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Conditions and diseases

The problem of teens texting throughout the night

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.…

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 …

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The problem of teens texting throughout the night

Drugs and prescribing

The ethical shortcomings of selling supplements

38

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…

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 …

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The ethical shortcomings of selling supplements

Health policy

4 hard truths about Obamacare

28

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…

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

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Drugs and prescribing

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

14

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,…

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, …

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

Health policy

The new HIPAA regulations: Do you know the rules?

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…

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. …

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The new HIPAA regulations: Do you know the rules?

Patient voices

Patients are the most important piece of the medical team

4

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…

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 …

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Patients are the most important piece of the medical team

Health policy

Loyalty and honesty are key to improving transparency in healthcare

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…

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 …

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Loyalty and honesty are key to improving transparency in healthcare

Medical education

Practical advice for the parent of a pre-med

8

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…

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. …

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Practical advice for the parent of a pre-med

Conditions and diseases

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

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.…

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 …

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

Health policy

Can David Goldhill fix healthcare?

3

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…

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?

Physician voices

Being a doctor in a time of crisis

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…

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

Physician voices

There is minimal oversight of hospital marketing

11

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…

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 …

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There is minimal oversight of hospital marketing

Patient voices

Misdiagnosis is more common than you think

4

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…

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 …

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Misdiagnosis is more common than you think

Health policy

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

3

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…

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 …

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

Physician voices

After the Boston Marathon: Trauma itself can bring strength

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…

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 …

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After the Boston Marathon: Trauma itself can bring strength

Physician voices

How would you react to a cancer diagnosis?

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…

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 …

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How would you react to a cancer diagnosis?

Physician voices

Treating the enemy still requires respect and professionalism

12

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.…

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 …

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Treating the enemy still requires respect and professionalism

TEDMED 2013 recap: Day 4

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,…

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.

Mariano-Vazquez

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

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TEDMED 2013 recap: Day 4

Physician voices

Dzhokhar Tsarnaev and the true cost of upholding the Hippocratic Oath

7

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…

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 …

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Dzhokhar Tsarnaev and the true cost of upholding the Hippocratic Oath

TEDMED 2013 recap: Day 3

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,…

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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