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AMA weighs in on the Senate health reform bill

Kevin

Health Policy

December 15, 2009

The following is part of a series of original guest columns by the American Medical Association.

by J. James Rohack, M.D.

As the year winds down, health system reform continues to move forward. The Senate bill currently under debate includes a number of provisions that are consistent with the AMA’s reform priorities, some provisions we oppose and others that need to be improved to better benefit patients and physicians. As part …

Why doctors and hospitals oppose expanding Medicare

Kevin

Health Policy

December 15, 2009

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

The notion of a public health insurance plan appears to be evaporating from the Senate’s healthcare reform bill, replaced in part with an expansion of Medicare — an idea that’s meeting resistance from doctor and hospital associations.

A proposal to scrap the public plan to allow people as young …

What’s a typical day of a primary care doctor like?

Edward J. Volpintesta, MD

Physician

December 14, 2009

It’s common knowledge that fewer medical students are entering primary care and that patients are having a hard time finding a primary care doctor. Part of the reason is that insurance companies place little value on much of the work that primary care doctors do.

Even though physicians’ complaints are seen in the medical and lay media, it is rare to see descriptions of a primary care physician’s “typical day” in …

How doctors can stay up to date with current medical information

Kevin

Patient

December 14, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

With the amount of research being published in medical journals and presented at meetings, it should not be surprising when a new finding slips by a busy physician.

Nor should it be surprising, then, that some decisions about patient care might be made without benefit of the most recent evidence.

Although experts …

Why juvenile delinquency may lead to poor adult health

Kevin

Conditions and Diseases

December 12, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Bad boys grow up to be sick men, researchers say.

In a long-running British study of juvenile delinquency in boys, death and disability at age 48 were strongly linked to antisocial behavior in youth, according to Jonathan Shepherd, PhD, of Cardiff University in Wales, and colleagues.

The imbalances in mortality and disability …

Some patients won’t accept a conservative approach to medical treatment

Michael Kirsch, MD

Conditions and Diseases

December 12, 2009

by Michael Kirsch, MD

Who says one person can’t make a difference? This past week, I personally set back health care reform. No, I wasn’t attending a ‘tea party’ or decrying Obamacare in a venomous letter to the editor. I single-handedly bent the health care cost curve in the wrong direction. I performed an unnecessary medical test on a hospitalized patient, which exposed her to risk and cost the system money. …

Doctors need to take care of themselves, for their patients’ sake

Kevin

Patient

December 11, 2009

by Nancy Rappaport, MD

In order to be truly effective in our work, we physicians need to conduct our own personal exploration, take time for introspection, and replenish our personal reserves. Part of our job is to balance the demands of our work (be they finding a cure for cancer, caring for terminally ill patients, solving the problems of healthcare or delivering twins—whatever our calling may be) with caring for ourselves. …

Should health care workers go to jail for medical errors?

Robert Wachter, MD

Physician

December 11, 2009

Two years ago, I wrote about the case of Julie Thao, the Wisconsin nurse sent to prison for a medication error. I argued then that – although Julie bypassed some safety rules – she most certainly did not deserve jail time.

Along comes another case involving jail time for a medical mistake, this one featuring an Ohio pharmacist named Eric Cropp. I became aware of Eric’s case through the efforts of …

Is constipation a sign of early Parkinson’s disease?

Kevin

Conditions and Diseases

December 11, 2009

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Constipation may represent one of the earliest signs of Parkinson’s disease, preceding the onset of motor symptoms by two decades or more, data from a case-control study suggest.

Patients with Parkinson’s disease were more than twice as likely to report a history of constipation compared with a control population. The …

Should body mass index (BMI) be used as a college graduation requirement?

Amy Tuteur, MD

Conditions and Diseases

December 10, 2009

It’s official. America hates fat people.

Human beings are constantly searching for socially sanctioned reasons to feel superior to others and in 2009, those who are thin feel mighty superior to those who are not. How else could a college dare to make body mass index (BMI) a graduation requirement?

According to James DeBoy, the chair of Lincoln’s Department of Health, Physical Education, and Recreation, the point of the new policy is …

Will electronic records raise the legal standard of care and increase malpractice risk?

Kevin

Physician

December 10, 2009

Originally published in HCPLive.com

by Robert J. Mintz, JD

As EHRs are widely adopted and the quantity of information about a patient expands dramatically, does provider liability increase even if the quality of care is vastly improved?

What happens if the quality of care really does get better but because of all the new and easily accessible information, the standard of care for …

How well can doctors diagnose child abuse from bone fractures?

Kevin

Conditions and Diseases

December 10, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Physicians often misdiagnose bone fractures caused by child abuse as accidental breaks, particularly if the child is male and the doctor is not a pediatrician, a new study found.

Of children who suffered fractures from abuse, about 20% had at least one previous medical visit during which a doctor missed …

Does smoking or obesity affect life expectancy more?

Kevin

Conditions and Diseases

December 9, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Gains in life expectancy from lower smoking rates over the next decade will be offset, to some degree, by reductions in life expectancy based on the rise in obesity, researchers estimated.

If obesity and smoking rates had held steady, the average 18-year-old would have seen a 2.98-year increase in …

Why the fear of cancer undermines the new mammography guidelines

Lucy Hornstein, MD

Conditions and Diseases

December 8, 2009

Fear is such a powerful emotion, humans will do almost anything to relieve it. The most effective way to control fear is to manage whatever it is we’re afraid of. Night lights against the monsters under the bed; locks on the doors and a handgun under the pillow to fend off intruders; annual mammograms and PSAs to keep us from dying of cancer. Although all these things may relieve fear …

How health IT can bankrupt healthcare

Kevin

Health Technology

December 8, 2009

Originally published in HCPLive.com

by Alberto Borges, MD

For those interested in health information technology, there is now an excellent, new, powerful article about this topic entitled, “Can Cleveland Clinic Be a Model for Digital Medicine?” where they discuss how this hospital system has failed to recoup their $100 million investment to date.

Here is my take on the Cleveland Clinic story, beyond the …

Read more…

How health IT can bankrupt healthcare

NFL football players with concussions may need independent neurologists to clear them

Kevin

Conditions and Diseases

December 8, 2009

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Responding to growing concern over concussions suffered by professional football players, the National Football League may soon require teams to seek opinions from independent neurologists before allowing head-injured players back on the field.

League officials have not confirmed the plan, but reports in The New York Times, the Associated Press, FOXSports.com, …

The inpatient, outpatient divide in patient care today

Helen Kao, MD

Physician

December 7, 2009

As the health reform debates continue, I am struck by the lack of attention to what seems to be a critical issue in poor health care delivery.

With the technologizing of medicine (and more recently the hospitalist “movement”), delivery of health care has come to be centralized around acute care hospitals. Over time, patient care has been divided into acute inpatient care and ‘ambulatory’ outpatient care. While transitions of care, hospital-at-home, …

Why it’s important to brand your medical practice

Kevin

Physician

December 7, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

You might be thinking, “Why should I consider branding or marketing?” And your reasoning might go something like this:

1. As a doctor, I already have a powerful, built-in identity;
2. My practice is full;
3. Even if my practice isn’t full, Congress is in the process of putting 40 million more insured people into the available patient pool over the next few years.

Radiologists don’t agree with the USPSTF breast cancer mammogram screening guidelines

Kevin

Conditions and Diseases

December 7, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Radiologists have rejected revised mammography guidelines from the U.S. Preventive Services Task Force (USPSTF), arguing that they are not backed by scientific evidence and will lead to unnecessary deaths.

Under the revised guidelines, “screening will begin too late and its effects will be too little,” said Stephen A. Feig, MD, of …