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Saying no to a re-tweet request, and whether Twitter as a legitimate news source

Social Media in Medicine

November 15, 2009

The other day I re-tweeted a tweet from someone whose Twitter activity I enjoy very much. I like where his links take me, and I appreciate the intellectual and emotional honesty of his own writing. The message I re-tweeted was about Gardasil, Merck’s HPV vaccine marketed in the US.

Diane Harper of the University of Missouri is a prominent researcher who was heavily involved in the Gardasil development program. Over the …

Medicine needs to get back to hands-on basics, rather than focusing on technology

Rahul K. Parikh, MD

Conditions and Diseases

November 14, 2009

There is plenty to criticize in our bungling trek toward health reform. Leaders on the right, left and at 1600 Pennsylvania Avenue have sidestepped the crucial conversation of controlling the cost of care, in favor of partisan rhetoric about “death panels” and “rationing care.” Worse, the entire focus of reform has centered on spending billions of dollars on technology solutions that will only make marginal changes in the cost and …

AMA’s democracy in action at this defining moment in the history of medicine

Kevin

Health Policy

November 13, 2009

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

by J. James Rohack, M.D.

Delegates Vote to Continue AMA’s Commitment to Reform, Medicare Vote Pending in U.S. House of Representatives

Twice a year, physicians come together for an exhibit of democracy at its best through the AMA House …

Surgeons don’t receive enough training when resident work-hours are capped

Crystal Phend

Medical Education

November 13, 2009

by Crystal Phend, MedPage Today Senior Staff Writer

Limiting surgical residents’ work hours has compromised both surgical education and patient safety, according to an analysis concluding that an 80-hour work week isn’t enough.

The maximum 80-work week imposed in the U.S. for residents is too little to provide mastery in surgery, Gretchen Purcell Jackson, MD, PhD, and John L. Tarpley, MD, …

How teamwork is essential in the emergency department

Edwin Leap, MD

Physician

November 12, 2009

I recently cared for a patient who raised my heart-rate a bit. Of course, any emergency physician will tell you, the potentially difficult and complicated cases often come at the end of the shift, as you’re trying to clean up all of the paperwork and ‘head for the house.’ Nurse Ginger came to me and said, ‘we need a doctor in room 11.’ I snarled, snatched the paper, grumped and …

Many women report nerve-related persistent pain after breast surgery

Kevin

Conditions and Diseases

November 12, 2009

Originally published in Insidermedicine

Nearly half of women who undergo surgery and other treatments for breast cancer report having persistent pain in and around the treatment area a year or more later, probably because of nerve damage, according to research published in the November 10 issue of the Journal of the American Medical Association.

Here is some information about neuropathic, or nerve, pain:

• It is a type of pain that occurs when …

Will video cameras in the OR decrease the rate of wrong-site surgery?

Kristina Fiore

Conditions and Diseases

November 12, 2009

by Kristina Fiore, MedPage Today Staff Writer

Rhode Island Hospital, located in Providence, will pay $150,000 and install video cameras in all of its operating rooms after performing its fifth wrong-site surgery since 2007, according to the state’s Department of Health.

The hospital will also have to open its ORs to an inspector who will observe surgical procedures and protocols for at …

Patients who want the H1N1 vaccine need to be triaged

Kevin

Medications

November 11, 2009

by Kairol Rosenthal

I am a young adult cancer patient who waited five and a half hours for the H1N1 vaccination along with 1200 other Chicagoans in a city college hallway. I do not have the trained eye of a public health analyst, yet it was easy to spy the glaring flaws that occurred in the whimsical distribution of this short supply vaccine. One of these oversights was the absence …

How do people with dementia die?

Kevin

Conditions and Diseases

November 11, 2009

Originally published in HCPLive.com

by Victor G. Dostrow, MD

Dementia is a terminal illness. However, people with advanced dementias often languish in skilled nursing facilities, far from the ministrations of specialists. And, with reasonable luck, they have directives that specify that they are not to be taken to the hospital in the event of a respiratory arrest. Consequently, most of us are not privy to the mechanisms of demise in such situations.

Will the abortion restriction survive the Senate health reform bill?

Kevin

Health Policy

November 11, 2009

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

After a controversial amendment to restrict abortion was approved as part of the House healthcare bill over the weekend, senators are grappling with the abortion language in their legislation.

Senate Majority Leader Harry Reid (D-Nev.), who personally opposes abortion, said the issue was being negotiated.

“I expect the bill that …

How should doctors discuss healthcare reform with patients?

Kevin

Health Policy

November 10, 2009

Originally published in HCPLive.com

Physicians are increasingly bringing their views on healthcare reform into the examination room. Others are distributing flyers or taping up signs in the office. Given that healthcare reform has become such a contentious subject in the United States, it is not surprising that conflicts have arisen between physicians and patients who hold different views.

The St. Petersburg Times …

Doctors and patients need to learn to live with health insurance companies

Kevin

Health Policy

November 10, 2009

by Marie Cooper

Consider two patients with the same managed care plan.

One has multiple sclerosis and receives an infusion of Tysabri every month. It needs pre-certification. The requirements are black and white. The patient qualifies if they have relapsing/remitting MS and have failed other therapies. The drug costs $2,000, the infusion center is another $1,000. The infusion center is a contracted provider that has …

Do home fetal heart monitors give mothers false reassurance?

Kevin

Conditions and Diseases

November 10, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Expectant mothers may enjoy listening to their unborn babies’ heartbeats, but they shouldn’t rely on home fetal heart monitors to provide an accurate picture of fetal health, researchers say.

The devices may provide false reassurance in some situations, according to Abhijoy Chakladar, MD, of Princess Royal Hospital in West Sussex, …

What’s next for health reform after the House passed their bill, H.R. 3962?

Kevin

Health Policy

November 8, 2009

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

The House of Representatives voted 220 to 215 to pass historic healthcare reform legislation late Saturday night, after 11 hours of debate before a packed gallery of spectators.

H.R. 3962 passed by a narrow margin: Democrats needed 218 votes to pass the bill and wound up with just two …

How the health care system is corrupting doctors

Kevin

Health Policy

November 7, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

I had the same reaction . . . shock at seeing an almost obscene claim about our profession in a national newspaper. But it got me thinking, which no doubt was its intended purpose. While we are thinking and feeling our way through this wide-ranging debate on health care, we might as well examine …

Op-ed: Injured patients deserve medical malpractice reform

Kevin

Physician

November 7, 2009

A version of this op-ed was published on October 26th, 2009 in the USA Today.

President Obama has acknowledged that changes in the medical malpractice system must be considered with other health reforms, and recently ordered that pilot projects to improve the way we compensate injured patients be implemented.

Reforming medical liability has historically been a source of major contention. Physicians argue that the system is expensive, promotes multi-million dollar awards …

Support for the patient centered medical home in the House health reform bill

Kevin

Health Policy

November 6, 2009

by Thomas C. Bent, MD

As the House of Representatives prepares to vote on its historic health care reform bill on Saturday, family physicians are heartened to see the support it gives to the emerging new model of care, the patient centered medical home.

The House bill is good news on many fronts. It would provide health insurance coverage for some 96 percent of Americans and would reduce the federal deficit by …

Vaccines do not cause autism in children, whether or not they have inborn errors of metabolism

Kevin

Conditions and Diseases

November 6, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Vaccination does not appear to cause autism or other health problems in children with inborn errors of metabolism, a researcher said here.

In a retrospective analysis, children with such conditions were not more likely than normal children to visit emergency rooms or need hospital care after vaccination, according to …

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