, 2010Feb 5, 2010

Originally published in MedPage Today by Kristina Fiore Physicians tend to prefer intellectual hobbies -- chess, reading, writing. Dr. Alfred Bove is no exception. His hobby often requires application of his expertise in physiology. You know him as the president…

Originally published in MedPage Today

by Kristina Fiore

Physicians tend to prefer intellectual hobbies — chess, reading, writing. Dr. Alfred Bove is no exception. His hobby often requires application of his expertise in physiology. You know him as the president of the American College of Cardiology. But you may not know that his heart belongs to the sea.

Bove’s interest in scuba diving …

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Conditions and diseases

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

Michael Jaff, MD

February 4, 2010Feb 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…

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 …

Health policy

Differences between the Senate and House approach to health insurance exchanges

Deborah Maggart

February 4, 2010Feb 4, 20103

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…

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 …

Health policy

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

MedPage Today

February 4, 2010Feb 4, 201010

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…

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 …

Physician voices

Why primary care doctors need to practice insurance free medicine

Matthew Mintz, MD

February 3, 2010Feb 3, 201052

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.…

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 …

Health policy

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

Jeff Brown, MD

February 3, 2010Feb 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…

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 …

Physician voices

How soon should the dead be buried in Haiti?

MedPage Today

February 3, 2010Feb 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…

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 …

Drugs and prescribing

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

George Van Antwerp

February 2, 2010Feb 2, 201011

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…

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 drug costs too …

Conditions and diseases

A comprehensive plan to fight obesity begins at an early age

Jeffrey Gene Kaplan, MD, MS

February 2, 2010Feb 2, 20104

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…

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 …

Health technology

What doctors need to know about Google Android and Nexus One

Satish Misra, MD

February 2, 2010Feb 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…

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 …

Health technology

10 ways an Apple iPad can help doctors improve patient care

Joseph Kim, MD, MPH

February 2, 2010Feb 2, 20104

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.…

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 …

Health technology

EMRs can slow medical charting by requiring too much information

Edwin Leap, MD

February 1, 2010Feb 1, 201013

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, …

Drugs and prescribing

Why doctors are too quick to prescribe drugs for ADHD

MedPage Today

February 1, 2010Feb 1, 20104

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…

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 …

Conditions and diseases

How the stress of caregiving can lead to stroke

MedPage Today

January 31, 2010Jan 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…

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 …

Conditions and diseases

Should society consider purchasing and selling tissues and organs?

Michael Kirsch, MD

January 31, 2010Jan 31, 20107

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…

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 …

Health technology

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

Kevin

January 30, 2010Jan 30, 20104

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…

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 …

Drugs and prescribing

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

John Mandrola, MD

January 30, 2010Jan 30, 201021

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…

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 …

Health policy

How can doctors make America a better place to live?

Richard Reece, MD

January 29, 2010Jan 29, 20105

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.…

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’ …

2010

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