Why doctors should profit from dispensing medications

Medications
January 15, 2011

Hold onto your hats. I am about to enter dangerous territory. I am about to suggest maybe doctors should profit from dispensing medications from their office to offset declining reimbursements and rising expenses by using prescriptions as a source of ancillary revenues.

Why dangerous?  For a number of reasons.

One, physicians still grapple with the perception that it is improper for a physician to make money from …

Read more…

Why doctors should profit from dispensing medications

What health reform compromise could look like

Health Policy
January 15, 2011

While the rhetoric around health reform has been incendiary from day one, in policy terms, a compromise between Democrats and Republicans using the outline of the Affordable Care Act (ACA) has always been available. The two primary problems with the health care system are costs and lack of coverage. The ACA does pretty well on the second, and is a start on the first, but much more is needed. It …

Read more…

What health reform compromise could look like

Alternative medicine and osteopathic medical education

Medical Education
January 14, 2011

by Tayson DeLengocky, DO

There has been a growing public interest in complementary and alternative medicine (CAM) in recent years. Osteopathic manipulative therapy, a form of physical manipulation of the body for improvement of health and body function, has been designated as complementary and alternative medicine (CAM) by the National Institutes of Health (NIH).

According to data reported in 2007 by the National Institutes of Health’s National Center for Complementary and Alternative …

Read more…

Alternative medicine and osteopathic medical education

Using failure as motivation for medical residents

Medical Education
January 14, 2011

Dear Dr. Brandt,

As a second year medical student, I know that my peers and I all struggle with what we view as “failure” at some point or another. I imagine this problem doesn’t stop (… ever), especially since medicine seems to attract people who hold themselves to extremely high, if not impossible, standards. If you’re looking for topics, I wonder if you might have some insight to offer on how …

Read more…

Using failure as motivation for medical residents

What is a concussion, and what does it mean for the child?

Conditions and Diseases
January 14, 2011

When it comes to football season,  it’s time to think about sports injuries. We frequently have children admitted to the PICU (or to what we call the intermediate or step-down unit) for observation, typically overnight, who have struck their head. They have had concussions. What is a concussion, and what does it mean for the child?

The term itself is centuries old, but even thirty-five years ago, when I was in …

Read more…

What is a concussion, and what does it mean for the child?

Obesity and the crossroads between relative health and medical illness

Conditions and Diseases
January 14, 2011

At the end of a busy afternoon, Mrs. MJ was exactly the kind of case I needed.

Two of my patients had come in late but needed to be seen and another was acutely short of breath and refusing to be admitted to the hospital. The chaos had put me almost an hour behind schedule, and I still had to return to the wards to round on my cancer patients. Fortunately …

Read more…

Obesity and the crossroads between relative health and medical illness

Blogs encouraging suicides in the gay community

Social Media in Medicine
January 13, 2011

Are reblogs encouraging suicides in the gay community?

Recently, we’ve seen numerous young gay people take their lives. Tumblr went purple and spread the word with 29,294 reblogs. The photo above has 17,300 reblogs. Obama even made an “It gets better” video with 704,000 views.

Is the blogosphere contributing and encouraging this recent suicide epidemic? Are we reblogging the stories of these “martyrs” without actually thinking about what we’re doing in …

Read more…

Blogs encouraging suicides in the gay community

How the vaccine and autism scare was a fraud to make money

Medications
January 13, 2011

Most parents and all pediatricians are aware of the 1998 study published in The Lancet by Dr. Andrew Wakefield that mentioned a causal link between measles, mumps, rubella (MMR) vaccine and the increased incidence of childhood  autism.  It shook the medical community and created an international movement of parents questioning the extensive combination of immunizations that are given to children.  Could these immunizations be the cause of the increase in …

Read more…

How the vaccine and autism scare was a fraud to make money

Legal tobacco and illegal marijuana are historical accidents costing billions

Health Policy
January 13, 2011

“What do you think of medical marijuana?” my mother, who has never smoked a thing in her life, of the tobacco or cannabis variety, asked me one day as we drove through beautiful upstate New York woods.  We had just passed a sign saying “We will destroy your crops,” with a marijuana leaf beneath. “It has its place,” I said.  “No reason to be against it.” “But isn’t marijuana a …

Read more…

Legal tobacco and illegal marijuana are historical accidents costing billions

Kind and thoughtful words from a fellow physician colleague

Physician
January 13, 2011

I was sitting on one of the hospital’s nursing units having a difficult telephone conversation.  Anyone working nearby could have easily discerned the situation from my end of the call.

Patient’s family member wants to keep aggressive care going for a comatose, terminally ill family member against the best advice of the medical team.

Having never had to make such a decision in my own life, I am left to imagine how …

Read more…

Kind and thoughtful words from a fellow physician colleague

Do satisfaction scores really measure quality care?

Physician
January 13, 2011

Does patient satisfaction matter? The answer is a resounding “yes.”

In fact, as the director of an emergency department, feedback from dissatisfied patients has provided both me and our group with an early warning about several physicians who were not performing up to our standards. Studies show a clear correlation between decreased patient satisfaction and increased medical malpractice risk, so meeting our patients’ needs is not only in their best interests, …

Read more…

Do satisfaction scores really measure quality care?

Optimization of the new PCMH neighborhood

Health Policy
January 13, 2011

by Matt Adamson

There are a number of care models now being explored to improve the manner in which healthcare can be delivered. Let’s take a quick look at a few of the well known options:

Accountable Care Organization (ACO): The ACO model has the ability to provide, and manage with patients, the continuum of care across different institutional settings, including at least ambulatory (outpatient) and inpatient …

Read more…

Optimization of the new PCMH neighborhood

Caregiving and living with those who have mental illness

Patient
January 12, 2011

Your mother has been up all night.

She has Alzheimer’s Disease and now it has progressed to that inevitable stage of the dementing process where she is paranoid, agitated, and confused. She fidgets and paces and walks all day. She gets out of bed multiple times each night. She has gone out the door into the back yard and tried to escape to the street, wearing only her night clothes. Sometimes …

Read more…

Caregiving and living with those who have mental illness

ADVERTISEMENT

How much we should try to help patients who do not want our help?

Patient
January 12, 2011

I recently completed a long stretch of night shifts in the emergency department. I have done a myriad of things – spent over twenty minutes trying to convince a patient to take a pill that she needed to treat her psychosis, sutured a facial laceration for a young gentleman who kept insisting that he wanted to leave AMA (against medical advice) and just place a …

Read more…

How much we should try to help patients who do not want our help?

How surgery is a team sport, and in awe of neurosurgery

Medical Education
January 12, 2011

I recently finished my 10 weeks in Internal Medicine and have moved on to 1 week each of Ophthalmology, Neurosurgery, Anesthesiology, and Otolaryngology.  This week: brain surgery.  (Tomorrow, the world.)

In 3rd grade, I wrote “I want to be a brain surgen [sic].”  Ever since, it’s been a goal of mine to be a neurosurgeon.  Well, until college … when other interests and the anticipated reality of a 7+ year residency …

Read more…

How surgery is a team sport, and in awe of neurosurgery

Saying Goodbye: How families can find renewal through loss, an excerpt

Patient
January 12, 2011

An excerpt from Saying Goodbye: How Families Can Find Renewal Through Loss. Published by arrangement with Berkley, a member of Penguin Group (USA), Inc. Copyright(c)2011.

by Barbara Okun, PhD and Joseph Nowinski, PhD

One of the first tasks facing families upon receiving a diagnosis is to learn more about the illness or disorder that faces them. There are many ways to do this: by visiting Internet web sites; by …

Read more…

Saying Goodbye: How families can find renewal through loss, an excerpt

Mischaracterizations by the popular media of medical conditions

Conditions and Diseases
January 12, 2011

by Joyce Graff

Medical dramas can play powerful roles in increasing awareness of rare diseases, but it’s critical that the diseases are portrayed accurately. Mischaracterizations by the popular media of medical conditions, particularly rare ones, can be very demeaning to people afflicted with those conditions, and can affect how people look at them in the workplace or at school.

The TV show, Grey’s Anatomy recently broadcast the first …

Read more…

Mischaracterizations by the popular media of medical conditions

Intubating the combative patient

Conditions and Diseases
January 11, 2011

How many times have I been asked by the trauma surgeons to see a trauma patient for respiratory failure? The reason for intubation and ventilatory support – being combative and non-cooperative.

Intubating, sedating and sometimes even paralyzing a combative patient is an established practice. Combative patients are dangerous to themselves and to the medical staff. Clinical and radiological evaluation of these patients is difficult as well. Asking “What is hurting, Sir” …

Read more…

Intubating the combative patient

Doctors play a role in helping people through transitions with rituals

Physician
January 11, 2011

When I was an intern in internal medicine, I admitted a patient to my service with pancreatic cancer.

Pancreatic cancer is a bad one; back then, only ten percent of patients with it would be alive within five years after being diagnosed.  My patient was a farmer in the full bloom of late middle-age health when he began rapidly losing weight. An abdominal CT scan ordered by his primary care physician …

Read more…

Doctors play a role in helping people through transitions with rituals

See the same doctor when the diagnosis isn’t obvious

Conditions and Diseases
January 11, 2011

I’m thankful that I don’t have to research symptoms on the internet, diagnose myself, and come up with my own treatment.  All I have to do is go to my doctor and describe my symptoms.  My doctor can listen to my symptoms, match them up to what he knows, ask questions to pinpoint what might be going on, order appropriate tests, and recommend a treatment plan.

Odds are, when people get …

Read more…

See the same doctor when the diagnosis isn’t obvious

1466
pages