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

Grading the Gates Foundation

Medications
May 31, 2009

A recent study in Lancet becomes the first study to pull back the curtain on the Bill and Melinda Gates Foundation and its impact on global health.

Since the money the Gates Foundation spends on global health (61% of its total $2.01 billion budget) is almost as large as the entire budget of the WHO, and because it is not a passive donor (it actively engages in policy making and agenda …

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Grading the Gates Foundation

6 top medical comments, May 31st, 2009

Health Technology
May 31, 2009

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

1. Dr. Grumpy on the art of medicine and electronic medical records:
I do use an EMR, but patient’s routinely tell me I’m good at listening. I think it’s an individual basis. Some doctors are technophiles, and put that first. That ain’t right. Some doctors are so intent on listening, that they may forget a detail, and then it …

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6 top medical comments, May 31st, 2009

How much time do doctors spend on paperwork?

Physician
May 29, 2009

A common complaint is that doctors these days are spending more time doing clerical tasks.

Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do not need a medical degree to do these tasks.

Bob Doherty points to a study that gives some numbers to back up the claims. Primary care doctors spend about 3.5 …

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How much time do doctors spend on paperwork?

AMA: Curbing the rise in health care costs is key to health-system reform

Health Policy
May 14, 2009

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

by J. James Rohack, M.D.

In an unprecedented endeavor aimed at achieving health-care reform this year, the American Medical Association (AMA) stood with President Obama and other key health-care stakeholders Monday to announce efforts to “bend the spending curve” on health care. U.S. health-care …

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AMA: Curbing the rise in health care costs is key to health-system reform

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Does violence on TV and in the media really lead to violent behavior?

Social Media in Medicine
May 10, 2009

We’ve become accustomed the notion that media violence is bad for children, and that exposure to it can lead to all kinds of problems, including violent behavior. Those us who remember Columbine in 1999 will certainly recall reports that the killers played the videogame Doom and listened to Marilynn Manson before they went on their tragic rampage. Less dramatic anecdotes pop up regularly.

But there’s a new, detailed analysis of media …

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Does violence on TV and in the media really lead to violent behavior?

6 top medical comments, May 10th, 2009

Physician
May 10, 2009

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

1. Anonymous on whether emergency physicians best served to staff urgent care centers:
As an ED doc, I understand the problem. We are taught to always rule out the emergencies, and I am constantly worrying about the worst case scenario, and likely will order more tests since they are at my disposal, which is …

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6 top medical comments, May 10th, 2009

Can you really kill a man by gluing his anus shut?

Potpourri
May 9, 2009

A recently reported method of torturing gay men in Iraq sounds horrifying.

Andrew Sullivan points to an article that spares no graphic details: “. . . anti-gay Shiite death squads are sealing their anuses with a powerful glue, then inducing diarrhea, which leads to a painful and agonizing death.”

But, can someone really die from this novel form of torture?

Emergency physician Shadowfax has his doubts. …

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Can you really kill a man by gluing his anus shut?

Abraham Verghese on the KevinMD Live Q&A: Monday, May 4th at 10:30pm Eastern

Patient
May 4, 2009

Abraham Verghese will be answering your questions at my next live Q&A.

Dr. Verghese, a Professor for the Theory and Practice of Medicine at the Stanford University School of Medicine, is one of the most accomplished and admired physician educators today. His pieces have appeared in The New York Times and The Wall Street Journal, and one of his recent articles, entitled Culture Shock, …

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Abraham Verghese on the KevinMD Live Q&A: Monday, May 4th at 10:30pm Eastern

6 top medical comments, May 3rd, 2009

Medications
May 3, 2009

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

1. Carla Kakutani on the lack of primary care access in Massachusetts:
So we have a chicken and egg problem. Do we wait health care reform until we have revived US primary care, or is that even possible without health care reform to create the disruption needed to change our entrenched fee-for-service, procedure-happy payment …

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6 top medical comments, May 3rd, 2009

Anti-vaccine ads, and how false advertising harms children

Social Media in Medicine
April 29, 2009

Where is the line between true and false advertising? And should we be more careful when the claims an ad makes has potential health consequences for children and communities?

Let’s ask newspapers that question about big adverts they’ve printed from Generation Rescue, an autism advocacy group, the one headed up by Jenny McCarthy, who regularly appears on National TV claiming vaccines cause autism.

The ads, which you can see on the Generation …

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Anti-vaccine ads, and how false advertising harms children

Reader take: Patients should be allowed to access their entire medical record

Health Technology
April 28, 2009

The following is a reader take, in response to a post on whether patients should own their medical records, by an anonymous nurse.

Dear Dr. Pho,

I wish to respond to your position on patient access to their medical records both as a patient and a nurse.

If a doctor or other health professional believes their documentation would be inappropriate or too sensitive for …

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Reader take: Patients should be allowed to access their entire medical record

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