Vegas recap
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I can't believe that I'm going back home later today. Had a great time out here. Check out the video above and you'll get the recap on my two quick days/nights here in Las Vegas. Have a great weekend, everybody! (Source: Doctor Anonymous)
Source: Doctor Anonymous - May 9, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Precipitating causes of heart failure exacerbation
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The OPTIMIZE-HF data base provided us with a wealth of information on heart failure. A report from that data base which focused on precipitating causes of exacerbations was recently published in the Archives of Internal Medicine.In heart failure one can think about underlying causes and precipitating causes. While a good deal of evidence supported the importance of the former, there was little, up until now, on the importance of the latter even though expert opinion (as well as my mentors going all the way back to med school and residency) held that we should think about both. This paper, by showing that a majority of hear...
Source: Notes from Dr. RW - May 9, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
So you want to be a doctor?
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In Reasons Not to Become a Doctor Tara Weiss writes that physicians’ professional rewards are shrinking, and that is contributing to a growing shortage of doctors. She quotes three authors from the recruiting firm of Merritt and Hawkins:This is not just a question of career choice---consumers will be affected greatly by this shortage. If you think there’s a long wait for an appointment now, it could be nothing compared with 15 years down the road. The three co-authors of Will the Last Physician in America Please Turn Off the Lights, all from the physician staffing firm of Merritt, Hawkins and Associates, say the wait w...
Source: Notes from Dr. RW - May 9, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Future american physician
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http://youtube.com/watch?v=lj3iNxZ8DwwMore and more bright young Americans are figuring out that there are much easier, faster, less painful and time-consuming ways to make money than being a physician. Hence, you may soon learn that your major surgical procedure, for example, is going to be performed by a gal like the one shown above. I imagine that being a physician will still be important enough, and will remain held in such high esteem by families like that of our little debutante above, that you may someday meet Miss Teen South Carolina just before you head into surgery to remove the meningioma from your cranium. Keep...
Source: M.D.O.D. - May 8, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Only in vegas (airport)
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I have a headache this morning for some reason (and I don't know why). Anyway, I knew no one was going to believe this when I told them, but this person (see video post above) was on the same plane with us arriving to Vegas. So, while in baggage claim, why not shoot a little video. Everyone else was. More video posts soon (when I can edit them). (Source: Doctor Anonymous)
Source: Doctor Anonymous - May 8, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Doctors need a better quality of life
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---according to this Medscape article. Docs are under too much pressure and that may negatively impact patient care. Not only do we face external pressures, but we bring a lot of it on ourselves. We’ve become an increasingly self-flagellating profession. That’s why it’s refreshing to read this:Doctors are under too much pressure, experts warn, and this is having a negative affect on patients. Physicians who are overworked, overburdened, and generally stressed out are less available to patients and not as effective. Disregard the basic needs of healthcare professionals and patients are soon neglected too. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 8, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Medical blogging featured in acp hospitalist
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---with mention of a few blogs including yours truly. Thanks for the link!Dear blog, my patients are nuts. Signed, anonymous. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 8, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Vegas nite one
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Wish you were here! What's the caption? Gimme your best shot... (Source: Doctor Anonymous)
Source: Doctor Anonymous - May 8, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Complications of influenza
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Reviewed In the American Journal of Medicine. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 8, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Israel vacation week 2
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F-15 Eagle that shot down 4 POS Syrian Migs back in the 80's. The F-15 was originally intended only to shoot down other aircraft, later models had air to ground capability added. The only F-15 aces in the world fly in the Israeli Air Force. Arranged an interview with an Israeli Army physician so I could deduct the trip as a business expense. (Just Kidding!! I've had quite enough of Federal Correctional Facilities thank you very much) She wasn't too impressed with my whole 4 days of combat experience from the first Gulf war.Ahh, the Brachial Plexus. Too bad your cadaver doesn't have yellow nerves with neat labels on them. T...
Source: M.D.O.D. - May 7, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Nearly finished nights
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So it’s my last night tomorrow, it’s not been my best set, but there’s been a bit of a break through. I’ve learnt to say ‘no’ to ridiculous refferrals from A and E that don’t really need admission. I’ve got into several silly arguments with Orthopaedics about whether elderly people with broken arms who can’t cope at home have a medical problem.
I think you’ll find they don’t…..
It’s great seeing so many intresting cases - but I do regret that I won’t be looking after most of there hospital admission. The other SHO is very nice, but shy and ...
Source: FtM Doctor - May 7, 2008 Category: Internists and Doctors of Medicine Authors: Z Tags: Medicine NHS Source Type: blogs
Viva las vegas
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As I mentioned previously on The Doctor Anonymous Show, there will be no show for May 8, 2008 since I will be out of town. Where am I going? Well, I will be in Vegas Baby! (see video post above) In case anyone is interested, here is the current forecast for Vegas (They say it's a dry heat, right?)I'm going out there with people from the hospital for a conference. I haven't even looked at the schedule yet, but I hope that it's not an all day thing. What's the time difference out there, anyway? I guess I'll find out. With me being on call last weekend, I'm still catching up on things and haven't been able to think ahead that...
Source: Doctor Anonymous - May 7, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Almost all doctors think they’re above average
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---when it comes to diagnostic accuracy according to Paul Mongerson in the foreword to a supplement in the American Journal of Medicine. The supplement examines the role of overconfidence in diagnostic error. Full text of the entire issue is available free of charge. Fascinating reading about the cognitive traps we fall into and potential remedies. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 7, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
My take on the electronic medical record
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Yesterday I took the curmudgeon role on EMRs. It’s not the first time and probably won’t be the last. DB responded here. He had previously posted a wonderful essay on the art of history taking. Maybe it was unfair to use his post (which was not a rant against EMRs at all) to support my own criticism of EMRs. At any rate, his response served to point out that I rant about EMRs at the risk of being misunderstood (the spike in blog traffic with the help of Kevin was a bonus). So, here’s my attempt at clarification:I regard electronic medical records in much the same way I regard the pharmaceutical companies---with healt...
Source: Notes from Dr. RW - May 7, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Grand rounds
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Grand Rounds 4.33 is now up and running over at Suture For A Living. (apologies for the late posting of this today). There is no theme this week. But in addition to the great posts, there are some great pics! Thanks to Dr. Ramona for including my post this week:Dr Anonymous asks a simple, yet, controversial question: If someone has used marijuana - even if used for medical reasons - should this prohibit him or her from being considered to be on a transplant list? Hospitals throughout this great nation struggle with this question every day.If you don't know what Grand Rounds is, it is a weekly compilation of the best posts ...
Source: Doctor Anonymous - May 6, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
The arrest call
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‘Is this the 21st Century last rites’ I wondered as we stood around the bed watching the life slipping away from us. Four Doctors, six nurses and three ‘health care assistants’. The 97 year old who had recently had a small heart attack, was still for ressus on the grounds that he might have a VT/VF arrest that we could shock back into Sinus rhythm.
Except he hadn’t - the heat was beating but not strongly enough for a pulse, and he wasn’t breathing - we carried on CPR, and gave some adrenaline and the heat beat more strongly, but he still wasn’t breathing. We carried on ‘Bag...
Source: FtM Doctor - May 6, 2008 Category: Internists and Doctors of Medicine Authors: Z Tags: Uncategorized Source Type: blogs
Has woo invaded your hospital yet?
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Sooner or later it will. The cover story on this topic in ACP Hospitalist and its accompanying editorial comment are completely non-critical, offering as evidence in favor of the trend a single anecdote along with the usual statistics on CAM’s rising popularity.So: You’re a hospitalist. Hospitalists are supposed to be the leaders of quality in the inpatient environment. When you see woo spreading through the wards of your hospital like MRSA whatcha gonna do? (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 6, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
The decline in the art of history taking
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---may be facilitated by electronic medical records. Two bloggers offer contrasting perspectives. DB reminds us of what it should be:Taking a history may seem simple, but it requires broad medical knowledge. Master clinicians alter their history taking in response to the patient’s answers, their body language and observation. As one performs the physical exam, more questions occur to the clinician.The history does not end with the admission. As one collects laboratory results, imaging studies, and clinical changes, more questions become relevant. Historytaking represents an ongoing activity, designed to help both the dia...
Source: Notes from Dr. RW - May 6, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Interview advice
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There are few professions where, upon reviewing job applicants, one must ask oneself: ‘Is this the type of person who wants to have sex with dead people?’.Gravedigger, Mortician, Pathologist, Hillary Clinton’s potential boy-toy… the list is short. And in the field of medicine, if you hire someone who would check the ‘yes’ box when asked if they liked violating Sylvia Plath while her head was in the gas oven, you have made a big mistake.It looks really bad when the family comes in to identify grandma’s body and the pathology assistant is humping her on the autopsy table. It is considered very bad taste when he...
Source: M.D.O.D. - May 5, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Doctors overmedicating kids
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You've probably seen this your morning news stories, but doctors are being blamed (imagine that) for overmedicating kids (again). In fact, according to a study reported by the Associated Press, American children are taking what are called "anti-psychotic" drugs at a rate six times higher than children in the UK.Does it mean U.S. kids are being over-treated? Or that U.K. children are being under-treated? Experts say that's almost beside the point, because use is rising on both sides of the Atlantic. And with scant long-term safety data, it's likely the drugs are being over-prescribed for both U.S. and U.K. children, researc...
Source: Doctor Anonymous - May 5, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Unhealthy pressure to implement electronic medical records
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Pressure to implement electronic medical records has been driven by hype, without due regard for the unintended consequences. Many thought leaders in medicine have contributed. IHI president Donald Berwick, in a Time Magazine commentary on how to “fix” healthcare, made this incredibly simplistic observation about EMRs:My pizza parlor is more thoroughly computerized than most of health care. It's high time to put the paper medical record where it belongs — in the Smithsonian, next to the typewriter.In a Medscape Webcast Video Editorial Dr. Carolyn Clancy, head of AHRQ, asked, in effect, “What are we waiting for?” ...
Source: Notes from Dr. RW - May 5, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Alpha-1 antitrypsin deficiency
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This topic was updated in a recent issue of the American Journal of Medicine.Key points:The condition is under diagnosed, and all patients with COPD should be screened once in their lifetime.Liver disease is due to accumulation of abnormal antitrypsin molecules in hepatocytes.Unusual disease associations include Wegener’s granulomatosis, aneurysms and necrotizing panniculitis. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 5, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Nonalcoholic fatty liver disease
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---is the hepatic manifestation of the metabolic syndrome. A topic review is presented in Nature Clinical Practice Gastroenterology and Hepatology. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 5, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
The changing spectrum of chronic pulmonary histoplasmosis
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Conventional wisdom, based on reviews from decades ago, holds that chronic pulmonary histoplasmosis typically occurs as cavitary disease in patients with COPD. A recent review in Medicine suggests a wider spectrum of presentations. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 4, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Diabetic foot infection: is it osteomyelitis?
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Featured in JAMA’s Rational Clinical Examination. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 4, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Citation mode
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Having spent a lot of time in doctors' clinics and hospitals, I was quite surprised the first time I saw doctors as people - drinking, smoking, enjoying life as much as any normal person would. It was during medical school when I realized that doctors are people too.I remember getting a glimpse of our family doctor on my way home from elementary school. He was playing mahjong. Needless to say, he was smoking and he sounded far from the mild-mannered doctor that I knew him to be.In medical school I saw that doctors are not any different from the ordinary person. Having an M.D. does not place you on a moral high ground, nor ...
Source: Bubbleman - May 4, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Prominent r wave in v1
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Interpreting a prominent R wave in V1 is an exercise in differential diagnosis. The clinician must be able to list the causes. Here’s the list:Left ventricular ectopyRight ventricular hypertrophyAcute right ventricular dilation (acute right heart strain)Type A Wolff-Parkinson-White syndromePosterior myocardial infarctionHypertrophic cardiomyopathyProgressive muscular dystrophyDextrocardiaMisplaced precordial leads Right bundle branch blockNormal variantYou’ll make fewer mistakes if you keep this list in mind when confronted with an electrocardiogram which displays an R wave in V1 of greater amplitude than the S wave.Vi...
Source: Notes from Dr. RW - May 3, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Frankie goes to holywood (or how i spent my economic stimulus check) week 1
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Theres something about Bugs Bunny in Hebrew thats just funny. I know I should be offended that a cartoon rabbit is out smarting a sacred Islamic figure, but I'm sorry. I bet even Bin Laden laughs when nobodys watching. What a trip, surly Arab cab drivers, fascist security guards, and that was just in Atlanta. El-Al is great. 100% American built jets (not the commie-Euro Airbus crap that most American airlines use) armed undercover agents on every flight, never had any jets end up in the side of tall buildings. The security helps keep out the riff-raff, it didn't feel quite as much like a Greyhound bus as your typical Delta...
Source: M.D.O.D. - May 3, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Computer not booting 2
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For details of my previous experience with the computer not booting, click here.In the Philippines, you can't rely on technical support when it comes to computers.Let me clarify that. If you build your own PC, you are technical support.Yesterday when I went home from Bacolod, I turned on the PC like I usually do and started downloading a file. I then leave the PC on so that I can do other things, like sleep, take a bath, and eat.I left to have lunch with my girlfriend Joy, eating most of the rice we ordered (good for 4-5 people!) and most of the oysters. When I returned home, I was surprised to see a BSOD that told me: PAG...
Source: Bubbleman - May 3, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Want to eliminate the drug company lunch?
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You’re not going to get doctors to drop the practice. Those who oppose it have the loudest voices but they’re in the minority. Want to eliminate the practice? Criminalize it. Look for, among many other unintended consequences, a spike in direct to consumer advertising. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 3, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
More on medicare’s latest no pay list
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A recent WSJ Health Blog post on the topic was more interesting for the comment thread than for the post itself. Aggrevated Doc Surg and Roy Poses of Health Care Renewal weighed in. One commenter best summarized the consensus of the thread:Ridiculous. Why don’t we just not treat people. No risk of medical errors there! Comment by Student. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 2, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Resubscribe please! (sticky post)
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Dear readers, we just changed our email feed program to feedblitz. If you want updates please do sign up again in the box to the right. (Source: M.D.O.D.)
Source: M.D.O.D. - May 2, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Whither health care reform?
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As the election nears NEJM Perspective piece writer Lawrence R. Jacobs asks if it’s 1994 All Over Again. Recall that the 1994 elections marked the final finishing blow to the Democrats’ health care reform proposals, starting with the Clinton plan, then evolving to the much less ambitious Mitchell plan before meeting defeat. According to Jacobs the landscape of public opinion in the U.S. hasn’t changed much since that time. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 2, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Hospitalists and drug seekers
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Despite evidence to the contrary, popular pain management dogma holds that narcotic addiction is rare among patients with chronic pain and that most patients who send up the red flags of drug seeking are really suffering from “pseudoaddiction.”Most hospitalists, though, know that they are likely to encounter drug seeking behavior. Here’s an article in Today’s Hospitalist with some tips on how to deal with the problem. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 2, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Electrocardiographic manifestations of ventricular aneurysm
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Left ventricular aneurysm often causes ST segment elevations in indicative infarct leads which persist after resolution of the infarction. Such findings may be difficult to differentiate from other causes of ST segment elevation, particularly acute infarction. A review in the American Journal of Emergency Medicine describes the electrocardiographic findings of left ventricular aneurysm and focuses on the differentiation form acute infarction. As opposed to acute infarction the ST elevations of ventricular aneurysm tend to be accompanied by well developed Q waves and reciprocal changes are lacking. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 2, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Cns infections: tips and pearls
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Via Today’s Hospitalist. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 2, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
More on the shortage of geriatricians
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Despite longer training requirements as compared to FPs and internists, geriatricians earn less. Why? Their case mixes are virtually 100% Medicare. From the American Journal of Medicine:Few other fields of medicine are faced with the challenge of proposing that residents complete additional training only to have their earning power decrease. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 2, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Bar stool economics
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In thinking about the recent posts regarding taxes, the 'right' to universal healthcare in the U.S., and - most importantly - our good friend Shrodinger's Cat's decision to become DOWNWARDLY MOBILE - I thought I would revisit this fun, old tale.Suppose that every day, ten men go out for beer and the bill for all ten comes to $100. If they paid their bill the way we pay our taxes, it would go something like this: The first four men (the poorest) would pay nothing.The fifth would pay $1.The sixth would pay $3.The seventh would pay $7.The eighth would pay $12.The ninth would pay $18.The tenth man (the richest) would pay $59.S...
Source: M.D.O.D. - May 2, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Dr. a show 34 - may 16,2008
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To be announced (Source: Doctor Anonymous Live)
Source: Doctor Anonymous Live - May 2, 2008 Category: Internists and Doctors of Medicine Authors: Doctor Anonymous Tags: Health Source Type: podcasts
Show 33 wrap-up
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Thanks so much to my guest Dr. John Halamka for being on The Doctor Anonymous Show. Very knowledgeable guy. So much so that I have to admit that I was a little intimidated after doing research for this interview. But, to my pleasant surprise, not only is he a knowledgeable guy, a very nice guy - and funny.We talked about his early love for medicine and technology. He is the first physician in his family and talked about how he built his first computer. Then, the talked about how he used this passion for technology in medical school and in residency. Following his emergency medicine residency, the pursued a fellowship in He...
Source: Doctor Anonymous - May 2, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Pubmed search made easier
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Pubmed is a premier source for biomedical researchers. PubMed is a service of the U.S. National Library of Medicine that includes over 17 million citations from MEDLINE and other life science journals for biomedical articles back to the 1950s. PubMed includes links to full text articles and other related resources. Gopubmed.org allows you to search pubmed in easier and faster way and helps to sort out the information. GoPubMed doesn't rank, the user does!
GoPubMed retrieves PubMed abstracts for your search query and sorts relevant information to the 4 top level categories:
"What", "Who", "Where&qu...
Source: Raman's Blog - May 2, 2008 Category: Internists and Doctors of Medicine Authors: Raman BV Source Type: blogs
Dr. a show 33: john halamka - may 02,2008
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John Halamka is author of the blog "Life as a Healthcare CIO." Not only is he a health information guru, he's also a practicing ER physician. (Source: Doctor Anonymous Live)
Source: Doctor Anonymous Live - May 1, 2008 Category: Internists and Doctors of Medicine Authors: Doctor Anonymous Tags: Health Source Type: podcasts
St segment elevation: mi or not?
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When confronted with electrocardiographic ST elevation it’s necessary to differentiate STEMI from early repolarization, pericarditis and other conditions. Look for reciprocal ST depression, which strongly favors MI. According to a study in the American Journal of Emergency Medicine sensitivity, specificity, positive predictive value, and negative predictive value for the electrocardiographic diagnosis of AMI were 69%, 93%, 93%, and 71%, respectively. This works only in the absence of confounding abnormalities such as bundle branch block, paced rhythm and hypertrophy. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 1, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Takotsubo cardiomypoathy: mechanisms and pathophysiology
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There has been a recent explosion of literature on this underappreciated entity. Here’s another review from Nature Clinical Practice Cardiovascular Medicine.What’s the practical importance of recognizing this syndrome? Patients, despite appearing to present with myocardial infarction and horrible ventricular function, are not doomed. Recovery of normal ventricular function is the rule provided they get appropriate supportive care. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - May 1, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Dr. a show 33: dr. john halamka
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Thursday, May 1st, 2008 at 9pm Eastern TimeJoin us tonight for The Doctor Anonymous Show . Our guest will be Dr. John Halamka who is Chief Information Officer of Beth Israel Deaconess Medical Center in Boston. He is author of the blog called Life as a Healthcare CIO. He is also an emergency physician, and apparently, a Blackberry guy. I'll have to ask him some iPhone questions just to be funny. You can even take part in the chat room. It is truly "The show within the show." You can even call in and say hello. A great opportunity to interact with medbloggers you've only read about. See you for the show!For first time Blog T...
Source: Doctor Anonymous - May 1, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
The bill of rights
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All this talk about a right to free health care got me kind of mad because I didn't believe it existed under our constitution. I also thought that patients should bear at least some of the burden for maintaining their own health and paying a reasonable fee either for insurance, or to physicians who treat them. Boy was I wrong! Witness the genius of America!The Bill of RightsAmendment I Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the governme...
Source: M.D.O.D. - May 1, 2008 Category: Internists and Doctors of Medicine Tags: Idiocy in Medicine Complimetary and Alternative Medicine Governmental Idiocy Universal Health Care Humor Source Type: blogs
Hospitalist news launched
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From the introductory article:HOSPITALIST NEWS will cover breaking news in clinical trials, new therapies, and regulatory and payment trends that have a direct impact on hospitalist practice. Our experienced journalists will write concise, easy-to-read, and balanced articles that are fact-checked for accuracy. They will report from medical specialty meetings where new research is presented, monitor regulatory agencies, and provide the perspectives of thought leaders in patient care.I’ll be linking from there often.Hospitalist News.Via Clinical Cases and Images blog. (Source: Notes from Dr. RW)
Source: Notes from Dr. RW - April 30, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Cms defines nine more hospital “errors”
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Last year CMS, in an ill conceived policy change, rolled out a list of hospital acquired conditions which could no longer be coded to increase DRG reimbursement, defining these conditions as “never events.” The media egregiously spun the issue as “Medicare no longer paying for mistakes.” I pointed out how manifestly unfair this was in several posts last year.Now they’ve added nine more to the list for consideration. Included in the new list of “medical mistakes” are iatrogenic pneumothorax, Legionella infection and delirium. Well, I’m at a loss for words, so go read what Bob Wachter and DB have to say about...
Source: Notes from Dr. RW - April 30, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
Poses vs pitts on ebm
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Peter J. Pitts, president of the Center for Medicine in the Public Interest, wrote a negative commentary in the Washington Times on evidence based medicine (EBM). Dr. Roy Poses, blogging at Health Care Renewal, offered a rebuttal. I’m not going to take sides in this debate, as good points were offered by both. Correctly noting that Mr. Pitts used a straw man argument (Pitts unfairly portrayed EBM as “one size fits all” medicine) and explaining what EBM really is (or is supposed to be) Dr. Poses then went on to base much of his own argument on an ad hominem attack against Mr. Pitts (it seems Pitts has ties to Big Phar...
Source: Notes from Dr. RW - April 30, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
The john halamka interview
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The Doctor Anonymous Show is proud to welcome John D. Halamka, MD who is the Chief Information Officer of Beth Israel Deaconess Medical Center in Boston. He is author of the blog called Life as a Healthcare CIO.I did want to share a couple of excerpts from his blog - The first of which I call the "Geek Doctor" portion from a post entitled "Designing the Ideal Electronic Health Record:"I was posed a simple question - If I had infinite resources, infinite time, and no legacy compatibility issues, how would I design the electronic health record of the future?The web is the way. Given the 24x7 nature of healthcare, the need fo...
Source: Doctor Anonymous - April 30, 2008 Category: Internists and Doctors of Medicine Source Type: blogs
