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Medical journals are shifting from science to politics

Wes Fisher, MD

Physician

January 13, 2013

Medical journals aren’t what they used to be. Just ten short years ago, medical journals were places to report scientific study, interesting cases or clinical updates and reviews. They were, for the most part, about science and discovery.

Now, there is a dramatic shift of scientific content in our journals to politics and policy.

No where is this more evident than the much-heralded and widely read New England Journal of …

Computers are meaningless in health care without computable data

Margalit Gur-Arie

Health Technology

January 12, 2013

If this were a business concerned with bottom lines, cash flows and sustainability, this would be a good time to begin planning one of those posh executive retreats to evaluate current strategy. People would be feverishly working on pulling data for PowerPoint presentations, summarizing market research and deciding whether to select the vegetarian meal or not. If this were a better …

Why the medical professions should be color blind

Peter Ubel, MD

Physician

January 12, 2013

The role of race in college and graduate school admissions remains controversial in the U.S. In fact, the Supreme Court is currently taking up a challenge to a University of Texas program that considers race in its admission decisions. Critics of race-based admissions question whether educational institutions would serve the goals of affirmative action better by relying exclusively on non-race based criteria, such as socioeconomic status and family …

The fiscal disaster of healthcare costs has a human toll

Timothy Johnson, MD, MPH

Health Policy

January 12, 2013

Today, I come back to the tragedy of medical economics in this country. And I would apply that word “tragedy” in at least two ways.

The first tragedy is that we are headed for fiscal disaster in this country because of healthcare costs.

We now spend twice as much per person on healthcare as the average per person cost of all developed countries. During the past several decades, the inflation rate for …

After Sandy: Change needs to go beyond traditional disaster planning

David B. Nash, MD, MBA

Health Policy

January 12, 2013

Not long after posting a recent column which, admittedly, was somewhat critical of healthcare providers in and around New York City following Super Storm Sandy, I decided to get a clearer picture from someone intimately connected to the disaster – my own brother.

A few months ago, Ira Nash, MD, was appointed Medical Director for Physician and Ambulatory Network Services at North Shore Long Island Jewish Health System (NSHS), a …

Unlike EMRs, paper charts never crash

Michael Kirsch, MD

Health Technology

January 11, 2013

Which of the following events is most traumatic for a practicing physician?

Your staff doesn’t show up because the roads are flooded, but the waiting room is full of patients.
Medicare notifies you that coding discrepancies will result in an audit of 2 years of Medicare records.
You receive an offer of employment by a corporate medical institution who will bury your practice if …
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Unlike EMRs, paper charts never crash

Regulate medical research so that it can help patients

Kevin R. Campbell, MD

Physician

January 11, 2013

Recently, my middle school daughter has been learning about the use of the scientific method in science class. In her school laboratory, she and the other sixth graders learn how to ask a question, perform background research, formulate a hypothesis, design and execute an experiment to test the hypothesis, and ultimately synthesize conclusions. She is being taught to accurately record and interpret data; the concept of manipulating data to suit …

My father had let me in and had allowed me to help him

Kendra Peterson, MD

Physician

January 11, 2013

I approached my father in the yard of his most recent home, a small, run-down duplex shack. His hair was whiter than I remembered, his old blue sweater shaggy. He was clipping the hedge in his careless but enthusiastic way; when finished, it wouldn’t look good, but it would look clipped.

One of his eyes was red and tearing up. A splinter …

Finding a cancer cure: Maybe we should shift gears

James C. Salwitz, MD

Physician

January 11, 2013

Now here is a novel idea to save lives and stop the cancer plague; stop trying! Sounds as crazy to me, as it does to you, but this idea actually may have merit. Some smart people are saying that we have spent too much money for little gain, thus it is time to give up and by retreating win more battles in the war on cancer, than by charging ahead.

The …

Towards patient and family centered care: Bridging the gap

Jonathan R. Welch, MD

Physician

January 11, 2013

How can hospitals and clinics deliver care that is patient and family centered? As an emergency physician, I’ve often pondered this question after my mother died of an untreated systemic infection in an out-of-state hospital. The experience, which I write about in the January 1 edition of the Washington Post as well as the December issue of Health Affairs, convinced me that healthcare still has room to grow …

What if I told you that you were going to die tomorrow?

Monica Williams-Murphy, MD

Physician

January 10, 2013

Please raise your hand if you are not going to die.

If you haven’t found the fountain of youth and we haven’t perfected anti-aging technology, then you my friend are going to die. But you are not alone, so am I, and so is your mother and your father and your brothers and sisters and even little Johnny down the street.

Now that I have reminded you of your own mortality. Does …

Don’t get frustrated with the uncertainties of medicine

Shirie Leng, MD

Physician

January 10, 2013

A few months ago, when I thought I should throw it all away and go to law school, an acquaintance who is a lawyer said something unexpected. He said “law school is learning how to think like a lawyer and deal with the uncertainty within the law.” Uncertainty? A law is a law right? Don’t speed. Don’t drink and drive. Write thank-you notes. Turns out the law often requires interpretation, …

If your doctor won the lottery, would he show up for work?

Lisa Maurer, MD

Health Policy

January 10, 2013

Some physicians will make over 7 times what the average college dropout will earn over a lifetime. Even within medicine there are significant differences in lifetime earnings between primary care, surgery, and specialty care. With the recent Powerball lottery jackpot at a record high, there was a lot of daydreaming going on recently for many Americans, maybe even some doctors: What would you do if you actually won it all? …

We speak volumes to our patients without opening our mouths

Kathy Nieder, MD

Physician

January 10, 2013

All professions need good communication skills. Obviously in healthcare the ability to communicate with patients should rank high in a physician’s list of talents. These days that interaction occurs in a number of ways: face-to-face, direct telephone contact or though a staff member, via emails, patient portals, or even texting. Because the communication is in the arena of medicine, the protection of an individual’s health information is paramount. Enter HIPAA, …

Physicians have an obligation to eliminate waste

Benjamin T. Galen, MD and Christopher T. Erb, MD, PhD

Physician

January 10, 2013

Physicians and the public are urging doctors to bring cost into consideration at the bedside when ordering laboratory tests and imaging studies. Although diagnostic testing represents an important component of the rising cost of medical care, asking what a test costs is the wrong question.

Cost-saving shouldn’t begin at the bedside, it should begin by training the next generation of doctors to think in terms of value; not bang-for-buck or potential …

Health information exchange is the foundation of care coordination

Brian Klepper, PhD

Health Technology

January 9, 2013

My wife Elaine was hospitalized for 6 days recently with an array of ailments related to her advancing cancer, so diagnosing and addressing her problems required a multidisciplinary approach. In addition to the nursing and support staffs, she was tended by an emergency physician, two hospitalists, three gastroenterologists, a pulmonologist, an infectious disease physician and an interventional radiologist. With the exception of one specialist who had performed a procedure on …

Build your network by writing a timely note

Neil Baum, MD

Physician

January 9, 2013

In my medical practice, I’ve used note writing extensively, to communicate with patients, with families of patients and with referring physicians. And yet, when I received a note, which is not related to patient care, it is always a little surprising and uplifting, and emphasizes why note writing (and note receiving) is so appealing.

In this Internet age and the age of information, we are bombarded with electronically conveyed messages, television …

What horses can teach us about health promotion

David L. Katz, MD

Health Policy

January 9, 2013

I think horses can teach us some things about health promotion. We invoke them routinely, although I suspect we are unaware of it much of the time.

Three of the more salient themes in modern health promotion involve incentives, disincentives, and what/how much people drink — with a particular emphasis, of course, on less soda, and more water. I hear hoofbeats in all of them.

Incentives are particularly prominent in worksite and …

Belichick, Brady and what healthcare can learn from the Patriots

Davis Liu, MD

Physician

January 9, 2013

It is always a treat, particularly when living on the West Coast, to watch the New England Patriots football team play on national television in their home stadium, Foxborough, Massachusetts. On Monday Night Football, the match-up was between the Patriots and the Houston Texans, which had the best record in the AFC and undefeated in all away road games. As previously …

How to get your kids to listen to you

Roy Benaroch, MD

Conditions and Diseases

January 9, 2013

We pay a lot of attention to hearing. Newborns get their hearing tested in most states, and periodic hearing screening is part of regular checkups. We know which children cannot hear. So why is it that so many kids don’t listen?

When we’re raising little kids, we know that we’re supposed to talk all the time. We yammer on in the grocery …

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How to get your kids to listen to you