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How physicians can incorporate genomic advances into clinical care

Kevin

July 10, 2011Jul 10, 20117

by W. Gregory Feero, MD, PhD The 10-year anniversary of the publication of the sequence of the human genome offers primary care physicians a look into how they can incorporate genomic advances into clinical care in the next decade. The…

by W. Gregory Feero, MD, PhD

The 10-year anniversary of the publication of the sequence of the human genome offers primary care physicians a look into how they can incorporate genomic advances into clinical care in the next decade.

The National Institutes of Health celebrated the 10th anniversary of the publication of the sequence of the human genome and the subsequent remarkable burst of scientific and clinical …

Drugs and prescribing

Medical marijuana in psychiatric illness

Christina Girgis, MD

July 9, 2011Jul 9, 201110

Recently, 16 states and Washington DC have legalized medical cannabis. An additional 10 states have pending legislation. With all the attention legalized medical marijuana has been receiving, patients have started asking if they are candidates for a prescription. Well, my…

Recently, 16 states and Washington DC have legalized medical cannabis.

An additional 10 states have pending legislation. With all the attention legalized medical marijuana has been receiving, patients have started asking if they are candidates for a prescription. Well, my answer is easy. Right now it is not legal in Illinois, although it is one of the states that is pending. Even if it does become legalized, I …

Health policy

We need a radical change in the way health care is delivered

Gary Oftedahl, MD

July 9, 2011Jul 9, 20116

Many of you are familiar with the famous "invisible gorilla" experiment, wherein an audience, being instructed to watch closely for the number of passes made with a basketball, fails to see a rather large and deliberate gorilla march slowly across…

Many of you are familiar with the famous “invisible gorilla” experiment, wherein an audience, being instructed to watch closely for the number of passes made with a basketball, fails to see a rather large and deliberate gorilla march slowly across the screen, stop in mid picture and thump its chest.

In fact over 1/2 of those tested failed to notice this obvious action. The predominant response is one of suspicion and …

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Conditions and diseases

Should young athletes be screened for heart disease?

Richard N. Fogoros, MD

July 8, 2011Jul 8, 201115

In the wake of sudden deaths in a young athletes, the question arises – as it does after each of these tragic events – whether all young athletes should be screened for occult heart disease before participating in sports. It appears, for instance, that 16-year-old Wes Leonard had an underlying heart condition which likely could have been identified with a simple echocardiogram.

The question is controversial, and accordingly, even the …

Health policy

Do physicians have the courage to implement comparative effectiveness?

George Lundberg, MD

July 8, 2011Jul 8, 20119

Comparative effectiveness outcome studies have shown that while percutaneous coronary intervention (PCI) may be more effective than optimal medical therapy (OMT) for treatment of acute coronary syndrome, it is not more effective for treatment of stable ischemic heart disease. Results…

Results of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial, published in 2007 and 2008 in the NEJM, demonstrated that PCI did not improve survival or prevent myocardial …

Physician voices

What cash only practices should be careful of when taking payments

Adam Alpers, DO

July 8, 2011Jul 8, 20113

There is no question that bank failure, credit problems, and other issues create a situation where people find it necessary to make payments in cash, only. While you will never need to worry about this money clearing for payment, it…

There is no question that bank failure, credit problems, and other issues create a situation where people find it necessary to make payments in cash, only.

While you will never need to worry about this money clearing for payment, it is still important to be aware of some of the risks associated with taking cash payments. In most cases, once you address these issues, you …

Health policy

Staff who resist quality improvement efforts

Donald Tex Bryant

July 8, 2011Jul 8, 20114

Perhaps you are just beginning a quality improvement program or project. Perhaps you have several project improvement projects successfully completed at your healthcare site. No matter what your level of experience, you have encountered staff who are roadblocks to your…

Perhaps you are just beginning a quality improvement program or project. Perhaps you have several project improvement projects successfully completed at your healthcare site.

No matter what your level of experience, you have encountered staff who are roadblocks to your efforts. What are you to do? Ignoring them or doing nothing will imperil your quality efforts eventually. Let me share some ideas on what to do based upon my own …

Physician voices

Fixing primary care requires more than free medical school

Nilesh Kalyanaraman, MD

July 8, 2011Jul 8, 201151

It’s well known that there is a shortage of primary care physicians which is only going to get worse over time. To address this problem, Dr. Peter Bach, the director of the Center for Health Policy and Outcomes at Memorial…

It’s well known that there is a shortage of primary care physicians which is only going to get worse over time.

To address this problem, Dr. Peter Bach, the director of the Center for Health Policy and Outcomes at Memorial Sloan-Kettering and Dr. Robert Kocher, a guest scholar at the Brookings Institution, propose making medical school free. They argue that medical students would be more likely to choose primary …

Conditions and diseases

Experiencing Dengue fever and lessons to prevent it during travel

Rachel Henrickson

July 8, 2011Jul 8, 20112

Everyone wants to feel like they are making a difference. This is why, in my opinion, international medical mission trips are what every med student dreams of upon completing his or her first year of medical school. With one year…

Everyone wants to feel like they are making a difference.

This is why, in my opinion, international medical mission trips are what every med student dreams of upon completing his or her first year of medical school. With one year of basic sciences and numerous standardized patient encounters under our belt, we are already eager to utilize our skills with “real patients” and …

Physician voices

Attending physicians who work too many hours need restrictions too

Felicity Billings, MD

July 8, 2011Jul 8, 201115

Dr. Lewis didn’t sleep last night. All day he stood, heavy in full surgical scrub with a human heart in his hands, replacing damaged valves and calcified arteries until the heart beat on its own again. After he finished, there…

Dr. Lewis didn’t sleep last night.

All day he stood, heavy in full surgical scrub with a human heart in his hands, replacing damaged valves and calcified arteries until the heart beat on its own again. After he finished, there were a few hours before the transplant to get some dinner, to call home.

The heart came on a helicopter. A young man, a bad accident, a perfect heart. Dr. Lewis pierced …

Physician voices

The radiation delivered by CT scanners has gone largely unregulated

Robert Wachter, MD

July 7, 2011Jul 7, 20119

Although the medical profession has been harming unlucky patients for centuries, the patient safety movement didn’t take flight until 1999, when the Institute of Medicine published its seminal report, To Err is Human. And that report would have ended up as just another doorstop if not for its estimate that 44,000-98,000 Americans each year die from medical mistakes, the equivalent of a jumbo jet crashing each …

Patient voices

Our health system defaults toward treatment rather than compassion

Sara Billings, RN

July 7, 2011Jul 7, 201126

I believe knowledge is power. There is no more complex topic in the healthcare debate than end-of-life care. I have been a Registered Nurse for thirty years. I deal with this every day. All of us will confront this issue eventually. When it’s your turn, I hope the medical profession will guide you to the best options for you and your family.

Often I see patients who have prepared living …

Physician voices

An apology to a terminal patient with colon cancer

Jordan Grumet, MD

July 7, 2011Jul 7, 201120

I'm sorry, Mrs. Lewis, for not making it to the hospital to see you yesterday. Yesterday was one of those days when I felt like I could never catch up. My wife was going downtown for work, and we had…

I’m sorry, Mrs. Lewis, for not making it to the hospital to see you yesterday.

Yesterday was one of those days when I felt like I could never catch up. My wife was going downtown for work, and we had to get up early. While she prepared, I helped my two-year-old son get dressed. We walked my wife to the train, then waited for the nanny. She was running late: I …

Health policy

Why the human brain seems to struggle with comprehending risk

Sam Wainwright

July 7, 2011Jul 7, 20116

There's a fascinating blog post over at the New York Times math blog that has the health policy program here at New America scratching our heads, sharpening our No. 2 pencils, and dusting off our calculators. Turns out, German mathematicians…

There’s a fascinating blog post over at the New York Times math blog that has the health policy program here at New America scratching our heads, sharpening our No. 2 pencils, and dusting off our calculators.

Turns out, German mathematicians have been studying how and why the human brain seems to struggle with comprehending risk. We find it difficult to translate the mathematical …

Medical education

Practical tips for new July resident physicians

Edwin Leap, MD

July 7, 2011Jul 7, 20116

July is the month that new resident physicians begin their training all across the United States. Our future family physicians and pediatricians, neurosurgeons and emergency physicians, plastic surgeons and laser tattoo removal specialists (ok, not really a specialty, just a…

July is the month that new resident physicians begin their training all across the United States.

Our future family physicians and pediatricians, neurosurgeons and emergency physicians, plastic surgeons and laser tattoo removal specialists (ok, not really a specialty, just a side-line) will begin learning how to be physicians, having completed four years of expensive college and four years of even more expensive medical school.

Anxiety-filled and debt-ridden, they will embark on …

Patient voices

Patients who bill their doctor for being late

Pamela Wible, MD

July 6, 2011Jul 6, 2011393

Meet Elaine. We lost touch for a while, but caught up with each other recently. Like most girlfriends, we shared adventures of love, travel, and work. I told Elaine that I left assembly-line medicine. Now I host town hall meetings-inspiring…

Meet Elaine.

We lost touch for a while, but caught up with each other recently.

Like most girlfriends, we shared adventures of love, travel, and work. I told Elaine that I left assembly-line medicine. Now I host town hall meetings-inspiring citizens nationwide to design ideal clinics and hospitals.

Elaine shared: “If I’m kept waiting, I bill the doctor. At the twenty-minute mark, I politely tell …

Health policy

Consumer driven health care will only shift costs if implemented poorly

Davis Liu, MD

July 6, 2011Jul 6, 20117

The creation of consumer-driven health plans (CDHPs), health insurance policies with high deductibles linked to a savings option and with more financial responsibility shouldered by patients and employees and less by employers, was completely inevitable. The American public likes to…

The American public likes to have everything, whether consumer electronics or other services, as cheap as possible. With escalating health care expenses rising far more rapidly than wages or inflation, it’s not surprising employers …

Health technology

How might we think about EHRs globally while acting locally?

Brian Klepper, PhD & David C. Kibbe, MD, MBA

July 6, 2011Jul 6, 20115

American health care information technology is undergoing two enormous leaps. First, it is moving onto Web-based and mobile platforms – which are less expensive and facilitate information exchange – and away from client-server enterprise-centric technologies, which are more expensive and…

American health care information technology is undergoing two enormous leaps.

First, it is moving onto Web-based and mobile platforms – which are less expensive and facilitate information exchange – and away from client-server enterprise-centric technologies, which are more expensive and have limited interoperability. In addition, more EHR development activity is headed into the cloud, driven by large consumer-based firms with the technological depth to take it there. Both these trends …

Health policy

Cost containment strategies for emergency care

Myles Riner, MD

July 6, 2011Jul 6, 20114

It strikes me that in developing payment reform related, compensation driven cost-containment strategies aimed at constraining the cost of emergency care, policy makers, emergency physicians, and health insurers should adhere to certain principles. The American College of Emergency Physicians should…

The American College of Emergency Physicians should be at the forefront when it comes to establishing these principles, which I hope will be focused on protecting our patients first, and our specialty second.

The concept and practice of …

Patient voices

When the parent becomes child and child becomes parent

Stewart Segal, MD

July 6, 2011Jul 6, 20114

I bet you didn’t know that the war for independence is being fought on a daily basis throughout our glorious country. From the time we are born until the time we die, each of us strives to assert our independence. Once the toddler learns to run, he insists on running wherever he wants to. As he ages, we foster his need to be independent and teach him …

Real physician voices, twice a week

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