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Should body mass index (BMI) be used as a college graduation requirement?

Amy Tuteur, MD

Conditions and Diseases

December 10, 2009

It’s official. America hates fat people.

Human beings are constantly searching for socially sanctioned reasons to feel superior to others and in 2009, those who are thin feel mighty superior to those who are not. How else could a college dare to make body mass index (BMI) a graduation requirement?

According to James DeBoy, the chair of Lincoln’s Department of Health, Physical Education, and Recreation, the point of the new policy is …

Will electronic records raise the legal standard of care and increase malpractice risk?

Kevin

Physician

December 10, 2009

Originally published in HCPLive.com

by Robert J. Mintz, JD

As EHRs are widely adopted and the quantity of information about a patient expands dramatically, does provider liability increase even if the quality of care is vastly improved?

What happens if the quality of care really does get better but because of all the new and easily accessible information, the standard of care for …

How well can doctors diagnose child abuse from bone fractures?

Kevin

Conditions and Diseases

December 10, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Physicians often misdiagnose bone fractures caused by child abuse as accidental breaks, particularly if the child is male and the doctor is not a pediatrician, a new study found.

Of children who suffered fractures from abuse, about 20% had at least one previous medical visit during which a doctor missed …

Does smoking or obesity affect life expectancy more?

Kevin

Conditions and Diseases

December 9, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Gains in life expectancy from lower smoking rates over the next decade will be offset, to some degree, by reductions in life expectancy based on the rise in obesity, researchers estimated.

If obesity and smoking rates had held steady, the average 18-year-old would have seen a 2.98-year increase in …

Why the fear of cancer undermines the new mammography guidelines

Lucy Hornstein, MD

Conditions and Diseases

December 8, 2009

Fear is such a powerful emotion, humans will do almost anything to relieve it. The most effective way to control fear is to manage whatever it is we’re afraid of. Night lights against the monsters under the bed; locks on the doors and a handgun under the pillow to fend off intruders; annual mammograms and PSAs to keep us from dying of cancer. Although all these things may relieve fear …

How health IT can bankrupt healthcare

Kevin

Health Technology

December 8, 2009

Originally published in HCPLive.com

by Alberto Borges, MD

For those interested in health information technology, there is now an excellent, new, powerful article about this topic entitled, “Can Cleveland Clinic Be a Model for Digital Medicine?” where they discuss how this hospital system has failed to recoup their $100 million investment to date.

Here is my take on the Cleveland Clinic story, beyond the …

Read more…

How health IT can bankrupt healthcare

NFL football players with concussions may need independent neurologists to clear them

Kevin

Conditions and Diseases

December 8, 2009

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Responding to growing concern over concussions suffered by professional football players, the National Football League may soon require teams to seek opinions from independent neurologists before allowing head-injured players back on the field.

League officials have not confirmed the plan, but reports in The New York Times, the Associated Press, FOXSports.com, …

The inpatient, outpatient divide in patient care today

Helen Kao, MD

Physician

December 7, 2009

As the health reform debates continue, I am struck by the lack of attention to what seems to be a critical issue in poor health care delivery.

With the technologizing of medicine (and more recently the hospitalist “movement”), delivery of health care has come to be centralized around acute care hospitals. Over time, patient care has been divided into acute inpatient care and ‘ambulatory’ outpatient care. While transitions of care, hospital-at-home, …

Why it’s important to brand your medical practice

Kevin

Physician

December 7, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

You might be thinking, “Why should I consider branding or marketing?” And your reasoning might go something like this:

1. As a doctor, I already have a powerful, built-in identity;
2. My practice is full;
3. Even if my practice isn’t full, Congress is in the process of putting 40 million more insured people into the available patient pool over the next few years.

Radiologists don’t agree with the USPSTF breast cancer mammogram screening guidelines

Kevin

Conditions and Diseases

December 7, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Radiologists have rejected revised mammography guidelines from the U.S. Preventive Services Task Force (USPSTF), arguing that they are not backed by scientific evidence and will lead to unnecessary deaths.

Under the revised guidelines, “screening will begin too late and its effects will be too little,” said Stephen A. Feig, MD, of …

Should medicine be efficient in the business sense?

Marya Zilberberg, MD, MPH

Health Policy

December 6, 2009

When we talk about efficiency in the business world, we are basically talking about getting as much profit as possible. This profit is wrung out of the system by reducing production costs to the maximum extent possible and by charging the top price that the market allows.

Some of the ways in which the US companies have increased their efficiencies over the last 30 years are, 1) by moving manufacturing to …

Do chest x-rays and mammograms increase the risk of breast cancer in young women?

Kevin

Conditions and Diseases

December 5, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Some women already at high risk of breast cancer should be cautious about having mammography or chest x-rays before the age of 30 because the imaging may increase the risk of developing the disease, researchers here said.

Five or more x-rays, or any exposure to ionizing radiation before age 20, …

Previous influenza exposure can protect against the H1N1 flu

Kevin

Conditions and Diseases

December 4, 2009

by Bruce Goldman

People of a certain age have been known to complain that, while they lucidly recall the details of childhood events, they can’t remember what they ate for breakfast.

As it is with brains, so it may be with immune systems. Older people’s immune responses, while generally somewhat sluggish in revving up after, say, a vaccine against seasonal influenza, seem to retain a knack for fending off the current H1N1 …

An oncologist takes on the recent breast and cervical cancer screening controversy

Don S. Dizon, MD

Conditions and Diseases

December 4, 2009

Recently, two groups released new guidelines that may affect breast cancer and cervical screening in women.

The US Preventive Services Task Force (USPSTF) recommended against screening women in their 40s and to screen women every other year starting at age 50. The USPSTF left room for individualized screening, particularly in the presence of risk factors such as family history. Still, it is …

Low pay for diabetes care harms patients

Kevin

Conditions and Diseases

December 4, 2009

Originally posted in MedPage Today

by John Gever, MedPage Today Senior Editor

Almost one-third of doctors in an industry-sponsored survey said they didn’t spend enough time with their diabetic patients and blamed low reimbursement rates for diabetes care, researchers said.

In a survey of 200 primary care physicians and 100 endocrinologists, 32% reported an inability to provide comprehensive diabetes care, Alyssa Pozniak, …

iPhone medical apps can be improved by Google Android

Kevin

Health Technology

December 3, 2009

by Felasfa Wodajo, MD

In a recent post, entitled, Why doctors should choose Google Android over the iPhone for medical apps, the author seems to have gone out of his way to make a series of increasingly hyperbolic arguments declaring Motorola Droid superior to the iPhone.

The long trail of negative comments on the site demonstrate that perhaps not all readers were swayed …

Specialists should staff the patient centered medical homes, not primary care doctors

Kevin

Health Policy

December 3, 2009

Originally published in HCPLive.com

by Alan Berkenwald, MD

The approaching fire storm over the “patient-centered medical home” model reminds me of the destructive powers seen before in HMOs. Once seemingly destined to revolutionize organized medicine, the HMO model nearly destroyed it.

We can learn from past failures. We need to promote best-practice models and make physicians accountable for their actions, both physiologically and …

Tamiflu kills babies, and other H1N1 flu pandemic misconceptions

Kevin

Medications

December 3, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

As one of the two MedPage Today writers on full-time H1N1 duty since the beginning of the outbreak in April, I feel like I know the issues well enough to help clear up misconceptions when they come up in conversation.

The other day, just such a situation presented itself. An …

Pharma, evidence, and trust

Kevin

Medications

December 2, 2009

by David Rind, MD

A number of the other blogs that have noted the existence of this blog seem to have “Pharma” in their titles in one way or another, and the implication is not that the blogger likes much about Big Pharma.

In the late 1990s, when I was spending much of my clinical time providing HIV care, I was a defender of Pharma on Usenet, at least as it related …

Read more…

Pharma, evidence, and trust

Seeing floaters or flashing lights can be caused by posterior vitreous or retinal detachment

Kevin

Conditions and Diseases

December 2, 2009

Originally posted in Insidermedicine

The eye is very similar to a camera. Both are optical systems that have lenses in the front to focus light rays onto a film. The retina is the eye’s film. It is a tissue that consists of 10 layers and is about 500 microns thick—or, half a millimeter. The main function of the retina is to trap light rays, convert them into electrical impulses, and send …

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