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The government reversal on end of life planning

Health Policy

May 5, 2011

After all the ridiculous fear-mongering about “death panels,” Congress dropped a proposal to encourage end-of-life planning from the health reform legislation passed last March.

But the administration had in fact quietly included reimbursing doctors for end-of-life counseling along with a host of new Medicare regulations. The provision, which authorizes payment for “voluntary advance care planning,” went into …

How genomics can help doctors target drug therapy

Stephen C. Schimpff, MD

Medications

May 5, 2011

Little more than a decade ago, most people had never heard of the word genomics; today it is used frequently. It is indeed a revolutionary science that is and will transform medical research and medical care. To better understand how this new science will markedly change medicine, it is convenient to consider it through a few categories:

Pharmacogenomics
Nutragenomics
Disease classification
Disease …
Read more…

How genomics can help doctors target drug therapy

Best hospital lists influence consumer decision making

Tobin Arthur

Patient

May 5, 2011

We all like lists. US News & World Report has told us for years which colleges are considered the top in the nation. Castle Connolly tells us which are the “Top Doctors” in our community and Car & Driver gives us a ranking of cars by type.

In The Order of Things, Malcolm Gladwell pokes serious holes in some of our most revered rankings and lists.

If …

The future of primary care in an ACO model

Kunmi Sobowale, MD

Health Policy

May 5, 2011

Primary care is a unique field of medicine.

Primary care physicians (PCPs) are the gatekeepers to specialized care, provide preventative care, and most importantly, they have the ability to manage patients with multiple chronic conditions. Thus, primary care physicians are in prime position to become the point men in the Read more…

The future of primary care in an ACO model

Medical students are part of each patient’s health care team

Matthew Gibson, MD

Physician

May 5, 2011

I realized last week one of the hardest mindset transitions that I’m having to make as a medical student. It has to do with not really feeling like I belong, and the need to really make my patients … well, MY patients!

As a medical student, you can actually function reasonably well without ever having to actually see a patient.

You can read …

New ACGME work hour regulations for interns: friend or foe?

angienadia, MD

Physician

May 5, 2011

On the night of October 4, 1984, a young girl named Libby Zion was admitted to New York Hospital in Manhattan for fever, agitation and strange jerking movements. No one knew that her death the next morning would, 27 years later, drastically change the quality of physician training, for better or worse.

When Libby was evaluated in the emergency room that night, neither the ER physician nor her family physician Dr. …

Cooperation between patient and doctor is essential today in health care

Paul Dorio, MD

Physician

May 4, 2011

There are many aspects to being a doctor. Just as important are the many aspects that go into being a patient. Of course, the difference is that one has been perceived as being a position of power and the other one has not. I don’t believe this distinction is useful or true in today’s world.

Patients and doctors work …

Why patient satisfaction scores won’t decrease health care costs

Edwin Leap, MD

Physician

May 4, 2011

So now, in addition to the many other bits of medical meddling we have from CMS (Centers for Medicare and Medicaid Services), there’s this.

Reimbursements to hospitals, from Medicare, will be partly tied to patient satisfaction scores. We’ve seen payments already being tied to ‘quality indicators,’ as dictated by the federal government; rewards for doing a better job on care for heart attacks, pneumonia, etc. At least that’s quantifiable, whether scientifically …

The mission of the hospice and palliative care is to ease patient suffering

Kathy Kastner

Patient

May 4, 2011

Until recently, I had but the vaguest idea of what hospice and palliative care and medicine (hpm) entailed.

Until tuning into the #hpm Twitter group – hospice and palliative medicine – both words conjured a gloomy atmosphere of despair, grief, anger, pain en route to dying. I wondered at those working in the field: they must be a bit weird.

I now know differently, …

Why quality did not improve with hospital EHR implementation

Roger Collier

Health Technology

May 4, 2011

The 2009 Health Information Technology for Economic and Clinical Health Act (HITECH) authorized incentive payments, potentially totaling some $27 billion over ten years, to clinicians and hospitals when they implement electronic health records in such a way as to achieve “meaningful use,” in terms of advances in health care processes and outcomes.

But, are EHRs really “meaningfully useful” or are …

Explaining why belief in pseudoscience is often evidence resistant

Amy Tuteur, MD

Conditions and Diseases

May 4, 2011

What links belief in tarot cards, UFOs and vaccine rejectionism? Yes, they are all forms of superstitious or magical thinking, but are there characteristics that predict who will believe in such nonsense? That’s one of the questions that psychologists Marjaana Lindeman and Kia Aarnio seek to answer in their paper, Superstitious, magical, and paranormal beliefs: An integrative model.

Lindeman and Aarnio postulate that believers in superstition, paranormal phenomena and pseudoscience make …

How skipping medical school lecture is preparing doctors for the future

Kevin

Medical Education

May 4, 2011

by Chris Chen

Recently in lecture, our professor wryly mentioned that in his many years of teaching, he had never seen so many laptops out as well as so many people taking advantage of the option to watch videos instead of attending class.

That was fine with him, he commented, as long as people were learning—although he was skeptical that students on laptops would learn as much, …

Direct primary care and a do it yourself health plan

Dave Chase

Health Policy

May 4, 2011

Now that I’m well out of my reckless youth phase of my life, I try to preserve the efficacy of my brain. With my lifestyle, there’s three actions I take to ensure the integrity of my brain.

Always wear a bike helmet when I bike
Avoid over-consumption of alcohol
Avoid looking at doctor bills and insurance “statement of benefits”

The first two …

How the fear of SIDS keeps infant sleep positioners on the market

Wendy Sue Swanson, MD

Patient

May 3, 2011

I hate infant sleep positioners. They are not safe or helpful. If you have one or know a family/friend who uses one for their infant, throw it out. Trash compact it. Stomp on it. Cut it up in bits. This is one rare thing you should feel good about putting in landfill.

When I was first started in practice, I didn’t even know sleep positioners existed; I …

End of life care is being influenced by politics

Kevin Pho, MD

KevinMD

May 3, 2011

A version of this op-ed was published on April 12, 2011 in USA Today.

“Would you like to discuss your end-of-life plans today?”

It’s a question that I ask my patients, although not as often as I would like. Talking about death may be uncomfortable, but it’s a conversation that needs to happen more often.

We can never know …

Medicine’s paradigm shift is a microcosm of a trend occurring in society

Paul Fischer, MD

Health Policy

May 3, 2011

In 1994 Jeff Bezos revolutionized how consumers shop. He founded Amazon.com.

Shortly after, Ebay followed suit—solidifying a paradigm shift that has redefined shopping from an in-person to online experience. In 2004, Facebook capitalized on another trend: individuals were becoming more comfortable sharing personal information online. Interestingly, people did not wake up one morning and decide it would be convenient to shop from home, or that sharing pictures with their friends online …

People feel anger and fear over our health care situation

Aldebra Schroll, MD

Health Policy

May 3, 2011

During the election season, the biggest loser appears to be civility. Anger, attack ads and name calling ruled the day. We are faced with enormous and complex challenges, issues not easily addressed in sound bites. Yet that is what we usually get from our representatives. I find myself asking are we not willing or able to do the hard work of examining the issues before us?

During the ongoing discussions over …