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The Haiti earthquake damage to hospitals and health care infrastructure

Kevin

Physician

January 13, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

The powerful earthquake that hammered Haiti Tuesday afternoon has left healthcare in the impoverished Caribbean nation in even worse shape than before.

Several hospitals have been seriously damaged and others are swamped by casualties from the magnitude 7.0 quake.

“We are seeing wave after wave of vehicles coming from the Port-au-Prince …

Why physician practices find it difficult to upgrade their computers to Windows 7

Kevin

Health Technology

January 13, 2010

Originally published in HCPLive.com

by Jonathan Bertman, MD

I recently talked about Microsoft’s newest desktop operating system, Windows 7, and outlined several reasons why you might want to purchase it when it comes out this year. Windows 7 will include some really cool features—like multi-touch technology and usability improvements—that can benefit medical practitioners and their office staff.

Because it is in Microsoft’s best interest …

The history of Medicare and its influence on American health care

Kevin

Health Policy

January 13, 2010

Originally published on MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

As Congress stands poised to make the most sweeping change to the U.S. healthcare system since the creation of Medicare, a look back at the incremental growth in that program may serve as a harbinger for the progress of healthcare reform.

The program — which provides insurance for some 43 million …

Why doctors in the United States order so many CT scans and MRI tests

Kevin

Conditions and Diseases

January 13, 2010

It’s commonly thought that health care in the United States is heavily dependent on diagnostic testing.

But how do we compare with the rest of the world? Perhaps these graphs, courtesy of the New York Times can provide a stark illustration.

Here’s the data regarding CT scans, showing the number of tests per 1,000 people. Guess which country’s on top:

Why I had to fire my primary care doctor

Susan Giurleo, PhD

Physician

January 12, 2010

I like my PCP. She is knowledgeable, kind, efficient, and trusts that I know my body best. All great qualities in a doctor.

But I need to fire her and find someone new. Why? Her support staff and their administrative systems don’t work for me. They make it difficult for me to access timely care and I dislike that very much.

Some background: I rarely visit the doctor. Overall, I’m healthy and …

Protecting the security of electronic patient data

David Harlow

Health Technology

January 12, 2010

Originally published on HCPLive.com

If your patient records aren’t already stored digitally, they are likely to be digitized soon. There is a tremendous push by the federal government—as well as by some private payors and self-insured employers—to get all healthcare providers wired in the near future, in order to better coordinate patient care, improve outcomes, and “bend the cost curve” all at the same time. There are some financial incentives in …

How sleeping late can lead to depression in teenagers

Kevin

Conditions and Diseases

January 12, 2010

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Later parent-set bedtimes and correspondingly shorter sleep durations appear to be related to the development of depression in adolescents, a cross-sectional analysis showed.

In addition to depression, adolescents with later bedtimes also had a greater risk of having suicidal thoughts, James Gangwisch, PhD, of Columbia University in New York City, and …

National Influenza Vaccination Week: Time to take stock of our influenza vaccination efforts

Kevin

Conditions and Diseases

January 11, 2010

The following is part of a series of original guest columns by the American Medical Association.

by Nancy H. Nielsen, MD

Back in September, I wrote in this space about ways physicians can prepare their practices to handle this challenging flu season and mentioned the importance of vaccination for all health care professionals. Today as National Influenza Vaccination Week begins, this is an excellent opportunity to remind ourselves, …

The American College of Cardiology (ACC) sues Medicare over physician rate cuts

Kevin

Health Policy

January 11, 2010

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

The American College of Cardiology (ACC) has filed suit against U.S. Department of Health and Human Services Secretary Kathleen Sebelius charging that the 2010 Medicare Physician Fee Schedule was adopted unlawfully.

The complaint seeks an injunction that will prevent the cuts — which the association claims used a flawed survey for …

Cardiologists discuss how far myocardial infarction management has come

Kevin

Medications

January 10, 2010

Originally published in MedPage Today

by Peggy Peck, MedPage Today Executive Editor

“What we did for patients with acute MI was place them in a cool, dark place. Give them morphine for pain and lidocaine to prevent arrhythmias and hope for the best.”

The speaker is Steven Nissen, MD, director of Cardiovascular Medicine at the Cleveland Clinic. He is describing standard care 25 …

Is erectile dysfunction associated with restless leg syndrome?

Kevin

Conditions and Diseases

January 9, 2010

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Men with restless leg syndrome (RLS) had a significantly increased risk of erectile dysfunction compared with men who did not have the neurologic disorder, data from a large cohort study showed.

The likelihood of erectile dysfunction increased with the frequency of restless leg episodes, reaching an adjusted risk apex about …

Op-ed: Ways to make primary care the key to health reform

Kevin

Health Policy

January 9, 2010

The following op-ed, co-written with Rahul Parikh, was published on December 16th, 2009 in CNN.com.

America is closer to meaningful health care reform than at any time in its history. As we have all witnessed, finding a way to both provide every American access to affordable health care while seeking to control health care costs has not been easy.

Many of the proposed solutions have led to sharp disagreements, with contention …

How a psychiatrist can write 100,000 prescriptions a year, and what that means for primary care

Matthew Mintz, MD

Physician

January 8, 2010

The Miami Herald is reporting an investigation of a psychiatrist who wrote almost 100,000 prescriptions a year. Sen. Grassley and the feds have halted payment to this Miami psychiatrist who stated that “he prescribes only what is medically necessary” and “works long hours, seeing patients for 10 minutes at a time and many of his patients need four or five medications.”

I have no personal knowledge, interaction, acquaintance with psychiatrist Dr. …

How similar is pandemic H1N1 influenza to the seasonal flu?

Kevin

Conditions and Diseases

January 8, 2010

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Pandemic H1N1 influenza behaved much like seasonal and previous pandemic flu viruses in an early, isolated outbreak at a New York City high school, researchers found.

Natural history and transmissibility characteristics were similar in an April outbreak that sickened about 800 students and staff members, according to Justin Lessler, PhD, …

Linking the USPSTF mammogram guidelines to their virtual colonoscopy recommendations

Kevin

Conditions and Diseases

January 7, 2010

by Mark E. Klein, MD

“I think anytime you use science to kind of fundamentally change what people are used to, I think it’s a difficult thing to grapple with.” So spoke Ned Calonge, chair of the United States Preventive Services Task Force (USPSTF) in explaining the reaction to that group’s recommendation to radically alter their previous guidelines for breast cancer screening. Regrettably the incorrect application of science, as in …

Doctors owe their patients some fiduciary responsibility

Kevin

Physician

January 7, 2010

Originally published in HCPLive.com

by Jeff Brown, MD

Fiduciary responsibility is the obligation for people entrusted with financial affairs to act in their client’s best interest, theoretically being both transparent in their dealings and accountable for them. Typically, this applies to CPAs, lawyers, financial advisers and the like. Would that it were also true for our legislators, but that’s a story for another day. To the point, physicians do not usually think …

How effective is CA 125 and other biomarkers to screen for ovarian cancer?

Kevin

Conditions and Diseases

January 7, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Rising blood levels of several biomarkers show the presence of ovarian cancer — just not early enough.

That’s the conclusion of a retrospective longitudinal case-control study of levels of half a dozen proteins linked to the disease, according to Garnet Anderson, PhD, of the Fred Hutchinson Cancer Research Center in …

The story behind a whistleblower doctor license reinstatement hearing

David K. Cundiff, MD

Physician

January 6, 2010

After the LA County + USC Medical Center closed my Pain and Palliative Care Service because of budget cuts in 1995, I spoke out publicly about the dysfunctional financial reimbursement system funding charity care in LA County.

For example, when my consultation service controlled the pain and distressing symptoms of over 400 terminally ill cancer and AIDS patients per year and discharged them to home hospice programs, the hospital lost about …

Despite no cure, progress in the treatment of HIV/AIDS

Kevin

Conditions and Diseases

January 6, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

It’s 1984. A 20-year-old homosexual man walks into the clinic complaining of swollen glands.

It could well be a death sentence.

It is only three years since the first handful of cases of what would come to be known as acquired immune deficiency syndrome (AIDS) were described. Little is known about …

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