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 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 …
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…
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 …
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…
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.
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…
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 …
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…
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 …
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…
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 …
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…
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 …
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…
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 …
Here are some of the more interesting comments readers have left recently.1. Anonymous on whether IV sedation is overused:I think it depends on the patient and on the procedure. For my colonoscopy, I did prefer the sedation. It wasn't something…
Here are some of the more interesting comments readers have left recently.
1. Anonymous on whether IV sedation is overused: I think it depends on the patient and on the procedure. For my colonoscopy, I did prefer the sedation. It wasn’t something that I cared to remember.
But I’ve also had a core needle biopsy of an abdominal tumor. The tumor was right …
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…
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 …
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…
The following is a reader take from the staff at HealthHarbor.We had a chance to attend the HIMSS conference two weeks ago. HIMSS is healthcare's premier annual tech expo, and was in Chicago this year. The undeniable theme of this…
The following is a reader take from the staff at HealthHarbor.
We had a chance to attend the HIMSS conference two weeks ago. HIMSS is healthcare’s premier annual tech expo, and was in Chicago this year. The undeniable theme of this year’s conference was the anticipated expansion of Health Information Technology (HIT) via the Economic Recovery Act. …
Here are some of the more interesting comments readers have left recently.1. Manalive on quality measures:It is almost always a leap of faith to apply evidence-based guidelines to the frail elderly, to patients with many medical problems, to alcoholics, to…
Here are some of the more interesting comments readers have left recently.
1. Manalive on quality measures: It is almost always a leap of faith to apply evidence-based guidelines to the frail elderly, to patients with many medical problems, to alcoholics, to the poorly insured — in short, to a large percentage of my practice. Accordingly, I have been on the wrong end of too many …
Here are some of the more interesting comments readers have left recently.1. Dr. Gwenn on limited health literacy:For us to do a better job with patients and teach them to be better advocates for themselves, we need more time -…
Here are some of the more interesting comments readers have left recently.
1. Dr. Gwenn on limited health literacy: For us to do a better job with patients and teach them to be better advocates for themselves, we need more time – plain and simple. At the same time, patients need more community supports to understand the complex health world and build the skills they need …
It's a well known phenomenon that hospitalists are taking over inpatient medicine.And no wonder, the payment system strongly discourages newly minted doctors to practice outpatient medicine, and the demand that hospitals have for inpatient physicians is surging at an unprecedented…
It’s a well known phenomenon that hospitalists are taking over inpatient medicine.
And no wonder, the payment system strongly discourages newly minted doctors to practice outpatient medicine, and the demand that hospitals have for inpatient physicians is surging at an unprecedented rate.
It’s a good time to be a hospitalist, but, as this reader writes to me, that may lead to an increasingly variability in the quality …
More hospitals are resorting to so-called "dayhawk" radiology services to read their x-rays.It's modeled after the "nighthawk" model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.Now, the…
More hospitals are resorting to so-called “dayhawk” radiology services to read their x-rays.
It’s modeled after the “nighthawk” model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.
Now, the phenomenon is happening during business hours as well, which according to radiologist Giles W. L. Boland, means that “some radiologists can no longer assume long-term …
Would Natasha Richardson be alive today if she had gone skiing in the United States instead?I don't think it would have made a difference.To recap the tragedy, Ms. Richardson died from an epidural bleed, after she fell while skiing. Her…
Would Natasha Richardson be alive today if she had gone skiing in the United States instead?
I don’t think it would have made a difference.
To recap the tragedy, Ms. Richardson died from an epidural bleed, after she fell while skiing. Her presentation was somewhat classic, with the well-described “lucid” period before she deteriorated.
According to Canada’s Globe and Mail, “ambulance workers were not …
Tragic news this morning regarding actress Natasha Richardson, who reportedly, suffered a head injury during a ski lesson in Canada.According to reports, she fell on a beginner's ski hill, and did not hit anyone or anything during the fall. There…
Tragic news this morning regarding actress Natasha Richardson, who reportedly, suffered a head injury during a ski lesson in Canada.
According to reports, she fell on a beginner’s ski hill, and did not hit anyone or anything during the fall. There was no obvious sign of injury, and in fact, she was “was walking around and feeling fine for an hour after her accident.”
Mariana Bridi da Costa, a 20-year old Brazilian model, tragically died early Saturday morning from Pseudomonas aeruginosa urosepsis.How can this happen? Miss Bridi da Costa initially presented on December 30th, and was diagnosed with kidney stones. An ultrasound, plain film,…
Mariana Bridi da Costa, a 20-year old Brazilian model, tragically died early Saturday morning from Pseudomonas aeruginosa urosepsis.
How can this happen?
Miss Bridi da Costa initially presented on December 30th, and was diagnosed with kidney stones. An ultrasound, plain film, or CT scan likely would have been done to confirm the diagnosis. I assume that a urinalysis was also performed, and if …
The following op-ed was published on January 14th, 2009 in the USA Today. Every patient's worst nightmare is going to the hospital for a procedure only to have a surgical instrument left in his body, the wrong limb or organ…
The following op-ed was published on January 14th, 2009 in the USA Today.
Every patient’s worst nightmare is going to the hospital for a procedure only to have a surgical instrument left in his body, the wrong limb or organ operated on or, worse, dying from a medical mistake. These types of mistakes should never happen.
So when Medicare recently instituted a plan to deny hospital payments for …
According to 
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.
