Why there needs to be a national healthcare information database

Tech
January 24, 2010

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 …

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Tips for doctors who negotiate reimbursement rates with insurance companies

Physician
January 19, 2010

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 …

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How psychiatrists may be giving their patients too many drugs

Meds
January 16, 2010

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 …

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Issues surrounding videotaping surgeries in the operating room

Physician
December 23, 2009

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 …

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12 most important medical advances of the decade

Physician
December 16, 2009

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 …

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What’s a typical day of a primary care doctor like?

Physician
December 14, 2009

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 …

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Should health care workers go to jail for medical errors?

Physician
December 11, 2009

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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Seeing floaters or flashing lights can be caused by posterior vitreous or retinal detachment

Conditions
December 2, 2009

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 …

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The joys of practicing rural emergency medicine

Physician
November 25, 2009

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 …

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How training to become a doctor in France differs from the United States

Education
November 22, 2009

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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Op-ed: Humor can be healing for both doctors and patients

Physician
November 21, 2009

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 …

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Can family doctors do safe first trimester abortions?

Conditions
November 18, 2009

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% …

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Why doctors are doing so many unnecessary Pap smears

Conditions
November 17, 2009

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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Why you should stop taking Vytorin for high cholesterol

Meds
November 16, 2009

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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How teamwork is essential in the emergency department

Physician
November 12, 2009

I recently cared for a patient who raised my heart-rate a bit. Of course, any emergency physician will tell you, the potentially difficult and complicated cases often come at the end of the shift, as you’re trying to clean up all of the paperwork and ‘head for the house.’ Nurse Ginger came to me and said, ‘we need a doctor in room 11.’ I snarled, snatched the paper, grumped and …

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Many women report nerve-related persistent pain after breast surgery

Conditions
November 12, 2009

Originally published in Insidermedicine

Nearly half of women who undergo surgery and other treatments for breast cancer report having persistent pain in and around the treatment area a year or more later, probably because of nerve damage, according to research published in the November 10 issue of the Journal of the American Medical Association.

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How health care reform can improve public health

Policy
October 13, 2009

by Paula Hartman Cohen

Have we overlooked the public health aspect of health care reform?

In the health care reform debate, we’ve heard and read how health care reform will or will not work, what it will or will not cost, and how it will or will not impact each one of us as individuals.

We’ve also heard from those who have great faith in our current system, and sincerely believe we should …

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Should doctors be paid to e-mail their patients?

Physician
October 11, 2009

by Michael Kirsch, MD

This is a less controversial issue than patients ‘friending’ their doctors on Facebook, which I oppose. Although most physicians’ offices are not e-mailing with patients, perhaps they should. There are several obvious advantages.

* Decompress phone lines, which are suffocating nearly every medical practice in America.

* Relieve patients of the cruel and unusual punishment of languishing on ‘hold’ listening to elevator music or dead air.

* Allow office staff …

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