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Depression and whether a behavioral problem is mental illness

Conditions and Diseases

November 22, 2010

It has been said that depression is the epidemic of the 21^st century. Certainly the rates of diagnosis have increased over the last 10-15 years. Some claim that this is due to better recognition of the issue and that actual rates are unchanged. Others feel that we are collectively more depressed than in years gone by.

The number of Americans prescribed an antidepressant doubled between 1996 and 2005 and those being …

Trust your life records to an unnamed chain of software vendors

Margalit Gur-Arie

Health Technology

November 21, 2010

Every day millions of Americans and billions of people around the globe are routinely accepting colorful pieces of paper in return for their labor and placing those hard earned possessions in modern glass buildings whose owners they do not know.

It took a few hundred years to change how business transactions are conducted, but today, there is very little apprehension about depositing one’s wealth in a bank. Public trust in both …

Do posters in the hospital really help patients?

Jaan Sidorov, MD

Health Policy

November 21, 2010

The Disease Management Care Blog received this posting from an experienced nurse with a background in clinical and administrative medicine.

We’ve all seen them. Those vacuous workplace posters exhorting teamwork, creativity and other forms of inspiration and accomplishment. A version has begun to creep into our nation’s health care facilities. reminding everyone of the need for privacy, how infections can be spread and the importance of patient service. And if my …

Routine use of sleep medication for children

Claudia M. Gold, MD

Medications

November 21, 2010

A recent study published in the journal Sleep Medicine revealed that most child psychiatrists prescribe medication for sleep at least once a month, despite the fact that no sleep medications are approved for use in children. The study was funded by Sanofi-Aventis, makers of Ambien.

Managing sleep is one of the greatest challenges of being a parent. It represents the first major separation and can be fraught with complex ambivalent feelings. …

Cardiothoracic surgery has a shortage of surgeons

Kevin

Physician

November 20, 2010

by Shawn Vuong

Some time in the years 2002-2005, cardiothoracic surgery hit the wall.

The specialty’s big time claim to fame, the CABG (coronary artery bypass graft), surgery was on a huge decline. The field of cardiothoracic surgery became super saturated with over trained surgeons who were no longer in demand. The interventional cardiologist had come along and started stenting coronary arteries, saving patients from the chest opening …

Quinine, artemisinin and our debt to traditional medical healers

Kevin

Medications

November 20, 2010

An excerpt from Sustaining Life: How Human Health Depends on Biodiversity.

by Eric Chivian, MD and Aaron Bernstein, MD

Ethnobotany, that is, the scientific study of the use of plants by native cultures, including their use as medicines, can be said to have begun with Carl Linnaeus, who in the 1730s published Flora Lapponica, his detailed account of plant use by the Lappish, or Sami, people, …

When does the duty to provide emergency medical care end?

Kevin

Physician

November 20, 2010

by Lyle Denniston

Hospitals know that medical care decisions often have legal consequences, which makes it all the more important to know what the law requires. But when judges can’t agree, and there also is some ambiguity in the way government officials see a legal issue affecting care decisions, hospitals may need to go to the ultimate authority – the U.S. Supreme Court – for an …

Taxing soft drinks to combat obesity

Arya M. Sharma, MD

Patient

November 19, 2010

One commonly heard propositions to combat the obesity epidemic is to tax soft drinks. No doubt, sugary soft drinks are a common and important source of “empty” calories, but will taxing soft drinks really reduce obesity rates?

This assumption was now examined by Yale University’s Jason Fletcher and colleagues, in a paper just published in Contemporary Economic Policy.

The researchers collected information on taxation of soft drinks with respect to specific excise …

Read more…

Taxing soft drinks to combat obesity

Caregiving requires that caregivers need practical and emotional support

Kenneth Lin, MD

Patient

November 19, 2010

Mr. B, the patient who first stirred my interest in family medicine, was a spry former World War Two fighter pilot who came to the ER complaining of an irregular heart beat. I remember him regaling me with stories about the Battle of Britain while his wife dutifully stood by his side in the chaos of the crowded emergency room at a private hospital affiliated with my medical school.

It was …

Never hesitate to seek a second medical opinion

Eric Van De Graaff, MD

Patient

November 19, 2010

To celebrate your 50th birthday you head to your doctor’s office to get your yearly exam. He rewards you for your diligence by poking and prodding you, sticking you with needles, and arranging for a colonoscopy (happy birthday!). He also sends you for a stress test out of concern about your strong family history of premature heart disease.

A slightly abnormal treadmill test leads to …

Teaching Dr. Oz about nosebleeds

Christopher Chang, MD

Conditions and Diseases

November 18, 2010

A reader informed me that Dr. Oz did a TV show recently on nosebleeds.

I took a look at the video clip and it is my opinion that some information Dr. Oz conveyed is not entirely correct. Again, I should stress that this is just my opinion and I’m sure there will be many who may feel differently.

Error #1:
Contrary to what was said on the show, ice packs do …

Read more…

Teaching Dr. Oz about nosebleeds

Why EHRs aren’t meaningful to doctors and hospitals

Richard Reece, MD

Health Technology

November 18, 2010

Electronic health record (EHR) advocates in Washington don’t seem to get it. They don’t seem to understand that hospitals and doctors aren’t rushing to install EHRs because many EHRs, despite the constant talk that EHRs are a prerequisite for good care. Caregivers are not walking the talk, because in their view, EHRs,

aren’t ready for prime time
slow productivity
decrease revenues,
show scant returns on investment
don’t talk to one …
Read more…

Why EHRs aren’t meaningful to doctors and hospitals

A National Quality Strategy can create improve patient safety

David B. Nash, MD, MBA

Health Policy

November 18, 2010

Among the many provisions in the Patient Protection and Affordable Care Act are elements intended to assure that every American has access to healthcare that is patient-centered, affordable, and of the highest clinical quality.

In my mind, one of the act’s most essential goals is to establish a National Health Care Quality Strategy — one that integrates disparate federal and private sector initiatives, building on and expanding current quality assessment and …

Our malpractice system needs to focus on patient safety

Donald H. Taylor, PhD

Physician

November 18, 2010

A malpractice lawsuit claims that a doctor treated a patient negligently and that this treatment caused harm, and it seeks monetary compensation. Negligence means that a physician failed to provide the standard of care expected by the prevailing medical custom. Juries decide cases that are tried, but most cases are settled or dropped. Lawyers get paid (typically 35 percent) only when they win or settle a case.

A successful malpractice system …

EMR is here to stay, which will be good for doctors and patients

Christopher Johnson, MD

Health Technology

November 17, 2010

The electronic medical record, the EMR, is upon us.

For those of us who learned medicine entirely with paper charts, some have enthusiastically embraced the EMR and some have refused, to the extent they can, to deal with it at all. But most of us have plowed ahead into learning how to use it as best we can. It seems to me that the degree of enthusiasm physicians show for the …

How the health care industry competes for patients

Shantanu Nundy, MD

Physician

November 17, 2010

On my drive in to work this past week I came across this:

A bus-side advertisement for a local hospital (sadly, not mine) claiming that it was “home to the city’s best transplant outcomes.” Normally I drive right by these moving billboards without paying much attention. But this time I immediately got excited, whipped out my cell phone and snapped …

Addressing the physician shortage in Texas

Tayson DeLengocky, DO

Medical Education

November 17, 2010

by Tayson DeLengocky, DO

The physician shortage in Texas has commanded an unusual amount of public interest in recent weeks.

The Houston Chronicle (Oct. 17), Star Telegram (Oct. 19) and Fort Worth Business Press (Oct. 27) all devoted space to the growing shortage of physicians in Texas and the steps necessary to correct the problem. The three articles recognized that the availability of residency slots is the determining factor in addressing the …

CAHPS measures are as important as profit and loss for hospitals

Kevin

Physician

November 17, 2010

by Steve P. Sanders, DO, MBA

Are hospitals coming clean? An article recently published in Health Affairs reveals details of a government–required survey conducted in 2008 and 2009.

The Hospital Consumer Assessment of Healthcare Providers and Systems survey or CAHPS is required of all hospitals receiving and hoping to continue to receive federal funding. Analysts compared CAHPS responses between 2008 and 2009 and gleaned what they believed …

Taking a multivitamin, vitamin D and fish oil every day

Mary L. Brandt, MD

Conditions and Diseases

November 17, 2010

There is very little doubt that if we eat the diet we were designed to eat and spend adequate time in the sun that we will get most if not all the nutrients we need.

That’s the ideal, but not the reality for a lot of us. I was recently advised by a group of physicians who are experts in the area that it is reasonable, and probably preferable, for adults …

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