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Public hospitals are the unsung jewels of our healthcare system

Physician

January 5, 2010

Public hospitals have a bad rap. They’re viewed by many as hospitals of last resort, and most patients with private insurance do anything to avoid them.

As a long-time physician in a public hospital, I’m sensitive to this reputation. I wouldn’t work in my hospital if I didn’t feel that it delivered excellent health care. I’m certainly aware that private hospitals have amenities that public hospitals can’t afford, but many of …

Will physician and hospital penalties improve patient care?

Kevin

Health Policy

January 5, 2010

Originally published in HCPLive.com

by Alan Berkenwald, MD

In 1904, the Scottish author Sir James Matthew Barrie sent Peter Pan off to Never-Never Land to escape growing up and to enjoy many-many adventures. As children, we all hoped it really existed. In truth, many of us fantasized, one day, to make the trip ourselves.

Well, good news for physicians – that day has arrived!

How patients are dying from H1N1 infection

Kevin

Conditions and Diseases

January 5, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Brazilian researchers have found three distinct patterns of lung damage in patients who died of the H1N1 pandemic flu.

They also found evidence of a so-called “cytokine storm,” a runaway immune response associated with the lung damage, according to Thais Mauad, MD, PhD, of Sao Paulo University Medical School, …

How can medical guidelines be immune from politics?

Marya Zilberberg, MD, MPH

Conditions and Diseases

January 4, 2010

The recent uproar over the new screening mammography recommendations got me thinking about a lot of stuff. One of the lessons cited by some journalists and pundits is on how potentially volatile information should be presented to the public. The USPSTF was excoriated by critics not only for what it said, but how it said it. While the objections over the former can be dismissed as ravings of loud and …

What’s the most popular way to diagnose a pulmonary embolism?

Kevin

Conditions and Diseases

January 4, 2010

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Emergency physicians and radiologists overwhelmingly choose computed tomography (CT) imaging to diagnose pulmonary embolism, a potentially deadly blockage of lung arteries, a new study found.

Ninety percent of radiologists and 96% of emergency physicians use CT as their first-line choice for the diagnosis of pulmonary embolism, according to a report …

How women can benefit from oral contraceptive pills

Kevin

Medications

December 31, 2009

Originally posted in MedPage Today

by Nancy Walsh, MedPage Today Contributing Writer

Hormonal contraceptives have a variety of noncontraceptive uses, ranging from common problems such as dysmenorrhea to severe conditions such as premenstrual dysphoric disorder, according to a new practice bulletin from the American College of Obstetricians and Gynecologists (ACOG).

“Combined hormonal contraceptives can correct menstrual irregularities resulting from oligo-ovulation or anovulation and …

How to tell a family that their loved one has died

Kevin

Patient

December 30, 2009

by Tim Noonan

When a team misses out on an opportunity to go to the Super Bowl, World Series, Final Four, or something similarly trivial, these words may be appropriate. When the person, who has been the center of your life dies, what is more insensitive than, We’re sorry for your loss?

What kind of language is that to use when providing some of the worst news we could imagine? True, we …

Why are women refusing an MRI to screen for breast cancer?

Kevin

Conditions and Diseases

December 30, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Many women at elevated breast cancer risk may refuse MRI as part of their screening program, largely because of fear and inconvenience, researchers found.

Among eligible women with dense breasts who were at intermediate to high risk for breast cancer, 42.1% refused additional MRI screening as part of a …

How to find the best cancer specialist for you

Kevin

Conditions and Diseases

December 29, 2009

by Dana Griffen

Receiving a cancer diagnosis is an upsetting experience for the patient, as well as his or her family and friends. Cancer patients are thrust into a new world with new language and new rules. Knowing where to turn and who you can trust is a huge concern.

One of the first things a cancer patient will discover is that he or she will not be treated by only one …

A cockpit checklist to improve patient safety

Kevin

Physician

December 29, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Medical teams should take a lesson from airplane crews, a new study concludes.

Medical personnel who used procedural checklists modeled after preflight checklists used by airplane crews were more likely to report safety-related incidents and feel empowered to address safety issues, according to an online report in the Dec. 21 …

Smoking related diseases are the number one cause of death in African-Americans

Erin Marcus, MD

Conditions and Diseases

December 28, 2009

Lawrence Jones started smoking Kool Menthols when he was playing Rhythm and Blues in the ‘70s, as a way of fitting in with his bandmates and the in crowd at the clubs where he played.

The band broke up after a few years, but the cigarettes remained. Instead of being a way to look sophisticated, smoking became a means for Jones to relax and, he says, to feel he was “in …

Issues surrounding videotaping surgeries in the operating room

Dr. Martin Young

Physician

December 23, 2009

The rapid advance in digital video and still camera technology has found its way into the operating room.

There is the potential to capture and record just about every minute of every surgical procedure in some way. The newest endoscopic camera systems and operating microscopes have integrated systems to record video footage. Storing all that data is just the press of a button away.

The advantages for surgeons are obvious, like the …

A review of the latest stroke studies

Kevin

Conditions and Diseases

December 23, 2009

Originally published in HCPLive.com

by Victor G. Dostrow, MD

There are some recent developments in the world of stroke, which are interesting:

The first manuscript is an evaluation of stroke risk and the “stroke belt” (North Carolina, South Carolina, Georgia, Tennessee, Arkansas, Mississippi, or Alabama).

The authors evaluated stroke risk measured over three decade census intervals for persons aged 30 to 80, based on …

Read more…

A review of the latest stroke studies

How constant H1N1 breaking news updates may be going too far

Jeffrey Hall Dobken, MD, MPH

Conditions and Diseases

December 23, 2009

Originally posted in MedPage Today

She is 11, a fifth grader, as prepubescent as nature allows, and utterly terrified.

She hasn’t eaten normally for nearly a month, her mother reports. She sleeps poorly, reports nightmares, and cleans her hands so obsessively that she is literally bleeding raw.

Her fifth grade peer group typically does not guard its language nor govern its remarks, …

10 ways patients can save on health care costs

Richard Reece, MD

Patient

December 22, 2009

It’s beginning to look like health care consumers are going to have to take lowering health care into their own hands since no answers are coming down from above.

Here are ten tips for lowering your costs.

One, encourage your employer to offer a health savings account with a high deductible. Encourage the employer to pay half the deductible. Your premiums will be much lower, and your employer will save up to …

How doctors can afford to have a vacation

Kevin

Physician

December 22, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

Now this is a fun topic. I’ve always liked writing, “For a vacation” on a script pad for those stressed out patients who need to go on one. Even a weekend away, or in this economy, a “staycation.” It’s good for the soul. And it’s a good use of medical authority to help your patients.

…

How medication mistakes happen in the hospital

Kevin

Medications

December 22, 2009

Originally published in MedPage Today

by Katrina Woznicki, MedPage Today Contributing Writer

Hospitalized patients were often clueless when asked about their medications, with almost all of them unable to name all their medications and many leaving out as many as a half-dozen drugs they have been prescribed, according to a small survey of patients in a Colorado hospital.

Ninety-six percent of the …

Would I vote for the Senate healthcare bill? Here’s where I stand on reform

Kevin

Health Policy

December 21, 2009

Now that the Senate health care bill is nearing its home stretch, some are wondering if I continue to support reform.

As a reminder, I wrote back in July that doctors should support Congress’ health care reform efforts, because, “some reform is better than none, and doctors advocating for a free market-based system shouldn’t hold out, hoping for the perfect package.”

There were deuling columns in last Friday’s New York Times, …

Is the end of pandemic H1N1 flu near?

Kevin

Conditions and Diseases

December 20, 2009

Originally posted in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

The end of the so-called second wave of pandemic H1N1 influenza may be in sight as testing rates — and the number of positive tests for the virus — show evidence of decline across the country, a report affirmed.

From their peak in late October, diagnostic H1N1 testing rates …

Read more…

Is the end of pandemic H1N1 flu near?

How only lawyers can determine medical standard of care

Michael Kirsch, MD

Physician

December 20, 2009

by Michael Kirsch, MD

A medical malpractice case was recently filed against me.

I received the thick envelope from noble and altruistic Cleveland barristers about 6 weeks ago. Once again, I saw my name in the good company of many other physicians and our local hospital. I reviewed my medical records and felt comfortable with the care I had provided. In a medical malpractice case, quality of medical care is important, …

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