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This page shows you the most recent publications within this specialty of the MedWorm directory.

Primary care physicians should advocate for fewer restrictions on women ’s choices
Our patient was a 15-year-old girl who came to the emergency room of our hospital saying she wanted to commit suicide after being raped several weeks ago at a classmate’s party. In the emergency room, a urine pregnancy test was positive. On admission to the hospital, she was very clear that her thoughts of killing herself came from her rape and current pregnancy. She was clear that she wished to end the pregnancy. Her mother, who was by her side throughout the hospitalization, supported her daughter’s right to seek an abortion. Our supervising doctor (who is also an abortion provider at an outside clinic) infor...
Source: Kevin, M.D. - Medical Weblog - July 22, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/joshua-st-louis-and-dana-marcinkowski-desmond" rel="tag" > Joshua St. Louis, MD, MPH and Dana Marcinkowski-Desmond, MD, MPH < /a > Tags: Physician OB/GYN Source Type: blogs

Augmented Reality In Healthcare Will Be Revolutionary
Augmented reality is one of the most promising digital technologies at present – look at the success of Pokémon Go – and it has the potential to change healthcare and everyday medicine completely for physicians and patients alike. By now, it is official: Pokémon Go conquered the world. TechCrunch reported that on the day when the game was launched, it immediately surpassed the daily time usage of Facebook, SnapChat or Twitter by the average iOS user on mobile phones. Tom Curry, a man living in New Zealand quit his job to become a full-time Pokémon hunter. In Central Park, herds of Pokémon Go players almost caused a...
Source: The Medical Futurist - July 21, 2016 Category: Information Technology Authors: nora Tags: Augmentation in Medicine Future of Medicine Health Sensors & Trackers AR augmented reality GC1 google glass Innovation Surgery technology Source Type: blogs

When You Confuse Excessive Productivity or Busyness with Success
Today, we try not to “waste” any time. When we’re waiting in line, we check email on our phones and maybe compose a few replies. When we have 10 minutes to ourselves, we try to cross off a task. When we’re at work or at home, we’re multi-tasking. We’re cooking and listening to productivity podcasts. We’re eating and texting. We’re taking work calls on our commute. We’re working on the weekends. When there’s any “white space” in our schedule, we try to fill it with something else — anything but introspection, said Cori Dixon-Fyle, LCSW, a psychotherapist in Chicago, Ill., who works with indivi...
Source: World of Psychology - July 21, 2016 Category: Psychiatry & Psychology Authors: Margarita Tartakovsky, M.S. Tags: General Habits Happiness Industrial and Workplace Self-Help Stress Success & Achievement achievements brene brown Burnout Cori Dixon-Fyle excessive busyness Exhaustion Fatigue Fulfilling Life health Healthy Lifestyle Intr Source Type: blogs

JellyBean 042 Liam Yore and MovinMeat
It is official; Donald Trump is the Republican Candidate for the Presidency on the United States of America. What does that mean? What does that mean for Healthcare in the USA? (Or world peace?) I don’t know so I asked someone who might. It’s Liam Yore. a.k.a. @MovinMeat Liam Yore is a man that has stuff to say. He has been saying stuff for years on All bleeding stops and he is still saying stuff. “So Liam; healthcare in the USA whats up with that?” Dr Yore says; “It feels irredeemably broken.” Turns out there is stuff to be said. Liam has managed to marry his interest in progressive politics with his full...
Source: Life in the Fast Lane - July 21, 2016 Category: Emergency Medicine Authors: Doug Lynch Tags: JellyBean Liam Yore movinmeat Source Type: blogs

Research and Reviews in the Fastlane 143
Welcome to the 143rd edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R ...
Source: Life in the Fast Lane - July 21, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Clinical Research Education Emergency Medicine Neurology R&R in the FASTLANE Trauma EBM literature recommendations research and reviews Source Type: blogs

A Care Coordination Innovation Intervention
By JOHN HALAMKA, MD Would you buy an iPhone if the only apps that ran on it were written by Apple? Maybe, but the functionality would not be very diverse. The same can be said of EHRs. Athena, Cerner, Epic, Meditech, and self developed EHRs such as BIDMC’s webOMR are purpose-built transaction engines for capturing data. However, it is impossible for any single vendor to provide all the innovation required by the marketplace to support new models of care I’m a strong believer in the concept of third party modules that layer on top of traditional EHRs in the same way that apps run in the iPhone ecosystem. There are 3 suc...
Source: The Health Care Blog - July 20, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Get Ready for the UMMC Blood Drive, July 26–28!
By Maggie Gill, System Communications Intern Now is the time to give, says the American Red Cross. On July 5, the not-for-profit organization issued an emergency call for blood and platelets. The request comes on the heels of a particularly slow donation season, when the available supply fell 39,000 donations short of hospital need – a number that’s expected to climb in the following weeks, as regular donors flock to the beaches and mountains for the summer holidays. Unfortunately for the five million Americans who rely on transfusions each year, a vacation is a luxury that they can’t afford. “We urge people to giv...
Source: Life in a Medical Center - July 20, 2016 Category: Universities & Medical Training Authors: Chris Lindsley Tags: Blood Drives Blood Donation hemoglobin UMMC Source Type: blogs

Get Ready for the UMMC Blood Drive, July 26 –28!
By Maggie Gill, System Communications Intern Now is the time to give, says the American Red Cross. On July 5, the not-for-profit organization issued an emergency call for blood and platelets. The request comes on the heels of a particularly slow donation season, when the available supply fell 39,000 donations short of hospital need – a number that’s expected to climb in the following weeks, as regular donors flock to the beaches and mountains for the summer holidays. Unfortunately for the five million Americans who rely on transfusions each year, a vacation is a luxury that they can’t afford. “We urge people to giv...
Source: Life in a Medical Center - July 20, 2016 Category: Universities & Medical Training Authors: Chris Lindsley Tags: Blood Drives Blood Donation hemoglobin UMMC Source Type: blogs

Cross-Isle Issue: Three Things You Should Know About Congress’ Opioid Bill
Last week Congress passed a landmark bill authorizing a significant increase in the level of support to addicts and addiction treatment providers throughout the country. However, like all political events there’s more to this story than meets the eye. Whether you’re the loved one of an addict, an addiction treatment provider, or an emergency medical professional, here are three things you should know about Congress’ most recent bill aimed at tackling the opioid epidemic ripping across our nation and ending countless lives. Treatment is at the forefront. The bill passed by Congress highlights a broad spectrum of tr...
Source: Cliffside Malibu - July 20, 2016 Category: Addiction Authors: Constance Scharff, PhD Tags: Abuse Addiction Recovery Addiction to Pharmaceuticals Addiction Treatment and Program Resources Alcoholism Behavioral Addictions Current Events Drug Rehab Information Drug Treatment Mental Health addiction treatment center drug abuse Source Type: blogs

Cross-Aisle Issue: Three Things You Should Know About Congress’ Opioid Bill
Last week Congress passed a landmark bill authorizing a significant increase in the level of support to addicts and addiction treatment providers throughout the country. However, like all political events there’s more to this story than meets the eye. Whether you’re the loved one of an addict, an addiction treatment provider, or an emergency medical professional, here are three things you should know about Congress’ most recent bill aimed at tackling the opioid epidemic ripping across our nation and ending countless lives. Treatment is at the forefront. The bill passed by Congress highlights a broad spectrum of tre...
Source: Cliffside Malibu - July 20, 2016 Category: Addiction Authors: Constance Scharff, PhD Tags: Abuse Addiction Recovery Addiction to Pharmaceuticals Addiction Treatment and Program Resources Alcoholism Behavioral Addictions Current Events Drug Rehab Information Drug Treatment Mental Health addiction treatment center drug abuse Source Type: blogs

Cross-Aisle Issue: Three Things You Should Know About Congress ’ Opioid Bill
Last week Congress passed a landmark bill authorizing a significant increase in the level of support to addicts and addiction treatment providers throughout the country. However, like all political events there’s more to this story than meets the eye. Whether you’re the loved one of an addict, an addiction treatment provider, or an emergency medical professional, here are three things you should know about Congress’ most recent bill aimed at tackling the opioid epidemic ripping across our nation and ending countless lives. Treatment is at the forefront. The bill passed by Congress highlights a broad spectrum of tre...
Source: Cliffside Malibu - July 20, 2016 Category: Addiction Authors: Constance Scharff, PhD Tags: Abuse Addiction Recovery Addiction to Pharmaceuticals Addiction Treatment and Program Resources Alcoholism Behavioral Addictions Current Events Drug Rehab Information Drug Treatment Mental Health addiction treatment center drug abuse Source Type: blogs

Care Coordination Innovation
Would you buy an iPhone if the only apps that ran on it were written by Apple?   Maybe, but the functionality would not be very diverse.The same can be said of EHRs.   Athena, Cerner, Epic, Meditech, and self developed EHRs such as BIDMC’s webOMR are purpose-built transaction engines for capturing data.  However, it is impossible for any single vendor to provide all the innovation required by the marketplace to support new models of care  I’m a strong believer in the concept of third party modules that layer on top of traditional EHRs in the same way that apps run in the iPhone ecosystem.There are 3...
Source: Life as a Healthcare CIO - July 20, 2016 Category: Information Technology Source Type: blogs

The Doctors Club
By  ANISH KOKA, MD Vatsal Thakkar, a psychiatrist, recently wrote of the perks doctors are afforded in everyone’s favorite instrument of social justice – the New York Times. Dr. Thakkar speaks effectively and correctly about a broken health care system navigated best by pulling the ‘doctor’ card. Some on the progressive left have seized on this blatant disregard for egalitarianism as yet another example of a broken healthcare system, despite the fact that a two tiered system is exactly what they have been building over the last eight years. To be clear, there has always been special treatment accorded fellow doct...
Source: The Health Care Blog - July 19, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Kokeshi phenomenon: stuck rotablator burr
Kokeshi phenomenon is a stuck rotablator burr in a heavily calcified coronary artery during attempted rotablation. Though it is a rare complication, it is a potentially serious one as it can cause coronary occlusion and necessitate emergency surgery. Different methods have been described for retrieval of the stuck burr. Mechery A and associates noted that deep engagement of the guiding catheter and manual traction is a safe method for retrieval of the burr [1]. Tanaka Y et al used a modified STAR (subintimal tracking and re-entry) technique using a 3 g tapered tip hydrophilic wire to remove the burr [2]. Successful removal...
Source: Cardiophile MD - July 19, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Cardiology Coronary Interventions Source Type: blogs

INSPIRE: seven strategies for ending violence against children
From the Centers for Disease Control: “The World Health Organization (WHO) along with the Centers for Disease Control, the President’s Emergency Program for AIDS Relief (PEPFAR), Together for Girls, United Nations Children’s Fund (UNICEF), United Nations Office on Drugs and Crime (UNODC), United States Agency for International Development (USAID), the World Bank, and the Global Partnership to End Violence Against Children came together to create an evidence-based technical package, INSPIRE. It contains solutions to help countries and communities prevent and respond to violence against children and adolescents....
Source: BHIC - July 18, 2016 Category: Databases & Libraries Authors: Kate Flewelling Tags: Children and Teens Source Type: blogs

Protecting kids from Zika
The Centers for Disease Control has information for parents about Zika, including printable fact sheets and kid-friendly activity books. Zika – Parents: http://bit.ly/2a6stji   (Source: BHIC)
Source: BHIC - July 18, 2016 Category: Databases & Libraries Authors: Kate Flewelling Tags: Children and Teens Emergency Preparedness Environmental Health Source Type: blogs

Prevent Carbon Monoxide Poisoning
According to the Centers for Disease Control, 50,000 people a year visit the emergency department because of carbon monoxide poisoning. Carbon monoxide is odorless and colorless, but poisoning can be prevented. Resources to learn more include: Carbon Monoxide (CO) Poisoning Prevention (CDC): http://bit.ly/2ab3kql Carbon Monoxide Poisoning (MedlinePlus): http://bit.ly/29QhRWa (Source: BHIC)
Source: BHIC - July 18, 2016 Category: Databases & Libraries Authors: Kate Flewelling Tags: Emergency Preparedness Environmental Health Source Type: blogs

LITFL Review 240
Welcome to the 240th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week TheResusRoom site just launched with great new podcasts on sepsis, CXR in trauma, PCI following ROSC and many more. For those more textually inclined there are paper summaries and guidelines to whet your appetite. [CC] Iain Beardsell’s “Throm...
Source: Life in the Fast Lane - July 18, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

2 Things Everyone Needs to Know About Alzheimer's Care and Urinary Tract Infections
The psychological and emotional devastation that comes from death as a result of an undetected urinary tract infection can be overwhelming.By Bob DeMarcoAlzheimer's Reading RoomThe words in the subheading above might seem harsh - but they are intentional.More than 10 readers of the Alzheimer's Reading Room have written to me about the overwhelming burden that comes with the death of their loved one as a result of an undetected urinary tract infection. It happened again yesterday.The purpose of this article is clear and intentional - don't let it happen to you.Dementia CareEvery long term Alzheimer's caregiver and dementia ...
Source: Alzheimer's Reading Room, The - July 17, 2016 Category: Neurology Tags: alzheimers care alzheimers caregiving alzheimers communication tip dementia help for caregivers family caregiving help alzheimer's help with dementia help with dementia care memory care Source Type: blogs

First Time Writing About It
I have to talk about it. Now. I am on the plane going home from the Autism Society of America Conference. There I presented a breakout workshop on Autism Adulthood: Strategies and Insights for a Fulfilling Life. But I had to tell them. The end of my book is not written yet, after all. On July 3 we were headed to a friend’s holiday party and I called Nat upstairs to come put on a new, festive shirt. He pulled his shirt off and there, screaming at me from his thin white chest, was a big yellow bruise. Fist-sized. I screamed for Ned. I don’t know how I formed the words but I did. “Someone has hurt Nat,”...
Source: Susan's Blog - July 17, 2016 Category: Child Development Authors: Susan Senator Tags: Uncategorized Source Type: blogs

Why nurses deserve a place in primary care
I’m feeling pretty good about myself today. My patient, recently admitted to home health care, was just not herself, low O2 sats, irregular heart rate with pain on inspiration and feeling a little clammy. While her recent surgery was a neck fusion, it still didn’t completely eliminate the possibility of a pulmonary embolism. Instead of spending 15 to 30 torturous minutes in her primary doctor’s voice mail hell, I made the call to go to the emergency room for evaluation; she was ultimately admitted. While I do not know her admitting diagnosis, I think I nailed it. Policy wonks and health system bean counters will crin...
Source: Kevin, M.D. - Medical Weblog - July 16, 2016 Category: Journals (General) Authors: Tags: Policy Primary care Source Type: blogs

DM / DNB Cardiology Entrance New Test Series 4
Time limit: 0 Quiz-summary 0 of 30 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 ...
Source: Cardiophile MD - July 16, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

Diagnostic Imaging May Be Safe for Pregnant Women
Some radiologic imaging can be safe for pregnant women who have sustained traumatic injuries, according to a review article published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).  Researchers from the Thomas Jefferson University in Philadelphia, PA, and the Garden State OB/GYN Associates in Voorhees, NJ reviewed the diagnostic dilemma that confronts emergency room physicians when pregnant women present with traumatic injuries that require diagnostic imaging.  Source: UBM Partner Site Diagnostic Imaging - For full article, please click here (Source: radRounds)
Source: radRounds - July 15, 2016 Category: Radiology Authors: Alessandra Simmons Source Type: blogs

Special needs urban bicycling - what streets are safe?
A few weeks ago I wrote about trying residential-urban (Saint Paul, MN) bicycle commute with #2. I realized he wasn’t ready, so we’re focusing on his mountain biking. He rides with a team I manage. It’s hard work for him, but he keeps persisting. I now do a scaled practice with him — about 50-70% of our novice rider practice routine. I got the scaling idea from my own CrossFit hobby — where I’m about 50% of the male athlete standard.At that time I wrote that #1 was doing relatively well with his bike commuting. He has quite different cognitive traits; the two boys have complementary strengths. Then, on a famil...
Source: Be the Best You can Be - July 14, 2016 Category: Disability Tags: ADHD adult autism brain and mind cognitive impairment exercise health smartphone smartphone4all transit Source Type: blogs

Kentucky Medicaid Program At A Crossroads
Discussion of benefits ranged from retaining current Medicaid benefits to expanding existing benefits (that is, expanded substance use treatment) to adding new benefits (that is, financial support for housing as well as help finding suitable housing, Uber as reimbursable transportation, among other social and economic support services). Participants overall felt that medically necessary services should be covered for all enrollees. Participants spoke of the need to streamline and accelerate the reimbursement process for providers; increase reimbursement rates for providers; and add new categories of services and providers ...
Source: Health Affairs Blog - July 14, 2016 Category: Health Management Authors: M. Gabriela Alcalde Tags: Featured GrantWatch Insurance and Coverage Medicaid and CHIP Access Health Care Delivery Health Philanthropy Health Reform Kentucky Matt Bevin Quality section 1115 waiver proposal States Substance Use Prevention Source Type: blogs

Dyspnea and Convex ST elevation, Marked LVH, with Bedside Echos
Case 1.Chief complaint: A 60-something African American male with 5 days of increasing SOB with dyspnea on exertion.This male in his 60's has a PMH of CAD with MI and CABG, HTN with LVH, hyperlipidemia, and mild HF with only moderately reduced ejection fraction (and some diastolic dysfunction as well).He presents with 5 days of worsening shortness of breath with orthopnea as well as chest pain.  His BP is 191/90.  He also has a history of venous thromboembolism and has not been taking his anticoagulants.  He was also off of his BP meds (lisinopril, amlodipine and carvedilol).Here is his ED ECG (ECG #1):...
Source: Dr. Smith's ECG Blog - July 14, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs

The business case for affordable housing
This report shows that the capital's social housing residents make a contribution that is five times greater than the housing benefit bill for social housing residents in London in the same year. It contains an analysis of social housing residents' occupations in the capital shows that over a third work in the emergency services such as ambulance services. Report Peabody - press release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - July 14, 2016 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Workforce and employment Source Type: blogs

A Tale of 2 T’s: When Analytics and Artificial Intelligence Go Bad
Editor’s Note: We’re excited to welcome Prashant to the Healthcare Scene family. He brings tremendous insights into the ever evolving field of healthcare analytics. We feel lucky to have him sharing his deep experience and knowledge with us. We hope you’ll enjoy his first contribution below. Analytics & Artificial Intelligence (AI) are generating buzz and making inroads into healthcare informatics. Today’s healthcare organization is dealing with increasing digitization – variety, velocities, and volumes are increasing in complexity and users want more data and information via analytics. In add...
Source: EMR and HIPAA - July 13, 2016 Category: Information Technology Authors: Prashant Tags: Digital Health EMR Healthcare Analytics Healthcare CIO Healthcare Leadership Personalized Medicine Population Health Management Precision Medicine Advanced Analytics Artificial Intelligence Big Data Source Type: blogs

A Tale of 2 T ’s: When Analytics and Artificial Intelligence Go Bad
Editor’s Note: We’re excited to welcome Prashant to the Healthcare Scene family. He brings tremendous insights into the ever evolving field of healthcare analytics. We feel lucky to have him sharing his deep experience and knowledge with us. We hope you’ll enjoy his first contribution below. Analytics & Artificial Intelligence (AI) are generating buzz and making inroads into healthcare informatics. Today’s healthcare organization is dealing with increasing digitization – variety, velocities, and volumes are increasing in complexity and users want more data and information via analytics. In add...
Source: EMR and HIPAA - July 13, 2016 Category: Information Technology Authors: Prashant Tags: Digital Health EMR Healthcare Analytics Healthcare CIO Healthcare Leadership Personalized Medicine Population Health Management Precision Medicine Advanced Analytics Artificial Intelligence Big Data Source Type: blogs

Research and Reviews in the Fastlane 142
This study demonstrated that very early administration (pre-hospital) did not change outcomes in terms of infarct size. There was also no reduction in ventricular dysrhythmias. Once again we see that earlier is not always better. Recommended by Anand Swaminathan The R&R iconoclastic sneak peek icon key The list of contributors The R&R ARCHIVE R&R Hall of famer You simply MUST READ this! R&R Hot stuff! Everyone’s going to be talking about this R&R Landmark paper A paper that made a difference R&R Game Changer? Might change your clinical practice R&R Eureka! Revolut...
Source: Life in the Fast Lane - July 13, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Clinical Research Education Emergency Medicine Pediatrics R&R in the FASTLANE critical care EBM literature recommendations research and reviews Source Type: blogs

Against Euphemisms - Part 2 - Compassionate Extubation
by Drew Rosielle(This is the second of four posts by Drew on the language we use in hospice and palliative care. You may want to read his reflection on 10 years of practice or his first post on euphemisms - "Comfort Care." - Ed.)Euphemistic phrase #2 that I'd like to never hear again: "Compassionate extubation."By which people typically mean 'extubating someone who is on invasive mechanical ventilation who is not expected to survive long, to a plan of care that focuses on symptom alleviation.'What bugs me about it is the use of the term 'compassionate' to try to encompass the idea of a dying patient, care goals focuse...
Source: Pallimed: A Hospice and Palliative Medicine Blog - July 13, 2016 Category: Palliative Care Tags: euphemisms icu rosielle The profession Source Type: blogs

The myth of when HIPAA gets waived
On the morning of the tragic mass shooting in Orlando, a tweet by CNN stated, “The White House waived HIPAA regulations so that hospitals could talk with family members of shooting victims, says Orlando Mayor Buddy Dyer.” Many, including me, retweeted this thinking that it was probably unprecedented. Later that day, several Twitter followers informed me that HIPAA had been waived during Hurricane Katrina. Despite rumors to the contrary about 9/11, Katrina was the only time a HIPAA waiver has ever been issued. Regarding Orlando, the White House never issued a HIPAA waiver. An article in Slate on Monday explained that H...
Source: Kevin, M.D. - Medical Weblog - July 13, 2016 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

CMS Receives Hundreds of Comments to include CME in MACRA
With the nearly 4,000 comments now in for the proposed MACRA rule, we are taking a look at what organizations had to say about including Continuing Medical Education (CME) as a Clinical Practice Improvement Activity (CPIA) under the new Merit-based Incentive Payment System (MIPS). Across the board, medical organizations and physicians were extremely supportive of including CME as a CPIA and strongly encouraged CMS to include CME-related language in the final rule. For example, an article by MeetingsNet highlights the hundreds of comments submitted describing the value of CME. As suggested by the CME Coalition's comments, C...
Source: Policy and Medicine - July 13, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Does your primary care physician actually provide your primary care?
You’ve just moved to a new city for a new job, and before you can find a primary care practice, you get sick.  So you visit an urgent care center.  The doctor examines you, treats you, and urges you in not-so-subtle (and sometimes judgmental) terms to quickly find and follow up with a PCP.  And so the search begins.   Step 1: Consult Google.  Find 150 doctors within 50 miles.  Realize you know nothing about any of the doctors on the list. Step 2: Ask colleagues for recommendations.  Receive great reviews of 2 doctors. Step 3: Call the recommended doctors.  None are taki...
Source: blog.bioethics.net - July 11, 2016 Category: Medical Ethics Authors: Bioethics Today Tags: Health Care Doctor-Patient Relationships patient care syndicated Source Type: blogs

Dear Mr. Slavitt, Please Come Visit My Office
By NIRAN AL-AGBA, MD Andy, if you want to fix primary care you must do some field research.  Come spend one day, or even a week at my office or another small primary care physicians’ office.  You need to see what we do on a daily basis and actually understand the view from a small practice perspective. This knowledge deficit is at the core of CMS’s problem.  You cannot repair what you do not comprehend. Once you understand what we are capable of doing, how we do it, and how it actually SAVES money in the long run, while still providing high quality, then you are ready to tackle Focusing on Primary Care for Bett...
Source: The Health Care Blog - July 11, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Build Your Own Zika Prevention Kit
Do you live in or are traveling to an area that has the mosquito that spreads Zika? The Centers for Disease Control (CDC) has downloadable posters and handouts in multiple languages. The materials provide guidance for pregnant women and for people who want to build a home Zika prevention kit. Download materials: http://bit.ly/29HfJAZ (Source: BHIC)
Source: BHIC - July 11, 2016 Category: Databases & Libraries Authors: Kate Flewelling Tags: Emergency Preparedness Multilingual Public Health Regional Information Source Type: blogs

Updates to FoodKeeper app
The United States Department of Agriculture has updated its food safety app, FoodKeeper, to include Spanish and Portuguese. In September, the app, which includes storage advice for 400+ foods, will be updated to include food recall alerts and training videos. The app is available via the web, Google Play and iTunes. More information and download instructions: http://bit.ly/29HeVMh (Source: BHIC)
Source: BHIC - July 11, 2016 Category: Databases & Libraries Authors: Kate Flewelling Tags: Emergency Preparedness Public Health Source Type: blogs

Experiencing Life and Death Through Sims
Simulation experiences are critical to learning especially when they’re situations students might not see during their clinical rotations. Two sims out of the Johns Hopkins School of Nursing’s Simulation Center that are especially meaningful for students are the airway emergency simulation ... Read More » (Source: Nursing Blogs at Johns Hopkins University)
Source: Nursing Blogs at Johns Hopkins University - July 11, 2016 Category: Nursing Authors: Hopkins Nursing Tags: New Johns Hopkins hospital Living Legacy Nancy Sullivan organ donation sim lab simulation Source Type: blogs

You’ll be surprised at how ERs are meeting their metrics
During a busy ED shift, my computer signaled the complaint and location of my next patient: a woman in bed 10 flagged with “GI bleed.”  I almost bolted to bed 10 to ensure this patient was stable, but then noticed orders pending, so my urgency eased. “I see you already saw the patient in 10,” I began, addressing the triage physician. “Yeah, she’s all set,” he replied, without turning from his computer. “You can go see the next one.” Confused by what “all set” meant, I pressed for clarification. “Does that mean you already saw her, and you’re keeping her?” Continue reading ... Your patients are...
Source: Kevin, M.D. - Medical Weblog - July 11, 2016 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

What a medical student learned during his psychiatry rotation
Psychiatry was my first clinical rotation, and I did not know what to expect when I began. When I initially got assigned to the dialectal behavioral therapy (DBT) team, I had no clue what that would entail beyond working with some borderline patients and that the preconception of borderline patients is that they can be “the most difficult” patients to help due to their intense emotional instability, chronic feelings of worthlessness, self-destructive behaviors, and unstable relationships. While sitting at rounds each morning, I found that our clients unpredictably struggled and triumphed with different matters day in a...
Source: Kevin, M.D. - Medical Weblog - July 11, 2016 Category: Journals (General) Authors: Tags: Education Medical school Psychiatry Source Type: blogs

Don’t Let Zika Stop the Olympics
By ASHISH JHA, MD An expert panel convened by the World Health Organization just declared that there is no scientific basis for canceling, postponing or moving the 28th Summer Olympics in Rio de Janeiro in August or the Paralympics in September because of the Zika outbreak. While many of us experts have expressed concerns about how the WHO handled Ebola and other outbreaks, this time the WHO got it right. There are ample reasons for alarm: The Zika virus continues to spread in Brazil. Zika infection during pregnancy can have devastating effects on developing fetuses, leading to severe brain damage. The risk is so substant...
Source: The Health Care Blog - July 10, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

LITFL Review 239
Welcome to the 239th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Josh Farkas weaves an elegant web around the NINDS Trial, not debating the therapy, but explaining Fragility Index and introducing the Instability Index. This is truly critical appraisal 2.0. [JS, AS, SO] The Best of #FOAMed Emergency Medicine ...
Source: Life in the Fast Lane - July 10, 2016 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Education LITFL review Source Type: blogs

News. News. And Too Much News.
Oh my, time has been getting away from me  and it's been a bit since I've written a blog post on Shrink Rap!  First let me steer you over to Clinical Psychiatry News where ClinkShrink has written an article called "New Mexico High Court States that Assisted Suicide is not a Right."  If you surf over, you'll also note that Clink has a lovely new head shot up next to her article.As I've mentioned before, the Boston Globe's famed spotlight team is doing a series on the trouble public mental health system in Massachusetts.  The second installation went up on July 7th and discusses the roll of the polic...
Source: Shrink Rap - July 10, 2016 Category: Psychiatry Authors: Dinah Source Type: blogs

Physicians go flatline on EHR enthusiasm
In a new study, physicians' enthusiasm levels for EHR's seem to resemble this EKG:Do physicians really experience a satisfaction 'J-curve' with EHRs? Max Green July 6, 2016 http://www.beckershospitalreview.com/healthcare-information-technology/do-physicians-really-experience-a-satisfaction-j-curve-with-ehrs.html There's a school of thought about EHR adoption that suggests physicians experience an initial decrease in their positive perceptions of the technology, but over time those levels creep back up and ultimately surpass their pre-implementation perceptions. But does that J-curve actually exists for EHR...
Source: Health Care Renewal - July 8, 2016 Category: Health Management Tags: Becker ' s Hospital Review EPIC healthcare IT dissatisfaction JAMIA Max Green Source Type: blogs

Somewhere between the extremes: The ideal health system for America
This is my 12th year as a physician in the United States. I was born in London, grew up in Berkshire, and decided to become a doctor when I was a teenager. I remember being asked what I thought about the National Health Service (or NHS, the UK’s government-run health system) during my medical school interview. That question is almost a rite of passage for anyone applying to medical school in the UK. My answer was an idealistic one, probably identical to what most people in England — if not Europe — would say. Health care is a birthright. The NHS is a wonderful concept and immensely fair and just. Nobody shou...
Source: Kevin, M.D. - Medical Weblog - July 7, 2016 Category: Journals (General) Authors: Tags: Policy Health reform Source Type: blogs

The Teleconsultation App: An Unmet Software Need in Hospitals
In a previous note, I raised the question about whether pathologists need to be physically located in close proximity to hospital patients to facilitate consultations with the clinicians caring for patients (see: Do Clinical Pathologists Need to Be Located in Close Proximity to Hospital Patients?). I further suggested that there was a need in hospitals for a teleconsultation app that would make it easy for clinicians to launch a short audio + video conversation with a pathologist. The use of such an app, of course, would not be restricted to pathologists but could be used by any specialist in ...
Source: Lab Soft News - July 7, 2016 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Healthcare Delivery Healthcare Information Technology Lab Information Products Lab Processes and Procedures Laboratory Industry Trends Pathology Informatics Radiology Surgical Pathology Source Type: blogs

Bogotá, Colombia – A Study of Medtech Contrasts
In conclusion, Colombia has a very pioneering spirit when it comes to medical technology. Despite some lack of resources as a still developing nation, an imperfect healthcare system, and a not-so-positive reputation based on its checkered history, Colombians have found a way to make things work, and in some cases, have shown themselves to be ahead of the curve in medical technology. With numerous tax incentives, a strategic location, and a friendly culture with a low cost of living, the government is hoping to make Bogotá the capital of medical technology in Latin America. If the country continues to make as much progres...
Source: Medgadget - July 7, 2016 Category: Medical Equipment Authors: Scott Jung Tags: Exclusive Source Type: blogs

Unity Farm Journal - Second Week of July 2016
As we scale up production of fruits, vegetables, honey, mushrooms, and compost, the key to our success is automation.    It’s challenging for two people (my wife and I) to run 15 acres of organic agriculture and support 150 animals part time using only handtools and muscles.  Last year, we produced 50 pounds of honey.   This year we’ll produce 1200 poundsLast year, we did not sell compost.   This year, we’ll bag up 10,000 poundsWe’ve added automation slowly, only in resposne to market demand for our products.   For honey extraction, we’ve used a hand cranked centrifuge, which is grea...
Source: Life as a Healthcare CIO - July 7, 2016 Category: Information Technology Source Type: blogs

Research and Reviews in the Fastlane 141
This study showed that while it’s feasible to acutely lower systolic blood pressure < 140 mm Hg, there’s no benefit to death or disability. Additionally, patients in the aggressive blood pressure treatment arm were more likely to have adverse renal events at 7 days. These results mirror those seen in the INTERACT-2 trial (prior to the statistical shenanigans used to spin the results positively). Based on the best available evidence, we can confidently say that it should not be standard care to aggressively drop blood pressure in these patients. Recommended by Anand Swaminathan Further reading The case of ...
Source: Life in the Fast Lane - July 7, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Clinical Research Emergency Medicine Neurology Neurosurgery Pediatrics R&R in the FASTLANE Resuscitation critical care EBM Education literature recommendations research and reviews Source Type: blogs

A case of abdominal pain in the ER. And a surprising cause.
(Triage note: 45-year-old male, vomiting for two days. Abdominal pain.) Dr. Stephen Cluff is like Yoda. Judging by body hair, he’s more like Chewbacca. But he’s short, wise, and with his white hair and arthritic limp, he may as well have green skin, poor sentence structure, and a Muppet’s voice. If I’m stumped on a case, I’ll ask him. If I’m pissed off about department politics, I’ll call him for advice. If I want to play a practical joke, like loosen the top of a coffee cup, I’ll pick someone else, because Cluffy might go ape-sh*t, like he does when we don’t pass t...
Source: Kevin, M.D. - Medical Weblog - July 7, 2016 Category: Journals (General) Authors: Tags: Conditions Emergency Source Type: blogs