Should medicine be efficient in the business sense?

Health Policy
December 6, 2009

When we talk about efficiency in the business world, we are basically talking about getting as much profit as possible. This profit is wrung out of the system by reducing production costs to the maximum extent possible and by charging the top price that the market allows.

Some of the ways in which the US companies have increased their efficiencies over the last 30 years are, 1) by moving manufacturing to …

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Should medicine be efficient in the business sense?

Do chest x-rays and mammograms increase the risk of breast cancer in young women?

Conditions and Diseases
December 5, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Some women already at high risk of breast cancer should be cautious about having mammography or chest x-rays before the age of 30 because the imaging may increase the risk of developing the disease, researchers here said.

Five or more x-rays, or any exposure to ionizing radiation before age 20, …

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Do chest x-rays and mammograms increase the risk of breast cancer in young women?

Previous influenza exposure can protect against the H1N1 flu

Conditions and Diseases
December 4, 2009

by Bruce Goldman

People of a certain age have been known to complain that, while they lucidly recall the details of childhood events, they can’t remember what they ate for breakfast.

As it is with brains, so it may be with immune systems. Older people’s immune responses, while generally somewhat sluggish in revving up after, say, a vaccine against seasonal influenza, seem to retain a knack for fending off the current H1N1 …

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Previous influenza exposure can protect against the H1N1 flu

An oncologist takes on the recent breast and cervical cancer screening controversy

Conditions and Diseases
December 4, 2009

Recently, two groups released new guidelines that may affect breast cancer and cervical screening in women.

The US Preventive Services Task Force (USPSTF) recommended against screening women in their 40s and to screen women every other year starting at age 50. The USPSTF left room for individualized screening, particularly in the presence of risk factors such as family history. Still, it is …

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An oncologist takes on the recent breast and cervical cancer screening controversy

Low pay for diabetes care harms patients

Conditions and Diseases
December 4, 2009

Originally posted in MedPage Today

by John Gever, MedPage Today Senior Editor

Almost one-third of doctors in an industry-sponsored survey said they didn’t spend enough time with their diabetic patients and blamed low reimbursement rates for diabetes care, researchers said.

In a survey of 200 primary care physicians and 100 endocrinologists, 32% reported an inability to provide comprehensive diabetes care, Alyssa Pozniak, …

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Low pay for diabetes care harms patients

iPhone medical apps can be improved by Google Android

Health Technology
December 3, 2009

by Felasfa Wodajo, MD

In a recent post, entitled, Why doctors should choose Google Android over the iPhone for medical apps, the author seems to have gone out of his way to make a series of increasingly hyperbolic arguments declaring Motorola Droid superior to the iPhone.

The long trail of negative comments on the site demonstrate that perhaps not all readers were swayed …

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iPhone medical apps can be improved by Google Android

Specialists should staff the patient centered medical homes, not primary care doctors

Health Policy
December 3, 2009

Originally published in HCPLive.com

by Alan Berkenwald, MD

The approaching fire storm over the “patient-centered medical home” model reminds me of the destructive powers seen before in HMOs. Once seemingly destined to revolutionize organized medicine, the HMO model nearly destroyed it.

We can learn from past failures. We need to promote best-practice models and make physicians accountable for their actions, both physiologically and …

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Specialists should staff the patient centered medical homes, not primary care doctors

Tamiflu kills babies, and other H1N1 flu pandemic misconceptions

Medications
December 3, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

As one of the two MedPage Today writers on full-time H1N1 duty since the beginning of the outbreak in April, I feel like I know the issues well enough to help clear up misconceptions when they come up in conversation.

medpage-today1The other day, just such a situation presented itself. An …

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Tamiflu kills babies, and other H1N1 flu pandemic misconceptions

Pharma, evidence, and trust

Medications
December 2, 2009

by David Rind, MD

A number of the other blogs that have noted the existence of this blog seem to have “Pharma” in their titles in one way or another, and the implication is not that the blogger likes much about Big Pharma.

In the late 1990s, when I was spending much of my clinical time providing HIV care, I was a defender of Pharma on Usenet, at least as it related …

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Pharma, evidence, and trust

Seeing floaters or flashing lights can be caused by posterior vitreous or retinal detachment

Conditions and Diseases
December 2, 2009

Originally posted in Insidermedicine

The eye is very similar to a camera. Both are optical systems that have lenses in the front to focus light rays onto a film. The retina is the eye’s film. It is a tissue that consists of 10 layers and is about 500 microns thick—or, half a millimeter. The main function of the retina is to trap light rays, convert them into electrical impulses, and send …

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Seeing floaters or flashing lights can be caused by posterior vitreous or retinal detachment

iPhone radiology app to diagnose appendicitis

Health Technology
December 2, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

For years, the pager and cell phone have summoned on-call radiologists to the emergency room. Now this leap in technology: an iPhone App that lets radiologists diagnose a patient remotely, wherever they may be.

Using a $20 iPhone application called OsiriX, radiologists made correct diagnoses of appendicitis in 124 of …

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iPhone radiology app to diagnose appendicitis

ACP: Teasing out science, politics, and emotion about the mammography guidelines

Conditions and Diseases
December 1, 2009

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

by Steven Weinberger, MD, FACP

It is difficult to find a medical guideline that has garnered so much press and controversy as the recent recommendations about breast cancer screening developed by the U.S. Preventive Services Task Force (USPSTF) and published in Annals …

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ACP: Teasing out science, politics, and emotion about the mammography guidelines

Medical student needlestick injuries

Medical Education
December 1, 2009

Originally posted in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Medical students are frequently stuck by needles, and few report their accidents, researchers say.

In a survey, about 60% of surgery residents reported being stuck with a needle while they were in medical school, Martin A. Makary, MD, MPH, of Johns Hopkins, and colleagues reported in the December issue of …

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Medical student needlestick injuries

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The billions spent on electronic health records, and why there’s no way to know if EHRs will save money

Health Technology
November 30, 2009

Barack Obama is certain that electronic health records (EHRs) can improve the quality of care and the efficiency with which it is delivered. How certain? Certain enough to have bet billions on a program that pays providers to adopt and meaningfully use EHRs.

Of course there are many ways to improve quality and efficiency. The Pennsylvania Health Care Cost Containment Council (PHC4) for example, publishes outcomes data for the states’ 172 …

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The billions spent on electronic health records, and why there’s no way to know if EHRs will save money

The privacy and security risks of electronic health records

Health Technology
November 30, 2009

Originally published in HCPLive.com

by Anthony Niehaus

As part of the 2009 HITECH Act, a national health information technology infrastructure (NHITI) is required for access and use of electronic health records resulting in a more “effective marketplace, greater competition… [and] increased consumer choice (HITECH Act, Section 3001(b)).”

Such a system is not only necessary, but it is cardinal to improving delivery and reducing costs …

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The privacy and security risks of electronic health records

Will the H1N1 flu virus mutate?

Conditions and Diseases
November 30, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

The CDC is keeping a careful eye on a mutation in some strains of the pandemic H1N1 flu that Norwegian researchers isolated from three patients with severe disease.

The mutation has been seen “sporadically” in the U.S., according to Anne Schuchat, MD, director of the CDC’s National Center for Immunization …

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Will the H1N1 flu virus mutate?

The joys of practicing rural emergency medicine

Physician
November 25, 2009

I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.” It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest. The natural beauty is breathtaking. Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some …

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The joys of practicing rural emergency medicine

Baby boomers don’t receive enough preventive health

Physician
November 25, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Only a quarter of baby boomers take advantage of preventive services such as flu vaccines and cancer screenings, a new report from the government and two powerful interest groups says.

At the same time, states are falling behind goals to increase certain screenings and reduce unhealthy behaviors, according to the …

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Baby boomers don’t receive enough preventive health

How the mammogram and Pap smear debates ignore the uninsured

Conditions and Diseases
November 24, 2009

by Jeoffry B.Gordon, MD, MPH

The recent recommendation of the US Preventive Services Task Force against routine screening mammograms for healthy, low risk women under the age of fifty has demonstrated our broad consensus about the value of breast cancer screening. The discussions about new guidance from the American Academy of Obstetrics and Gynecology on when to start and how often to do PAP smears illuminate the impact, effectiveness and support …

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How the mammogram and Pap smear debates ignore the uninsured

The health reform politics of mammograms and breast cancer screening

Conditions and Diseases
November 24, 2009

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

The emotional debate over a federal panel’s proposal to end routine mammograms for women in their 40s has reignited controversy over a contentious healthcare reform issue: comparative effectiveness research.

Healthcare reform opponents say the new mammogram guidelines by the U.S. Preventive Services Task Force (USPSTF) make their point: If …

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The health reform politics of mammograms and breast cancer screening

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