Here are two vignettes illustrating the failure of doctors to master the obvious and maybe a window onto the future struggles to control medical costs.
A 90-year old is referred for care due to “end stage dementia.” End-stage dementia is medical speak and as such does not really convey the appropriate imagery. It means a skeletal man, in a wheelchair or mostly in bed, with diapers, who has does not know …
Early last year, my boss Talmadge King and I were at an ABIM meeting (we’re both on the board), and the group was debating a controversial topic. Another participant at the meeting, like Talmadge the chair of a prominent department of medicine, said, “We polled 250 people at our grand rounds last week, and they said ‘X’.” The audience gasped – ‘X’ was a completely unexpected …
Here are the top 10 preventive services. These items were chosen by the National Commission on Prevention Priorities, and highlight those preventive services including immunizations, screenings, preventive medications, and counseling that give “the most bang for the buck.”
For an in depth discussion of methods and results, read Am J Prev Med 2006;31(1):52–61
Discuss Daily Aspirin Use
This counseling does not mean everyone should take aspirin to prevent heart attack and stroke, but …
Medicare, the government insurance company for everyone over age 65 (and for the disabled), pays fees to primary care physicians that guarantee bankruptcy.
Additionally, 70 percent of hospitals in the United States lose money on Medicare patients. That’s right, for every patient over age 65, it costs the hospital more to deliver care than the government reimburses. That is why Mayo Clinic has said it will not accept Medicare payments for …
The majority of Americans have a great deal of personal health information in their physician’s medical record. Many of these physicians have an electronic healthcare record (EHR) to store this information.
Unless you are in an integrated healthcare system, and most Americans are not, this information is just not available to you or any physician seeing you who does not belong to the same physician group as your primary physician. Even …
The following is part of a series of original guest columns by the American College of Physicians.
by Steven Weinberger, MD, FACP
At times of calendar transitions, e.g., at the onset of a new year or a new decade, the popular press often takes a broad view in looking retrospectively at the outstanding or defining events and people of the past …
Originally published in HCPLive.com
by Ed Rabinowitz
When it comes to negotiating fees with health plans, practices and physicians have more leverage than they realize. The problem, says John Schmitt, a managed care expert with EthosPartners Healthcare Management Group, is that practices often don’t even try. “Groups negotiate an agreement with a payor and then, for whatever reason, just fi le it away. Most medical groups do not have a good, proactive …
Originally published in MedPage Today
by John Gever, MedPage Today Senior Editor
Psychiatrists who prescribe drugs for their patients today usually give more than one at a time, often with little scientific basis, researchers said.
About 60% of patients with psychiatrist office visits leading to a drug prescription received at least two medications in 2005-2006, according to government survey data analyzed by Ramin …
It’s commonly thought that health care in the United States is heavily dependent on diagnostic testing.
But how do we compare with the rest of the world? Perhaps these graphs, courtesy of the New York Times can provide a stark illustration.
Here’s the data regarding CT scans, showing the number of tests per 1,000 people. Guess which country’s on top:
The rapid advance in digital video and still camera technology has found its way into the operating room.
There is the potential to capture and record just about every minute of every surgical procedure in some way. The newest endoscopic camera systems and operating microscopes have integrated systems to record video footage. Storing all that data is just the press of a button away.
The advantages for surgeons are obvious, like the …
As the first decade of the 21st century comes to an end, it is interesting to look back and reflect on the most significant medical advances we’ve seen. I’d like to present 12 medical advances that I consider to have been the most important over the past decade, and I’d like to ask you, the wider world, to contribute in two ways:
– Add your nomination in the comment field regarding …
It’s common knowledge that fewer medical students are entering primary care and that patients are having a hard time finding a primary care doctor. Part of the reason is that insurance companies place little value on much of the work that primary care doctors do.
Even though physicians’ complaints are seen in the medical and lay media, it is rare to see descriptions of a primary care physician’s “typical day” in …
Two years ago, I wrote about the case of Julie Thao, the Wisconsin nurse sent to prison for a medication error. I argued then that – although Julie bypassed some safety rules – she most certainly did not deserve jail time.
Along comes another case involving jail time for a medical mistake, this one featuring an Ohio pharmacist named Eric Cropp. I became aware of Eric’s case through the efforts of …
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Originally posted in Insidermedicine
The eye is very similar to a camera. Both are optical systems that have lenses in the front to focus light rays onto a film. The retina is the eye’s film. It is a tissue that consists of 10 layers and is about 500 microns thick—or, half a millimeter. The main function of the retina is to trap light rays, convert them into electrical impulses, and send …
I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.” It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest. The natural beauty is breathtaking. Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some …
Among the many differences between the U.S. and the French health-care systems is the approach to medical training. While U.S. medical school graduates in 2008 had an average debt of $154,000, French medical students receive their training virtually for free. For example, first-year medical students at the Faculte de Medecine Pierre et Marie Curie in Paris have only one mandatory cost for this year: an enrollment fee of $264.
The amount …
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A version of this op-ed, co-written with Doug Farrago, was published on October 26th, 2009 in Medscape.
It’s tough to be a doctor these days. Whether it’s listening to the difficulties of our medical colleagues as they try to best care for their patients, or engaging other health professionals about the uncertainties surrounding health reform, we’ve noticed a tense, sometimes gloomy, atmosphere among physicians.
A recent survey from the Annals of Internal …
Originally published in MedPage Today
by Chris Emery, MedPage Today Contributing Writer
Complications from first trimester abortions performed by family practitioners are rare, and family doctors could help address abortion provider shortages across the U.S., a new study found.
Among more than 2,500 abortions performed by family physicians, abortion was successful without complications in 96.5% of patients using medications (95% CI 95.5% …
The Wall Street Journal and other sources reported on a study from the Annals of Internal Medicine that showed that most US doctors don’t know the guidelines of how often women should get a pap smear. More importantly, doctors were doing a lot of pap smears on women who didn’t need them. In all the talk about health care reform, reducing costs by eliminating unnecessary testing has been mentioned multiple …
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At the American Heart Association meeting in Orlando, the results of the ARBITER 6-HALTS study were released. No Vytorin was used in the study, but I am sure that all the headlines will mention Vytorin.
The actual study published ahead of press online in the New England Journal of Medicine. Essentially, they enrolled over 200 patients from Walter Reed and Washington Adventist who had known heart disease or were at …
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