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HIV sufferers benefit from the FDA’s unapproved drugs initiative

Kevin

Medications

October 13, 2010

by Gary Puckrein, PhD

Unapproved drugs have never been tested by the Food and Drugs Administration for safety and efficacy. Prescribed by the million every year in the United States, these products pose a potential danger to all patients, but HIV/AIDS patients who suffer weakened immune systems are at an even higher risk as they are more vulnerable to injury due to their disease.

That’s why we …

Narcotic use is rampant in workers compensation

Joseph Paduda

Medications

October 12, 2010

Just in case you thought the problems with abuse of powerful prescription drugs have been overstated, here’s a wake-up call.

The CDC’s Director is taking this very seriously, saying: “Overdose with prescription drugs is one of the most serious and fastest-growing problems in this country.”

The problem is showing up in a doubling of emergency room admissions due to prescription drug abuse, driven primarily by oxycodone, methadone, and hydrocodone.

Narcotic use is rampant …

Making health care better, faster, and cheaper with collective innovations

Joe Flower

Health Policy

October 12, 2010

The country seems to have shifted in less than 18 months from a slogan of “Yes We Can!” to “Oh, well…” and a shrug, then back to “Cool! I think. What was that, really?”

Hopes for a true rebirth of health care turned into the Year of Screaming Inanely, then took that long slide from what we might hope for to what we might settle for. Yet suddenly it seems like …

Does being a lawyer or journalist stack up with being a physician?

Colin Son, MD

Physician

October 12, 2010

I don’t think there is anything nobler than being a physician. In it’s most prime form it is service to life’s most basic needs.

Certainly there are professions and lives with similar dedication. But lawyers and journalist I can’t reasonably place amongst them. This from someone who favors liberty and transparency in society above most else; certainly things that lawyers and journalists can help foster.

And yet, for all the respect thrown …

How medical practice operations impacts productivity and profitability

Rosemarie Nelson

Physician

October 12, 2010

“How many staffers should we have per doctor?” was the opening question in a recent column. We looked at the impact of staff on provider productivity and ultimately practice profitability as an approach to address that question.

In that piece, we focused primarily on clinical staff, but in this column, we’ll dig even deeper into medical practice operations, looking at the way a practice utilizes nonclinical support staff for traditionally …

Intimate partner violence an epidemic of grave proportion

Jennifer Gunter, MD

Patient

October 12, 2010

October is breast cancer awareness month. There are pink ribbons and wristbands to wear, pink products to buy, and pink races to run — all to improve awareness about screening and raise money for a cure. And rightly so, because breast cancer affects 250,000 American women every year.

Fewer people know that October is also intimate partner violence awareness month. Purple is the color representing the more than 1.3 million women …

Deal with your triggers when trying to lose weight

Melanie Lane, MD

Patient

October 11, 2010

One of the most common complaints that I hear from people attempting to lose weight is, “I don’t know how to deal with my triggers.” Most of us have had the experience of eating just one bite of something and suddenly wanting to devour the entire thing. Sometimes we do, even though we know we won’t be happy with ourselves when we finish.

I am familiar with the experience of insisting …

Avandia aftermath: winners and losers

Larry Husten, PhD

Medications

October 11, 2010

Responses to the Avandia panel have been all over the map, as cleverly noted on the Wall Street Journal‘s Health Blog. Avandia is “dead” (Forbes), or, perhaps worse, “now a Zombie” (BNET). By contrast, others thought the panel granted Avandia a “reprieve” (Wall Street Journal and that Avandia would now probably be allowed to stay on the market (Los Angeles Times, Pharmalot).

All …

Read more…

Avandia aftermath: winners and losers

Medicare needs to be more like a credit card

Steven H. Rudolph, MD

Health Policy

October 11, 2010

I live in New York. Last week my daughter in Chicago called to say that a five dollar charge had been refused at a local coffee shop. My credit card company had identified an unusual pattern of purchases, and had put a hold on the card.

No similar process exists for the Medicare system, where cost savings could be realized by systems that identify unusual patterns of charges and outright abuse …

How time can be used as a diagnostic tool

Edward Pullen, MD

Conditions and Diseases

October 10, 2010

I can’t remember which lecture it was, or even just when in my first two years of medical school the lecture was given, but I do remember how the concept struck me as really important.

The gist of the message was that the timing of onset of a patient’s symptoms is a key part of understanding the nature of the patient’s diagnosis. Symptoms from a neoplasm come on gradually, tend to …

Trust your doctor but review your medical bills

Dennis Grace

Physician

October 10, 2010

by Dennis Grace

The last time I visited my physician for an epidural injection, as the doctor’s assistant was situating me under the fluoroscope, the doctor was feverishly dictating notes on his previous patient’s procedure. No doubt your physician has a similar work schedule: when not dashing off notes from one patient or burrowing through medical research to diagnose another, he’s performing delicate medical procedures …

How observation admissions affect Medicare patients

WhiteCoat, MD

Health Policy

October 10, 2010

A revealing article in Bloomberg recently described the latest way in which elderly patients are getting screwed by the system.

Medicare reviews all admissions and if the patients don’t meet indications for admission, the hospital doesn’t get paid by Medicare. Medicare has also recently implemented a mercenary system called Recovery Audit Contractors (or RAC for short) in which third parties audit hospital charts to see whether Medicare “overpaid” for a patient’s …

Quality programs have social and medical consequences

Douglas Perednia, MD

Health Policy

October 9, 2010

Like it or not, “garbage in, garbage out” is the rule rather than the exception for the vast majority of bureaucratically dictated “quality control” programs that we’re ever likely to launch. There are three primary reasons for this.

First and foremost, there’s Goodhart’s Law:

“Originally, an economic theory stating that if a particular definition of the money supply were to be used as the basis for monetary policy, the stability …

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Quality programs have social and medical consequences

Should the public participate in preparing cadavers for students?

Josh Herigon, MPH

Medical Education

October 9, 2010

The Wall Street Journal’s Health Blog carries an interesting piece about a program at Indiana University–Northwest that allows volunteers from the general public to participate in preparing cadavers for first year medical students.

This is a brilliant idea for several reasons:

One persistent problem facing physicians is the extremely low health literacy of most patients. Simply put, “health literacy” refers to how well patients can comprehend what their …
Read more…

Should the public participate in preparing cadavers for students?

Watchful waiting is underutilized for most men with prostate cancer

John Schumann, MD

Conditions and Diseases

October 8, 2010

NPR has a great blog on their website called Shots about current events in health care. Recently, Scott Hensley, the main blogger there, posted a recent article on treatment of prostate cancer from the Archives of Internal Medicine.

If you look at the article, you may notice a very small subheading above the article’s title. It reads “Less is More.”

Very telling.

The thrust of the article …

When parents should be concerned about a lump on their child

Michael Gonzalez, MD

Conditions and Diseases

October 8, 2010

I was recently scanning an online forum about pediatric health concerns. (What can I say? I sometimes need inspiration.) One thread within the forum was significantly longer than any other. Parent after parent posted about how they had noticed a knot on their infant or toddler. This concern parallels what I see in practice. An unexplained knot on the head is a common reason parents bring their child to …

How open medical charts help Healthy Survivorship

Wendy S. Harpham, MD

Patient

October 8, 2010

[Editor’s note: Please visit part 1 of Dr. Harpham’s take on OpenNotes.]

“Our” Chart

Does the opportunity for patients to read their medical charts help or hurt patients’ ability to become Healthy Survivors?

Open notes can facilitate Healthy Survivorship for some patients.

Unfortunately, other patients may learn something about their condition that makes it more difficult to get good care or live as fully as possible. Or they may experience feelings that threaten the physician-patient bond. …

Why doctors should care about Regional Extension Centers (RECs)

David B. Nash, MD, MBA

Health Policy

October 8, 2010

Over the past year, states across the country have begun to develop Regional Extension Centers (RECs) to help support the broad electronic health record (EHR) initiative passed as part of the economic stimulus package in 2009.

Why should physicians care? With benefit of a little background information, the answer is pretty clear.

The evidence suggests — and it is generally believed — that adoption of EHRs by physicians and other healthcare providers …

How to foster a cycle of excellence in medicine

Ron Li

Physician

October 8, 2010

“What does it take to be good at something in which failure is so easy, so effortless?” asks Atul Gawande in his book, Better. For medical students who will soon have responsibility over people’s lives, it’s a daunting question. It draws out our fears of messing up and making mistakes. Of getting a lower grade than our peers on a Structure Function exam. Of answering a question incorrectly and embarrassing …

Medical malpractice and how legal waste increases overall costs

Chris Rangel, MD

Physician

October 7, 2010

Dr. Kirsch at MD Whistleblower has written about his recent unpleasant experience with malpractice litigation. Despite having full access to the patient’s chart and medical records, the plaintiffs attorney chose to include Dr. Kirsch in the suit … apparently … just because … he had seen the patient.

In Ohio – where this case was filed – a plaintiff in a medical malpractice case is required to obtain …