Originally published in MedPage Today
by Michael Smith, MedPage Today North American Correspondent
A vaccine against cocaine was effective in nearly 40% of users of the drug, researchers said.
In a randomized, placebo-controlled study, volunteers who reached a high level of antibodies after vaccination used less cocaine than those whose response was lower, according to Thomas Kosten, MD, of Baylor College …
Is a cocaine abuse vaccine coming soon?
When the patient safety field began a decade ago with the publication of the IOM report on medical errors, one of its first thrusts was to import lessons from “safer” industries, particularly aviation. Most of these lessons – a focus on bad systems more than bad people, the importance of teamwork, the use of checklists, the value of simulation training – have served us well.
But one lesson from …
Is incident reporting effective in reducing medical errors and increasing patient safety?
The following is part of a series of original guest columns by the American College of Physicians.
by Steven Weinberger, MD, FACP
In the Fall of 2009, we physicians should perhaps change the Biblical phrase, “Physician, heal thyself” to “Physician, immunize thyself” and then follow the phrase twice – once for seasonal influenza and once for H1N1. To date, physicians and other health care workers have too often been lax …
Flu and H1N1 influenza vaccine recommendations for doctors and health care workers
Originally published in MedPage Today
by Michael Smith, MedPage Today North American Correspondent
Men who were in utero during the peak of the 1918-1919 flu pandemic were at increased risk of heart disease when they reached their 60s, 70s, and 80s, researchers said.
In those men, the rate of heart disease was more than 23% higher than among those whose mothers …
Did the 1918 flu pandemic increase the risk of heart disease?
Originally posted in MedPage Today
by Emily P. Walker, MedPage Today Washington Correspondent
The Senate Finance Committee finished work on its healthcare reform bill in the wee hours of Friday morning, paving the way for a committee vote next week.
After considering hundreds of amendments, the committee is now waiting for a cost-estimate from the Congressional Budget Office (CBO) before it …
Analysis of the Senate Finance Committee health care reform bill
by Marie Cooper
I have been in senior executive management in both managed care and a major hospital system. I find the hysteria over “reform” bitterly amusing because it is so misdirected.
The real problem with health care in America? Greed, indifference and incompetence, pure and simple. But not in the places everyone is pointing.
Insurer side
Insurance companies have to maximize their revenue because they answer to their boards. They …
Health care reform analysis from a former insurance and hospital executive
Originally published in MedPage Today
by Todd Neale, MedPage Today Staff Writer
Men might not be getting the information they need to make an educated decision about prostate cancer screening, two new studies suggest.
Among 375 men surveyed by telephone, only 69.9% had discussed a prostate-specific antigen (PSA) test with their physician before making a decision about screening, according to the …
Not all doctors discuss the risks and benefits of prostate cancer screening to patients
The doctor-patient relationship must remain the central focus of good health care. Diminish or hinder that relationship, and no technological advance, funding system, or government intervention in the world will be able to compensate. Many complaints about present health care systems can be seen as evidence of relationship dysfunction, not in the least due to the interference of third parties, administrators, payers and insurers, who wield the financial clout. Transparency …
Informed consent is central to the doctor-patient relationship
Recently, a former staff medical writer at a MECC (Medical Education Communication Company) anonymously alerted me to a particularly sleazy advertising tactic used by a medical writing company. This person had worked as a pharma-supported medical writer for several years, but recently quit because, “I really couldn’t stomach the ethical problems associated with writing for the pharma industry.” Recently, looking for medical writing jobs, this writer came across a company …
Medical ghost-writing influences doctors to prescribe more drugs
Two things are missing from the bustling conversations on health care reform jamming the Internet highway. First, where among the finger-pointing anecdotes and critical analyses of our “broken” American medical system are the stories and discussions of all that is right? Second, where is our sense of hope?
I’ve experienced American health care from an unusual, yet useful, vantage: that of a physician with chronically recurring cancer. From both sides of …
What doctors can learn from patients in the health care reform debate
A recent issue in The Lancet included an article entitled “The Death of Ivan Ilyich and pain relief at the end of life.” This is a thought provoking article focused on the question of whether there is overuse of pharmaceuticals to treat various forms of suffering in hospice and palliative medicine.
The authors argue that a good death, as seen through their interpretation of The Death of Ivan Ilyich, may include …
Are hospice doctors relying too much on symptom scores to assess pain?
There can be little doubt that the lethal combination of aging baby boomers, the obesity epidemic, and the growing success of medical and interventional therapies for CV disease (resulting in more and more survivors of major events) is going to produce a flood of cardiovascular disease in the coming decades, and cardiologists in great numbers will be needed to care for these people.
However, that doesn’t mean that the message conveyed …
Will there really be an impending shortage of cardiologists?
by an anonymous NICU nurse
There is a medical controversy brewing over in England that is threatening to invade the United States. Ms. Capewell, a 23-year old British mother, is claiming English doctors let her 21 5/7 week infant die, only because they were following national perinatal guidelines.
If only he was born at 22 weeks, she insists, they would have tried everything to save him and admitted him to the …
Should letting a premature infant die be considered health care rationing?
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by Michael Kirsch, MD
The concept of medical excess is very difficult for ordinary patients to grasp. The medical community has worked hard for decades teaching them that more medicine meant better medical care. The public has learned these lessons well. Physicians who sent their patients for various diagnostic tests or specialty consultations were regarded as conscientious and thorough. Patients approved of doctors who prescribed antibiotics regularly for colds and other …
Does the bulk of excessive medical care happen in the ER?
by an anonymous radiologist
I recently read the article and comments on this link from this post, concerning radiologists, from Musings of a Dinosaur.
I was disturbed to discover the animosity with which this topic is covered. The tenor of the blog is that radiologists are greedy, self-serving and are out to erode the doctor-patient relationship. The suggestion that radiologists would schedule percutaneous breast biopsies for their financial enhancement is both …
Radiologists and communicating mammogram results to patients and their doctors
It happens over and over. I call a surgeon about a patient with abdominal pain.
‘Well, what’s the white count?’
‘Normal.’
‘Did you get a CT Scan?’
‘Yes, and it was normal. But they just look uncomfortable.’
‘Sounds like nothing for me to do. Call the hospitalist.’
It happens in other specialties. Cardiologists who aren’t interested in a patient with a normal stress test, pediatricians unimpressed with negative chest x-rays and normal labs. ENT’s unconcerned if …
Is medical technology making doctors less relevant?
by Mark Adelman, MD
While diseases like prostate cancer and heart disease have become household concerns, abdominal aortic aneurysms (AAA), the 10th leading cause of death in men age 55 and older, have been overshadowed by more prominent diseases for far too long. It’s time we pull back the curtain and take a closer look at this serious disease and how it can be both detected and prevented.
An AAA, which …
How to protect yourself from abdominal aortic aneurysms
by Todd Neale, Staff Writer, MedPage Today
Flu appears to act as a trigger for myocardial infarction and cardiovascular death, a review of the literature showed.
All observational studies included in the review found an association between times when influenza viruses were circulating and increases in cardiovascular death, according to Charlotte Warren-Gash, MBChB, of University College London, and colleagues.
There was …
Is the flu a heart attack risk factor?
by Mark N. Simon, MD
What can hospital medical staff leaders learn from University of Oregon football coach Chip Kelly? In the morning of September 4th, Kelly had an opportunity to review video tape from the conclusion of his team’s game with Boise State University the night before. What he saw was his senior running back LeGarrette Blount punch an opponent and then lose his cool with the fans …
How hospitals should deal with disruptive physician behavior
What makes a good doctor?
There are two important characteristics. The first is clinical skill: the ability to find a pattern in the patient’s signs and symptoms, the ability to identify the pattern, and the judicious use of medical tests to fill in the blanks of the pattern. The second characteristic is compassion: the ability to care about the patient and empathize with his or her situation.
Many doctors have one or …
Is an efficient physician necessarily a good doctor?
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