KevinMD.com

Choose primary care and follow your heart, not your brain

Physician

June 22, 2010

Reams have been written on how medical students ought to select their field of medicine.

There are even personality-type tests that ask questions about what kinds of situations you like, how you react to problems, and your working style that purport to predict for which specialty you are suited. (I came up as an oncologist or a nephrologist.)

Others have opined that once you crunch the lifetime salary numbers, and then compare …

A patient in chief is what American healthcare needs

Dave deBronkart

Patient

June 22, 2010

“These are exciting and very promising times for the widespread application of information technology to improve the quality of healthcare delivery, while also reducing costs, but there is much yet to do, and in my comments I want to note especially the importance of the resource that is most often under-utilized in our information systems – our patients.”
– Charles Safran MD, testimony to the House Ways & Means subcommittee on health [Emphasis …

Read more…

A patient in chief is what American healthcare needs

How healthcare reform will affect Medicaid

MedPage Today

Health Policy

June 22, 2010

by Cole Petrochko

Medicaid expansion under new healthcare reform laws could add millions of participants to the program over the next nine years and greatly decrease the number of uninsured Americans — with the federal government picking up most of the tab, according to a Kaiser Family Foundation report.

One set of projections in the report, prepared by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, estimates that …

How transparency reduces malpractice and defensive medicine

Brad Wright, PhD

Physician

June 22, 2010

Physician errors have been the subject of discussions about both health care costs and health care quality.

We are told that if we reform the malpractice system — capping damages — that physicians will practice medicine less defensively and costs will go down as a result. We are also told that the quality of care delivered by our health care providers is less than optimal — there are estimates that nearly …

ACP: Increasing the attractiveness of general internal medicine

American College of Physicians

Health Policy

June 21, 2010

A guest column by the American College of Physicians, exclusive to KevinMD.com.

by Steven Weinberger, MD, FACP

In this era of health care reform, much has been written and discussed about the shortage of primary care physicians in the United States, which is projected to get substantially worse over the coming years.

A number of different types of physicians have been …

Treating friends, and when worlds collide in the hospital

Bruce Campbell, MD

Physician

June 21, 2010

All the world is a stage,
And all the men and women merely players.
They have their exits and entrances;
Each man in his time plays many parts.
-Shakespeare

“There’s a consult downstairs, Campbell. Go check it out and I’ll catch up with you later.”

“Sure, OK.” I was a third-year medical student fumbling through my first clinical rotations. The resident headed off to whatever he needed to accomplish and I trotted down the back …

Screening studies that blur the mortality and case fatality line

Marya Zilberberg, MD, MPH

Conditions and Diseases

June 21, 2010

When do tests improve mortality?

This is a question well worth asking, particularly as we argue about the merits of mammography screening. The USPSTF has really stirred up the hornet’s nest with this one, and the politicians cannot help but get on their populist pulpit, ignoring the facts completely.

But the question remains, do screening or diagnostic tests that are more sensitive save lives? We all hear that mortality from many diseases …

Citalopram and other SSRI drugs can reduce hot flashes

Charles Bankhead

Medications

June 21, 2010

by Charles Bankhead

Hot-flash frequency and severity declined by 50% in postmenopausal women treated for six weeks with the antidepressant citalopram, according to data from a placebo-controlled, randomized clinical trial.

The trial, conducted among 254 women with frequent hot flashes (at least 14 hot flashes a week for a month or longer), found that the lowest of three citalopram doses was as effective as the highest for dousing hot flashes, but the …

Clinical trial conflict of interest for doctors

Paul Levy

Physician

June 21, 2010

This is a painful story to write.

A close friend of mine, in his 40’s, had a persistent light cough for many months. Finally, when he had an X-ray taken, it showed a large tumor on his lungs. He was diagnosed with stage 4 lung cancer. As a non-smoker and strapping, physically fit man, he was shocked, as you can imagine.

He went to his non-Boston-based medical practice, and he was told …

What if blogs were run like a paper medical record system?

Rob Lamberts, MD

Health Technology

June 20, 2010

I always find it very ironic to see doctors bashing EMR on the Internet. They are bashing a tool designed to gather and organize information, improve communication, and give immediate access to important information, while using a tool that gathers and organizes information, improves communication, and gives immediate access to important information.

It is fine to bash the current state of EMR (I saw one site complain that EMRs have a …

C. Diff and how dentists overuse antibiotics

Michael Kirsch, MD

Medications

June 20, 2010

Why do dentists prescribe antibiotic prophylaxis so often?

Because they can.

Why am I dissing my dental colleagues? Because I can.

Perhaps, this is a simple case of dental envy, since their profession remains within secure borders far beyond the health care reform line of fire. Consider these dental incidentals:

• Not a syllable in the ~2000 page health care reform law that affects dentists. Every filling is still worth its weight in gold
• …

Indoor tanning is associated with melanoma

MedPage Today

Conditions and Diseases

June 20, 2010

by Michael Smith

Indoor tanning is associated with a 74% higher risk of melanoma, researchers said.

And, in a large case-control study, some forms of indoor tanning machines were associated with a four-fold increase in the risk of skin cancer, according to DeAnn Lazovich, PhD, of the University of Minnesota, and colleagues.

The risk rose in a dose-response fashion depending on years of use, hours of use, or number of sessions, Lazovich and …

Fracture risk with Prilosec and other proton pump inhibitors

Matthew Mintz, MD

Medications

June 19, 2010

The FDA released a Drug Safety Communication warning about a possible risk of increased fractures with acid blocking medications called proton pump inhibitors or PPIs.

PPIs have been a major advance in medical science. Prior to these and earlier medications, the treatment for severe gastroesophageal reflux disease (GERD) was major surgery. PPIs are now commonly prescribed for GERD and less serious heart burn, many are generic, and some are now sold …

Radiation or watchful waiting for prostate cancer treatment?

Charles Bankhead

Conditions and Diseases

June 19, 2010

by Charles Bankhead

There is still not enough evidence to show that radiation therapy for localized prostate cancer is better than surveillance, according to a report prepared for the Centers for Medicare and Medicaid Services (CMS).

Only retrospective analyses have compared irradiation with no treatment or no initial treatment. Data comparing the relative efficacy of different types of radiation therapy also are insufficient to permit definitive conclusions regarding efficacy, safety, and toxicity, …

Return control of our health system back to doctors and patients

Kevin

Health Policy

June 19, 2010

by William Lawson, MD

Representative David Price recently wrote the Chapel Hill News to “set the record straight” regarding Washington’s newly‐passed health care legislation.

Rep. Price argues that the government’s central planning will make health insurance more affordable for small businesses and individuals. Touting tax credits covering 35% of premiums for small businesses with less than 25 employees and less than $50,000 in average annual wages, Rep. Price asserts that the new …

8 insomnia tips to help you fall asleep without drugs

Jill of All Trades, MD

Conditions and Diseases

June 19, 2010

Difficulty with sleep is one of the most common patient complaints presenting to the primary care office.

Chances are, you will suffer from difficulty with insomnia at some point in your lifetime. It can be distressing, and cause difficulty with functioning during your wake hours. The first thing you may want to do is to run to the doctor for a prescription for a medication to help you sleep.

However, you don’t …

Heart catheterization worries that every cardiologist face

John Mandrola, MD

Physician

June 18, 2010

Malpractice and heart catheterization have been in the news recently.

A spicy concoction for sure. An epidemiological study published in an online subsidiary of Circulation addresses the role of three major medical issues facing cardiologists today: malpractice, heart catheterization, and medical costs.

It is hard to get more controversial.

Heart catheterization, the invasive assessment of the coronary artery lumen, has always been a hot-potato topic. The “percent-normal” was the buzz word when I …

Should prisons require co-pays for inmate health care?

Jeffrey Knuppel, MD

Patient

June 18, 2010

In the U.S., correctional facilities are required by law to provide inmates with access to medical care. As health care costs have spiraled out of control everywhere, jails and prisons have attempted to develop innovative ways of reducing this hefty financial burden while simultaneously meeting their legal obligation to provide care.

One approach that has gained significant popularity in recent years is to require inmates to pay a small fee, usually …

Gay men and whether they should donate blood

MedPage Today

Conditions and Diseases

June 18, 2010

by Michael Smith

It’s time to revisit the touchy issue of gay men and blood donation now that accurate HIV testing is widely available, Canadian researchers argue.

The lifetime ban on giving blood for men who have had sex with other men was justified in 1983 when HIV testing was relatively insensitive but can no longer be supported, according to Mark Wainberg, PhD, and colleagues at Montreal’s …

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts