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Does being on the America’s Best Hospitals list affect patient outcomes?

Physician

September 4, 2009

by Charles Bankhead, Staff Writer, MedPage Today

A news magazine’s rankings of top-rated hospitals for heart failure care did not include many hospitals that performed at least as well as the ranked centers, according to a comparison of the magazine’s list and government data.

Hospitals that made the U.S. News & World Report list had a better 30-day mortality than …

How hospitalists can provide high quality patient care at the lowest possible cost

Robert Wachter, MD

Physician

September 3, 2009

Much has been made of the superior performance – on both cost and quality – of integrated health care organizations like the Mayo and Geisinger Clinics. But since the defining characteristic of these standout systems is at least 50 years of integrated history, few believe that the rest of us – namely the docs and hospitals that provide the bulk of American health care – can quickly achieve such seamless …

The ultrasound that saved a baby girl’s life

Kevin

Patient

September 3, 2009

by Linda Lee, MD

Bob Hebert, in his column in The New York Times, recently wrote that, “Life in the United States is mind-bogglingly violent. But we should take particular notice of the staggering amounts of violence brought down on the nation’s women and girls each and every day for no other reason than who they are. They are attacked because they are female.”

As a family physician I can …

What can health reform in the United States learn from Africa?

Dr. Martin Young

Health Policy

September 2, 2009

As an outside observer of the American health reform debate, I cannot help but notice the disparity of views, the fractured arguments, the protectionism and desperation. My country is in a similar struggle for health care reform, with the main difference being America is a rich nation, and we are poor by comparison. In both debates, however, I have looked for the humanitarian argument, and in many cases found it …

Is alternative health a form of fundamentalism?

Amy Tuteur, MD

Physician

September 1, 2009

There once was a time when all food was organic and no pesticides were used. Health problems were treated with folk wisdom and natural remedies. There was no obesity, and people got lots of exercise. And in that time gone by, the average lifespan was … 35!

That’s right. For most of human existence, according to fossil and anthropological data, the average human lifespan was 35 years. As recently as 1900, …

Health care reform: The uncivil war dividing America

American College of Physicians

Health Policy

August 31, 2009

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

by Steven Weinberger, MD, FACP

The unfettered debate about ideas that characterizes the democratic process in the United States operates best when there is a truthful presentation of the issues, and when the process is civil and respectful. Unfortunately, the debate about health care reform has evolved to the point that it …

How a wealth of information takes attention away from the patient

Kevin

Patient

August 31, 2009

by Abraham Verghese, MD

This month I am the attending physician overseeing an internal medicine team, one of four such teams that admit patients to my teaching hospital. It’s a great time to be an attending physician. I have seasoned interns who in just a few weeks will be junior residents, and I have even more seasoned senior residents on their way to entering practice or entering subspecialty training. The team …

Health care as a futures exchange

Kevin

Health Policy

August 30, 2009

by Susan H

It seems that health insurers are serving as exchange and clearing firm for “health futures” traders. Traders of “health futures” are potential patients, and health care providers. Patients are synthetic buyers of futures on health care provision, doctors and providers of medical goods and services are short sellers of those futures. The exchange and clearing firm (health insurer) represents that it serves to stand as guarantor in the …

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Health care as a futures exchange

Why following a delayed vaccine schedule may be dangerous

Kevin

Conditions and Diseases

August 29, 2009

by Steve Perry, MD

I recently read a post by Dr. Bob Sears which listed several “Vaccine Friendly Doctors” in Colorado and across the nation.

As a pediatrician and vaccine advocate, I thought I’d be on this list. I am “vaccine-friendly doctor” who works with moms and dads to find the best health care plan for their babies. I read the information on both sides of the issue and weighed the science …

Are relationships being lost in medicine, and are hospitalists partly responsible?

Edwin Leap, MD

Physician

August 29, 2009

An emergency physician, like me, may be the worst possible person to discuss relationships with patients. I mean, one of the reasons I chose this specialty was that I didn’t want long-term relationships with my patients. I see, now, that God has a great sense of humor.

See, the county I landed in after residency is small enough that I do know many of my patients, and I do see them …

Increasing radiation exposure to patients from CT scans and other imaging tests

Kristina Fiore

Conditions and Diseases

August 28, 2009

by Kristina Fiore, Staff Writer, MedPage Today

Imaging procedures can expose patients to high cumulative doses of radiation, researchers say.

In a large study, 193.8 people per 1,000 were exposed to moderate doses of radiation each year, while 18.6 per 1,000 were exposed to high doses, and 1.9 per 1,000 received very high doses, according to Reza Fazel, MD, of …

Will medical malpractice reform be included in the final health bill?

Jeffrey Segal, MD, JD

Physician

August 27, 2009

Believe it or not, some element of federal tort reform is not only possible, but likely.

Sounds counterintuitive? We all know that Congress has a strong majority with Democrats. We know the President is also a Democrat. We know the plaintiff’s bar strongly supports the Democratic Party. We know that Democrats have traditionally shied away from specific reforms, such as caps on pain on suffering. So, this would seem the worst …

New troponin tests to better diagnose a heart attack

Crystal Phend

Conditions and Diseases

August 27, 2009

by Crystal Phend, Senior Staff Writer, MedPage Today

A generation of new, more sensitive troponin assays has improved hospitals’ ability to diagnose a heart attack to a point as early as the time of emergency department presentation, two separate studies affirmed.

In one multicenter study, a sensitive troponin I assay had an early diagnostic accuracy of 96%, compared with conventional …

Drug company ethics and the pharmaceutical industry’s pursuit of profit

Steve Woodruff

Medications

August 26, 2009

Ghostwritten clinical papers. Off-label marketing. Channel-stuffing. Hiding of negative data.

Pharma companies have earned a hefty percentage of the opprobrium heaped on them by a skeptical public. And it’s mainly because of a failure to heed the Golden Rule. We all know the “classical” Golden Rule: Treat others the way you’d wish to be treated. But in so many cases, drug manufacturers seem to adhere to a different version: the Gold-in …

Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

Kevin

Conditions and Diseases

August 26, 2009

Caster Semenya is the South African track and field star who recently was engulfed in controversy at the recently concluded World Track and Field Championships.

Turns out, there are some who are questioning her gender, and subsequently, tests are being conducted to see if she is really a woman.

It’s not as cut and dry as it appears.

Consider the possibility of Read more…

Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

How to make industry influence transparent in continuing medical education

Larry Husten, PhD

Medical Education

August 25, 2009

by Larry Husten, Ph.D.

A recent hearing of the Senate Aging Committee on continuing medical education (CME) should scare anyone who might need to see a doctor in the next few years. But you don’t need to be a Washington policy wonk to discover that there’s a huge problem with CME.

Just walk into the lobby of any major downtown hotel when a large medical conference is in town and you will …

Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?

Kevin

Conditions and Diseases

August 24, 2009

Recent reports have said that Michael Jackson died from a propofol overdose. Is that really the case?

Here’s what happened, according to the published timeline.

— At about 1:30 a.m., [Dr. Conrad] Murray gave Jackson 10 mg of Valium.
— At about 2 a.m., he injected Jackson with 2 mg of the anti-anxiety drug Ativan.
— At about 3 a.m., Murray then administered 2 mg of the sedative Versed.
— At about 5 …

Read more…

Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?

Is health care a public good?

Jeoffry B. Gordon, MD, MPH

Health Policy

August 24, 2009

by Jeoffry B. Gordon, MD, MPH

The public policy and current political action around changing the system overlooks two important technical fallacies:

(1) That health care is most efficiently distributed by a free market mechanism; and,
(2) That medical services are an ordinary commodity.

The commercial market model is a failing economic and public policy ideology used to rationalize and justify corporate control of the health care system to profit from the enterprise. …

Read more…

Is health care a public good?

Will nurses solve the primary care crisis?

Kevin

Physician

August 23, 2009

by Derek Mazique

Between “death panels,” a NICE-style cost effective analysis board, and Obama’s slowly graying hair, one conspicuously absent part of reform are reimbursement rates. Medicare and private insurance typically reimburse for expensive procedures, which ultimately rewards procedure-heavy specialists while discourage those cognitive-heavy services like primary care docs.

The result? As a recent Baltimore Sun op-ed and this very blog pointed out, a combination of pay and burn-out are encouraging …

What can John Mackey and Whole Foods learn from publicizing their views on health reform?

David Harlow

Health Policy

August 21, 2009

Today’s health care communications lesson is brought to you courtesy of Whole Foods … I mean John Mackey.

John Mackey’s stepped in it again. Last week, Mackey, the libertarian CEO of natural-foods behemoth Whole Foods, wrote an op-ed piece on health reform for The Wall Street Journal. But Mackey felt it necessary to republish it on his blog because the Journal editors lightly edited it, Journal headline writers wrote a …

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