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Why doctors should be allowed to fire patients

Physician

February 23, 2012

A recent article in the Wall Street Journal is getting a lot of attention: More Doctors ‘Fire’ Vaccine Refusers. The article discussing the increasing frequency of pediatricians who are “firing” patients/families from their practices because they refuse to take recommended vaccines for fear of autism or other concerns (rampant on the internet, but all proven untrue).

It is important to note that not only should physicians be able to fire patients, …

The lack of concussion awareness in the medical field

Mandy Huggins, MD

Conditions and Diseases

February 23, 2012

With all the media attention to concussion these days, most people are familiar with the term “concussion” and know what it means. If you’re not involved in the medical field, and you never watch CNN or ESPN, fine. You might not be in the loop. But it is extremely alarming when we still see the lack of awareness in the medical field.

I don’t mean to speak ill of other specialties, …

Should doctors talk about the cost of drugs with their patients?

Peter Ubel, MD

Medications

February 23, 2012

I first realized something was amiss when I picked up my prescriptions and the pharmacist explained that she could not fill the anti-malarial medications as prescribed: “Your medication plan only pays for 30 days of pills, and your prescription was for five pills.” The pharmacist continued: “Your PBM [that’s an acronym for pharmacy benefits management company, the type of company that coordinates many peoples’ medication coverage] only fills this medication …

America has a medical care system not a health care system

Stephen C. Schimpff, MD

Health Policy

February 23, 2012

As Americans we believe we have the best healthcare system in the world. But think again, it’s really not the truth. We do have superb medical schools, very well trained providers, superb science and technology but the delivery of medical care is just not what it should be. We spend more for healthcare than any other country does on a per capita basis.

And yet when we compare ourselves to other …

Why physicians don’t want patients to have their cardiac device data

David Lee Scher, MD

Health Technology

February 22, 2012

There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers. I have discussed in other articles why patients deserve their data and the benefits derived thereof. There are no substantive arguments against this practice, and I always thought, throughout my 12 years of remotely monitoring patients with these devices, that they not only were entitled to the …

Impersonal communication on the Internet fuels cyberbullying

Dominic A. Carone, PhD

Health Technology

February 22, 2012

In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over another, typically from a roughly similarly aged peer group. The bullying could be mild such as occasional name calling and having one’s books knocked down when walking in the hallway. This does not mean the effects of the bullying were mild but comparatively speaking, this is generally not …

The analogy between baseball hierarchy and medical systems

Michael Fisch, MD, MPH

Physician

February 22, 2012

From age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but the lure of the game has always remained. To my colleagues, it must seem that I can hardly understand the world without the comfort of baseball analogies. I was thrilled when my son Ryan, age 12, saw the …

Saving patients from Internet health information

Stewart Segal, MD

Physician

February 22, 2012

Lately, I get the feeling that I’m doing something wrong. I’m supposed to form a partnership with my patients. My patients are supposed to be the working partner and I’m supposed to be the consulting partner.

My job as the consulting partner is to offer sagely medical advice to the boss (working partner). As a consultant, I’m supposed to help in the making of key decisions, find the appropriate tools to …

Understanding what patient centered care really means

Jordan Grumet, MD

Physician

February 21, 2012

There was nothing the professor despised more then the syrup that oozed out of his partner’s lips when dealing with patients. He often cringed as he walked by the examining room and imagined the hand holding that was taking place behind closed doors.

Privately, they argued about the different approaches. One saw the world in terms of black and white, while the other was steeped in a foggy haze of gray. …

A letter of thanks to my organ donor

Jim deMaine, MD

Physician

February 21, 2012

I have tried to write a letter of thanks but don’t know what to say or even how to begin. I don’t know the persons I am writing to, but part of their loved one is literally now a part of me.

It began with a phone call from my brother. “Jim, what the hell is Fuchs’ Dystrophy anyway – do you have it too?”

I racked my brain and tried to …

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A letter of thanks to my organ donor

Health IT and doctors: A framework for successful partnerships

Sean O'Grady and Jeeshan Chowdhury

Health Technology

February 21, 2012

We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology. We have firsthand experience of the shortcomings in the healthcare industry, and we know that it’s going to take a concerted effort to upend the system. Those of us who are able to adapt and apply new technology solutions to existing problems will undoubtedly make positive changes.

Barriers to entry into entrepreneurship …

Answers to common vaccine questions

Erica Armstrong, MD

Medications

February 21, 2012

Here are some of the most common questions I encounter regarding vaccines and my answers. I’m writing this post, from a parent to a parent, because I want to equip you with accurate information to protect your child.

We give so many vaccines now and it seems like we are constantly adding more. Isn’t this too much for my child’s immune system? Isn’t it antigen overload?

The immune system is very complex, …

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Answers to common vaccine questions

Doctors cannot be expected to be financial engineers

Andrew Schutzbank, MD, MPH

Physician

February 20, 2012

Peggy was in her early 70s and suffered from a terrible lung disease known as pulmonary hypertension. So bad in fact, that she had a pump infusing a medicine under her skin 24 hours a day to keep the blood supply to her lungs open. Once started, this medicine, treprostinil, was known to improve life in those with pulmonary hypertension. Unfortunately, like all continuous infusion medicines of this type, it …

Reading between the lines of breast cancer treatment studies

Vineeta Vijayaraghavan and Clayton Christensen

Health Policy

February 20, 2012

Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently, breast cancer has certainly gotten a lot of play in the media as of late.

Every major news outlet in America covered the breast cancer study released by JAMA which said that nearly half of the women who had second surgeries for breast cancer may not have needed the …

Why patient engagement is reciprocal

Steve Wilkins, MPH

Patient

February 20, 2012

It is said that “turn around is fair play.”

So if providers (physicians, hospitals and other health care professionals) expect patients to become more engaged in their own care, isn’t it fair for patients to expect their physicians to also get more involved in their care?

If you look closely at “proxy measures” for physician engagement, you will see that this is a legitimate if not equally important line of inquiry.

Hello? Hello? …

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Why patient engagement is reciprocal

A diagnosis of stomach cancer profoundly changes an oncologist

Jennifer Kelly, MD, PhD

Physician

February 19, 2012

I was jogging one day while on a business trip in LA and collapsed during the run. Within hours, I was at the hospital at UCLA Medical Center on a gurney headed for a CT scan of my abdominal cavity. I remember telling the ER physicians that I was a doctor and recommending my own course of action. As my advice to the ER doctors went largely ignored, I realized, …

What you need to know about antithrombotic guidelines

Gordon Guyatt, MD

Conditions and Diseases

February 19, 2012

The lack of evidence supporting the “economy class syndrome” myth in air travel made major news headlines recently. While certainly interesting and accurate, that topic was just one among many topics addressed in the larger framework of the new evidence-based guidelines.

The American College of Chest Physicians (ACCP) released the Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in its February issue …

Why are labor and deliveries closing?

Vivian E. von Gruenigen, MD

Health Policy

February 18, 2012

Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no closures, conversations in hospital boardrooms are probably questioning whether they should be. But why? Because of health care reform, increasing medical expenditures, hospitals are making less money due to reduced reimbursement, and because of the financial margin of obstetrics. To explain the complex answer further, we need to …

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Why are labor and deliveries closing?

MKSAP: 35-year-old woman with right upper quadrant abdominal pain

mksap

Conditions and Diseases

February 18, 2012

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

A 35-year-old woman is evaluated for a 6-month history of right upper quadrant abdominal pain that has slowly increased in intensity and is worse on deep inspiration. The patient is otherwise well, and her only medication is an oral contraceptive pill that she has taken for …

A Grammy artist with Tourette Syndrome

Michele R. Berman, MD

Conditions and Diseases

February 17, 2012

Would you consider a career as a singer if you had involuntary tics from Tourette Syndrome?

Well, it apparently didn’t stop 20-year-old Contemporary Christian musician Jamie Grace.

In fact, Grace attributes singing with helping her cope with her disease.

And now she is being rewarded with a Grammy nomination for best contemporary Christian music song, Hold Me. The song features TobyMac, who is a Grammy winning Christian recording and hip/hop artist. He …

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A Grammy artist with Tourette Syndrome

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