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Rosiglitazone (Avandia) stays on the market, with stronger warnings

Medications

July 14, 2010

by Emily P. Walker

An advisory panel voted 20-12 to recommend that the FDA allow rosiglitazone (Avandia) to stay on the market, but most panelists want to see the controversial diabetes drug carry tougher warnings on its label.

Wednesday’s vote marks the second time an FDA advisory panel has essentially endorsed rosiglitazone. In 2007, a panel voted that while the drug appears to …

Treating intellectual disabilities in patients who can’t talk

Jeffrey Knuppel, MD

Conditions and Diseases

July 14, 2010

Psychiatrists treating patients who can’t talk. Sounds fishy, doesn’t it?

Well, I do it 2-3 days per week, and as strange as it may sound, it makes perfect sense.

Let me explain.

I provide psychiatric consultation services in a facility for people with intellectual and developmental disabilities. (Intellectual disability is the newer term for mental retardation). Some of my patients are short-term admissions from the community, and others are long-term residents of the …

Fire in the OR and how hospitals should report medical mistakes

Maggie Mahar

Physician

July 14, 2010

Did you know that if there is a fire in the OR during surgery hospitals in some states don’t have to report the event to anyone?

When I read a recent story in the Cleveland Plain Dealer headlined, “Reporting Surgical Fires Could Improve Patient Safety in Ohio, Experts Say,” I was stunned.

The piece begins:

When fire breaks out and burns a patient during surgery in Pennsylvania, the hospital is required by law …

Read more…

Fire in the OR and how hospitals should report medical mistakes

Free clinics need more government funding

MedPage Today

Health Policy

July 14, 2010

by Cole Petrochko

The nation’s free clinics provide medical service to 1.8 million patients annually — more than half of those clinics operate without government funding and serve patients who are almost all uninsured — according to the first census of free clinics in 40 years.

Responses to a national mail survey by 764 free clinics in the U.S., reported in the June issue of the Archives of Internal Medicine, revealed that …

Pregnant with triplets, and a premature delivery

Jennifer Gunter, MD

Conditions and Diseases

July 14, 2010

An excerpt from The Preemie Primer.

There’s a well-entrenched theory that OB/GYNs have the most complicated pregnancies.

In reality most of us probably do not, but doctors remember complications most vividly when they happen to people they know and love. My pregnancy was, unfortunately, a good example of that old adage. Many of my colleagues who looked after me during that time have said, “It was the worst night of my life.” …

Final meaningful use rules for electronic health records reaction

Kevin

Health Technology

July 14, 2010

by Joyce Frieden

The Department of Health and Human Services has released its final rule on “meaningful use” of electronic health records with the goal of making it easier for physicians to comply.

“We want these objectives to be ambitious but achievable,” David Blumenthal, MD, MPP, the department’s National Coordinator for Health Information Technology, said at a press conference on Tuesday announcing the release of the …

What residents and medical students should wear in the hospital

Vineet Arora, MD and Shalini Reddy, MD

Medical Education

July 13, 2010

At a recent meeting I attended, a vigorous discussion broke out about what medical students, residents and attendings should wear, and more importantly what they should not wear.

Interestingly, patients have been asked to weigh in on this discussion. What to wear is also on the mind of many current second year medical students who may find themselves trying to take study breaks from USMLE 1 to go buy …

Cancer in a transplant kidney, is it the doctor’s fault?

Amy Tuteur, MD

Physician

July 13, 2010

May you never be an interesting case.

That’s a cautionary proverb familiar to medical professionals. While it’s bad to get sick, it’s much worse to get sick with something uncommon or unusual. The more fascinating a case is for doctors, the more difficult it is for patients. Difficult to diagnose, difficult to treat, and often difficult to survive.

Kenneth Liew was doubly unfortunate. He was an interesting medical case and an interesting …

The individual mandate and the impending Supreme Court challenge

Roger Collier

Health Policy

July 13, 2010

The individual mandate is the single most controversial feature of the Patient Protection and Affordable Care Act (PPACA). Everyone who can afford coverage—unless an undocumented immigrant or exempted on religious grounds—is required to have it or pay a penalty of $695 or 2.5 percent of income.

The rationale is straightforward: without a mandate, many people would wait until they needed care before buying insurance, driving up premiums for those with ongoing …

Ecstasy overdose is becoming more frequent at rave parties

Crystal Phend

Medications

July 13, 2010

by Crystal Phend

Overdoses of the “club drug” ecstasy at all-night rave dance parties may be a rising but under-reported public health problem, the CDC said.

What may be the first public health investigation into the epidemiology of ecstasy overdose revealed that 18 patients landed in hospital emergency departments for illness related to the hallucinogenic stimulant within 12 hours after a Los Angeles New Year’s Eve rave.

This cluster of events was accompanied …

Healthcare reform: Who’s getting stuck with the bill?

Kevin

Health Policy

July 13, 2010

by Shelly Towns

Many people have the mistaken idea that “socialized healthcare” means that medicine and care will now be free for everyone, but in all actuality, nothing could be further from the truth.

The new healthcare bill represents one of the largest, most sweeping domestic policy changes in a generation, and aims to provide an estimated $940 billion in healthcare to over 32 million uninsured Americans (and that’s only for the …

When the doctor is the patient, humanism and competency matter

Wendy Sue Swanson, MD

Patient

July 13, 2010

Over the past few weeks I’ve had ample opportunity to be on the other side. Not like some parents with chronically ill children or those with children who have suffered tragic illness. No, not like that; I am fortunate that hospitals aren’t a part of my family’s everyday (except for work). My children have had amazing fortune and I remain in awe of good health. Lately though, we’ve had some …

Will Avandia survive the FDA advisory panel?

Kevin

Medications

July 13, 2010

by Crystal Phend and Emily Walker

Despite hints that the FDA may be leaning toward pulling rosiglitazone (Avandia) from the market, it’s going to be a tough decision for the advisory committee slated to begin meeting on Tuesday, and things could still go either way, leading endocrinologists predict.

“I think the FDA advisory committee is going to struggle with this because none of the data is conclusive,” …

How this OB/GYN handled her unexpected maternity leave

Kevin

Physician

July 12, 2010

by RH+, MD

About 3 weeks after my son was born I read this post and I was extremely jealous as I read about the author’s extended leave. As I began to consider my “maternity leave” I realized that I could quite possibly have a truly unique situation on my hands.

I work in private practice and my husband is an amazing stay at home Dad. We had been waiting to …

AMA health insurer report card finds need for more accuracy

Kevin

Health Policy

July 12, 2010

A guest column by the American Medical Association, exclusive to KevinMD.com.

There has been some notable progress in just two years since the American Medical Association’s first National Health Insurer Report Card evaluated the claims processing performance of the nation’s largest insurers. Health plans have made improvements in the efficiency and transparency of their claims processes, but there is still a lot of room for improvement – and the AMA …

Not all pain patients in the ER are drug seekers

Kevin

Physician

July 12, 2010

by Melissa Velez-Avrach

About eight years ago, I was in an accident that left me with chronic lower back pain and muscle spasms.

Then, about a year and half ago, I was in a car accident. Bad combo for the pain. I’ve been to chiropractors, orthopedic spine specialists, had MRIs, the works and am following my doctor’s recommendations, doing yoga, deep breathing and physical therapy when needed. It has all helped me …

Why technology and the Internet may not be good for patients

Kent Bottles, MD

Potpourri

July 12, 2010

Paro the robot baby harp seal was the final straw.

I had vowed to myself not to think about or write about “the internet makes you smarter, the internet makes you dumber” argument. Even when some of my favorite authors (Steven B. Johnson, Clay Shirky, Nicholas Carr, and Jonah Lehrer) weighed in, I thought it best not to participate.

And then I read about Paro, either “a disturbing turn in our treatment …

Is health care experience mandatory for a pharmaceutical CEO?

Roy Poses, MD

Medications

July 11, 2010

A persistent theme for Health Care Renewal has been how concentration and abuse of power in health care trap patients and heath care professionals in a maze of bureaucracy, perverse incentives, deception, and conflicts of interest.

To anyone who has to make the transition from person to patient, some of these problems become immediately obvious.

Consider, for example, this account of “going into a hospital for a minor procedure”:

The very idea of …

Read more…

Is health care experience mandatory for a pharmaceutical CEO?

How H1N1 influenza is similar to the influenza A virus

MedPage Today

Conditions and Diseases

July 11, 2010

by Todd Neale

The pandemic H1N1 influenza virus is similar to seasonal influenza A viruses in terms of viral shedding, symptoms, and household transmission, researchers in Hong Kong found.

The researchers prospectively followed 99 patients testing positive in rapid diagnostic tests for influenza A virus and found 45 had the H1N1 pandemic virus and 54 were infected with a seasonal influenza A virus, H3N2, but the two strains did not differ significantly, …

iPhone, Android or Blackberry? The right smartphone for doctors

Iltifat Husain, MD

Health Technology

July 11, 2010

Lately, I’ve often been asked the question, “What type of smartphone should I get?” by my medical peers. I’ve been asked this by physicians, residents, medical students, and others. Many of my friends are entering residency and plan on upgrading to a smart phone, while others already entrenched in residency have phone contracts finishing up.

The answer to this question is not easy. Rather, as Facebook nomenclature would demand, “it’s complicated”. …