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A formula to help Congress with health care costs

Kevin

Health Policy

September 30, 2009

by Gary R. Gibson, MD, FACP

In his 2007 book Critical, Tom Daschle said lawmakers were “flummoxed” when attempting to craft specific reform legislation. They seem flummoxed again as they fail to recognize the primacy of the patient-physician covenant and try to analyze a complex problem without a suitable conceptual model.

The formula below represents a valid conceptual model describing health care costs.

“E” is expressed in monetary units …

What doctors can learn from patients in the health care reform debate

Wendy S. Harpham, MD

Health Policy

September 30, 2009

Two things are missing from the bustling conversations on health care reform jamming the Internet highway. First, where among the finger-pointing anecdotes and critical analyses of our “broken” American medical system are the stories and discussions of all that is right? Second, where is our sense of hope?

I’ve experienced American health care from an unusual, yet useful, vantage: that of a physician with chronically recurring cancer. From both sides of …

Are hospice doctors relying too much on symptom scores to assess pain?

Eric Widera, MD

Conditions and Diseases

September 29, 2009

A recent issue in The Lancet included an article entitled “The Death of Ivan Ilyich and pain relief at the end of life.” This is a thought provoking article focused on the question of whether there is overuse of pharmaceuticals to treat various forms of suffering in hospice and palliative medicine.

The authors argue that a good death, as seen through their interpretation of The Death of Ivan Ilyich, may include …

Migraines and the stigma of chronic pain medication use

Kevin

Medications

September 28, 2009

by Diana Lee

A recent episode of the A&E show Intervention about a woman with occasional migraines and other serious health problems who takes up to 50 Percocet pills a day made me uncomfortable. Maybe Danielle, the woman featured in the episode, really does have migraine attacks. But she is also an addict. One condition really has nothing to do with the other. Many people with acute or chronic pain use …

Will there really be an impending shortage of cardiologists?

Larry Husten, PhD

Health Policy

September 28, 2009

There can be little doubt that the lethal combination of aging baby boomers, the obesity epidemic, and the growing success of medical and interventional therapies for CV disease (resulting in more and more survivors of major events) is going to produce a flood of cardiovascular disease in the coming decades, and cardiologists in great numbers will be needed to care for these people.

However, that doesn’t mean that the message conveyed …

What’s the latest on prostate cancer and the PSA screening test?

Kevin

Conditions and Diseases

September 28, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Prostate specific antigen (PSA) tests may lead to unnecessary treatment of healthy men for prostate cancer, and there is little evidence supporting the common but controversial test for routine cancer screening, two new studies found.

Measurements of blood concentrations of PSA failed to predict cancer with the accuracy generally …

Should letting a premature infant die be considered health care rationing?

Kevin

Conditions and Diseases

September 27, 2009

by an anonymous NICU nurse

There is a medical controversy brewing over in England that is threatening to invade the United States. Ms. Capewell, a 23-year old British mother, is claiming English doctors let her 21 5/7 week infant die, only because they were following national perinatal guidelines.

If only he was born at 22 weeks, she insists, they would have tried everything to save him and admitted him to the …

Is the seasonal flu vaccine associated with H1N1 pandemic influenza?

Kevin

Conditions and Diseases

September 26, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

In unpublished data, Canadian researchers have suggested that seasonal flu vaccination may increase the risk of catching the H1N1 pandemic strain, but such a pattern has not been found in the U.S., the CDC said.

The Canadian data appear to suggest that people who had been vaccinated against …

Does the bulk of excessive medical care happen in the ER?

Michael Kirsch, MD

Physician

September 25, 2009

by Michael Kirsch, MD

The concept of medical excess is very difficult for ordinary patients to grasp. The medical community has worked hard for decades teaching them that more medicine meant better medical care. The public has learned these lessons well. Physicians who sent their patients for various diagnostic tests or specialty consultations were regarded as conscientious and thorough. Patients approved of doctors who prescribed antibiotics regularly for colds and other …

Radiologists and communicating mammogram results to patients and their doctors

Kevin

Conditions and Diseases

September 24, 2009

by an anonymous radiologist

I recently read the article and comments on this link from this post, concerning radiologists, from Musings of a Dinosaur.

I was disturbed to discover the animosity with which this topic is covered. The tenor of the blog is that radiologists are greedy, self-serving and are out to erode the doctor-patient relationship. The suggestion that radiologists would schedule percutaneous breast biopsies for their financial enhancement is both …

What does socialism have to do with the health care reform debate?

Kevin

Health Policy

September 24, 2009

by David Alway, MD

In thinking about socialism and medicine in the United States let’s adopt socialist point of view and ponder some logical conclusions.

Injustice Exists

The socialist notices that some people are starving, don’t have adequate shelter, or are relatively uneducated. He also observes that others are very well off, having access to the finest meals, enough money to buy grand homes and are well-educated. This state of affairs, …

Should soft drinks be taxed and be called a public health hazard?

Kevin

Health Policy

September 24, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Soft drinks and other beverages loaded with sugar should be taxed as a public health hazard, much as cigarettes are, a group of prominent medical researchers says.

Since extensive evidence ties sugary drinks to an epidemic of obesity and related health problems, such as heart disease and diabetes, they …

Is medical technology making doctors less relevant?

Edwin Leap, MD

Conditions and Diseases

September 23, 2009

It happens over and over. I call a surgeon about a patient with abdominal pain.

‘Well, what’s the white count?’

‘Normal.’

‘Did you get a CT Scan?’

‘Yes, and it was normal. But they just look uncomfortable.’

‘Sounds like nothing for me to do. Call the hospitalist.’

It happens in other specialties. Cardiologists who aren’t interested in a patient with a normal stress test, pediatricians unimpressed with negative chest x-rays and normal labs. ENT’s unconcerned if …

How to protect yourself from abdominal aortic aneurysms

Kevin

Conditions and Diseases

September 22, 2009

by Mark Adelman, MD

While diseases like prostate cancer and heart disease have become household concerns, abdominal aortic aneurysms (AAA), the 10th leading cause of death in men age 55 and older, have been overshadowed by more prominent diseases for far too long. It’s time we pull back the curtain and take a closer look at this serious disease and how it can be both detected and prevented.

An AAA, which …

Is the flu a heart attack risk factor?

MedPage Today

Conditions and Diseases

September 22, 2009

by Todd Neale, Staff Writer, MedPage Today

Flu appears to act as a trigger for myocardial infarction and cardiovascular death, a review of the literature showed.

All observational studies included in the review found an association between times when influenza viruses were circulating and increases in cardiovascular death, according to Charlotte Warren-Gash, MBChB, of University College London, and colleagues.

There was …

Read more…

Is the flu a heart attack risk factor?

Health care reform protests and how fears and beliefs are exploited

Kevin

Health Policy

September 21, 2009

by Abraham Verghese, MD

The unfortunate politicians who have braved town hall meetings to talk about health reform seem to have been taken by surprise by the vitriol and volume of the push back. Yes, I know the audiences were marshaled and recruited to shout down the speakers but still the passion on display was genuine and not in the least surprising to me. What the President and our politicians should …

How eliminating waste and taking fewer steps can improve patient care

Donald Tex Bryant

Patient

September 21, 2009

Recently I was on a canoe trip in Ontario, Canada with a close friend. As he and I were portaging our gear and canoe between two lakes I was thinking that the uphill path was difficult and wondered how many more steps it would take. The sooner it was done the better.

I often find myself counting steps during my daily activities as I know that the fewer physical steps it …

How will the H1N1 vaccine be distributed to patients?

MedPage Today

Conditions and Diseases

September 21, 2009

by Michael Smith, North American Correspondent, MedPage Today

A minimum of 3.4 million doses of vaccine against H1N1 pandemic flu will be available in the first week of October, the CDC said.

Those doses — all in the form of a live attenuated nasal spray vaccine — may be supplemented by some injectable vaccine, according to Jay Butler, MD, the …

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