2010

January 22, 2010Jan 22, 2010

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…

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 …

Physician voices

Primary care needs a face lift, and a better agent

Jennifer Adaeze Anyaegbunam

January 21, 2010Jan 21, 201016

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 …

Conditions and diseases

Primary care doctors should discuss organ donation with patients

MedPage Today

January 21, 2010Jan 21, 20108

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…

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. …

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Health policy

How ideology is shaping health care reform

Richard Reece, MD

January 21, 2010Jan 21, 201022

I’m an ideological pragmatist. I believe in what works and what suits the temperament of American people, rather than what is politically correct or what passes some moral litmus test. Whatever reform measure passes, it will be a public-private mix…

I’m an ideological pragmatist. I believe in what works and what suits the temperament of American people, rather than what is politically correct or what passes some moral litmus test.

Whatever reform measure passes, it will be a public-private mix and will superimpose more government regulations on our private system. It will have uneven effects. It will cost more than the status quo. And it will expose the reality, that when …

Conditions and diseases

How to prevent diabetes with diet and exercise

Erin Marcus, MD

January 20, 2010Jan 20, 20104

By all accounts, Frances Vasquez ought to be a diabetic. Raised on a diet of fried steak, fried pork chops and lots of rice, her father, mother, and two sisters suffered from the disease. At age 47, Frances was overweight…

But over the past 11 years, Frances has been able to avoid diabetes, and her sugars are now normal. By participating in a ground-breaking, government-funded …

Physician voices

Why scaring patients to quit smoking may not be effective

MedPage Today

January 20, 2010Jan 20, 20102

Originally published in MedPage Today by Crystal Phend, MedPage Today Senior Staff Writer Telling people about the benefits of quitting is more likely to help smokers break the habit than scaring them with the dangers of continuing, researchers found. Callers…

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Telling people about the benefits of quitting is more likely to help smokers break the habit than scaring them with the dangers of continuing, researchers found.

Callers to a tobacco quitline were nearly twice as likely to stop in the short term when they got positive messages rather than …

Health policy

Did Martha Coakley kill health reform, and what Senator Scott Brown means for healthcare

Kevin

January 20, 2010Jan 20, 201018

In case you haven't heard, in a stunning result in yesterday's special election in Massachusetts, Republican Scott Brown won the Senate seat previously occupied by the late Edward Kennedy. Needless to say, pundits are going crazy analyzing the results, and…

In case you haven’t heard, in a stunning result in yesterday’s special election in Massachusetts, Republican Scott Brown won the Senate seat previously occupied by the late Edward Kennedy.

Needless to say, pundits are going crazy analyzing the results, and its implications on health reform. I’ll leave the political commentary to them, but I’ll comment on what this means for health reform’s future.

In essence, what turned into a 95% likelihood …

Physician voices

A doctor writes about his first day in Haiti

Jonathan Crocker, MD

January 19, 2010Jan 19, 2010

From Cange, Central Plateau Haiti 01-18-10 We arrived at Cange, in the Central Plateau, the heart of operations for Partners In Health/Zamni Lasante, yesterday. As we expected, things are incredibly busy. People are still arriving from Port au Prince. Those…

From Cange, Central Plateau
Haiti
01-18-10

We arrived at Cange, in the Central Plateau, the heart of operations for Partners In Health/Zamni Lasante, yesterday. As we expected, things are incredibly busy. People are still arriving from Port au Prince. Those who have been fortunate enough to survive their injuries this long are now running into complications of wound infections, some of which have turned septic, and venous blood clots (from immobility and trauma).

Patients …

Medical education

ACP: 10 major challenges that confront medical education over the next decade

American College of Physicians

January 19, 2010Jan 19, 20109

The following is part of a series of original guest columns by the American College of Physicians. by Steven Weinberger, MD, FACP At times of calendar transitions, e.g., at the onset of a new year or a new decade, the…

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

At times of calendar transitions, e.g., at the onset of a new year or a new decade, the popular press often takes a broad view in looking retrospectively at the outstanding or defining events and people of the past year or decade. Since we are now at a …

Physician voices

Tips for doctors who negotiate reimbursement rates with insurance companies

Ed Rabinowitz

January 19, 2010Jan 19, 20104

Originally published in HCPLive.com by Ed Rabinowitz When it comes to negotiating fees with health plans, practices and physicians have more leverage than they realize. The problem, says John Schmitt, a managed care expert with EthosPartners Healthcare Management Group, is…

Originally published in HCPLive.com

by Ed Rabinowitz

When it comes to negotiating fees with health plans, practices and physicians have more leverage than they realize. The problem, says John Schmitt, a managed care expert with EthosPartners Healthcare Management Group, is that practices often don’t even try. “Groups negotiate an agreement with a payor and then, for whatever reason, just file it away. Most medical groups do not have a good, proactive methodology …

Physician voices

How root cause analysis can improve patient safety

Robert Wachter, MD

January 19, 2010Jan 19, 20106

Hospitals face so many urgent tasks in safety – computerize, promote teamwork, implement evidence-based safety practices, discover unsafe conditions – that it’s hard to know where to start. If you’re struggling, I recommend that you put your Root Cause Analysis enterprise on steroids. This is what we did at UCSF Medical Center, and it was the most important change we’ve made in our safety journey. Here’s the story, …

Physician voices

Scenes from Haiti before the earthquake, and what the future holds

MedPage Today

January 18, 2010Jan 18, 2010

Originally published in MedPage Today by Michael Smith I remember walking through the squalid downtown of Port-au-Prince and coming across a woman sitting by the roadside selling carefully washed tin cans. That was how she made her meager living. There…

Originally published in MedPage Today

by Michael Smith

I remember walking through the squalid downtown of Port-au-Prince and coming across a woman sitting by the roadside selling carefully washed tin cans. That was how she made her meager living.

There were scenes that were more appalling — a man on a street corner with his head split open by a machete, a corpse …

Physician voices

Good doctors sometimes may make patients unhappy

Edwin Leap, MD

January 18, 2010Jan 18, 201018

Most of us went into medicine because, in addition to being good students, we wanted to help people. How many oceans of ink and forests of paper have been used explaining that point to admissions committees we’ll never know. Suffice it to say, it felt very good when our professors wrote us glowing letters of recommendation. Of course, we were also saying, “I want to feel good about helping people. …

Patient voices

How a doctor’s office can affect patient trust

MedPage Today

January 17, 2010Jan 17, 20108

Originally published in MedPage Today by Marianne Mattera Trust is an essential element in the doctor-patient relationship. You’re well aware of how important it is that you can trust the history the patient gives you. You know the problems that…

Originally published in MedPage Today

by Marianne Mattera

Trust is an essential element in the doctor-patient relationship.

You’re well aware of how important it is that you can trust the history the patient gives you. You know the problems that can arise in planning and managing care if you’re working with only part of the story. And you probably even feel a twinge …

Physician voices

How doctors can look for the right non-clinical medical job

Joseph Kim, MD, MPH

January 17, 2010Jan 17, 20106

How many physicians do you know who have chosen to leave their clinical practice? There's no doubt that physicians are getting burned out. Many are tired of fighting insurance companies and even more physicians are getting discouraged about reductions in…

How many physicians do you know who have chosen to leave their clinical practice?

There’s no doubt that physicians are getting burned out. Many are tired of fighting insurance companies and even more physicians are getting discouraged about reductions in reimbursement. This has caused some physicians to drop Medicare and Medicaid. Others have switched to cash-only or concierge/boutique practice models. Then you have your group of physicians who have simply decided …

Drugs and prescribing

How psychiatrists may be giving their patients too many drugs

MedPage Today

January 16, 2010Jan 16, 20102

Originally published in MedPage Today by John Gever, MedPage Today Senior Editor Psychiatrists who prescribe drugs for their patients today usually give more than one at a time, often with little scientific basis, researchers said. About 60% of patients with…

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Psychiatrists who prescribe drugs for their patients today usually give more than one at a time, often with little scientific basis, researchers said.

About 60% of patients with psychiatrist office visits leading to a drug prescription received at least two medications in 2005-2006, according to government survey data analyzed by Ramin …

Physician voices

How bad patient outcomes affect physicians

Shantanu Nundy, MD

January 16, 2010Jan 16, 2010

Ms. FR didn’t look so great even when I first met her. She had been admitted to the hospital three times in past 6 weeks for nausea/vomiting and generalized malaise. While the cause of her acute illness was not entirely…

By the time I met her she had already been in the hospital for 1 week. …

Conditions and diseases

What diseases can arise from the lack of clean water in Haiti?

MedPage Today

January 15, 2010Jan 15, 2010

Originally published in MedPage Today by Michael Smith, MedPage Today North American Correspondent The lack of clean water in the stricken Haitian capital fosters conditions that may spawn an epidemic of enteric disease. "Having large numbers of people in close…

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

The lack of clean water in the stricken Haitian capital fosters conditions that may spawn an epidemic of enteric disease.

“Having large numbers of people in close proximity and not using appropriate sanitation can potentially spark those epidemics, particularly if people are forced to drink surface water,” said Rebecca Dillingham, …

Patient voices

We are becoming a nation of people with multiple chronic diseases

Monte Ladner, MD

January 15, 2010Jan 15, 20102

Many Americans are resolving that this will be the year they finally lose weight. Sadly, most of them will reach the end of 2010 heavier than when they started. We continue losing the weight loss game because our efforts are…

Dr. Dana King of the Medical University of South Carolina recently published two papers on the erosion of American lifestyle habits between 1988 …

2010

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