KevinMD.com

How should doctors discuss healthcare reform with patients?

Kevin

Health Policy

November 10, 2009

Originally published in HCPLive.com

Physicians are increasingly bringing their views on healthcare reform into the examination room. Others are distributing flyers or taping up signs in the office. Given that healthcare reform has become such a contentious subject in the United States, it is not surprising that conflicts have arisen between physicians and patients who hold different views.

The St. Petersburg Times …

Doctors and patients need to learn to live with health insurance companies

Kevin

Health Policy

November 10, 2009

by Marie Cooper

Consider two patients with the same managed care plan.

One has multiple sclerosis and receives an infusion of Tysabri every month. It needs pre-certification. The requirements are black and white. The patient qualifies if they have relapsing/remitting MS and have failed other therapies. The drug costs $2,000, the infusion center is another $1,000. The infusion center is a contracted provider that has …

Do home fetal heart monitors give mothers false reassurance?

Kevin

Conditions and Diseases

November 10, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Expectant mothers may enjoy listening to their unborn babies’ heartbeats, but they shouldn’t rely on home fetal heart monitors to provide an accurate picture of fetal health, researchers say.

The devices may provide false reassurance in some situations, according to Abhijoy Chakladar, MD, of Princess Royal Hospital in West Sussex, …

What’s next for health reform after the House passed their bill, H.R. 3962?

Kevin

Health Policy

November 8, 2009

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

The House of Representatives voted 220 to 215 to pass historic healthcare reform legislation late Saturday night, after 11 hours of debate before a packed gallery of spectators.

H.R. 3962 passed by a narrow margin: Democrats needed 218 votes to pass the bill and wound up with just two …

How the health care system is corrupting doctors

Kevin

Health Policy

November 7, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

I had the same reaction . . . shock at seeing an almost obscene claim about our profession in a national newspaper. But it got me thinking, which no doubt was its intended purpose. While we are thinking and feeling our way through this wide-ranging debate on health care, we might as well examine …

Op-ed: Injured patients deserve medical malpractice reform

Kevin

Physician

November 7, 2009

A version of this op-ed was published on October 26th, 2009 in the USA Today.

President Obama has acknowledged that changes in the medical malpractice system must be considered with other health reforms, and recently ordered that pilot projects to improve the way we compensate injured patients be implemented.

Reforming medical liability has historically been a source of major contention. Physicians argue that the system is expensive, promotes multi-million dollar awards …

Support for the patient centered medical home in the House health reform bill

Kevin

Health Policy

November 6, 2009

by Thomas C. Bent, MD

As the House of Representatives prepares to vote on its historic health care reform bill on Saturday, family physicians are heartened to see the support it gives to the emerging new model of care, the patient centered medical home.

The House bill is good news on many fronts. It would provide health insurance coverage for some 96 percent of Americans and would reduce the federal deficit by …

Vaccines do not cause autism in children, whether or not they have inborn errors of metabolism

Kevin

Conditions and Diseases

November 6, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Vaccination does not appear to cause autism or other health problems in children with inborn errors of metabolism, a researcher said here.

In a retrospective analysis, children with such conditions were not more likely than normal children to visit emergency rooms or need hospital care after vaccination, according to …

Clostridium difficile infection is spreading from the hospital to the community

Kevin

Conditions and Diseases

November 5, 2009

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Clostridium difficile infection has spread from the hospital to the community but has proved manageable thus far.

From 1991 to 2005, the incidence of community-acquired C. difficile in Olmsted County, Minn., quadrupled but still remained less common than the hospital-acquired gastrointestinal infection, Sahil Khanna, MD, of the Mayo Clinic in …

Diagnosing and treating disease is only a small part of a doctor’s job

Danielle Ofri, MD, PhD

Physician

November 4, 2009

If asked what a doctor does, most people would probably come up with the standard description of diagnosing and treating disease, usually while wearing an ill-fitting white coat. Before I entered practice, even during my medical training that probably would have been my answer too.

But my years in the trenches of real medicine have altered that definition greatly. I do spend time doing the things I learned in medical school …

Saving what’s good about the United States’ health care system

Kevin

Health Policy

November 4, 2009

by Bruce Goldman

The U.S. health care system, although it’s the costliest in the world, doesn’t even deliver the goods when it comes to delivering health. That’s the conventional wisdom. But is it true?

At least a few well-researched studies by credentialed and respected experts suggest we might want to pause to consider whether, in the mad dash now underway to fix our ailing health care system, we could inadvertently end up …

How long should children stay out of school after H1N1 flu?

Kevin

Conditions and Diseases

November 4, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Children appear to shed particles of the H1N1 pandemic flu virus longer than adults do, which may have implications for how long they stay out of school, a researcher said here.

The finding comes from an analysis of an outbreak in a Pennsylvania elementary school in May and June, …

Football is linked to dementia, and why it should be banned from high schools

Kevin

Conditions and Diseases

November 3, 2009

by Brian E. Moore, MD

Two neuropathologists are prominently spotlighted in an article by Malcolm Gladwell in the October 19 issue of The New Yorker. The article explores a provocative question raised by autopsy results on football players: namely, should football be illegal?

Featured are Dr. Ann McKee, neuropathologist at the Veterans Hospital in Bedford, Massachusetts and Dr. Bennet Omalu, forensic neuropathologist and San Joaquin Valley (CA) chief medical examiner. Drs. McKee …

H1N1 vaccine adverse events, and how to reassure patients

Kevin

Medications

November 3, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Failure to account for background rates when considering adverse events from pandemic H1N1 flu vaccination could spark public panic, researchers cautioned.

Coincidental cases of dramatic events including sudden death, Guillain-Barré syndrome, and spontaneous abortion can be expected to boost the true incidence of adverse events after immunization, said Steven …

Does the tort-based medical malpractice system improve patient care?

Michael Kirsch, MD

Physician

November 2, 2009

by Michael Kirsch, MD

Physicians and plaintiff attorneys have philosophically divergent views on our tort system. I know the attorneys’ views on this issue well. There are lawyers in my family who have prosecuted physicians for alleged medical malpractice. Sometimes, there hasn’t been enough antacids in our house to douse my flaming heartburn after some of our discussions.

Obviously, one reason that lawyers support the current system is because it enriches them. …

Rheumatologists debate whether fibromyalgia is really a disease

Kevin

Conditions and Diseases

November 2, 2009

Originally published in HCPLive.com

What defines a “disease?” At what point does a collection of symptoms and causes make the transition from “condition” to disease? Is it when a consensus forms around a concrete, observable, and repeatable set of biochemical and/or physiological processes and outcomes? Surely there is little doubt that diabetes or hypertension qualify as a disease under the standard paradigm. …

Who’s most likely to spread infection in the hospital?

Kevin

Physician

November 2, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Good hand hygiene among healthcare workers is an important factor in preventing the spread of disease, but exactly how important depends on an individual’s job, researchers said.

In a mathematical model, so-called “peripatetic” workers — such as therapists or radiologists — were most likely to spread pathogens if they …