Healthcare workers in the ER hit hard by H1N1

Physician
April 13, 2010

by Michael Smith

Healthcare workers in a New York City emergency department had the highest rate of infection among employees of an urban hospital system during the first wave of the H1N1 pandemic flu, researchers said.

In a single-institution study using medical and administrative records, the adult emergency department had an H1N1 infection rate of 28.8% during April, May, and June of 2009, according to Robert Bristow, MD, and colleagues at New …

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Healthcare workers in the ER hit hard by H1N1

Real world meaningful use of health IT for physicians

Health Technology
April 13, 2010

by David C. Kibbe, MD, MBA

An article in the April 10, 2010 New York Times entitled “Doctors and Patients, Lost in Paperwork,” brought attention to what may be, in the near term, the Achilles heel of the plan to incentivize doctors for the “meaningful use of EHR technology.”

The article cited a study published in the Archives of Internal Medicine this past February, which asked a large cohort of physicians in …

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Real world meaningful use of health IT for physicians

Neosporin and other OTC drugs to avoid

Medications
April 12, 2010

Most people use non-prescription medications without giving much thought to the potential side effects or problems that may be associated with their use.

Here are 5 popular OTC meds you should avoid, and better alternatives. I bet most of you use one or more of these. Neosporin, Topical Vitamin E, Afrin nasal spray (or other short acting nasal decongestant sprays), daily headache medications, and sedating antihistamines.

1. Neosporin: Neosporin in the most …

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Neosporin and other OTC drugs to avoid

Emergency departments are frequently used by young adults

Physician
April 12, 2010

by Kristina Fiore

Twenty-somethings rely on emergency departments (EDs) for care far more than do other age groups, researchers have found.

In 2006, nearly a quarter of all young adult healthcare visits — 22.1% — took place at an ED, compared with 12.6% for children and adolescents and 8.3% for patients over 30.

That rate has significantly increased over a 10-year period, Robert J. Fortuna, MD, MPH, of the University of Rochester Medical …

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Emergency departments are frequently used by young adults

iPad review for doctors: A hands on guide for medicine

Health Technology
April 12, 2010

The iPad has finally been released and we’ve got our hands on one so we can provide the medical community a healthcare perspective of the device.  Here are my initial impressions.

Fits in your white coat

The iPad should fit comfortably your white coat.  If you continue on to the rest of the review you’ll see pictures of the device easily settling into …

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iPad review for doctors: A hands on guide for medicine

iPhone medical apps may be medical malpractice targets

Health Technology
April 11, 2010

Medical practice is a big business. Conservative estimates put the total cost of medical malpractice at nearly $35 billion annually and, according to a Kaiser Family Foundation report, nearly $5 billion is paid in claims each year. With an average claims payment of about $300,000 and up to 50% of that going to the lawyers representing the patient, its not surprising that practically every show on cable television has at …

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iPhone medical apps may be medical malpractice targets

Flu may be associated with seasonal deficiency of vitamin D

Conditions and Diseases
April 11, 2010

by Michael Smith

If you look at the world map, the shapes of South America and Africa look as though they should fit together. Maybe they were once together and then drifted apart.

That theory was first put forward in the late 1500s by a Dutch map maker, but it wasn’t until the 1960s that the discovery of plate tectonics finally put the idea on a — well, …

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Flu may be associated with seasonal deficiency of vitamin D

Can house calls be revived under health reform?

Physician
April 11, 2010

Beginning in the 1970s, the house call began a slow death. As the medical-industrial complex (MIC) burgeoned, with bigger hospitals and a surfeit of technology, it became incumbent on patients to come see us rather than us going to see you.

Yet there are pockets of house calls still left in the U.S.

For the geriatric age group, there has been growth in the care-at-home sector, especially for homebound elders. They can …

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Can house calls be revived under health reform?

Statistical analysis in medical journals should be unbiased

Medications
April 10, 2010

by Todd Neale

Editors of medical journals should unite in requiring independent statistical analyses of industry-sponsored clinical trials, according to the two top editors of the Journal of the American Medical Association.

Such a measure would help prevent any inappropriate influence from the study sponsors on data analysis and reporting, wrote Catherine DeAngelis, MD, MPH, editor-in-chief of JAMA, and Phil Fontanarosa, MD, MBA, executive deputy editor …

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Statistical analysis in medical journals should be unbiased

Cell phone use and driving requires attention that few have

Conditions and Diseases
April 10, 2010

by Crystal Phend

Only one person in 40 has an extraordinary ability to do safely what many take for granted in daily life — talk on a cell phone while driving.

These “supertaskers” excelled on a simulated driving exercise and a demanding, simultaneous test of memory and math skills conducted over the phone without any loss in performance on either, according to Jason M. Watson, PhD, and David L. Strayer, PhD, both …

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Cell phone use and driving requires attention that few have

Op-ed: Patient satisfaction doesn’t mean the best medical care

Physician
April 10, 2010

A version of this op-ed was published on March 15th, 2010 in the USA Today.

If you recently saw a doctor, you might subsequently receive a survey in the mail asking whether your physician was friendly, spent enough time with you, or showed the appropriate level of concern for your medical issues.

Patient satisfaction surveys are being increasingly used in hospitals nationwide. Press Ganey, a leading organization measuring patient satisfaction, counts more …

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Op-ed: Patient satisfaction doesn’t mean the best medical care

Children who are traumatized need more than medication

Medications
April 9, 2010

In the Academy Award winning film, Precious, the main character’s transformation comes about largely through her ability to tell the story of her trauma, specifically in the form of writing. In this endeavor she is encouraged by a loving teacher.

In the book History Beyond Trauma, two French psychoanalysts argue that symptoms their patients exhibit represent the horrors of war that are not spoken of, sometimes for generations. The patient is …

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Children who are traumatized need more than medication

Patient beliefs and their role in non-adherence

Patient
April 9, 2010

Patient non-adherence is a big problem. Non-adherence among chronic disease patients is associated with higher rates of hospital re-admissions, higher costs and poorer outcomes.

Research has identified over 200 possible factors thought to influence patient adherence. According to the experts, these factors can be categorized into two groups:

1. unintentional non-adherence
2. intentional non-adherence.

Unintentional non-adherence is related to a patient’s ability and resources to take their medication (e.g., problems with manual …

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Patient beliefs and their role in non-adherence

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Retail clinics are starting to do more primary care

Physician
April 9, 2010

by Joyce Frieden

Retail clinics aren’t just for strep throats any more; they’ll also be managing diabetes and other chronic diseases.

“It’s a new service strategy,” Sandra Ryan, CPNP, told attendees at a meeting on retail clinics sponsored by the Convenient Care Association and the Jefferson School of Population Health.

“We’re evolving our clinic offerings,” said Ryan, chief nurse practitioner officer for Take Care Health Systems, which operates retail clinics inside Walgreens pharmacies, …

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Retail clinics are starting to do more primary care

AMA: Health reform victories for physicians and what still needs to be done

Health Policy
April 8, 2010

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

by J. James Rohack, MD

As our country turns the corner on the historic path toward health system reform, many physicians are left with questions as to how this new law will affect them and their patients.

The AMA has been an active participant in the health reform debate since …

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AMA: Health reform victories for physicians and what still needs to be done

Medicine residency survival tips during pregnancy

Medical Education
April 8, 2010

by Dr. Whoo, MD

Q. I just found out last week that I’ll be a new mom in November, making me an official mother in medicine! I’ve been reading the blog for a while, because I love hearing what all of you have to say about your lives. Here’s my question: What tips would you give for surviving residency while pregnant, especially 30-hour calls (without caffeine)?

— From a future mom and …

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Medicine residency survival tips during pregnancy

Advance planning helps families cope with loss

Patient
April 8, 2010

by Crystal Phend

Advance planning improves end-of-life care for elderly patients and helps families cope with the loss, researchers found.

In a randomized trial, hospitalized patients over age 80 who were formally assisted with documenting their end-of-life treatment wishes and with designating a surrogate were almost three times more likely to have those wishes followed (86% versus 30% in usual care, P<0.001).

Family members of patients in the advance planning intervention reported significantly …

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Advance planning helps families cope with loss

Preventive medicine may not always help patients

Physician
April 8, 2010

If there’s one thing everyone agrees on, it’s that preventive care is always a good thing. Well, I’m a doctor and I’m afraid of preventive medicine.

The theory behind preventive medicine is sound. It is better to treat prevent disease than to treat it. It is better to refrain from smoking and never get lung cancer than it is to treat lung cancer. It is better to refrain from alcohol abuse …

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Preventive medicine may not always help patients

Psychiatry benefits when psychologists prescribe drugs

Medications
April 7, 2010

I want to touch on what is probably the hottest topic in psychiatry: whether psychologists should obtain prescription privileges. This is topical because Oregon just overwhelmingly passed a law authorizing prescriptive privileges for psychologists, although it is unclear whether the governor will sign the bill.

I endorse psychologists prescribing, and here’s why: it would be the single best thing that could happen to psychiatry.

Yes, I know it sounds ridiculous, but …

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Psychiatry benefits when psychologists prescribe drugs

Epidemiology and how confounding statistics can confuse

Conditions and Diseases
April 7, 2010

Now, as you know, I am a big fan of epidemiology. I do not believe that a randomized controlled trial is the be-all-and-end-all in evidence generation, and a well done observational study can add to our reservoir of knowledge much more efficiently. Of course, I, as many others, acknowledge certain limitations of epidemiologic design. However, many of them can be overcome with careful design and analysis.

I have to confess, though, …

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Epidemiology and how confounding statistics can confuse

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