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5 reasons doctors should love the Healthy, Hunger-Free Kids Act

dr_som, MD

Health Policy

January 11, 2011

The Healthy, Hunger-Free Kids Act provides increased funding beyond inflation for school meals for the first time in 30 years and addresses both food insecurity and obesity in children. Here are the details:

1. Growing bodies and brains need good nutrition, the best medicine for our patients. Children at or below 185% of the poverty level qualify for free or reduced cost meals. Although children compose only 25% of …

Alzheimer’s disease diagnosis criteria: A critical review

Ken Covinsky, MD

Conditions and Diseases

January 10, 2011

Generally, Alzheimer’s disease is diagnosed only after patients have progressed to major levels of cognitive impairment that results in substantial problems in daily functioning. But the brain changes that result in cognitive impairment start years, if not decades, before patients become symptomatic. So, wouldn’t it make sense to try to diagnose Alzheimer’s Disease in patients who have the brain changes, before they have clinical symptoms?

The answer would be yes if …

How patients can advocate for themselves

Erin Breedlove

Patient

January 10, 2011

Advocacy is an important and vital skill for any young adult, but young adults with cerebral palsy and other disabilities have a bit of a unique need for developing the skills. I would argue that the skills needed for self advocacy need to have the opportunity to develop in small ways when a child becomes a toddler.

For me, the roots of my advocacy were planted in the years prior to …

The safety of biosimilars and FDA regulation

Kevin

Medications

January 10, 2011

by John Horton

When the FDA was created in 1906, not even Nostradamus could have predicted the medical advances that would come to extend and improve our lives: childhood vaccines, insulin, and the use of lasers in surgery were all unimaginable a century ago.

While many future advances are beyond our imaginations’ reach, it seems certain that the advances in biologics — medicines made from living organisms — will stand out as …

A culture of fear worsens the nursing shortage and medical errors

Jeffrey I. Kreisberg, PhD

Health Policy

January 10, 2011

There has been a lot talk about changing how we reimburse providers for healthcare from one that pays for services performed, to another that reimburses providers depending on what happens to the patient.

I think we must take a couple of steps back and first tackle the public health crises we are facing that is putting our healthcare in danger, namely, medical errors and the growing nursing shortage. Despite identifying work …

Are physicians motivated by virtue or are they passive victims?

Stephen C. Schimpff, MD

Physician

January 9, 2011

An interesting article in JAMA by Drs. Jain and Cassel referred to the British economist Julian Le Grand who suggested that public policy “is grounded in a conception of humans as knights, knaves or pawns.”

Basically, are we motivated by virtue, by self interest or are we just passive victims? The authors suggest that this is a good question not only for physicians to contemplate but …

Disconnect between knowledge of STIs and behaviors to reduce risk

PalMD

Conditions and Diseases

January 9, 2011

In my opinion, people are often too embarrassed to see their doctor about sexually transmitted infections (STIs)—in my opinion.

“In my opinion” is one of the most dangerous phrases in science. But when in comes to attitudes toward STIs, the data are scarce. STI’s are very much a “behavior”-based disease, so knowing what attitudes prevail can help us design effective prevention strategies. Attitudes toward HIV have been …

Can a doctor dodging a question help the patient?

Doctor D, MD

Patient

January 8, 2011

Doctor D has dodged some questions in his career, but he has also been on the receiving end of some non-answers and can attest to their usefulness on the patient’s side of things.

How can a doctor dodging a question help the patient?

Let me tell you a story:

Doctor D’s son Little D was born with a very rare genetic condition which required he see an expert at a big university. As …

Lotteries in life may have to do with suffering, disability and death

Jeffrey Knuppel, MD

Patient

January 8, 2011

Winning the lottery — yes, I’ve heard the horror stories of how people’s lives have taken a turn for the worse after it’s happened. But, like many others, I still wonder what it would be like. I’d be willing to take my chances with the win!

But this post is not about money. Not at all. Actually it’s about gratitude.

It’s about the many ‘lotteries’ in life that have nothing to do …

Employing a virtual assistant in your medical practice

Daniel McKennitt, MD

Physician

January 8, 2011

The many benefits of utilizing virtual assistant in the physician’s office have become clear to many. Physicians report greater job satisfaction, patient retention and cost-efficiency as some of the most obvious areas impacted by the use of virtual assistants in their practices.

Physicians preparing to shift some of their staffing needs to a virtual assistant or virtual assistance company have many questions and concerns that will be addressed by the person …

A modest proposal for a truly useful EMR

Lucy Hornstein, MD

Health Technology

January 7, 2011

I love computers. Really, I do. Despite my oft-repeated claims about the shortcomings of electronic medical records in their current form, I do believe that information technology has the potential to be of great help to me and other physicians in providing quality care to Americans.

Stop laughing. I really mean it.

I do not believe, however, that IT best serves the medical needs of our patients when …

Explore information technology and safely digitize medicine

Aaron J. Stupple, MD

Health Technology

January 7, 2011

We have an intuitive sense of what is meant by those urging medicine to “go digital.” It seems to refer to modernizing, becoming more flexible, and basically following the path of modern computing and information technology.

Is it useful to think more rigorously than this hazy conception, without necessarily reading a special report from The Economist?

Digital information is special because it can be transmitted to and instantiated within any number of …

Common things are common, except when the diagnosis is rare

Michael Aaronson, MD

Conditions and Diseases

January 7, 2011

During my training at Hennepin County Medical Center (HCMC) in Minneapolis, MN, my mentor would use the following teaching pearl during rounds: “When you hear hoofbeats, think of horses not zebras!” He would also frequently use: “If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck.” What did my mentor, the Sage of HCMC, mean by this?

From Wikipedia: “Zebra …

Little Patient Big Doctor: One Mother’s Journey, an excerpt

Kevin

Patient

January 7, 2011

An excerpt from Little Patient Big Doctor: One Mother’s Journey.

by Haleh Rabizadeh Resnick

Dear Doctor,

I want to share with you my experiences with two of my children . . . . I share the hecticness our lives with you for a reason. We are all the same. We are all busy. We all face adversity. And while we want most to trust the opinions of professionals, …

Your 10 minute office visit needs 8 people and 45 minutes of work

Mary Pat Whaley

Physician

January 7, 2011

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I sat at the checkout desk in my practice last week for the first time and as always, it was a revelation. If you haven’t worked your check-in and check-out desks recently, I highly recommend it.

An insured patient that I checked out was shocked when I said the charge for her visit was $100. She said, “But he was only in …

Why your health insurance medical appeal was rejected

Nicholas Fogelson, MD

Patient

January 6, 2011

One thing that many residents do not know is that there are more benefits to becoming a board certified physician than just that plaque on the wall. One of these benefits is that ability to pick up a few extra hours of work here and there doing consulting for the multitude of companies that would like the opinion or expertise of a physician.

In some cases this consulting can be about …

Will health care melt down, like the mortgage industry?

Dan McCoy, MD

Health Policy

January 6, 2011

Clearly, one issue dominated the election this past fall: the economy, and more specifically the lack of jobs.

So I would like to pose a few questions and ideas on just how government actually performs in creating economic growth and in kick starting job growth. I don’t necessarily have the answers, but I’m real good at asking questions.

Did government assisted mortgages help the economy? …

Secrets of good health website design

Lisa Gualtieri, PhD

Patient

January 6, 2011

I interviewed Tania Schlatter, one of the best designers I know and a guest-lecturer for Web Strategies for Health Communication, about color, imagery, and other aspects of health website design.

Lisa: How is the design of health websites different than for other types of sites?

Tania: The design of any site goes back to the goals of an organization and what people coming to a site need. Healthcare consumers can …

Read more…

Secrets of good health website design

MKSAP: 74-year-old man with gradually progressive dyspnea

mksap

Conditions and Diseases

January 6, 2011

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 74-year-old man is evaluated for a 5-year history of gradually progressive dyspnea and dry cough without wheezing or hemoptysis. For the past 2 years he has had pain and occasional swelling in both knees. He has not had fever or lost weight. He smoked one pack …

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