by Shanti Bansal, MD
In the cardiac catheterization lab one Tuesday morning, I encountered a situation that made me reflect on a bit of 18th-century British history.
At that time, the British government was overburdened with prisoners. A plan was hatched for sea captains to transport many of them to Australia. Due to poor conditions, up to one third died on the voyage. Politicians and clergy members …
Judicious use of complex medical procedures
At LesliesList.org we get many emails asking where an adult can get low cost vaccines.
It appears the answer is… nowhere. They don’t exist– unless you are an established patient in one of the county-funded or low-cost clinics in your metropolitan area. However, you can save a little money by comparison shopping. I think your best bet is to try one of the walk-in …
Where an adult can get low cost vaccines
A fair amount has been written on EMR for the individual physician facing retirement.
But I have come across a more complicated variation of the question. What if a multi-physician group has one physician approaching retirement who is the “lone hold-out,” opposing EMR while the rest of the docs in the group are ready to take the plunge?
The older physician has a …
Should older doctors be allowed to opt out of EMR?
I am a self-taught bass guitarist in a church band, and, to be honest, it sometimes shows. I know I need to improve my skills, but time commitments make formal lessons difficult. So two days ago I opened up YouTube and entered “bass guitar lessons” into the search box.
19,000 hits registered. I selected a few that looked good on …
Can doctors learn surgical skills on YouTube and Facebook?
In the recent Coen brothers’ remake of the 1969 movie True Grit, Mattie Ross, an intrepid 14-year-old, is determined to hunt down and kill the man who murdered her father.
To accomplish this, she hires U.S. Marshal Rooster Cogburn, (played by a mumbling Jeff Bridges) a rough, one-eyed veteran of many such quests – then announces that she plans to come along. She figures she is prepared.
After all, she and her …
True Grit and sharing decisions on health care with our doctors
In my forays into the history of medicine I came across these six little words by Hippocrates.
They seem strangely modern, almost like something you might find on a Hallmark-card for today’s medical school graduates. I don’t know how old the translation is and I couldn’t understand the original text if I tried – but these simple words really touched me when I …
Natural forces within us are the true healers of disease
A guest column by the American Medical Association, exclusive to KevinMD.com.
As physicians, many of us realize on some level that our practices contribute to our state and national economies – we just lacked the empirical evidence to understand how much.
That changed last month, when the American Medical Association released a report that studied the economic impact of office-based physicians. While a handful of states have previously studied the economic impact …
AMA: Getting the best value for our health care dollars
David C. Kibbe and Joseph C. Kvedar’s article, “Building a Research Agenda for Participatory Medicine” highlighted two of their “ready-to-go” research questions:
Recently, the Legacy Foundation’s Schroeder Institute focused …
Using social networks to help patients quit smoking
by Diana E. Lee
None of us really wants to sabotage a doctor’s appointment through our own behavior. But it’s easy to do just that by not paying attention to the factors within our control that affect the quality of our appointments.
These are some behaviors to avoid at all costs:
1. Show up late for appointments. It’s an unfortunate …
How to sabotage a doctor’s appointment
by Sally Scroggs, RD
About 130 million Americans will eat out on any given day this year. While dining out shouldn’t mean “pigging out,” picking a salad over cheese fries can sometimes be difficult.
According to the American Cancer Society, making healthy food choices is one of the most important things you can do to reduce your cancer risks. But nutritional experts say many of us don’t make good …
by Benjamin P. Geisler, MD, MPH
Everybody is talking about Accountable Care Organizations or ACOs these days.
The reason being that the Centers for Medicare and Medicaid Services or CMS has released the rules for shared savings between ACOs and CMS.
The complete proposed rule is 429 pages long and they’re seeking comments on it now until early June.
What is an ACO?
ACOs will take care of …
How an ACO will affect physicians and Medicare patients
She was a Korean woman, spoke passable English. We always exchanged pleasantries, and she called me “doctor” when I picked up my laundry. This time she was notably quiet, distant.
I didn’t figure it out until I got home and hung up my jacket, on the inside of which I noticed she’d pinned an envelope. It contained a photo I’d taken months ago, left and forgotten in one of my pockets. …
Sixteen stab wounds, seriously delivered
I’ve played over a thousand ice hockey games in my life, but I had no idea that yesterday’s adult men’s league game in Cleveland would be the most memorable.
I grew up in Canada, three blocks from Wayne Gretzky, the greatest hockey player ever, but I wouldn’t be surprised if my game last night was more important than any game that my former neighbor played. Tonight’s game was literally a matter …
What happens when two hockey teams and a defibrillator cross paths?
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As the number of restrictions on physicians working with industry continue to grow, and the places where policies prohibit physicians from collaborating with industry expand, close examination of the reasons supporting these policies is necessary.
The current trend of academic medical centers (AMCs), professional organizations, and States that have begun adopting policies that restrict permissible interactions and activities between industry and …
Policies prohibiting collaboration between physicians and industry
ACO regulations and related federal issuances hit the street, after several months of waiting — from CMS, OIG, FTC, DOJ and IRS.
They cover the waterfront, ranging from the central regulation defining the structure and workings of the ACO, to limited Stark self-referral ban and anti-kickback statute waivers in the fraud and abuse arena, to new frameworks for antitrust analysis, to rules governing joint ventures involving taxable …
How the ACO regulations set the stage for Accountable Care Organizations
Insomnia plagues me. In that, I’m no different from millions of other Americans. But I am different in that I sought supposed experts to help me deal with this situation. My experience proved to be a nightmare.
First, I believed my sleeplessness due to the fact I feel “on,” all the time, doing too many things in the space of 24 hours. …
Screen your sleep lab when evaluating your insomnia
When I was a family medicine intern, I met a diabetic patient in the hospital who had stopped seeing his regular doctor after he lost his job and his health insurance.
His untreated diabetes made his feet go numb. He stepped on a nail and didn’t realize it until he noticed …
Preventing disease saves the crippling costs of tertiary care
My Google Reader accidentally picked up an intriguing abstract that examined a research study of resources that medical students use in solving diagnostic cases.
The abstract was picked up because it contained the word “exercise” that is one of my PubMed filter queries. Although we often think that most diagnostic decision-making occurs from learned information stored in physician’s brains, information resources can …
Google affects how clinicians and the public collect diagnostic information
Recently, I attended a conference on integrative medicine. It was a lovely conference and I learned a lot: about Chinese therapies used for cancer, about osteopathic manipulation, and about the growing community of doctors that respect the value of complimentary medicine practices and are working to integrate them into their general practice.
I also left with a sense of dissatisfaction with what …
Could alternative medicine practitioners take the lead in health policy?
by Neha Jain, MD
Think back to your first memory of death.
Was it a loved one? A stranger? A pet? Were you sad, happy, or just curious?
My grandmother, Nani, died unexpectedly. During the wake, my cousins and I played together in the bedroom where we had been restricted. All through that memory, there’s a strange, dark, terrible …
Palliative care and medical interventions are not mutually exclusive
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