A surge in demand for physicians from newly insured patients

Health Policy
December 23, 2010

The Affordable Care Act is the most important piece of federal health care legislation since the Social Security Act of 1965 established the Medicare program. It assures that 32 million Americans will have access to health insurance for the first time. But who will care for these people?

Our health care system was plagued by a severe and worsening physician shortage even before the new law took effect. In fact, a …

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A surge in demand for physicians from newly insured patients

Say goodbye to your patients the right way

Patient
December 23, 2010

When I realized that I would be moving to a different county within Southern California and would have to change jobs, I knew it would be inevitable that I would have to say goodbye to my patients. I was dreading this. I mean, really dreading it. I don’t like goodbyes.  I feel as though I am breaking up, and in a way I am.

Like any other relationship, my patient-physician relationships …

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Say goodbye to your patients the right way

Maximizing enrollment in insurance exchanges is essential

Health Policy
December 22, 2010

Massachusetts’ Connector, operational since 2006, is the prototype for PPACA’s insurance exchanges. Connector boosters have claimed it is a vital and successful part of Massachusetts’ health care reform; its critics have noted its failure to influence either benefit or administrative costs or to attract significant enrollment. However, whether success or failure, the Connector offers lessons for other states.

Low enrollment means failure

As Massachusetts discovered, it’s impossible for the exchange to influence …

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Maximizing enrollment in insurance exchanges is essential

Solve the obesity crisis to ensure our country’s financial stability

Patient
December 22, 2010

If I was Surgeon General, I would follow the lead of our country’s first Mom.

This is serious folks.

We, as an American society, need to solve the obesity crisis.  Not just for our physical health, but for our country’s financial stability.

Reducing the spiraling costs of health care is wanted by all.  So far, prevention of the diseases which contribute most to our health care costs, (heart disease, cancer and orthopedic issues, …

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Solve the obesity crisis to ensure our country’s financial stability

Physicians need to take responsibility for their actions

Physician
December 21, 2010

As the saying goes, when you’ve got a hammer, everything looks like a nail. Send a patient to a surgeon, and he very well might get surgery. Send a patient to a psychiatrist, and he very well may end up on psychotropic medication.

As physicians, we need to take responsibility for our own actions. We should not prescribe or perform procedures unnecessarily. However, even if we are responsible for our own …

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Physicians need to take responsibility for their actions

How an iPad is replacing medical textbooks

Health Technology
December 21, 2010

by Kal Shah

Kal Shah, a first year medical student at the University of California Irvine who received his undergraduate degree from UC Berkeley in Bioengineering, has given iMedicalApps the scoop on how the iPad is being used by himself and classmates.

He highlights how medical textbooks are being utilized, along with an app he feels is better at note taking than the popular Read more…

How an iPad is replacing medical textbooks

Pay close attention to what doctors say to patients

Patient
December 20, 2010

In a report from the Archives of Internal Medicine, it was reported that most hospitalized patients (82%) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted.  Of the physicians, 67% thought the patients knew their name and 77% of doctors thought the patients “understood their diagnoses at least somewhat …

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Pay close attention to what doctors say to patients

Progressive commercialization of American medicine

Health Technology
December 20, 2010

by Lucas Restrepo, MD

There is only one fundamental problem with American medicine: its progressive commercialization.

Every other problem derives from it centrifugally. Medicine, wrote William Osler, is “a calling, not a business.” Patients are not clients, nor physicians businessmen. People do not spend over a decade studying medicine ―living years in poverty or overburdened with debt― merely hoping to get rich. While it is perfectly …

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Progressive commercialization of American medicine

Natural lifespan and whether a woman is designed to give birth

Conditions and Diseases
December 19, 2010

Advocates of alternative health attribute all sorts of fantastical properties to the human body. The body supposedly “knows” how to live a long healthy life; the body is supposedly “designed” to work perfectly. The tenets of natural childbirth philosophy also invoke these fantastical properties. The body “knows” how to give birth; a woman’s body is “designed” to give birth.

On their face these claims are obviously false. The body doesn’t “know” …

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Natural lifespan and whether a woman is designed to give birth

Physician barriers to EMR acceptance

Health Technology
December 19, 2010

Recently, I had my first visit with my new primary care doctor.

I picked him based on recommendations (plus he’s one of the few that accepts my insurance), and also because he seemed to be an eager adopter of electronic medical records (EMR). On his website, there was a portal for making appointments on-line, asking questions of the doctor and staff by e-mail and once a registered patient, I could also …

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Physician barriers to EMR acceptance

Everything about medicine is now big business

Health Policy
December 18, 2010

Med­i­cine used to be different. Doc­tors couldn’t do too much for you. They didn’t get paid very much and they were focused more on helping than on managing a business.

Hospitals were community-based not-for-profit or public entities. Drugs and devices were not as sophisticated or expensive, and they weren’t marketed directly to consumers. Well Toto, we’re not in Kansas any­more.

After witnessing our “health­care reform” process you must have seen that almost …

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Everything about medicine is now big business

Giving children probiotics

Conditions and Diseases
December 18, 2010

I’m becoming more of a believer in giving children probiotics. Not for everything and not for everyone; I really don’t think we should put them in the water.

Probiotics, essentially live “good” bacteria we use to supplement our diet (usually Lactobacillus Acidophilus in the US), are becoming more and more available and recommended by more and more physicians. The role microbes play in our health is a hot …

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Giving children probiotics

Medical school and medical training in Ireland

Medical Education
December 17, 2010

I recently spent a week in Ireland, taking in the sights and spirits.

I was actually there for work too – visiting the University College of Dublin and the Mater Miserecordia Hospital – or the original Mercy Hospital as they refer to it.   As the future of primary care, residency work hours, and the healthcare insurance system continue to cause angst in the US, we often find ourselves referencing what our European …

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Medical school and medical training in Ireland

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The art of medicine and mastering relationships

Physician
December 17, 2010

by Kelly, MD

There is a reason why people often say “the art of medicine.”

It’s not just the fact that so much of what we do is based on culture and habit rather than science, but also the fact that there is a lot of finesse when it comes to relationships as a doctor.  Oh sure, we know all about patient-doctor relationships and its importance.  There are …

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The art of medicine and mastering relationships

Comparative effectiveness research (CER) needs honest discussion

Health Policy
December 17, 2010

Comparative effectiveness research (CER) is suddenly a hot topic at all the health care conferences.

How come? Everybody agrees that we have to decrease per-capita cost and increase quality. Why? Government programs like Medicare and Medicaid foot more than 50% of our nation’s health bill, and if everything stays the same these programs will go belly up (bankrupt) in 8 years. Big problem.

Health and Human Services (HHS) has defined comparative effectiveness …

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Comparative effectiveness research (CER) needs honest discussion

Social media helps doctors manage their online reputation

Social Media in Medicine
December 16, 2010

Once a provider realizes the increasing importance of building and managing their online reputation, they need some practical tools and steps. Bear in mind, I am writing this, not for the small percentage of physicians already active with social media, but rather for those of you giving it consideration and looking for some …

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Social media helps doctors manage their online reputation

An ice cream label as a health literacy tool

Patient
December 16, 2010

When is an ice cream label a health literacy tool?

When Dr. Barry Weiss decided to use an ice cream label as a tool to asses whether we (patients) are able to understand medical instructions. Funded by Pfizer-backed Clear Health Communication initiative, Weiss’s research resulted in the creation of “The Newest Vital Sign.”

A health literacy assessment tool, with findings published in the Annals of Family Medicine.

However, the document, Why …

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An ice cream label as a health literacy tool

The cost of keeping the terminally ill alive

Physician
December 16, 2010

Last year, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients’ lives.

And it has been estimated that 20 to 30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked. This statistic is from a 60 Minutes story on “The Cost of Dying” and …

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The cost of keeping the terminally ill alive

A physician story of addiction and recovery

Physician
December 16, 2010

by an anonymous physician

I am a physician now in recovery.

I don’t like that term. The correct thing to say is, I am sober.  I am going on a year sober without any problems. Recovery suggests some disease state and I don’t think it is that simple.  It also suggests an ongoing daily struggle or effort to remain sober, and I don’t find that the case, either.  I know this …

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A physician story of addiction and recovery

How to intubate: Teaching a medical student during anesthesia residency

Medical Education
December 16, 2010

The first time I let a medical student try to intubate was in August. Now in my final year of anesthesia residency, I had volunteered to mentor a third-year medical student for a week. A few weeks in advance I got an email with the form she had filled out. Anesthesia experience: none. Excited to learn: yes.

I met her on Monday morning after she navigated through the preoperative holding area …

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How to intubate: Teaching a medical student during anesthesia residency

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