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Nikolaos I. Kakavoulis, MD

Physicians increase revenue with better appointment analysis

April 3, 2010Apr 3, 201010

by Nikolaos I. Kakavoulis, MD Physicians are working harder than ever to generate even a small increase in their income. Despite seeing more patients, average physicians net income between 1995 and 2003 has declined about 7% after adjusting for inflation,…

by Nikolaos I. Kakavoulis, MD

Physicians are working harder than ever to generate even a small increase in their income. Despite seeing more patients, average physicians net income between 1995 and 2003 has declined about 7% after adjusting for inflation, according to a national study from the Center for Studying Health System Change.

Why is this happening?

Now more than ever, physicians face an avalanche of complex rules, regulations, and administrative processes needed …

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The individual mandate may collapse health reform

Richard Reece, MD

April 3, 2010Apr 3, 201021

Obamacare faces a shaky future because of its call for an individual mandate. This mandate requires people to buy insurance or face income tax penalties, which the IRS would presumably enforce. As I write, attorney generals in 35 states are…

Obamacare faces a shaky future because of its call for an individual mandate. This mandate requires people to buy insurance or face income tax penalties, which the IRS would presumably enforce.

As I write, attorney generals in 35 states are in the process of challenging the individual mandate as unconstitutional.

The individual mandate issue is important. Kill it, and you kill Obamacare.

Why? Because the individual mandate is the political mechanism for controlling …

Peer review helps doctors improve medical care

John Mandrola, MD

April 2, 2010Apr 2, 20109

While typing words, the advertisement for yet another hospital is overheard from the TV. "Ignore it John," I think to myself, but, it is impossible to not look up and see. The head shakes with a smirk, like my grandfather…

While typing words, the advertisement for yet another hospital is overheard from the TV. “Ignore it John,” I think to myself, but, it is impossible to not look up and see. The head shakes with a smirk, like my grandfather did and without words displeasure was easily conveyed.

Do people really think the graphical professionalism of a TV spot is even remotely an accurate metric of quality of medical care?

At work, …

Physicians should be involved in health care decisions

Jeffrey Knuppel, MD

April 2, 2010Apr 2, 20103

As physicians progress through medical training and acquire new knowledge and skills, something interesting happens. They also develop a new and increasing awareness of not only how much they didn’t previously know but also how much they still don’t know. This process sounds paradoxical but has been consistent with my personal experience: The more I learn, the less I think I know.

Any seasoned clinician knows that in order for one …

Conditions and diseases

Children whose parents refuse vaccination may spread measles

April 2, 2010Apr 2, 20109

by Todd Neale Children whose parents refuse vaccinations for them provide fertile ground for the spread of vaccine-preventable diseases, an investigation of a 2008 measles outbreak in San Diego demonstrated. Although the rate of two-dose immunization against measles was 95%…

by Todd Neale

Children whose parents refuse vaccinations for them provide fertile ground for the spread of vaccine-preventable diseases, an investigation of a 2008 measles outbreak in San Diego demonstrated.

Although the rate of two-dose immunization against measles was 95% in the area, a single case of measles from a 7-year-old child returning from overseas sparked an outbreak that exposed 839 people and sickened 11 other children, according to David Sugerman, …

Medicare for all may be next for healthcare reform

George Lundberg, MD

April 2, 2010Apr 2, 201036

In the Journal of the American Medical Association on May 15, 1991, in our first of many theme issues dedicated to "Caring for the uninsured and underinsured," I wrote: "An aura of inevitability is upon us. It is no longer…

In the Journal of the American Medical Association on May 15, 1991, in our first of many theme issues dedicated to “Caring for the uninsured and underinsured,” I wrote: “An aura of inevitability is upon us. It is no longer acceptable morally, ethically, or economically for so many of our people to be medically uninsured or seriously underinsured. We can solve this problem. We have the knowledge and the resources, …

Medical education

Residency training is like James Cameron’s Avatar

Vineet Arora, MD

April 1, 2010Apr 1, 20102

Dr. Carolyn Clancy, head of the Agency of Healthcare Research and Quality, recently highlighted the definite need for enhanced patient safety and training on healthcare IT for residents who will be the practicing docs of the future. At the very…

At the very end, she compared the future of residency training to James Cameron’s Avatar – an epic battle followed by enlightenment.

Because I am a huge science fiction fan and working in graduate medical …

Insurance companies fail at rating physicians on cost

April 1, 2010Apr 1, 20105

by Emily P. Walker A physician profiling method used by private insurance companies to steer patients toward lower-cost physicians isn't reliable, researchers found. According to a study published in the March 18 issue of the New England Journal of Medicine,…

by Emily P. Walker

A physician profiling method used by private insurance companies to steer patients toward lower-cost physicians isn’t reliable, researchers found.

According to a study published in the March 18 issue of the New England Journal of Medicine, 43% of physicians who are ranked as “lower cost” doctors according to a common formula used by insurance companies are not actually treating patients for any less than physicians with …

How health reform can be popular with the American public

Kevin Pho, MD

April 1, 2010Apr 1, 201012

The health reform legislation was decidedly unpopular, with a variety of polls showing the majority disapproved of the bill. What did the people want? The ACP's Bob Doherty linked to a post by Princeton's Uwe Reinhardt, who observed 10 things…

The health reform legislation was decidedly unpopular, with a variety of polls showing the majority disapproved of the bill.

What did the people want?

The ACP’s Bob Doherty linked to a post by Princeton’s Uwe Reinhardt, who observed 10 things that the public wants in health care reform:

1. Lets only patients and their own physicians determine how to respond clinically to a given medical condition, never an insurance clerk or, even

…

Teaching patient safety starts in medical school

David Harlow

March 31, 2010Mar 31, 20104

Ten years after the release of the IOM report To Err is Human, which documented the toll taken by medical errors in this country, the question remains: What can be done to reverse the trend of ever-increasing morbidity and mortality…

Ten years after the release of the IOM report To Err is Human, which documented the toll taken by medical errors in this country, the question remains: What can be done to reverse the trend of ever-increasing morbidity and mortality due to medical errors?

Last December, a look back over the decade since the release of To Err is Human — and a steady medical error death rate of about 100,000 …

Patient voices

Sex habits of older women and men

Sex habits of older women and men

March 31, 2010Mar 31, 2010

Originally published in MedPage Today by Kristina Fiore, MedPage Today Staff Writer Thirty-somethings can expect to enjoy at least another 30 years of sex, researchers have found. At age 30, men will be sexually active for another 35 years, while…

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Thirty-somethings can expect to enjoy at least another 30 years of sex, researchers have found.

At age 30, men will be sexually active for another 35 years, while women will be active for another 30, Stacy Tessler Lindau, MD, and Natalia Gavrilova, PhD, of the University of Chicago, reported online …

Read more…

Conditions and diseases

Radiology tests, and how to find their price

Leslie Ramirez, MD

March 30, 2010Mar 30, 201017

I am often asked how we get the prices for the radiology imaging tests, such as MRI's and mammograms, or ultrasounds. Most people assume that my day job as a doc gives me some sort of special access to this…

I am often asked how we get the prices for the radiology imaging tests, such as MRI’s and mammograms, or ultrasounds. Most people assume that my day job as a doc gives me some sort of special access to this info. But that’s just not the case. Anyone can find out testing prices.

However, over the last year, those of us working at LesliesList.org have gotten more experienced and better at …

Drugs and prescribing

Drug companies are using community doctors for dinner talks

March 30, 2010Mar 30, 20103

Originally published in MedPage Today by John Fauber, Milwaukee Journal Sentinel/MedPage Today Reporter When looking for a doctor to travel the country to promote its prescription fish oil product, a leading pharmaceutical company looked to a small-town community doctor rather…

Originally published in MedPage Today

by John Fauber, Milwaukee Journal Sentinel/MedPage Today Reporter

When looking for a doctor to travel the country to promote its prescription fish oil product, a leading pharmaceutical company looked to a small-town community doctor rather than an academic heavyweight.

Its choice was a Delafield, Wis., primary care physician and clinical lipidologist who entered private practice in 2001.

For speaking …

Why healthcare may not embrace the iPad

Primary care is the loss leader of medicine

Kevin

March 30, 2010Mar 30, 20108

Medicare's sustainable growth rate, or SGR, has been the bane of doctors for years now. To encapsulate, this is the reason for Medicare's annual threat to cut doctors' fees by 20% or more, only to be staved off at the…

Medicare’s sustainable growth rate, or SGR, has been the bane of doctors for years now.

To encapsulate, this is the reason for Medicare’s annual threat to cut doctors’ fees by 20% or more, only to be staved off at the last minute.

Emergency physician Shadowfax has a nice take on it, explaining why it has devastated primary care:

Primary care has many fixed expenses in addition to those we bear: they pay

…

Drugs and prescribing

Oxycontin should be prescribed less often by doctors

Edward Pullen, MD

March 29, 2010Mar 29, 201018

Oxycontin is an oral pain medication that contains the single active ingredient oxycodone. Oxycodone is one of the most potent of the oral opiates, and has more euphoric effect than many other opiate analgesics. Oxycontin is the most notorious prescription…

Oxycontin is the most notorious prescription drug of abuse in the US, and for good reason. Though marketed as a sustained release medication, as much as 30% of the medication is absorbed immediately and the rest absorbed …

Health technology

Why healthcare may not embrace the iPad

Satish Misra, MD

March 29, 2010Mar 29, 20103

The excitement and hype surrounding the announcement of Apple’s iPad have subsided for the time being, perhaps just a lull prior to the actual release in a few months. It's expected that the iPad could make significant contributions to healthcare,…

The excitement and hype surrounding the announcement of Apple’s iPad have subsided for the time being, perhaps just a lull prior to the actual release in a few months. It’s expected that the iPad could make significant contributions to healthcare, such as potentially replacing the physician’s clipboard or medical textbooks.

However, we did disagree at times on the extent to which the iPad could penetrate the healthcare market, for a variety …

Read more…

Medical education

Diet Coke and the AHA red dress endorsement