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Will replacing fee for service really reduce costs?

Health Policy

September 2, 2011

In this enlightened era of evidence-based medicine, you’d think that the progressive academics, viziers, and mandarins who are cluttering the policy making commentariat would pay more attention to what was tried before. That should be doubly true if those lessons come from that health care nirvana called Europe, where enlightened central bureaucracies wisely allocate health care for its caffè sipping, plaza strolling and beret adorned citizenry.

Case in point is …

Control and be responsible for your diabetes

Trey Stephens

Conditions and Diseases

September 2, 2011

Diabetes tries to steal moments from me every second of every day. I choose to steal these moments back. Thus, the chosen name for my attitude toward diabetes, Outlaw Diabetic.

Unlike the majority of the 360 million diabetics worldwide, I did not become a diabetic in my adult life. I became a type I diabetic at 14 months old. As a result, I have never had to change my way …

Natural language processing in electronic health records

Joe Petro

Health Technology

September 1, 2011

80 percent of the clinical documentation that exists in healthcare today is unstructured. It is sometimes referred to as “the text blob” and is buried within electronic health records (EHRs). The inherent problem with “the text blob” is that locked within it lies an extraordinary amount of key clinical data – valuable information that can and should be leveraged to make more informed clinical decisions, to ultimately improve patient …

When parents respond to the meaning of a child’s behavior

Claudia M. Gold, MD

Patient

September 1, 2011

It was a peaceful Saturday morning at Fuel, a local coffee shop in Great Barrington. People sat quietly murmuring with friends over coffee and muffins, or intently working at their laptops. I was doing the final edits for my forthcoming book Keeping Your Child in Mind, when I looked up to see a small boy of about two years tottering down the narrow aisle holding a plate with an …

How medical students can prepare to be hospitalists

Happy Hospitalist, MD

Medical Education

September 1, 2011

A second year medical student reader asked me to comment on what rotations to take in medical school to prepare for an internal medicine or hospitalist medicine career.

I am a second year medical student, very interested it practicing the art of Hospital Medicine, and I was wondering if you had any advice/comments on any specific electives to consider to help prepare me for an Internal Medicine residency.

Great question. As …

The medical legacy of Rick Perry

Robert Luedecke, MD

Health Policy

September 1, 2011

While liability reforms have been good for the health of Texans, many laws favored by Governor Perry have damaged health. As a physician on the Committee on Public Health of Bexar County Medical Society, I have been trying for many years to help not only my patients, but also Texans in general. San Antonio, my home for the last 30 years, is reported to have a population mix very similar …

Read more…

The medical legacy of Rick Perry

How not to convince doctors to embrace single payer

Kevin Pho, MD

KevinMD

September 1, 2011

What would happen to physician salaries if the United States adopted a single payer system?

The concept of a single payer system is a progressive ideal, and has been vociferously pursued by some left-leaning physician groups. For a variety of reasons, not least of which is the political climate in our country, I think the chances of single payer happening …

How managed care is bad news for pregnant women

Linda Burke, MD

Physician

August 31, 2011

I read an article in my local newspaper the other day that gave me reason to pause. The State of Florida intends to hand over 3 million Medicaid patients to managed care companies who will reduce payments to physicians and hospitals. In exchange for accepting these low payments for professional services, doctors are guaranteed through pending legislation that no matter what egregious errors they make, the patient will only receive …

How government can improve EMR usability

Jonathan Baran

Health Technology

August 31, 2011

Government involvement in usability has been the talk recently. In case your not aware, EMR usability is such as problem the government is exploring ways to get involved. As you might imagine the topic is a very sticky subject, especially EMR vendors, as the topic conjures images of committee-centered design and EMRs being worse of then they already are now.

However, when you think objectively about it, I believe the government …

William Osler and the necessity of the exam

Dr. Chris Nickson

Physician

August 31, 2011

Osler said that exams were something of a menace to the true student of medicine:

“Perfect happiness for student and teacher will come with the abolition of examinations, which are stumbling blocks and rocks of offense in the pathway of the true student.”
— William Osler, from Aequanimitas, 3rd edition, 1932.

Perhaps this is because no examination can be passed by knowing the subject matter alone. One must also master the “hidden curriculum,” …

Family medicine needs to take advantage of buzzwords

MaverickMD2012

Physician

August 31, 2011

I was driving into work recently listening to the radio and heard one of the fancy ads that our hospital has been airing over the last few years of it’s “Good People, Great Medicine” campaign. The ad was talking about getting results for a patient recovering from a heart attack. Around central PA, this patient is far too common. And listening to the ad brag about how quickly this …

Medical students spending time in a nursing home as a patient

Marilyn Gugliucci, PhD

Medical Education

August 31, 2011

An interview by Curaspan Health Group with Marilyn Gugliucci, PhD.

Every summer, a handful of medical students spends two weeks in a nursing home as a patient. That’s part of what’s been called “the life-altering education” established by Marilyn Gugliucci, Ph.D., the director of geriatrics education and research at the University of New England College of Osteopathic Medicine.

Gugliucci spoke with Curaspan Connections about the inspiration for her unique approach to …

Physicians need to understand subtle marketing manipulation

Toni Brayer, MD

Medications

August 31, 2011

There is do doubt that the way pharmaceutical companies market drugs to both doctors and consumers sways prescribing and drives up health costs. Prescription drug costs have outpaced other health care spending and are predicted to exceed the growth rates for hospital care and physician services going forward from 2010-2019.

Two researchers (Howard Brody, MD, PHD, University of Texas Medical Galveston and Donald Wright, PhD, University of Medicine and Dentistry …

Should patients be allowed to record their office visit?

David Troxel, MD

Patient

August 31, 2011

Whether your office has wireless access or not, there will be patients texting, surfing the Internet, Facebooking, and otherwise engaging with the outside world on their smartphones while in your office.

These smartphones have another function: the ability to record audio or video. It is understandably tempting for patients to record consent discussions, medication and follow-up instructions, and other physician or staff interactions.

Recording a medical discussion via video or audio is …

Treating fungal laryngitis in patients with asthma

Christopher Chang, MD

Conditions and Diseases

August 31, 2011

It is a big bummer to be an asthmatic. Not only is breathing a problem, but even the treatment for asthma can cause problems.

Take for example steroid inhalers like Advair, Symbicort, fluticasone, etc.

All asthma patients know to rinse their mouth out after inhaler use due to risk of oral thrush, but what about from the back of the mouth down to the vocal cords? This nether region can’t be …

Properly delete electronic medical records, or face fines

Pamela Wible, MD

Health Technology

August 30, 2011

Could a complete stranger receive your echocardiogram results in the mail?

Could a homeless guy in Boston end up with your labs in his shopping cart?

Is it possible that your medical records were sold on eBay?

Yes. Yes. And yes.

On February 24, 2011, Massachusetts General Hospital was fined $1 million dollars by the federal government when an employee inadvertently left a stack of papers on the subway. These documents contained the …

A physician responsibility for the financial health of patients

Stephen Meyers, MD

Patient

August 30, 2011

Much as war begets both high-profile losses and the unsung wounded, two ranks of casualties lay fallen, rent financially by medical treatment.

First are those of headlines, injured mortally, or nearly so, by insurmountable debt. Such wretched tragedy serves notice to all that a singular turn of fate may lead one swiftly to financial ruin.

Less-celebrated are members of the second order, surviving but spending more than requisite for their care. In contrast to the …