If you are one of the more than 100 million Americans who visit emergency rooms (ER) at least once a year, you’re not alone.
Americans, insured and not, make ample use of hospital emergency rooms. One out of every five visited an ER at least once in 2007, the latest year for which the National Center for Health Statistics …
Danger of multiple emergency room visits to different hospitals
by Peter J. Pitts
“Newspeak,” the language of Big Brother, was designed “not to extend but to diminish the range of thought.”
Some well-known examples of Newspeak are Bellyfeel (a blind, enthusiastic acceptance of an idea), Duckspeak (meaning literally to quack like a duck or to speak without thinking), Crimethink (the Newspeak word for thought crime) and Goodthink (or “political orthodoxy”).
Which brings us from the nightmare fantasy of “1984” to the health …
The differences between comparative and clinical effectiveness
As in anyone’s life, the hardest thing to achieve in life is a balance. Whether it’s work, school, home, or play, it’s just plain tough. For those of us with challenges such as cerebral palsy, it brings a new set of challenges. Here’s why.
Task execution takes longer. Where it might take my sister thirty minutes to get herself ready and out the door in the mornings, it will take me …
Achieving balance in life with cerebral palsy
Governor Brewer’s decision to withhold liver transplants for Medicaid recipients in Arizona should serve as a loud warning to the electorate regarding governmental intrusions into health care financing and health care operations.
The decision was ill advised on the basis of multiple factors. The survival rates differ from one facility to another.
What is the liver transplant survival rate and what information needs to be considered when looking at such numbers?
For example, …
Withholding liver transplants for Medicaid recipients in Arizona
I sometimes wonder if we spend too much time talking about professionalism.
It is not that I don’t think we should promote professionalism. Of course we should. But many discussions of professionalism descend into overly academic and scholarly treatises that end up obscuring rather than clarifying the values such discussions hope to promote. It may be a mistake to overly …
Humility in medicine and our academic training environments
Despite the advances in evidence-based medicine, not every patient benefits.
In a recent column from the New York Times, Pauline Chen looks at a study showing exploring the issue:
For many patients, evidence-based medicine isn’t working. Two-thirds of patients with diabetes, a disease with some of the strongest evidence-based guidelines available, continue to have trouble controlling their blood sugar levels; and only half of all …
Why team based primary care won’t help evidence based medicine soon
When I go to the doctor for my yearly physical (OK, not quite yearly, but…) he puts me through the ringer. He asks me dozens of questions, follows up with more questions, and does a (thorough!) physical exam. Then he takes some blood, and sometimes runs some other tests. The big question is “why”? What are …
Prevention of disease and monitoring of chronic diseases in a yearly physical
What should we expect of a physician leader today? I believe it should be something much different than what leaders do now.
Today, a hospital physician CEO might be expected to develop new or improved clinical programs, in part by recruiting the best and the brightest, by building new wings, and by purchasing new technologies. The measure of success would be improved finances as a result of added …
What should we expect of a physician leader today?
An international ACEP member has been giving real-time updates to the ACEP Disaster Section about the developing situation in Japan. He agreed to share the information with the emergency medicine community and will try to continue to provide updates when he can.
by Dr. Takashi Nagata
Friday, March 11, 2011 1:13 AM CST
Hello. I am Dr. Takashi Nagata, …
Japan earthquake and tsunami first hand physician account
Here is a letter to the editor in a recent Philadelphia Inquirer:
… In 1986, Congress passed and President Ronald Reagan signed the Emergency Medical Treatment and Active Labor law, which requires hospitals to admit all who arrive at the emergency room and treat them without regard for their ability to pay.
In essence, we had federally mandated national health care – signed …
Challenge the constitutionality of EMTALA
by Robert Bresalier, MD
Did you hear the one about the cancer-sniffing dogs?
Sounds crazy, right? This is just one of many recent headlines that may leave you scratching your head.
Not every study you read in the news is the final word. But recent research can provide interesting new insight on colorectal cancer — the second leading cause of cancer death in the United States.
Here’s some insight to help you make sense …
Making sense of colorectal cancer headlines
iMedicalApps reviewed some recent news articles regarding business/enterprise adoption of the iPad as a legitimate alternative to Windows machines in the workplace, taking it as a sign that healthcare IT is poised to adopt it, too: “All in all, these developments bode well for the adoption of the iPhone and iPad as a mainstream, IT-blessed mobile healthcare solution.”
iPad …
What will prevent the iPad from dominating health care IT?
Working as a psychiatrist is very rewarding. It’s stressful in a unique way, and some people may look at me strangely for having an unusual job. But overall I really enjoy it. Here are some of the aspects of psychiatry that I really appreciate.
1. Being trusted. Psychiatrists meet people when they are at their most vulnerable points, and we are entrusted with extremely …
Aspects of psychiatry this doctor appreciates
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A guest column by the American Medical Association, exclusive to KevinMD.com.
The Centers for Medicare and Medicaid Services (CMS) has pushed back the April 1 deadline for states to implement their Medicaid recovery audit contractor (RAC) programs until an unspecified time later this year. The implementation delay was welcomed by the American Medical Association (AMA) and other national physician organizations who have vocally urged CMS to improve its proposed Medicaid RAC …
AMA push against Medicare recovery audit overreach
Ten years on, Ian Morrison’s “Hamster Health Care: Time to Stop Running Faster and Redesign Health Care” is still eminently applicable.
In his words:
Across the globe doctors are miserable because they feel like hamsters on a treadmill. They must run faster just to stand still. In … the managed care systems in the United States doctors feel that they have to see more patients to maintain their incomes. But systems …
Using Facebook, Twitter and other social media to change health care
I decided to dedicate a medical blog on smoking cessation after realizing that too many people in Douglas County (Omaha, Nebraska) smoke. Did you know that despite a smoking ban in restaurants and bars, 18.3% of people in Nebraska are smokers? That’s one in five people. And this number contributes to Omaha’s health ranking of 142 out of 182 cities in …
Taking Chantix to help smokers quit may be worth the risk
By now, most healthcare professionals — and many well-read consumers — are aware of the disturbingly high rate of surgical site infections (SSIs) in our nation’s hospitals.
Each year, approximately 500,000 surgical patients develop SSIs. In some types of operations, such as colorectal surgery, the rate is close to 10%.
Many hospitals submit information about SSIs in their institutions through the …
High rate of surgical site infections (SSIs) in our nation’s hospitals
For Christmas Eve dinner, our family congregated at Café Opera, in the Intercontinental Hotel for a scrumptious seafood buffet. Going to a buffet is a little bit evil, as you know that you’re about to commit the sin of gluttony.
I usually tell my patients who suffer with gout to avoid buffets. That 3rd mountain of prawns may precipitate an acute episode of gout. Christmas party season is a dangerous time.
Overindulgence …
Gout is a common cause for episodic joint pain and swelling
What, exactly, is a difficult patient?
Doctors can tell many tales of what they term as a difficult encounter. Just as many patients can recall doctors whom they would say are difficult to work with as well.
According to a study from the Journal of General Internal Medicine, here’s a definition:
Patients deemed difficult included those with more than five symptoms, severe symptoms or an underlying mental disorder or were less functional. These …
What is a difficult patient, and how doctors may be responsible
My current practice is getting ready to go live on Electronic Medical Records (EMR), but it’s taken us over a year to get here. When I first started this job, we were supposed to go live with EMR in two months. After I’d had a chance to speak with everyone, I just knew the timing wasn’t right for the EMR. We would need to be able to run, and at …
Signs that your practice is ready for EMR
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