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Teaching patient safety starts in medical school

David Harlow

Physician

March 31, 2010

Ten years after the release of the IOM report To Err is Human, which documented the toll taken by medical errors in this country, the question remains: What can be done to reverse the trend of ever-increasing morbidity and mortality due to medical errors?

Last December, a look back over the decade since the release of To Err is Human — and a steady medical error death rate of about …

Sex habits of older women and men

Kevin

Patient

March 31, 2010

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Thirty-somethings can expect to enjoy at least another 30 years of sex, researchers have found.

At age 30, men will be sexually active for another 35 years, while women will be active for another 30, Stacy Tessler Lindau, MD, and Natalia Gavrilova, PhD, of the University of Chicago, reported online …

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Sex habits of older women and men

Radiology tests, and how to find their price

Leslie Ramirez, MD

Conditions and Diseases

March 30, 2010

I am often asked how we get the prices for the radiology imaging tests, such as MRI’s and mammograms, or ultrasounds. Most people assume that my day job as a doc gives me some sort of special access to this info. But that’s just not the case. Anyone can find out testing prices.

However, over the last year, those of us working at LesliesList.org have gotten more experienced and better at …

Drug companies are using community doctors for dinner talks

Kevin

Medications

March 30, 2010

Originally published in MedPage Today

by John Fauber, Milwaukee Journal Sentinel/MedPage Today Reporter

When looking for a doctor to travel the country to promote its prescription fish oil product, a leading pharmaceutical company looked to a small-town community doctor rather than an academic heavyweight.

Its choice was a Delafield, Wis., primary care physician and clinical lipidologist who entered private practice in 2001.

For speaking …

Primary care is the loss leader of medicine

Kevin

Physician

March 30, 2010

Medicare’s sustainable growth rate, or SGR, has been the bane of doctors for years now.

To encapsulate, this is the reason for Medicare’s annual threat to cut doctors’ fees by 20% or more, only to be staved off at the last minute.

Emergency physician Shadowfax has a nice take on it, explaining why it has devastated primary care:

Primary care has many fixed expenses in addition to those we bear: they pay …

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Primary care is the loss leader of medicine

Oxycontin should be prescribed less often by doctors

Edward Pullen, MD

Medications

March 29, 2010

Oxycontin is an oral pain medication that contains the single active ingredient oxycodone. Oxycodone is one of the most potent of the oral opiates, and has more euphoric effect than many other opiate analgesics.

Oxycontin is the most notorious prescription drug of abuse in the US, and for good reason. Though marketed as a sustained release medication, as much as 30% of the medication is absorbed immediately and the rest absorbed …

Why healthcare may not embrace the iPad

Kevin

Health Technology

March 29, 2010

The excitement and hype surrounding the announcement of Apple’s iPad have subsided for the time being, perhaps just a lull prior to the actual release in a few months. It’s expected that the iPad could make significant contributions to healthcare, such as potentially replacing the physician’s clipboard or medical textbooks.

However, we did disagree at times on the extent to which the iPad could penetrate the healthcare market, for a variety …

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Why healthcare may not embrace the iPad

Diet Coke and the AHA red dress endorsement

Kevin

Medical Education

March 29, 2010

Originally published in MedPage Today

by Peggy Peck, MedPage Today Executive Editor

A red dress jauntily displayed on cans of Diet Coke has become the latest symbol in the ongoing debate about pharmaceutical company support of research or CME.

But whose dress is it? The American Heart Association says it’s “not our red dress,” even as leading pharma critic Steven Nissen, MD, …

Jargon dominates medicine and how doctors verbalize nouns

Robert Wachter, MD

Physician

March 28, 2010

One of my interns was “running the list” with me last week (giving me a thumbnail update on the plans for each of our inpatients). It was standard stuff until he got to Ms. X, a 80ish-year-old woman admitted with urosepsis who was now ready for discharge. “I stopped her antibiotics, advanced her diet, called her daughter, and YoJo’ed her.”

Say whaa?

I’m pretty sure that the most valuable thing I’ve done …

Death in a hospital is not always comfortable

John Schumann, MD

Physician

March 28, 2010

In America, too many people die in the hospital.

I don’t mean that they die due to medical error or incompetence, though that’s always a hot topic of discussion amongst doctors, researchers, administrators, and regulators.

What I mean is that if you ask most people, they say they’d rather die at home, surrounded by their loved ones, drifting off to sleep painlessly after having had last rites administered (feel free to plug …

Patient questions during doctor visits are uncommon

Steve Wilkins, MPH

Patient

March 27, 2010

Ask your doctor. I think most of us would agree that is good advice, at least up to the point that we find ourselves sitting half naked on an exam table in our doctor’s office. Then the doctor walks in and for some reason many of us just “clam up.”

Patient question-asking during the primary care office visit was and continues to be an “index” of patient health information …

Guilt used in a positive manner can help with parenting

Claudia M. Gold, MD

Patient

March 27, 2010

In my pediatric practice, it is not uncommon for a mother, given the time, to move quickly away from telling me about her child’s behavior problem, to talk about herself, sharing vivid stories of emotional distress from her own life. I may suggest that this distress could make it difficult for her to deal with the challenging behavior of her child.

Rather than finding this statement helpful, she might collapse back …

Primary care access isn’t guaranteed by health insurance

Matthew Mintz, MD

Physician

March 26, 2010

An excellent article appeared recently in the Washington Post, entitled, “Having health insurance doesn’t ensure it will be easy to find a doctor,” where a young, otherwise healthy and insured woman discusses her extreme difficulty in finding a doctor in Washington, DC who will see her.

“I was just 23, basically healthy and, most important, insured. So I pulled out my computer, looked up the UnitedHealthcare list of pre-approved doctors …

10 salt reducing tips that can lower your blood pressure

Erin Marcus, MD

Patient

March 26, 2010

It’s hard for Cassandra Mathieu to describe her mother’s cooking without mentioning the salt shaker.

“I remember my mother used to cook with seasoning salt, garlic salt, every kind of salt you can imagine,” she said recently. “We grew up on salt.”

Cassandra grew up fixing food the same way, adding generous amounts of salt to dishes she prepared and to her food at the table. At age 42, she discovered her …

Cancer deaths are improving, but a cure remains distant

Kevin

Conditions and Diseases

March 26, 2010

Originally published in MedPage Today

by Joyce Frieden, MedPage Today News Editor

Almost 40 years and 100 billion federal dollars have been invested in the “War On Cancer” since President Richard M. Nixon declared it, but the campaign is far from over, two researchers concluded this week in the Journal of the American Medical Association.

“These funds have been more than matched by …

VBAC rates are low, but are obstetricians to blame?

Kenneth Lin, MD

Conditions and Diseases

March 25, 2010

My daughter, who turns two years old in June, is becoming something of a medical rarity. This isn’t because she is showing signs of a late-developing handicap or extraordinary ability for her age – it’s because she came into the world as a vaginal birth after Cesarean section (VBAC), delivered by a certified nurse midwife.

Although more than three-quarters of women who choose a trial of labor over a repeat Cesarean …

VBAC should not be a woman’s right

Amy Tuteur, MD

Conditions and Diseases

March 25, 2010

VBAC activists are clinging to their resentment and aggressively ignoring reality.

Amy Romano at Science & Sensibility asks the bizarre question: Do women need to know the uterine rupture rate to make informed choices about VBAC? It’s bizarre because she implies that this is a medical question and that the answer is unknown. However, this is a legal question and the answer has been clearly established by the courts. Not …

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VBAC should not be a woman’s right

Cancer side effects are being ignored by the media

Kevin

Conditions and Diseases

March 25, 2010

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

When the mainstream media report on cancer treatments, they seldom note that aggressive therapies may fail or cause severe side effects, researchers said.

Analyzing more than 400 articles about cancer in major newspapers and magazines, investigators at the University of Pennsylvania found that adverse outcomes or palliative care were hardly …

Government-controlled health insurance may politicize health

Paul Hsieh, MD

Health Policy

March 25, 2010

During President Obama’s final push for “universal health care” legislation, his biggest obstacle was not Republicans but rather anti-abortion Democrats let by Congressman Bart Stupak (D-Michigan).

Stupak eventually reached a last-minute deal with the White House on federal funding of abortion services. But no one should be surprised that under government-controlled health insurance, medical coverage decisions will be based on political considerations. Rather, the recent wrangling over abortion will be …

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