A guest column by the American College of Physicians, exclusive to KevinMD.com.
by John Tooker, MD, MBA, MACP
On March 31, 2011, CMS issued a proposed rule to implement a section of the Patient Protection and Affordable Care Act (ACA) that requires the HHS Secretary to establish a Medicare Shared Savings Program. Under the proposed rule, eligible providers and …
ACP: How accountable care is a team sport
To address the huge problem of errors by health professionals causing injuries and deaths to hospitalized patients, the U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius unveiled the Partnership for Patients initiative.
Secretary Sebelius referred to a recent study showing that adverse events in hospitalized patients, including those caused by human errors (i.e., preventable), occur about 10 times …
Cut hospitalizations to reduce hospital related medical errors
I love running.
I typically run 3-4 miles a day 5 to 6 days per week. It’s only about a half hour of time, and it’s well worth it. I get ‘in the zone’ when I run, and I can tune out the rest of the world and enjoy just being. It feels great physically and mentally each time. It’s helped me immensely to stave off the obesity issues that have …
A psychiatrist on the compulsion behind running and exercise
Part one of the three-part series, Let’s Pay Popular People More!
My patient only had 20 minutes to wait for the van headed to detox. The people who had worked to get him into a detox program already numbered in the double digits. Sam (not his real name) was the classic public inebriate — he woke on sidewalks with the shakes, vomited blood on a regular basis, had lost most of …
How basing physician pay on popularity marginalizes some patients
Felasfa Wodajo, MD has written a post for iMedicalApps on the iPad’s future role in healthcare institutions. The title says it all: Why Locked Android Tablets Will Beat the iPad for Hospital Use.
The gist of his argument is that Android’s “openness” and hardware-agnosticism will make it more ubiquitous in the market in general, and a more robust and …
Will an Android or iPad platform dominate hospitals?
If you develop a swollen knee, please don’t consider it a normal occurrence.
If there was a clear cause, such as a fall to the knee, or some twisting injury to the knee, it’s likely that the cause is due to some mechanical damage. An easily recognized example would be a football or rugby player sustaining such an injury on the playing field. In that case, its typically serious and when …
Why you shouldn’t ignore a swollen knee
by George H. Northrup, PhD
No one becomes a mental health professional—in my case, a clinical psychologist—for the financial rewards.
With comparable (or less) education, far more lucrative careers exist in law, business, or other health care specialties. Psychotherapy tends to draw practitioners who are fascinated by the mysteries of the mind and who find satisfaction helping others in distress. Money has typically been a …
How managed care caused the mental health care crisis
Why does health care seem to lag behind other industries in innovation?
There’s a temptation to manufacture reasons that don’t necessarily explain why health care has not seen the kinds of revolutionary changes evident in industries from computing and telecommunications to music and retail? People routinely marvel at how easy it is to manage their bank account these days, but they don’t appreciate continuing to wait hours in their doctors’ offices, …
How medical students are key to innovating in medicine
by James Lamberg
When medical students are applying for residency positions, what do program directors care about most? This may become the ultimate question for many students on clinical rotations.
Thankfully, publications exist to help answer this very problem.
Unfortunately, many students are not aware of this published information. In a 2005 article from Medical Education Online titled “Residency Selection …
Getting into residency: What medical students need to know
There’s an underlying tension between physicians and health policy experts.
Health policy experts take subtle jibes against physicians in their analyses, with many feeling American doctors are overpaid, which exacerbates health costs. They tend to be politically progressive, and generally dismiss the issues that most doctors care deeply about. Medical malpractice, tort reform and the cost of medical education, for instance.
And …
The tension between physicians and health policy experts
Does physician denial of patient requests result in decreased patient satisfaction?
The short answer: No.
At least not in the context of a strong physician-patient relationship.
Many physicians have legitimate concerns about the prospects of having their salary or level reimbursement linked to patient satisfaction. I would too given the way most health …
How denying patient requests may not impact patient satisfaction
Private practices are organized in a corporate model where the physicians are shareholders, or where one or more physicians own the practice and employ other physicians or providers. Private practices are almost exclusively for-profit. Physician practices are organized into corporations for the tax benefits as well as protecting the owners from liability judgments.
Hospitals can be for-profit, not-for-profit …
Pros and cons of private or hospital owned practice
There’s been a movement afoot for several years now to quantify pain as the so-called “Fifth Vital Sign.” It all started as a well-intentioned effort to raise the level of awareness of inadequate pain control in many patients, but has gotten way out of hand.
The problem is that the word “sign” has a specific meaning in …
Why pain cannot be a vital sign
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Lying on the backboard, a frail little old lady moaned with discomfort.
She had fallen beside her bed in the nursing home and was then tightly bound by straps onto the backboard, a cervical collar pushing her chin up and holding her immobile. A person not familiar with modern medicine might think the ensemble looked like a torture device. Indeed, it can …
Why confused, weak elderly patients are subjected to aggressive care
Gary Schwitzer is Publisher of HealthNewsReview.org, where he and his team grade daily health news coverage. He works to improve health journalism with the goal of improving consumer knowledge and decision-making. He was the founding editor-in-chief of the MayoClinic.com site. While his guest lecture at Web Strategies for Health Communication was on health news reporting, I realized that his review criteria seemed equally applicable to any health content …
Improve health journalism to improve consumer knowledge and decisions
The FDA has issued a statement alerting physicians and patients to a possible link between breast implants and a rare type of cancer. Although anaplastic large cell lymphoma (ALCL) is extremely rare, the FDA believes that women with breast implants may have a very small but increased risk of developing the condition.
ALCL in the presence of breast implants has been noted in sporadic case reports over the past 25 years. To date, …
Breast implants and the risk of cancer
by Kristine Casal
The moment you get accepted to medical school, you never really think about how everything is going to be different. You figure everything’s going to stay the way they are, with the exception of the inevitable long and laborious hours of studying day and night. You don’t think about how much time you won’t have …
Transitions of a first year medical student
by Joe F. Lau, MD and Jeffrey W. Olin, MD
Physicians who perform percutaneous endovascular procedures encounter a multitude of vascular diseases that may masquerade as obstructive atherosclerotic arterial disease. While atherosclerosis is clearly the most common condition seen, complex inflammatory, genetic or structural processes may either not be amenable to an endovascular approach or actually be harmful and thus lead to outcomes that are not …
Vascular diseases that present as obstructive atherosclerotic arterial disease
In the summer of 2001, I was preparing to begin my 19th year on the faculty of U.C. Davis School of Law. Then I got sick with what the doctors thought was an acute viral infection. I have yet to recover.
Being diagnosed with a chronic illness or condition can take a toll on your relationships, partly because all of the …
When chronic illness strikes: Tips on talking to family and close friends
Medical care in America isn’t doing so well when compared to other developed nations. Historically physicians did not want to take ownership of their patients’ problems. Patients have free will. They can “choose” to be non-adherent. They can choose to not take the medication the doctor prescribes — even if the one prescribed is $70 dollars a month when there is a $4 dollar Read more…
How physicians can take more responsibility in the care of patients
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