Early last year, my boss Talmadge King and I were at an ABIM meeting (we’re both on the board), and the group was debating a controversial topic. Another participant at the meeting, like Talmadge the chair of a prominent department of medicine, said, “We polled 250 people at our grand rounds last week, and they said ‘X’.” The audience gasped – ‘X’ was a completely unexpected …
How to make your medical grand rounds thrive
Originally published in HCPLive.com
by Ed Rabinowitz
There’s a great scene in the movie The Big Chill where the main characters are having a discussion on the topic of rationalizations. One individual comments that he doesn’t know anyone who could get through the day without two or three juicy rationalizations. That may be true. But when a rationalization involves taking things from the office or workplace, and that office just happens to …
How to stop theft from your medical practice
Originally published in MedPage Today
by Emily P. Walker, MedPage Today Washington Correspondent
President Barack Obama’s State of the Union speech Wednesday night will likely focus on job creation and the economy and not — as many Democrats once hoped — on congratulations for the passage of healthcare reform.
In the week following the election of Republican Scott Brown to the U.S. …
How President Barack Obama’s State of the Union speech will impact healthcare reform
Johns Hopkins Hospital is consistently named one of the best in the country. I can’t disagree with that; after all, I just started working there as an internist in September. Coincidentally, in the midst of the raging debate around health care reform, the past few months have seen increasing discussion of a small but crucial question: why do some of the best hospitals spend more money than others? If other …
How should patients decide which hospitals are best for them?
I’ve been given permission to deliver the National Consortium of Breast Centers (NCBC) position statement. It does a far better job with a critique of the USPSTF Screening recommendations than I did when I shared my first thoughts. As the President for the NCBC, I want to acknowledge the work done on behalf of our organization by our Policy Chairpersons, Drs. John Bell and Barbara Rabinowitz, both of whom are …
Originally published in MedPage Today
by John Gever, MedPage Today Senior Editor
The longer that U.S. Army soldiers spent in Iraq and Afghanistan, the greater the likelihood that their wives would seek psychiatric treatment, researchers said.
The risk that a woman would receive a new mental illness diagnosis during her husband’s deployment was significantly higher when he was overseas for a year …
Extended military deployments to combat areas increase stress, anxiety and depression among families
One, develop a plan that the presently privately insured Americans, estimated at 200 million, pay more in premiums, and to just make sure you succeed, immediately starting raising taxes by $400 billion over the next decade.
Two, alienate those over 65, the most dependable voting bloc, by promising to cut Medicare by $500 billion over the next ten years with the false promise, which you know you cannot …
10 ways United States health reform may fail
Here are the top 10 preventive services. These items were chosen by the National Commission on Prevention Priorities, and highlight those preventive services including immunizations, screenings, preventive medications, and counseling that give “the most bang for the buck.”
For an in depth discussion of methods and results, read Am J Prev Med 2006;31(1):52–61
Discuss Daily Aspirin Use
This counseling does not mean everyone should take aspirin to prevent heart attack and stroke, but …
10 cost effective preventive medicine services
Originally posted in MedPage Today
by Todd Neale, MedPage Today Staff Writer
The use of morphine may prevent the development of post-traumatic stress disorder (PTSD) in military personnel injured in combat, an observational study showed.
Those who received the drug during resuscitation or trauma care were about half as likely to later develop PTSD (OR 0.47, P<0.001), according to Troy Lisa Holbrook, PhD, …
Can morphine help prevent post-traumatic stress disorder (PTSD)?
Medicare, the government insurance company for everyone over age 65 (and for the disabled), pays fees to primary care physicians that guarantee bankruptcy.
Additionally, 70 percent of hospitals in the United States lose money on Medicare patients. That’s right, for every patient over age 65, it costs the hospital more to deliver care than the government reimburses. That is why Mayo Clinic has said it will not accept Medicare payments for …
Why the Mayo Clinic is refusing to see Medicare patients
Originally published in MedPage Today
by Todd Neale, MedPage Today Staff Writer
Too much television watching could be shortening lifespans, a study of Australian adults showed.
Aussies who reported watching four or more hours of TV a day were 46% more likely to die during a 6.6-year period than those who watched less than two hours a day, according to David Dunstan, PhD, of Monash University in Melbourne, and colleagues.
How television can shorten your life
The majority of Americans have a great deal of personal health information in their physician’s medical record. Many of these physicians have an electronic healthcare record (EHR) to store this information.
Unless you are in an integrated healthcare system, and most Americans are not, this information is just not available to you or any physician seeing you who does not belong to the same physician group as your primary physician. Even …
Why there needs to be a national healthcare information database
Originally published in MedPage Today
by Todd Neale, MedPage Today Staff Writer
Patients suffering an acute ischemic stroke are about 20% more likely to receive clot-busting therapy with tissue plasminogen activator (tPA) if they arrive at the hospital on the weekend, a retrospective study showed.
However, there was no difference in rates of inhospital mortality based on the time of admission, Abby …
When are stroke patients more likely to receive clot busting drugs?
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As I explore the latest EMR offerings, and read all the blogs and media releases for and against EMRs, I am forced to wonder, “Has anybody ever asked us doctors what we either want or need?”
Too often it seems the requirements of EMR’s are more suited to organizations, systems, and number-crunchers than to either doctors or our patients. I understand that the data is important, but why should the adaptation …
Why touchscreen computers are the future for electronic medical records
“Je m’a…,” I stuttered to Aristede Mezondes, the serious young man in a grey wool overcoat, standing before me with ramrod posture. “Je m’appelle Dr. Ofri.”
There. I’d gotten it out.
The language of Descartes, Voltaire, and Balzac had clearly vacated my cortex. Despite those years of French classes and one brief visit to Paris, “Je m’appelle” was the best I could come up with. And even that was a struggle. Pushed …
Talking to a patient, without a translator, in mutual non-native languages
Originally posted in HCPLive.com
by Jeff Brown, MD
When I am in a civilian situation and someone asks me what I do, if I am feeling whimsical, I sometimes answer “I’m in sales.”
Think about it – almost all of our professional interchanges can be seen as: 1) trying to talk someone out of doing something, like smoking, or 2) trying to talk someone into something, like exercising. Using a broader brush, you …
Teaching doctors the art of negotiation
We’ve gotten some questions from our readers on iMedicalApps.com asking if medical applications in the App Store will work just as well on the iPod touch as they do on the iPhone.
The short answer to this question is, yes, they will. The long answer is you should know some key differences.
Of the approximately 60 million total iPhone and …
iPhone medical apps for your iPod Touch
Last week, the Office of the National Coordinator for Health Information Technology (ONC) released criteria that will be used to certify EHRs as appropriate support tools for providers who want to qualify for Bonanza Days.
The criteria are subject to a 60-day comment period before being finalized.
I congratulate ONC on its elegant piece of rule making. Its so-called Interim Final Rule (IFR) provides a foundation that can support years of progress …
Did the government get it right on EHR certification?
General medicine is not sexy. Less than a fourth of the doctors in the United States are currently primary care providers like Pediatricians, Ob/Gyns, and Internists. According to a recent study published by the Journal of the American Medical Association, only 2% of medical students intend on pursuing a career in general internal medicine. So when health-care reform becomes a reality, and the 46 million uninsured men, women, and children …
Primary care needs a face lift, and a better agent
Originally published in MedPage Today
by Charles Bankhead, MedPage Today Staff Writer
Primary care physicians rarely discuss organ donation with patients, even though most of the doctors believe organ donation is within the scope of their practice, a survey of primary care physicians showed.
Fewer than 4% of physicians said they discussed organ donation with patients, compared with 30% who discussed end-of-life issues. …
Primary care doctors should discuss organ donation with patients
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