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Elimination of industry support for CME is an urban myth

Medical Education

September 23, 2011

Urban myths come in all shapes and sizes. Recent medical scares include a rogue politician claiming that a vaccine is no good, based on someone they met in the audience who was not trained in medicine or science. How many physicians know patients who are scared of taking a medication or getting a needed procedure based on an Internet story or a friend of a friend?

Recently, there has been controversy …

Ivan Ilyich gives voice to the agony of the afflicted

Richard Barager, MD

Patient

September 22, 2011

Pity me as I wish to be pitied. That is the plea of the tortured protagonist in Leo Tolstoy’s brilliant 1886 novella, The Death of Ivan Ilyich.

Tolstoy was born in 1828 into Czarist Russia’s landed gentry. Though orphaned at a young age, he enjoyed the typical privileges wealth and title afforded—passive income, summers in the country, and enrollment at Kazan University. But it was later, after dropping out of school and …

Interactions about our health care are increasingly conducted online

Jessie Gruman, PhD

Patient

September 22, 2011

The outsourcing of work by businesses to the cheapest available workers has received a lot of attention in recent years. It has largely escaped notice, however, that the new labor force isn’t necessarily located in Southeast Asia, but is often found here at home and is virtually free. It is us, using our laptops and smart phones to perform more and more functions once carried out by knowledgeable salespeople and …

The online health information divide

Susannah Fox

Patient

September 22, 2011

This post is first and foremost a thank-you note.

Thank you to everyone who posted a comment, emailed me, or tweeted a suggestion in response to my request for input last July: Crowdsourcing a Survey. Six new topics came directly from those conversations. Thank you to Veenu Aulakh and the California HealthCare Foundation who provided funding for the survey. Thank you to Lee …

Read more…

The online health information divide

Holistic medicine needs to be rescued by physicians

Stewart Segal, MD

Physician

September 22, 2011

The word “holistic” has been kidnapped by practitioners of alternative medicine and marketers. Holistic has become synonymous with “all natural” treatments and cures. Those who kidnapped the word holistic imply that medical doctors are not holistic. The implication is that docs treat the disease and not the person.

According to the Merriam-Webster Dictionary, holistic means, “relating to or concerned with wholes or with complete systems rather than with the analysis of, treatment …

Why doctors and patients have turned against each other

Hans Duvefelt, MD

Patient

September 22, 2011

“Where there is love of humanity there will be love of the profession.”
-Hippocrates

Reading some of the blog posts and comments on the Internet, you might get the impression that a majority of American doctors hate their jobs. Actually, according Family Practice News, only 35% of my colleagues are unsatisfied with their careers, but that is still a remarkable number.

Are Hippocrates’ words implying an answer to why some doctors today don’t …

Patients need help to navigate the health care system

Benjamin Geisler, MD, MPH

Health Policy

September 22, 2011

The New York Times recently ran an op-ed by Paul Krugman with the intriguing title, “Patients Are Not Consumers.”

Here’s an open letter to him:

Dear Dr. Krugman,

As a comparative effectiveness researcher, I agree with many of the arguments that you are making in your most recent article. However, I disagree with your main point that patients are not consumers.

I understand your sentiment and agree that patients are more …

Unintended consequences of standardizing physician practice

Steve Wilkins, MPH

Physician

September 22, 2011

Turns out there is an unintended consequence of many of the current efforts to standardize the way doctor’s practice medicine. It is called de-skilling. De-skilling can occur when physicians and other providers try to adapt to standardized, new ways of doing things. Examples of such standardization include clinical based care guidelines, electronic medical records (EMRs), pay for performance (P4P), patient centered medical home (PCMH) requirements and so on.

Examples of …

Doctors are the true consumers of health care dollars

Ian Metzler

Physician

September 21, 2011

With computerized health systems, physicians can place orders as easily as they can shop online at Amazon.com. Just a few clicks and your physician can purchase a panel of blood tests, futuristic imaging and diagnostic procedures that will hopefully guide their path to solving your ailments.

Search. Click. Submit. Repeat.

Except, unlike online shopping, physicians don’t see the price tags and they never get the bill. Doctors are the true consumers …

Florida’s gag order on pediatricians blocked

Matthew Toohey, MD

Patient

September 21, 2011

This past spring, I wasn’t sure if I was looking through a fun house mirror when I read that Florida pediatricians were going to face criminal charges for bringing up the topic of gun safety in the office with patients. I couldn’t believe what I was reading.

The irony of the whole charade was the reasoning of those who brought about the bill. “Direct questions about firearm ownership when it …

Efficient billing in your medical practice

Rosemarie Nelson

Physician

September 21, 2011

Billing is way more than billing.

In a typical medical practice, more than 300 insurance cards cross the front desk every month. The variety of plans and coverage along with the complexities of coding and the difference among payers requires expertise and technology to effectively manage accounts receivable, regardless of practice size.

There are two basics required to manage your billing and accounts receivable — a practice management system and a clearinghouse.

The …

Kids and their fascination with foreign objects

Sharon Bahrych, PA-C, MPH

Patient

September 21, 2011

Kids will swallow or poke up their noses, or into their ears the strangest things. I remember during my student days, I was doing a rotation in pediatrics when a 6 year old came into see us. I went in to take the history and her mom told me that her daughter had a very pungent odor to her, which she couldn’t get rid of.

I examined the patient and …

Discussing a colostomy in a patient with rectal cancer

Sid Schwab, MD

Conditions and Diseases

September 21, 2011

Sturdy and thickly-built, long since widowed, cheery in a sardonic sort of way, tough and opinionated, Flora’s European roots ran deep; she’d been an Italian farm girl, and she’d rather be in her garden than anywhere else. The only reason she agreed to come inside and go to the doctor was that her bowel movements had finally gotten too painful, and too bloody to ignore. Which she had been doing, …

Why an ACO is essentially an American product

David Harlow

Health Policy

September 21, 2011

There has been a significant outcry against the proposed ACO regulations: everything’s wrong and nothing’s right about them, or so some would have us believe.

Today’s “nattering nabobs of negativism” focus on: the estimated price tag for complying with the regulatory requirements (IT and other infrastructure included), the slim chance of success by ACOs in righting the wrongs of decades of bloat in the health care system, the …

Elimination of industry support for CME

Daniel J. Carlat, MD

Physician

September 20, 2011

Something huge happened at the American Medical Association House of Delegates meeting. Although the meaning of what happened will be spun throughout the blogosphere, twittersphere, and schmuckosphere, the bottom line is that the AMA just voted most commercial funding of CME out of existence.

Specifically, the delegates voted to approve a report of the AMA ethics committee that calls for a near elimination of industry support for CME. The report is …

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Elimination of industry support for CME

Appropriately dejected after an annual physical

Colleen Kelly Mellor

Patient

September 20, 2011

Print out the eye chart, cover one eye, and see how you read it from 20 feet out. I failed line 8 abysmally.

I went for my annual check-up, and I must say, this doctor was thorough. In fact, he was too thorough. He told me way more than I ever wanted to know.

During the two-hour examination, I found out I’ve gained weight (too much ice cream), my blood pressure …

Exercise can help treat fibromyalgia

William R. Yates, MD

Conditions and Diseases

September 20, 2011

What is fibromyalgia and what exactly what does exercise have to do with the treatment and long-term outcome of the condition? A recent study published in Medicine & Science in Sports & Exercise is helpful in understanding the relationship between fibromyalgia and exercise and how clinicians (and patients) might find better strategies for treatment.

Fibromyalgia is a clinically defined pain syndrome estimated to affect about 5 per cent of the general population with criteria for …

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Exercise can help treat fibromyalgia

Are medical students responsible for the primary care shortage?

Emily Lu

Physician

September 20, 2011

There is a lot of speculation about why there are fewer and fewer primary care physicians joining the workforce every year. Some have focused on the choices that medical students are making when choosing residencies. Whether due to laziness, desire to make money or the drive to be perceived as “successful” in choosing a more prestigious specialty, the new generation of physicians are being blamed for Read more…

Are medical students responsible for the primary care shortage?

The value of a mentor during medical training

Michael A. Zadeh, MD

Medical Education

September 20, 2011

I grew up playing a variety of different organized sports. Looking back now, I notice that no matter what the sport my best performances were always on teams which were led by inspiring coaches. The same could be said about my education, with teachers replacing the coaches. Whether I knew it at the time or not, throughout my life I have had a number of mentors who have brought the …

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