Part two of a series. See also part one.
Previously I’d discussed how most of the time diagnoses are relatively straightforward. But what do doctors do when a diagnosis isn’t immediately clear to them?
Likely one or more of the following:
1. Revert to “novice” thinking. Which, in fact, is completely appropriate. We’re taught in medical school that approximately 90% of all diagnoses are made from the history, so if we can’t …
Originally published in MedPage Today
by Kristina Fiore
Physicians tend to prefer intellectual hobbies — chess, reading, writing. Dr. Alfred Bove is no exception. His hobby often requires application of his expertise in physiology. You know him as the president of the American College of Cardiology. But you may not know that his heart belongs to the sea.
Bove’s interest in scuba diving …
by Michael Jaff, MD
Peripheral Arterial Disease (PAD), a condition commonly correlated with diabetes, also known as a “silent killer,” affects at least one in every three diabetics over the age of 50 and approximately eight million Americans in total over the age of 40. Although PAD is prolific among diabetic and senior populations, current data show that public and physician knowledge of the disease is startlingly low, with only 25 …
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 …
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 …
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 …
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 …
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 …
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 …
ADVERTISEMENT
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 …
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.
id=”play_continuous_flvs” classid=”clsid:d27cdb6e-ae6d-11cf-96b8-444553540000″ width=”385″ height=”239″ codebase=”http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0″>Read more…
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 …
Robert Ricketson is a spine surgeon who was involved in a high profile 2003 medical malpractice case in Hawaii where a surgical screwdriver was implanted into a patient’s back. This is his account of the ordeal.
by Robert Ricketson
I am writing today out of frustration and anger, as I am frankly quite tired of passively going along as my name appears year after year in malicious “medical blogs” and …
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 …
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 …
A few days ago, we talked about how Scrubs was a relatively accurate portrayal of medical life.
Let’s talk about the other end of the spectrum, namely, Fox’s House M.D.
As an emergency physician notes, the doctors in the House-universe seem super-human. Indeed, “the docs on that show are not only walking encyclopedias of rare diseases, but they are …
Get free updates delivered free to your inbox.
