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Should doctors be paid to e-mail their patients?

Physician

October 11, 2009

by Michael Kirsch, MD

This is a less controversial issue than patients ‘friending’ their doctors on Facebook, which I oppose. Although most physicians’ offices are not e-mailing with patients, perhaps they should. There are several obvious advantages.

* Decompress phone lines, which are suffocating nearly every medical practice in America.

* Relieve patients of the cruel and unusual punishment of languishing on ‘hold’ listening to elevator music or dead air.

* Allow office staff …

Will riding in a convertible harm your hearing?

Kevin

Conditions and Diseases

October 10, 2009

Originally published in MedPage Today

by Ed Susman, MedPage Today Contributing Writer

Cruising down the highway in a sleek convertible, with the wind blowing in your hair, may sound like the ideal road trip — but it could harm your hearing, British scientists said.

In a study conducted on the high-speed motorways of the U.K., doctors found that at highway speeds, …

Does the Max Baucus health reform plan do enough for doctors?

Glenn Laffel, MD, PhD

Health Policy

October 10, 2009

Max Baucus’ decision to release his solo album—subtitled the Senate Finance Committee’s proposal on health reform—was timed with the precision of a 4th grade marching band.

Physicians could live with that, but the bill contained gornisht on tort reform and not much more than that on Medicare reimbursement. Upon seeing that, the Long White Coats reacted as if they’d seen earwax on their stethoscopes.

“The feeling of most doctors is that …

Will more primary care doctors keep patients out of the ER?

Edwin Leap, MD

Physician

October 9, 2009

One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I think I know why.

Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency …

Can ventilating patients spread H1N1 flu in hospitals?

Kevin

Conditions and Diseases

October 9, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Plumes of virus-laden air shooting out from the masks of patients undergoing noninvasive ventilation could put healthcare workers at increased risk for infectious diseases such as the pandemic H1N1 (swine) flu, researchers said.

A positive-pressure ventilation mask on a simulated patient yielded a jet of exhaled air extending …

The alternative, complementary, and integrative health obsession with toxins

Amy Tuteur, MD

Conditions and Diseases

October 8, 2009

Everything old is new again and that is certainly true in the world of “alternative” health. One of the axiomatic premises of contemporary “alternative” health puts its believers behind the times … by approximately 500 years.

A fundamental premise held by believers in “alternative” health is that we are swimming in a world of “toxins” and those “toxins” are causing disease. Like most premises in “alternative” health it has no basis …

AMA: Permanent repeal of the Medicare physician payment formula must be part of health reform

Kevin

Health Policy

October 8, 2009

The following is part of a series of original guest columns by the American Medical Association.

by J. James Rohack, M.D.

All eyes are on the Senate Finance Committee this week as they prepare to vote to move health reform legislation forward. The AMA is committed to health reform, and as the process moves to the Senate floor, it’s crucial that the Senate include permanent repeal of the current Medicare …

CBO cost analysis of the Baucus health reform plan

Kevin

Health Policy

October 7, 2009

Originally posted in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

In its much-anticipated cost estimate, the Congressional Budget Office (CBO) said the Senate Finance Committee’s healthcare reform bill would cost $829 billion over 10 years and begin to drive down the federal deficit after that first decade.

The price tag is lower than Sen. Max Baucus’ (D-Mont.) previous …

When political discourse is like borderline personality disorder

Marya Zilberberg, MD, MPH

Health Policy

October 7, 2009

When I was a kid in Odessa my Dad and I went to see The Sound of Music at least 17 times in the span of 3 months. Remember that song sung by the nuns when Maria is late for the vespers, “How do you solve the problem like Maria?” One nun says “She’s an angel”, another one counters “She’s a demon”, when the voice of reason from Mother Superior …

Is a cocaine abuse vaccine coming soon?

Kevin

Conditions and Diseases

October 7, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

A vaccine against cocaine was effective in nearly 40% of users of the drug, researchers said.

In a randomized, placebo-controlled study, volunteers who reached a high level of antibodies after vaccination used less cocaine than those whose response was lower, according to Thomas Kosten, MD, of Baylor College …

Read more…

Is a cocaine abuse vaccine coming soon?

Is incident reporting effective in reducing medical errors and increasing patient safety?

Robert Wachter, MD

Health Policy

October 6, 2009

When the patient safety field began a decade ago with the publication of the IOM report on medical errors, one of its first thrusts was to import lessons from “safer” industries, particularly aviation. Most of these lessons – a focus on bad systems more than bad people, the importance of teamwork, the use of checklists, the value of simulation training – have served us well.

But one lesson from …

Does Chantix increase suicide risk?

Kevin

Medications

October 6, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Contrary to information that led the FDA and other regulatory agencies to release warnings about varenicline (Chantix), a new study has found “no clear evidence” of a relationship between the risk of suicide and the smoking-cessation drug.

Both varenicline and bupropion (Zyban), another drug used in smoking cessation programs, were …

Read more…

Does Chantix increase suicide risk?

Flu and H1N1 influenza vaccine recommendations for doctors and health care workers

American College of Physicians

Conditions and Diseases

October 5, 2009

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

by Steven Weinberger, MD, FACP

In the Fall of 2009, we physicians should perhaps change the Biblical phrase, “Physician, heal thyself” to “Physician, immunize thyself” and then follow the phrase twice – once for seasonal influenza and once for H1N1. To date, physicians and other health care workers have too often been lax …

Did the 1918 flu pandemic increase the risk of heart disease?

Kevin

Conditions and Diseases

October 5, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Men who were in utero during the peak of the 1918-1919 flu pandemic were at increased risk of heart disease when they reached their 60s, 70s, and 80s, researchers said.

In those men, the rate of heart disease was more than 23% higher than among those whose mothers …

Analysis of the Senate Finance Committee health care reform bill

Kevin

Health Policy

October 3, 2009

Originally posted in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

The Senate Finance Committee finished work on its healthcare reform bill in the wee hours of Friday morning, paving the way for a committee vote next week.

After considering hundreds of amendments, the committee is now waiting for a cost-estimate from the Congressional Budget Office (CBO) before it …

Health care reform analysis from a former insurance and hospital executive

Kevin

Health Policy

October 3, 2009

by Marie Cooper

I have been in senior executive management in both managed care and a major hospital system. I find the hysteria over “reform” bitterly amusing because it is so misdirected.

The real problem with health care in America? Greed, indifference and incompetence, pure and simple. But not in the places everyone is pointing.

Insurer side

Insurance companies have to maximize their revenue because they answer to their boards. They …

What the United States health care system can learn from Mexico

Kevin

Health Policy

October 2, 2009

by Esther Buddenhagen, MSW

I write as a lay person concerned about the gap between what many people should receive and what they actually receive. The question of good medical care for ordinary people is being buried not only by insurance issues but by failure to come to terms with what primary care should be about.

Even Atul Gawande, who is particularly good at making distinctions between good and …

Not all doctors discuss the risks and benefits of prostate cancer screening to patients

Kevin

Conditions and Diseases

October 2, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Men might not be getting the information they need to make an educated decision about prostate cancer screening, two new studies suggest.

Among 375 men surveyed by telephone, only 69.9% had discussed a prostate-specific antigen (PSA) test with their physician before making a decision about screening, according to the …

Informed consent is central to the doctor-patient relationship

Dr. Martin Young

Conditions and Diseases

October 1, 2009

The doctor-patient relationship must remain the central focus of good health care. Diminish or hinder that relationship, and no technological advance, funding system, or government intervention in the world will be able to compensate. Many complaints about present health care systems can be seen as evidence of relationship dysfunction, not in the least due to the interference of third parties, administrators, payers and insurers, who wield the financial clout. Transparency …

Medical ghost-writing influences doctors to prescribe more drugs

Daniel J. Carlat, MD

Medications

October 1, 2009

Recently, a former staff medical writer at a MECC (Medical Education Communication Company) anonymously alerted me to a particularly sleazy advertising tactic used by a medical writing company. This person had worked as a pharma-supported medical writer for several years, but recently quit because, “I really couldn’t stomach the ethical problems associated with writing for the pharma industry.” Recently, looking for medical writing jobs, this writer came across a company …

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