Improve primary care access before guaranteeing universal health coverage, my address at the National Press Club

Health Policy
July 17, 2009

The following are my prepared remarks at Health Care Reform: Putting Patients First, held at the National Press Club in Washington, DC, on July 17th, 2009.

President Obama recently declared that, “We are not a nation that accepts nearly 46 million uninsured men, women, and children.” And indeed, finding a way to provide universal health coverage to every American is one of the focal points in today’s health care debate. …

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Improve primary care access before guaranteeing universal health coverage, my address at the National Press Club

How soon should patients receive their test results?

Conditions and Diseases
July 9, 2009

And should you assume that no news is good news?

The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent.

That’s almost a quarter of abnormal test results from that center that patients were never …

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How soon should patients receive their test results?

ACR: Reducing medical imaging costs requires a short term investment

Health Policy
July 9, 2009

The following is a guest post from the American College of Radiology.

by James H. Thrall, M.D.

Health care reform cannot be approached with a “one size fits all” cost-cutting mentality. Reducing costs in the long term often requires an investment in the short term — particularly, in regard to medical imaging.

Medical imaging saves lives. Imaging also saves dollars through earlier disease diagnosis, less invasive medical procedures, shorter hospital stays, and …

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ACR: Reducing medical imaging costs requires a short term investment

5 top medical comments, July 5th, 2009

Health Policy
July 5, 2009

Here are some of the more interesting comments readers have left recently.

1. Rogue Medic on how Oprah should be handling medical issues:
If she is going to give medical advice, and she is giving medical advice, and she is going to focus on giving advice contrary to the guidelines of reputable medical organizations, maybe some of her viewers need to start suing her for the bad medical advice.

I am guessing …

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5 top medical comments, July 5th, 2009

The AMA and Sermo break up, and how it’s getting ugly

Social Media in Medicine
July 3, 2009

When the online physician discussion site, Sermo, and the American Medical Association joined forces in 2007, it was heralded as a promising partnership for both entities.

In fact, as Sermo’s CEO Daniel Palestrant said back then, “As a company, we had to take a very rational perspective on that by saying we’re a small software company, not an advocacy organization. Who is the best entity to turn voice into action? …

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The AMA and Sermo break up, and how it’s getting ugly

Vicodin and Percocet banned and taken off the market, or is a black box warning more likely?

Medications
June 30, 2009

The FDA has declared war on acetaminophen, with Vicodin and Percocet being collateral damage.  You can bet Dr. Gregory House is sweatin’ pretty hard over this news.

In the last few days, acetaminophen, otherwise known as the brand name Tylenol, has been squarely in the FDA advisory panel’s crosshairs. In general, it’s a very safe medication, but there is …

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Vicodin and Percocet banned and taken off the market, or is a black box warning more likely?

Reader take: Moral hazard, and whether patients should consider cost in their health care decisions

Patient
June 30, 2009

The following is a reader take by an anonymous medical student.

One of the ideas that comes up in the search for explanations of high healthcare costs is the so-called “Moral Hazard”—the idea that insured patients are more likely to agree to unnecessary procedures because they don’t pay for them directly. Not everyone thinks it is real—does a patient have the medical knowledge to make an informed decision? …

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Reader take: Moral hazard, and whether patients should consider cost in their health care decisions

Can the American Medical Association still be an influential voice in health reform?

Health Policy
June 29, 2009

The repercussions after Obama’s speech to the AMA’s delegates continue to be felt.

Not least of which are the murmurings of the other professional physician groups, who say that the AMA does not represent a majority of physicians. In this piece from pediatrician Rahul Parikh, he notes that about 30 percent of physicians are AMA members. Remaining doctors belong to groups with more liberal political leanings, including the American …

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Can the American Medical Association still be an influential voice in health reform?

Did Demerol cause Michael Jackson’s cardiac arrest and death?

Conditions and Diseases
June 26, 2009

Michael Jackson’s death continues to consume the news cycle.

There is currently no clear explanation. Some have speculated that it may be related to the narcotic pain drug, Demerol. According to this report from the UK’s The Sun, “An Emergency Room source at UCLA hospital said Jackson aides told medics he had collapsed after an injection of potent Demerol …

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Did Demerol cause Michael Jackson’s cardiac arrest and death?

How did Michael Jackson die, and the medicine behind sudden cardiac death

Conditions and Diseases
June 25, 2009

Michael Jackson is dead at age 50.

I’ve received several e-mails to comment on this story, but there’s really too few details to go on. I’m sure more will emerge in the near future.

According to news reports, emergency medical services were called to his home in Los Angeles, where he was found in presumed cardiac arrest. CPR …

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How did Michael Jackson die, and the medicine behind sudden cardiac death

ACP: Embracing a culture of cost-effective health care

Health Policy
June 25, 2009

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

by Steven Weinberger, MD, FACP

In his column in the June 1 issue of The New Yorker, Dr. Atul Gawande used the example of McAllen, Texas, to illustrate the widely disparate spending on health care around the country. This oft cited article captured the attention of President Obama, who reportedly has made it required …

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ACP: Embracing a culture of cost-effective health care

Steve Jobs received a new liver, and the ethics surrounding his transplant

Conditions and Diseases
June 22, 2009

Orac, a general surgeon who blogs at Respectful Insolence, writes the most comprehensive entry I’ve seen thus far on Apple’s Steve Jobs’ liver transplant.

For those interested in the medicine behind the transplant, go and read his post in its entirety. I’d like to highlight some of the potentially questionable ethics surrounding the case.

For one, there is the question why Mr. …

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Steve Jobs received a new liver, and the ethics surrounding his transplant

Reflections from the AMA: President Obama’s Speech

Health Policy
June 21, 2009

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

by J. James Rohack, M.D.

We have a historic opportunity for health reform this year and the AMA was delighted to welcome President Obama to our Annual Meeting in Chicago earlier this week. Like the President, we are committed to health-care reform that will provide all Americans with affordable, high-quality health coverage.

I was personally honored …

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Reflections from the AMA: President Obama’s Speech

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My reaction to President Obama’s speech to the AMA

Health Policy
June 15, 2009

I was seeing patients during the actual speech, so I had to rely on the transcript.

The points that interested me the most were any language pertaining to malpractice, addressing the AMA’s recent concerns about the public plan option, and reforming the physician payment system.

I think he did pretty well.

Regarding the physician payment system, he again addressed McAllen, Texas, which is fast becoming the symbol of what’s wrong with American …

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My reaction to President Obama’s speech to the AMA

5 top medical comments, June 14th 2009

Patient
June 14, 2009

Here are some of the more interesting comments readers have left recently.

1. Carla Kakutani on how Massachusetts’ health reform won’t relieve ER overcrowding:
Insurance does not equal access (although it’s better than nothing). Nothing changes until every stakeholder recognizes they have to control costs and allow a rebuilding of primary care in the US. That includes doctors and patients, along with everybody’s favorite villains, the insurance companies and big pharma. …

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5 top medical comments, June 14th 2009

AMA: Health information technology help for physicians

Health Technology
June 11, 2009

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

by Joseph M. Heyman, M.D.

Health information technology (HIT) remains a hot button issue for many physicians, and opinions run the gamut. There are physicians and practice managers who are satisfied long-time users and those who question how HIT will benefit their practice and their patients.

My own experience is that of a solo-practitioner using HIT …

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AMA: Health information technology help for physicians

Maggie Mahar: Removing the hazardous waste from healthcare

Health Policy
June 8, 2009

Most of us are now familiar with the estimates that as much as one-third of our health care dollars are squandered on ineffective, often unnecessary, unproven and overpriced products and services. But which third?

The fat in our health-care system is not hanging out conveniently on the edges of the steak, waiting to be trimmed. It will take a scalpel, a keen eye, and a steady hand to remove at least …

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Maggie Mahar: Removing the hazardous waste from healthcare

5 top medical comments, June 7th 2009

Health Policy
June 7, 2009

Here are some of the more interesting comments readers have left recently.

1. David Block on the ACP’s guest column, A practice model for increasing the appeal of General Internal Medicine:
Weinberger talks about the efficiency of Care. Our commentators talk about the efficiency of Consumption. Weinberger assumes the one-on-one of two individuals, known to each other, who together negotiate the terms of personhood. Medicine is “spiritus”; no wonder he became …

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5 top medical comments, June 7th 2009

Physician payment reform is the key to fixing the health care system

Health Policy
June 1, 2009

Changing the way doctors are paid is more important than the debate over the public insurance option, or the arguments over whether we should adopt a single-payer system or not.

Atul Gawande’s recent New Yorker article is a tour de force, and gets down to the core of why American health care is so expensive. I won’t bother summarizing it here – it deserves to be read in its …

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Physician payment reform is the key to fixing the health care system

ACP: A practice model for increasing the appeal of General Internal Medicine

Physician
June 1, 2009

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

by Steven Weinberger, MD, FACP

Much is written and discussed these days about the importance of care coordination by a primary care physician, not only to facilitate patient-centered quality of care, but also to curb the unsustainable growth in the nation’s health care tab. Yet, we hear that the current shortage of …

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ACP: A practice model for increasing the appeal of General Internal Medicine

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