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The problem of teens texting throughout the night

Conditions and Diseases

April 28, 2013

I visited with 5 charming teenagers last week. Four of them had something in common: These teenagers are texting in the middle of the night, nearly every night.

Texting in the middle of the night is not a new phenomenon. Over 2 years ago, reports on teenagers texting at night began to surface. One study concluded the average teenager sends 34 texts after lights out. Simply based on the conversations I …

The ethical shortcomings of selling supplements

Lucy Hornstein, MD

Medications

April 28, 2013

A crunchy friend of mine on Facebook re-posted something from an even crunchier friend of hers who was shocked to find that many naturopaths sell supplements. Actually, she feels that selling them is okay; so is prescribing them. But selling what they prescribe apparently tips her ethics meter over into “unacceptable”.

As I read her screed against the ND who conducted a cursory history and exam before checking off $750 worth …

4 hard truths about Obamacare

Bob Doherty

Health Policy

April 28, 2013

It was recently the Affordable Care Act’s third birthday, but you might have missed it for all of the (lack of) attention it received. Sure, there was the usual back and forth from the law’s supporters and opponents, but almost nothing that provided any new insights.

Supporters, such as the liberal New York Times editorial page, marked the ACA’s anniversary by touting the tens of millions already being helped …

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4 hard truths about Obamacare

It’s time to put the vaccine-autism link behind us

Roy Benaroch, MD

Medications

April 27, 2013

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First, it was the MMR-autism link—that turned out to be a complete fabrication, a fraud invented by a single “researcher” who made up his data. He was taking money from plaintiff’s lawyers, and he was trying to patent his own, competing vaccine. Too bad for the scare and the resulting surge in measles.

Then, the mercury connection. A mercury-containing preservative, thimerosal, …

The new HIPAA regulations: Do you know the rules?

Susan Crawford

Health Policy

April 27, 2013

Even stronger controls have just been set out for HIPAA. They come in the final regulations for the Omnibus Health Insurance Portability and Accountability Act, or the HIPAA rule. The new rules became effective March 26. However, medical offices and business associates have until September 23 to comply.

Mostly, the changes affect patient requests and approvals, breach reporting, and business associates. Along with that, the penalties for noncompliance have gone up. …

Patients are the most important piece of the medical team

Danea Horn

Patient

April 27, 2013

After reading Dr. Mona Kotech’s article titled “Is the era of patient centered care decidedly anti-physician?” I immediately thought of several instances when knowing my health history and current lab readings were vital for providing me with safe care.

I was born with VACTERL Association, a birth disorder that impacts a variety of systems in the body. I have had more than twelve surgeries and a variety of …

Loyalty and honesty are key to improving transparency in healthcare

Matthew D. Rifkin, MD

Health Policy

April 27, 2013

People are people, whether they are identified by their career or their role in the healthcare process. So, whether you’re working with a referring physician or a patient, it’s important to consider emotions, their role in the sales process and how they drive and destroy value. One of the most valuable emotions to have in our business is loyalty. Loyalty is what providers work towards with referring physicians and what …

Practical advice for the parent of a pre-med

Suzanne M. Miller, MD

Medical Education

April 27, 2013

For over a decade, I have advised pre-meds on how to maximize their chances of getting into medical school. During this time, as I witnessed thousands of anxiety-ridden pre-meds wade doggedly through the murky waters of medical school admissions, I have noticed pre-med difficulties often pale in comparison to those of pre-meds parents. It’s often much easier to be the athlete on the field than the coach on the sidelines. …

MKSAP: 35-year-old woman with an acute exacerbation of asthma

mksap

Conditions and Diseases

April 27, 2013

A 35-year-old woman is evaluated in an urgent care center for an acute exacerbation of asthma. She has a history of frequent asthma exacerbations requiring unscheduled visits; however, between these exacerbations, her examination and pulmonary function studies have been unremarkable. Her current medications are inhaled budesonide and inhaled albuterol.

On physical examination, she is in moderate distress with audible inspiratory and expiratory wheezing. Temperature is 37.0 °C (98.6 °F), pulse rate …

Can David Goldhill fix healthcare?

Davis Liu, MD

Health Policy

April 26, 2013

First I believe our health care system must be better so I’m always curious to hear how others might propose to fix it. I recently had the opportunity to listen in two conversations with businessman David Goldhill about how healthcare might be made better. Goldhill lost his father to a hospital acquired infection and witnessed multiple errors during his hospitalization which compelled him to write not only a piece in …

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Can David Goldhill fix healthcare?

Being a doctor in a time of crisis

Ishani Ganguli, MD

Physician

April 26, 2013

I was sitting in the resident workroom at Massachusetts General Hospital (MGH) when my co-resident showed me the text from her sister: two explosions had shaken the finish line of the Boston marathon. Though news sites had not yet published the headline, it was immediately corroborated by the cacophonic wails of ambulances heading towards us and our shock was quickly replaced by the urge to learn more and to do …

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Being a doctor in a time of crisis

There is minimal oversight of hospital marketing

Joanne Conroy, MD

Physician

April 26, 2013

I am old enough to remember when physicians did not advertise. It was considered a professional ethical issue. Hospital advertising consisted of institutional “We’re here” ads. Anything aggressive by docs or hospitals was considered bad taste… but that was before health care became as competitive as any other type of business.

I have been barraged, as have many of you, by a wave of hospital advertisements as our health care marketplaces …

Misdiagnosis is more common than you think

Evan Falchuk

Patient

April 26, 2013

An important study in the Journal of the American Medical Association finds that misdiagnosis is more common than you might think. According to the study, almost 40% of patients who unexpectedly returned after an initial primary care visit had been misdiagnosed. Almost 80% of the misdiagnoses were tied to problems in doctor-patient communication, and more than half of those problems had to do with things that were missed in the …

Access to care isn’t enough: It’s about access to high quality care

Ashish Jha, MD, MPH

Health Policy

April 26, 2013

Ensuring that Americans who live in rural areas have access to healthcare has always been a policy priority. In healthcare, where nearly every policy decision seems contentious and partisan, there has been widespread, bipartisan support for helping providers who work in rural areas. The hallmark of the policy effort has been the Critical Access Hospital (CAH) program– and new evidence from our latest paper in the Journal of the …

After the Boston Marathon: Trauma itself can bring strength

Suzanne Koven, MD

Physician

April 26, 2013

Not long ago I noted a certain older patient’s name on my schedule. I really dreaded seeing her. It’s not that I dislike her–in fact she’s one of my favorite patients. It was just that I hated the prospect of seeing her looking as poorly as I knew she would. She’d been through so much: an accident resulting in devastating injuries followed by painful surgeries, and, worst, in the middle …

How would you react to a cancer diagnosis?

Suzanne Koven, MD

Physician

April 26, 2013

There’s this weird feeling I get when I hear bad news, or even not that bad news, or even the possibility of bad news: a tingling that spreads across my forehead, down my face, into my jaw, and then to my chest, where it settles like a…no, not a lump…a void. I get the feeling every time I go for my annual mammogram or any other medical test, I wonder …

Treating the enemy still requires respect and professionalism

Ryan Gray, MD

Physician

April 26, 2013

A city is free. A town is celebrating.

I sat and watched the local news station announce that the second suspect in the 2013 Boston Marathon bombings had been taken into custody and was being transported to a nearby hospital.

I am relieved. And thankful.

Then I wonder. I wonder about the hospital that this suspect is being transferred to, and I wonder about my colleagues. What are the nurses, the doctors, and …

TEDMED 2013 recap: Day 4

Michael Moore and Gene Ostrovsky

Potpourri

April 26, 2013

The final day of last week’s TEDMED 2013 consisted of two sessions, tastefully interspersed with self-reflection and humor by the curators. The first session, “Hiding in Plain Sight,” looked forward to new developments in technology, and data analysis in particular, that can give us new capabilities in healthcare.

Computational physicist Mariano Vázquez discussed his work in creating a “computational world” with a supercomputer …

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TEDMED 2013 recap: Day 4

Dzhokhar Tsarnaev and the true cost of upholding the Hippocratic Oath

Ron Cheung, MD, PhD

Physician

April 25, 2013

It has been weeks since the Boston marathon bombings. The hospitals in that city, by most accounts, were remarkably well prepared, expertly and compassionately caring for the injured innocents. Emergency response was fluid and efficient. As tragic as the events of April 15 were, the health care workers of Boston were beacons of inspiration for a city in shock.

Yet these heroics do not represent the most impressive actions performed by …

TEDMED 2013 recap: Day 3

Michael Moore and Gene Ostrovsky

Potpourri

April 25, 2013

Day 3 of TEDMED 2013 kicked off with “Session X,” which was a special session focusing on innovation and entrepreneurship, and consisted of a spirited panel discussion of two hot topics. During the first half of the session, Marleece Barber, Jennifer Kurkoski, Rick Valencia, Geeta Nayyar and Jeff DeGraff participated in a discussion titled “Every Company is a Healthcare Company: Innovating From …

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TEDMED 2013 recap: Day 3

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