Increasing radiation exposure to patients from CT scans and other imaging tests

Conditions and Diseases
August 28, 2009

by Kristina Fiore, Staff Writer, MedPage Today

Imaging procedures can expose patients to high cumulative doses of radiation, researchers say.

medpage-today In a large study, 193.8 people per 1,000 were exposed to moderate doses of radiation each year, while 18.6 per 1,000 were exposed to high doses, and 1.9 per 1,000 received very high doses, according to Reza Fazel, MD, of …

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Increasing radiation exposure to patients from CT scans and other imaging tests

Will medical malpractice reform be included in the final health bill?

Physician
August 27, 2009

Believe it or not, some element of federal tort reform is not only possible, but likely.

Sounds counterintuitive? We all know that Congress has a strong majority with Democrats. We know the President is also a Democrat. We know the plaintiff’s bar strongly supports the Democratic Party. We know that Democrats have traditionally shied away from specific reforms, such as caps on pain on suffering. So, this would seem the worst …

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Will medical malpractice reform be included in the final health bill?

New troponin tests to better diagnose a heart attack

Conditions and Diseases
August 27, 2009

by Crystal Phend, Senior Staff Writer, MedPage Today

A generation of new, more sensitive troponin assays has improved hospitals’ ability to diagnose a heart attack to a point as early as the time of emergency department presentation, two separate studies affirmed.

medpage-today1 In one multicenter study, a sensitive troponin I assay had an early diagnostic accuracy of 96%, compared with conventional …

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New troponin tests to better diagnose a heart attack

Drug company ethics and the pharmaceutical industry’s pursuit of profit

Medications
August 26, 2009

Ghostwritten clinical papers. Off-label marketing. Channel-stuffing. Hiding of negative data.

Pharma companies have earned a hefty percentage of the opprobrium heaped on them by a skeptical public. And it’s mainly because of a failure to heed the Golden Rule. We all know the “classical” Golden Rule: Treat others the way you’d wish to be treated. But in so many cases, drug manufacturers seem to adhere to a different version: the Gold-in …

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Drug company ethics and the pharmaceutical industry’s pursuit of profit

Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

Conditions and Diseases
August 26, 2009

Caster Semenya is the South African track and field star who recently was engulfed in controversy at the recently concluded World Track and Field Championships.

caster-semenya Turns out, there are some who are questioning her gender, and subsequently, tests are being conducted to see if she is really a woman.

It’s not as cut and dry as it appears.

Consider the possibility of Read more…

Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

How to make industry influence transparent in continuing medical education

Medical Education
August 25, 2009

by Larry Husten, Ph.D.

A recent hearing of the Senate Aging Committee on continuing medical education (CME) should scare anyone who might need to see a doctor in the next few years. But you don’t need to be a Washington policy wonk to discover that there’s a huge problem with CME.

Just walk into the lobby of any major downtown hotel when a large medical conference is in town and you will …

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How to make industry influence transparent in continuing medical education

Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?

Conditions and Diseases
August 24, 2009

Recent reports have said that Michael Jackson died from a propofol overdose. Is that really the case?

Here’s what happened, according to the published timeline.

— At about 1:30 a.m., [Dr. Conrad] Murray gave Jackson 10 mg of Valium.
— At about 2 a.m., he injected Jackson with 2 mg of the anti-anxiety drug Ativan.
— At about 3 a.m., Murray then administered 2 mg of the sedative Versed.
— At about 5 …

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Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?

Is health care a public good?

Health Policy
August 24, 2009

by Jeoffry B. Gordon, MD, MPH

The public policy and current political action around changing the system overlooks two important technical fallacies:

(1) That health care is most efficiently distributed by a free market mechanism; and,
(2) That medical services are an ordinary commodity.

The commercial market model is a failing economic and public policy ideology used to rationalize and justify corporate control of the health care system to profit from the enterprise. …

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Is health care a public good?

Will nurses solve the primary care crisis?

Physician
August 23, 2009

by Derek Mazique

Between “death panels,” a NICE-style cost effective analysis board, and Obama’s slowly graying hair, one conspicuously absent part of reform are reimbursement rates. Medicare and private insurance typically reimburse for expensive procedures, which ultimately rewards procedure-heavy specialists while discourage those cognitive-heavy services like primary care docs.

The result? As a recent Baltimore Sun op-ed and this very blog pointed out, a combination of pay and burn-out are encouraging …

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Will nurses solve the primary care crisis?

What can John Mackey and Whole Foods learn from publicizing their views on health reform?

Health Policy
August 21, 2009

Today’s health care communications lesson is brought to you courtesy of Whole Foods … I mean John Mackey.

John Mackey’s stepped in it again. Last week, Mackey, the libertarian CEO of natural-foods behemoth Whole Foods, wrote an op-ed piece on health reform for The Wall Street Journal. But Mackey felt it necessary to republish it on his blog because the Journal editors lightly edited it, Journal headline writers wrote a …

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What can John Mackey and Whole Foods learn from publicizing their views on health reform?

Do patients really need their complete lab and radiology reports?

Conditions and Diseases
August 21, 2009

Most prefer the bottom line, sparing them the raw data.

Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.

So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):

lab-values

Do patients really need their complete lab and radiology reports?

A doctor in Cuba becomes a nurse in the United States

Physician
August 20, 2009

When physicians in other countries come to the United States, they often become nurses or lab technicians, rather than re-taking rigorous board exams to remain doctors.

One example includes doctors from Cuba. According to this story in The New York Times, “6,000 medical professionals, many of them physicians, have left Cuba in the last six years.” Cuban doctors, who often earn $25 per month, find it significantly more …

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A doctor in Cuba becomes a nurse in the United States

The consequences of doing everything in end-of-life-care

Physician
August 19, 2009

Fear-mongering about health care reform killing grandma really burns me: I have delivered “everything”, I know what “everything” looks like. I know its dark side. I also know that these deliberate and self-serving lies will ultimately hurt not only grandma, but the rest of us too. Here is what I mean.

When I was in practice I cared for critically ill patients. I loved the ICU for its complex physiology and …

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The consequences of doing everything in end-of-life-care

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Is it fair to compare American health care with systems in Europe or Canada?

Health Policy
August 18, 2009

by Ralph Silverman, MD, FACS, FASCRS

I am tired of the comparisons people make between health care in the United States and other countries. For instance, there are those who think that we should have universal health care because some European countries and Canada do.

It is true that those countries do have universal health care, but is it a fair comparison?

Who does Canada rely on to defend its borders? When the …

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Is it fair to compare American health care with systems in Europe or Canada?

How to fix the primary care shortage

Physician
August 17, 2009

The primary care physician (PCP) shortage has attracted a lot of attention recently, and for good reason. Individual Americans are concerned that they will not have timely access to needed medical care, and policy makers are concerned that our specialist-heavy medical system is failing, giving us expensive but disjointed, poor quality care. Many experts rightly think that a robust primary care system would give us better health care for …

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How to fix the primary care shortage

Robert Ricketson and the surgical screwdriver medical malpractice case: The medical records revisited

Physician
August 11, 2009

Robert Ricketson is a spine surgeon who was involved in a high profile 2003 medical malpractice case in Hawaii where a surgical screwdriver was implanted into a patient’s back. This is his account of the ordeal.

by Robert Ricketson

I am writing today out of frustration and anger, as I am frankly quite tired of passively going along as my name appears year after year in malicious “medical blogs” and …

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Robert Ricketson and the surgical screwdriver medical malpractice case: The medical records revisited

Op-ed: Wikipedia isn’t really the patient’s friend

Patient
August 8, 2009

The following op-ed was published on July 15th, 2009 in the USA Today.

“I researched my condition on Wikipedia.” That’s what more doctors, myself included, are hearing from patients every day.

Wikipedia is the Web’s most popular online encyclopedia. Its more than 13 million articles cover almost every topic imaginable. It is among the most visited sites primarily because its articles routinely show up near the top of search engine results, like …

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Op-ed: Wikipedia isn’t really the patient’s friend

ACP: Putting effectiveness into the health care equation: Rational or rationing?

Health Policy
July 30, 2009

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

by Steven Weinberger, MD, FACP

“Effectiveness” has become a buzzword these days in discussions about healthcare reform. It is often accompanied by different preceding modifiers, such as “cost” or “comparative,” each conjuring up different images in the minds of physicians, patients, insurers, and the pharmaceutical industry. Some say that cost effectiveness and comparative …

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ACP: Putting effectiveness into the health care equation: Rational or rationing?

AMA working for reform that benefits patients and physicians

Health Policy
July 26, 2009

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

by J. James Rohack, MD

Physicians know first-hand the frustrations of caring for patients in our broken system and also the joys of patient care that get us out of bed before the sun rises. The AMA is committed to getting health reform this year – so that the joys can again outnumber the …

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AMA working for reform that benefits patients and physicians

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