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What does H1N1 pandemic flu as a national emergency mean?

Kevin

Conditions and Diseases

October 27, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

President Barack Obama’s declaration that the H1N1 pandemic flu is a national emergency doesn’t mean the course of the outbreak has changed, health experts said.

But as the volume of cases increases, the declaration allows doctors and hospitals more flexibility in handling the expected surge in patients, they said.

“I …

The high cost of hiring, and firing, a doctor

Kevin

Physician

October 26, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

One area we need to look at is the surprisingly high costs of hiring and firing people who work with us. And as always, I rebuke our training programs for their ostrich-like attitudes, ignoring how important managerial and organizational competence is to the quality of medicine that we practice.

We know that recruiting a …

Discussing end-of-life care in the ICU and saving Medicare money

Marya Zilberberg, MD, MPH

Health Policy

October 25, 2009

I think by now there is not a person in the US who cannot quote at least approximately how much we spend annually on healthcare. Fewer people appreciate that nearly 1/3 of this $2.2 trillion bill is eaten by hospitalizations, amounting to about $680 billion. Although the data in the diagram below represent a single year, the overall distribution of expenses is remarkably constant over time.

When compassion meets progress in American health care

Edwin Leap, MD

Health Policy

October 24, 2009

Does anyone realize that the chaos of modern American health-care is not a tragedy, but a triumph? We’re so busy trying to fix what isn’t broken and ignoring what is, so busy casting stones and casting doubts that we are blind to what we have.

I have practiced medicine in this labyrinth for 16 years. I am an emergency physician. I practice in what may be considered the ‘epicenter’ of modern …

Why pregnant women should get the H1N1 flu vaccine

Amy Tuteur, MD

Conditions and Diseases

October 23, 2009

Doctors are often compelled to make quick decisions in life threatening cases with only limited information. Unfortunately, pregnant women are now going to be put in the same situation.

The H1N1 flu has taken an extraordinary toll among pregnant women. A new vaccine is now available. Because of the nature of the emergency, there has not been time to do any long term studies of the vaccine. Yet pregnant women will …

How to take money out of health care, and is a single-payer system inevitable?

Kevin

Health Policy

October 22, 2009

by Bruce Douglas, MD

I’ve been practicing my health care specialty for sixty years and have enjoyed almost every minute of it. The minutes I have not enjoyed all have to do with “money.”

Financial transactions in doctors’ offices are the root of most evils in the relationship between doctor and patient. Along with that evil goes an additional detraction from good, humane health care called the fee-for-service system, which …

Should doctors fire young patients if their parents refuse to vaccinate them?

Kevin

Conditions and Diseases

October 22, 2009

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

If parents refuse to vaccinate their children, it’s ethical and legal to dismiss the child as a patient, a pediatrician told attendees of the American Academy of Pediatrics meeting here.

“In the middle of treatment, you can’t just say, I’m done,” Gary Marshall, MD, of the University of Louisville …

When patients receive too much radiation from CT scans by mistake

Kevin

Conditions and Diseases

October 21, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Reports of stroke patients who were accidentally exposed to eight times the normal radiation dose during diagnostic CT scans at Cedars-Sinai Medical Center in Los Angeles are prompting safety warnings and soul searching among radiologists nationwide.

Over an 18-month period, 206 patients at the center received 3 to 4 …

Google Android versus the iPhone for medical apps

Kevin

Health Technology

October 20, 2009

by Jeff Brandt

Verizon, Motorola, and Google, along with 9 other cell phone manufactures and countless world carriers, have teamed up to provide a smartphone with the power to deliver useful applications for medicine: the Verizon “Droid” smartphone, based on the Google Android operating system (OS).

The Droid’s processor is the same processor that powers the iPhone. The main reasons this …

Will co-sleeping with your infant increase the risk of SIDS?

Kevin

Conditions and Diseases

October 20, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Just over half — 54% — of sudden infant death syndrome (SIDS) cases in southwest England occurred when the baby was co-sleeping in the same bed as a parent, a case-control study showed.

That compares with 20% of infants among randomly selected families and controls deemed to be at high …

What health reform can learn from Regina Holliday

Rahul K. Parikh, MD

Health Policy

October 19, 2009

If you want to get insights into the problems of our health care system, look at a mural by Washington DC resident Regina Holliday.

Holliday is a 37-year old mother of two and an art teacher. Last summer, her husband, Fred, died from kidney cancer at the age of 39. The Hollidays’ experience is a case study in …

Does robotic surgery for prostate cancer help patients?

Kevin

Conditions and Diseases

October 19, 2009

Originally published in MedPage Today

by Peggy Peck, MedPage Today Executive Editor

Men who opt for minimally invasive prostate surgery — often with a helping hand from a robot — are twice as likely to have genitourinary complications as men who have a traditional prostatectomy.

That finding is especially troubling because the use of robotic-assisted minimally invasive prostatectomy has increased exponentially in …

How the patient-centered medical home can improve our health care system

David Harlow

Physician

October 17, 2009

Dr. Paul Grundy is on a mission — a mission to promote the patient-centered medical home model that he has been instrumental in developing and rolling out, in his dual role as Director of Healthcare, Technology and Strategic initiatives for IBM Global Wellbeing Services and Health Benefits, and President of the Patient-Centered Primary Care Collaborative.

I had the opportunity to speak with him last month (here’s the transcript and …

Doctors need to fix the health care system that they had a hand in breaking

Kevin

Health Policy

October 16, 2009

by Daniel A. Graubert, MD

Medicine has changed so dramatically since I graduated medical school in the 1980’s, that it is hardly recognizable.

Certainly, there has been an enormous growth in knowledge which is often beneficial, but has often led us down the wrong path. For example, when advanced imaging techniques such as CT scans and MRIs became available, we were able to see the inside of large numbers of patients …

Texting young liver transplant patients to take their medications

Kevin

Conditions and Diseases

October 16, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Here’s a case where texting may actually improve a teenager’s health: Text message reminders appear to be effective in getting young liver transplant patients to take their immunosuppressive medications, a small study showed.

In 41 patients with a median age of 15, there was a significant improvement in medication compliance …

Embracing the change coming to our health care system

Donald Tex Bryant

Health Policy

October 15, 2009

As Bob Dylan sang so long ago, The Times They Are A-Changin’. Some like change; some do not.

Consider these change scenarios:

* One of the important scenes of change for health care providers is the national debate on health care coverage currently playing out in Washington D.C. Some are very vocal in their support. The media covers many of the vocal opponents. Certainly some sort of change will come out of …

One way to treat patients with severe H1N1 flu

Kevin

Conditions and Diseases

October 15, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Most patients who underwent extracorporeal membrane oxygenation (ECMO) for respiratory failure survived their struggle with pandemic H1N1 flu, according to a study by researchers from Australia and New Zealand.

Of the 68 patients treated with ECMO during the Southern Hemisphere’s winter, 54 were still alive as of Sept. 7, according to …

Should medical journals use the term nauseous, nauseated, or nauseating?

Kevin

Conditions and Diseases

October 14, 2009

by Phil Sefton

Writers and editors rushing to meet deadlines know the feeling. The effects of stress, a few too many cups of coffee, and perhaps a candy bar or bag of chips in place of a meal can conspire to make the most steely-nerved wordsmith feel a tad nauseated. Or is it nauseous? And what of that stress, that coffee, that ill-chosen meal replacement—are its effects nauseating or nauseous?

Grammarians with …

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