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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 …

Is the impending physician shortage worse than we thought?

Kevin

Health Policy

October 31, 2009

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

The physician workforce in the U.S. is growing smaller and younger, according to data from the Census Bureau, but conflicting estimates make it difficult to determine just how many doctors are out there — and how many the nation will need.

The census survey showed 67,000 fewer physicians than estimates based …

Implementing an EMR or health IT system is harder than it looks

Robert Wachter, MD

Health Technology

October 31, 2009

In 2001, when my colleagues and I ranked nearly 100 patient safety practices on the strength of their supporting evidence (for an AHRQ report), healthcare IT didn’t make the top 25. We took a lot of heat for, as one prominent patient safety advocate chided me, “slowing down the momentum.” Some called us Luddites.

Although we hated to be skunks at the IT party, we felt that the facts spoke for …

Health reform ignores primary care doctors at its own peril

Richard Reece, MD

Health Policy

October 30, 2009

I would like to introduce you a remarkable article by Edward J. Volpintesta, MD, a 65-year old solo primary care doctor in Bethel, Connecticut. Dr. Volpintesta is a veritable writing machine and has been published in The Wall Street Journal, the New York Times, medical journals, and other publications. His articles cry for a deeper understanding of primary care dilemmas.

In the October issue of Connecticut Medicine, Dr. Volpintesta hits the …

Are doctors getting enough skin cancer exam training?

Kevin

Conditions and Diseases

October 30, 2009

Originally published in MedPage Today

by Nancy Walsh, MedPage Today Contributing Writer

Opportunities to learn how to perform skin cancer examinations during medical training are inadequate, a survey of residents found.

More than half (55.3%) of residents said that they had never observed a skin cancer examination, 75.8% said they’d never been taught to perform one, and 57.4% had never practiced doing …

ACP: How to fix the primary care problem in health care

American College of Physicians

Physician

October 29, 2009

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

Many would argue that lack of universal coverage is the primary problem with health care in the United States, accompanied by the logistical and financial difficulties of obtaining coverage for someone with a pre-existing medical condition. Others would argue …

An obsession with making money can be a sign of physician burnout

Kevin

Physician

October 29, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

Physician burnout has a tremendous effect on the financial bottom line and is far more common than docs want to talk about.

When I say the bottom line, I am referencing studies that have been done on “workaholics,” another softly defined term, that show in spite of increased hours and apparently focused activity, productivity in …

Beware using the web for H1N1 pandemic flu drugs

Kevin

Medications

October 29, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

The Internet can be a great source of information about the pandemic H1N1 flu, but it’s also the mother lode of swine flu scams, the FDA is warning.

The agency says consumers should beware of products sold over the Internet that claim to diagnose, prevent, treat, or cure the …

This is why children need the H1N1 flu vaccine

Crystal Phend

Medications

October 28, 2009

by Crystal Phend, MedPage Today Senior Staff Writer

The pandemic H1N1 influenza virus continues to disproportionately attack the young, the CDC warned.

Children and adults under age 25 have accounted for 53% of hospitalizations for laboratory-confirmed H1N1 and 23.6% of related deaths since Sept. 1, the agency reported at a press briefing.

Seniors, on the other hand, have accounted for just 7% of …

Have drug companies really curbed gifts to doctors at medical conferences?

Kevin

Medications

October 27, 2009

by Roberta Friedman, PhD

Banning pharmaceutical companies from handing out token items to doctors at conferences is so tip of the iceberg.

I have tales to tell of conferences past, where the excesses were beyond farcical. As a medical reporter covering such meetings, I have seen everything. When my kids were young, I enjoyed roaming the floor of the exhibit hall along with the docs, collecting such swag as bouncy balls that …

Is the newest, long-lasting insulin necessarily the best?

Kevin

Medications

October 27, 2009

Originally published in HCPLive.com

by Anita Ramsetty, MD

We are very fortunate to have a number of newer insulins available for our patients.

For years we had animal insulins only. NPH and Regular, then we had Ultralente. The development of analog insulins marked the upswing in technology that we would sustain for a period of time. The most recent big blip in the …

What does H1N1 pandemic flu as a national emergency mean?

Kevin

Conditions and Diseases

October 27, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

President Barack Obama’s declaration that the H1N1 pandemic flu is a national emergency doesn’t mean the course of the outbreak has changed, health experts said.

But as the volume of cases increases, the declaration allows doctors and hospitals more flexibility in handling the expected surge in patients, they said.

“I …

The high cost of hiring, and firing, a doctor

Kevin

Physician

October 26, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

One area we need to look at is the surprisingly high costs of hiring and firing people who work with us. And as always, I rebuke our training programs for their ostrich-like attitudes, ignoring how important managerial and organizational competence is to the quality of medicine that we practice.

We know that recruiting a …

Discussing end-of-life care in the ICU and saving Medicare money

Marya Zilberberg, MD, MPH

Health Policy

October 25, 2009

I think by now there is not a person in the US who cannot quote at least approximately how much we spend annually on healthcare. Fewer people appreciate that nearly 1/3 of this $2.2 trillion bill is eaten by hospitalizations, amounting to about $680 billion. Although the data in the diagram below represent a single year, the overall distribution of expenses is remarkably constant over time.

When compassion meets progress in American health care

Edwin Leap, MD

Health Policy

October 24, 2009

Does anyone realize that the chaos of modern American health-care is not a tragedy, but a triumph? We’re so busy trying to fix what isn’t broken and ignoring what is, so busy casting stones and casting doubts that we are blind to what we have.

I have practiced medicine in this labyrinth for 16 years. I am an emergency physician. I practice in what may be considered the ‘epicenter’ of modern …

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