KevinMD.com

April 28, 2010Apr 28, 20109

by John Gever The Department of Veterans Affairs' long-term investment in healthcare information technology paid off at a rate of more than $500 million in net annual benefits from 2001 to 2007, researchers said. That added up to more than…

by John Gever

The Department of Veterans Affairs’ long-term investment in healthcare information technology paid off at a rate of more than $500 million in net annual benefits from 2001 to 2007, researchers said.

That added up to more than $3 billion in benefits for the Department of Veterans Affairs (VA) during the study period, after an initial billion-dollar loss.

In particular, the department’s computerized patient record system “was the dominant contributor to …

Charles R. D'Agostino, MD

Primary care is burdened by excessive paperwork

April 28, 2010Apr 28, 201015

We’ve all seen the headlines –- “Primary Care Physicians Becoming a Scarce Breed”, “Wait Times for Appointments Increasing”, “Primary Care in Crisis” –- and have heard the pundits pontificating on the deteriorating state of primary care. But rarely do we…

But rarely do we hear what’s happening from physicians on the front lines, those actually seeing patients. Consequently, with direct access to the primary care trenches, replete with an overworked physician and staff members, …

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Patient voices

Questions for doctors are powerful patient tools

Toni Bigby

April 27, 2010Apr 27, 201021

by Toni Bigby Our Federal Government is investing in a consumer education campaign called, “Questions are the Answer.” The idea is to encourage people to watch out for themselves a little better and be their own advocate by asking their…

by Toni Bigby

Our Federal Government is investing in a consumer education campaign called, “Questions are the Answer.” The idea is to encourage people to watch out for themselves a little better and be their own advocate by asking their doctors questions like, “Why do I need this surgery?” and “Are there any side effects from this drug?”

Why are we as health care consumers, who collectively spend trillions of dollars each …

Primary care shortage solutions after health care reform

Toni Brayer, MD

April 27, 2010Apr 27, 201019

The new reform law which is called the Patient Protection and Affordable Care Act (PPACA) will be a huge disappointment to the millions of previously uninsured people who finally purchase insurance policies when they try to find a doctor. Primary…

Primary care physicians are already in short supply and the most popular ones have closed practices or long waits for new patients. Imagine when 2014 hits and all of those patients come …

Sleep apnea increases stroke risk in men

April 27, 2010Apr 27, 2010

by Charles Bankhead Severe obstructive sleep apnea almost tripled stroke risk in men, data from a prospective cohort study showed. Among men with mild or moderate apnea, each one-unit increase in the obstructive apnea hypopnea index (OAHI) raised stroke risk…

by Charles Bankhead

Severe obstructive sleep apnea almost tripled stroke risk in men, data from a prospective cohort study showed.

Among men with mild or moderate apnea, each one-unit increase in the obstructive apnea hypopnea index (OAHI) raised stroke risk by 6%. Obstructive sleep apnea did not have a significant association with stroke risk in women, investigators reported online in the American Journal of Respiratory and Critical Care Medicine.

“This study provides compelling …

Aneurysm as a cause of the Bret Michaels brain hemorrhage

Kevin Pho, MD

April 26, 2010Apr 26, 20102

Bret Michaels continues to be monitored in the intensive care unit after suffering a subarachnoid hemorrhage. According to his road manager, "further testing this week will help locate the source of the bleeding." What exactly does that entail? As I…

Bret Michaels continues to be monitored in the intensive care unit after suffering a subarachnoid hemorrhage.

According to his road manager, “further testing this week will help locate the source of the bleeding.”

What exactly does that entail?

As I mentioned previously, aneurysms are responsible for the majority of brain bleeds. Finding that source is critical. Angiography, or …

Texas Medical Association & William H. Fleming III, MD

Texas Medical Association: Stop the Medicare meltdown

April 26, 2010Apr 26, 201024

A guest column by the Texas Medical Association, exclusive to KevinMD.com. by William H. Fleming III, MD So we have this new health law that’s intended to provide better health care access for most Americans. Many of the reforms rely…

A guest column by the Texas Medical Association, exclusive to KevinMD.com.

by William H. Fleming III, MD

So we have this new health law that’s intended to provide better health care access for most Americans. Many of the reforms rely upon the sustainability and effectiveness of Medicare.

Medicare, however, is doomed to failure unless Congress fixes a fundamental problem existing within the current program — the Sustainable Growth Rate (SGR) formula. The …

Undocumented individuals make hospital discharge difficult

John Schumann, MD

April 26, 2010Apr 26, 20108

Working in the hospital this month, my team has been caring for Mr. M. He was here when we started on service at the beginning of the month, and unless his planned transfer to another facility goes through, he’ll be…

Mr. M is in his fifties. He speaks Spanish. He is an undocumented immigrant from Central …

Quality care requires open clinical transparency

Paul Levy

April 26, 2010Apr 26, 2010

Let's face it. Health care is an odd field. Costs are unknown or indecipherable. Prices for the services offered are hidden from consumers. Likewise, the value (efficacy, quality, safety) of the services received is hidden from consumers. In no sense…

Let’s face it. Health care is an odd field. Costs are unknown or indecipherable. Prices for the services offered are hidden from consumers. Likewise, the value (efficacy, quality, safety) of the services received is hidden from consumers. In no sense does it represent other markets, in which transparency of these elements reigns and which therefore have a better chance of reaching the “efficient market” described by economists.

In such an environment, …

Drugs and prescribing

Alternative medicine isn’t taught to doctors in medical school

April 26, 2010Apr 26, 201032

by Crystal Phend Physicians don't know much more about complementary and alternative medicine than their patients do, according to a new survey. Most healthcare professionals who answered an online survey of Drug and Therapeutic Bulletin subscribers said their profession was…

by Crystal Phend

Physicians don’t know much more about complementary and alternative medicine than their patients do, according to a new survey.

Most healthcare professionals who answered an online survey of Drug and Therapeutic Bulletin subscribers said their profession was just as poorly informed about herbal medicines (75.5%) as the general public (86.3%).

And almost half of respondents rated their own knowledge about herbal medicines as “quite” or “very” poor (36.2% and 10.4%, …

Health reform won’t help the ER

Health reform won’t help the ER

Chris Rangel, MD

April 26, 2010Apr 26, 20102

Contrary to popular belief, those without health insurance are not flooding emergency rooms as a consequence of being cut off from routine and preventive care. Actually, frequent visitors to the local ER are far more likely to have insurance according…

Frequent users account for about 8% of ED patients but 28% of visits. Although frequent

…

Read more…

ADHD needs more than drugs to appropriately treat

Claudia M. Gold, MD

April 25, 2010Apr 25, 20108

I consider my most successful cases to be the ones that do not seem me any more. Not that they are "better", but they and their families have come to realize the full complexity of the problems they are struggling…

I consider my most successful cases to be the ones that do not seem me any more. Not that they are “better”, but they and their families have come to realize the full complexity of the problems they are struggling with, and are getting appropriate help.

I inherited my “ADHD practice” from another pediatrician. He was wonderful man, a larger than life, toss babies in the air pediatrician with a hearty …

Don Berwick and whether he can change Medicare and Medicaid

April 25, 2010Apr 25, 20107

by Marianne Mattera President Obama is planning to appoint Don Berwick -- the Harvard pediatrician, recognized health policy expert, and head of the Institute for Healthcare Improvement (IHI) -- as the new head of CMS. Berwick's nomination has been heralded…

by Marianne Mattera

President Obama is planning to appoint Don Berwick — the Harvard pediatrician, recognized health policy expert, and head of the Institute for Healthcare Improvement (IHI) — as the new head of CMS.

Berwick’s nomination has been heralded by many as a terrific choice.

Our own health policy columnist, David Nash, said that “Berwick’s global following is a powerful political force …

C-section rates and its association with lawsuits

Amy Tuteur, MD

April 25, 2010Apr 25, 201033

The National Center for Health Statistics recently released a new report, Recent Trends in Cesarean Delivery in the United States. The report is most notable for a startling statistic; the C-section rate has reached the astronomical level of 32%, an…

Why is the C-section rate sky high?

The pervasive nature of the increase may hold some clues. The increase has …

St. Vincent’s Hospital closes, but who’s to blame?

Marie Cooper

April 24, 2010Apr 24, 20104

St. Vincent’s Medical Center in Greenwich Village was founded in 1849, making it the third oldest hospital in New York City. It has been an occasional scene of notoriety but mostly it has witnessed countless episodes of anonymous compassion and care. My two sons were born there. As a major teaching hospital, it has over 1000 affiliated physicians. It is where generations of New Yorkers …

Colorectal cancer in blacks is affected by healthcare utilization

April 24, 2010Apr 24, 2010

by Todd Neale The greater burden of colorectal cancer in the black community appears to be related to healthcare utilization, and not biology, researchers found. Similar proportions of black and white patients had polyps or masses detected by flexible sigmoidoscopy,…

by Todd Neale

The greater burden of colorectal cancer in the black community appears to be related to healthcare utilization, and not biology, researchers found.

Similar proportions of black and white patients had polyps or masses detected by flexible sigmoidoscopy, but black patients were less likely than whites to have the recommended follow-up colonoscopy (62.6% versus 72.4%), according to Adeyinka Laiyemo, MD, MPH, of Howard University in Washington, and colleagues.

After adjustment for …

Op-ed: Health insurance doesn’t mean doctors will be available

Kevin Pho, MD

April 24, 2010Apr 24, 201013

The following op-ed was published on March 30th, 2010 in AOL News. Health reform has passed, and the United States is poised to join the rest of the industrialized world in providing most of its citizens with affordable health coverage.…

The following op-ed was published on March 30th, 2010 in AOL News.

Health reform has passed, and the United States is poised to join the rest of the industrialized world in providing most of its citizens with affordable health coverage.

But having health insurance doesn’t necessarily mean it will be easy to find a doctor. Even before reform, reports projected a shortfall of 40,000 primary care physicians over …

Bret Michaels has a subarachnoid hemorrhage, and what that means

Kevin Pho, MD

April 23, 2010Apr 23, 201019

Bret Michaels is in critical condition from a subarachnoid hemorrhage. I've been watching Celebrity Apprentice recently, and he comes across as a genuine person who, of course, has been raising awareness for Type 1 diabetes. As most people know, he…

Bret Michaels is in critical condition from a subarachnoid hemorrhage.

I’ve been watching Celebrity Apprentice recently, and he comes across as a genuine person who, of course, has been raising awareness for Type 1 diabetes. As most people know, he has battled various diabetic complications on the show, and recently underwent an emergency appendectomy.

What’s his prognosis like?

Not good, I’m …