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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 2.

Project ECHO GEMH: Disruptive Technology For Geriatric Mental Health
New York State is a leader on many health fronts, whether it be antismoking, obesity reduction, or insurance coverage. But our state is also a leader in another area: we are among the states with the greatest shortages in physician supply. According to the Healthcare Association of New York State, the deficits are especially large in rural areas, which lack both primary care physicians and specialists. This situation hits particularly hard in rural communities since primary care doctors may be their only source of health services, including those for mental health. The prevalence of mental illness is not much different in ...
Source: Health Affairs Blog - May 28, 2015 Category: Health Management Authors: Brian Byrd and Bronwyn Starr Tags: Drugs and Medical Technology GrantWatch Health IT Health Professionals Access Chronic Care Dementia Health Care for the Elderly Health Philanthropy Innovation Mental Health Primary Care Rural Health Care States Workforce Source Type: blogs

Proactive Psychiatric Consultation For Hospitalized Patients, A Plan for the Future
The Yale Behavioral Intervention Team (BIT) is a proactive, multi-disciplinary psychiatric consultation service for all internal medicine inpatients at Yale-New Haven Hospital. The goal of the team, which includes nurses, social workers, and psychiatrists, is to shift from a “reactive” to a “proactive” paradigm of psychiatric consultations on hospital inpatient medical floors. The team screens for, identifies, and removes/mitigates behavioral barriers to the effective receipt of health care among hospitalized medical patients, especially among those with co-occurring mental illness and/or substance abuse. To facili...
Source: Health Affairs Blog - May 28, 2015 Category: Health Management Authors: William H. Sledge and Hochang Ben Lee Tags: Hospitals Innovations in Care Delivery Organization and Delivery Behavioral Health Behavioral Intervention Team Mental Health Nursing Patient Care Psychiatry Social Work Source Type: blogs

Developing a Framework for Competency Assessment: Entrustable Professional Activities (EPAs)
Editor’s Note: This post is the second of two on the topic of competency-based medical education. Read the first post here. By: Robert Englander, MD, MPH, Terri Cameron, MA, Amy Addams, Jan Bull, MP, and Joshua Jacobs, MD Dr. Englander is the former senior director of competency-based learning and assessment at the Association of American Medical Colleges (AAMC). Ms. Cameron is director of curriculum programs at the AAMC. Ms. Addams is director of competency-based admissions at the AAMC. Ms. Bull is lead specialist in competency-based learning and assessment at the AAMC. Dr. Jacobs is senior director of electronic portfo...
Source: Academic Medicine Blog - May 26, 2015 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective CBME competency assessment competency framework competency-based medical education entrustable professional activities EPA Source Type: blogs

Transitioning to private practice: What it has taught me about our underserved
After four years working as a child and adolescent psychiatrist in Brooklyn treating the underserved, I decided it was time to dedicate myself fully to my growing private practice. Functioning solely as an out of network provider in private practice, as expected, my clientele grossly changed. Unlike my hospital patients, a majority of my patients are upper class to wealthy. Finances are not concerns or stressors. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 21, 2015 Category: Journals (General) Authors: Tags: Policy Psychiatry Source Type: blogs

Top stories in health and medicine, May 18, 2015
From MedPage Today: Remote Monitoring, a New Paradigm for Cardiac Implanted Devices? Patients who used the remote monitoring (RM) function of their cardiovascular implantable electronic devices (CIEDs) had less healthcare utilization and better survival than those without RM according to a pair of studies. Migraine, Carpal Tunnel Syndrome Linked in Association Study. Migraine headache and carpal tunnel syndrome (CTS) may be associated, researchers reported, with individuals reporting one in a large federal survey having greater likelihood of also reporting the other. Antidepressant Use on the Rise Among Patients with Dem...
Source: Kevin, M.D. - Medical Weblog - May 18, 2015 Category: Journals (General) Authors: Tags: News Heart Neurology Psychiatry Radiology Source Type: blogs

Casual Fridays don’t have a place in medicine
A disclaimer before I even get started on this post. Some of you who know me or work with me will think that by writing this post I am talking about you or even attacking you. I am not. If you’re especially sensitive, don’t read any further. I am simply writing something that has been kicking around in my head for a long time. Feelings that I have about a concept. A concept called casual Friday. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 16, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

What’s it like to live with depression? This poem shows you. Wow.
Dan Roman gives a powerful account on what it’s like to live with depression, performing at the 2015 College Unions Poetry Slam Invitational.  Sometimes, words can’t explain it.  In this case, poetry can. Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 14, 2015 Category: Journals (General) Authors: Tags: Video Psychiatry Source Type: blogs

Why must doctors complete extra training to prescribe buprenorphine?
I recently completed the buprenorphine waiver training. Buprenorphine, itself a partial opiate, is a medication that can be prescribed to patients who have opiate use disorders (e.g., taking Oxycontins or injecting heroin to get high). A physician must complete an eight-hour training and take an exam to become eligible to prescribe this medication. The physician must then apply for a specific “X license” through the DEA to prescribe it. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 9, 2015 Category: Journals (General) Authors: Tags: Meds Medications Psychiatry Source Type: blogs

Explaining Hilary
Megan McCardle goes a long way in explaining Hilary for me. One of the things I object to is academic high mindedness about the relationship of pharmaceutical companies to doctors. In part this is, for me, about profitable interchange of ideas that may occur at dinners to promote a product. For instance I learned more about the physiology of pain at a talk on Neurontin. Or it may just be about things that make life a little easier or more fun. For instance I weigh patient's on an Equetro branded scale. I didn't know about the type of scale it is an example of. These things are now not apparently permissible. Many politicia...
Source: a psychiatrist who learned from veterans - May 8, 2015 Category: Psychiatry Source Type: blogs

Why board certification is important to this physician
Recently there has been a great deal of controversy surrounding the American Board of Internal Medicine (ABIM), and its board certification requirements. Currently, the board require physicians to take an exam and recertify every ten years in a process termed MOC, or maintenance of certification. The process is time-consuming and costly, and many physicians claim it does not improve their day-to-day practice. Doctors have become more vocal in their grievances with the organization, and its possible misuse of funds. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A s...
Source: Kevin, M.D. - Medical Weblog - May 6, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Greg Mankiw, Chairman of Harvard's Economics Department, Favors the Abolition of the Estate Tax
Here. My own view of it is that it is a burden on high middle earners and their offspring. Given that you have enough funds, you can engage in estate planing and work to avoid the tax like people used to avoid income taxes, not so inclined or having the time, the estate gets taxed. That would tend to fall on people who are not primarily significant financiers. (Source: a psychiatrist who learned from veterans)
Source: a psychiatrist who learned from veterans - May 6, 2015 Category: Psychiatry Source Type: blogs

Feeling Grey About Fifty Shades
The following post originally ran on Huffington Post Women on April 16th and can be seen here. The author is Aimee Gallagher, MPH, MS the Scientific Program Manager at the Society for Women’s Health Research. The much-anticipated release of the Fifty Shades of Grey movie and its novel series precursor struck chords of concern among women’s health advocates. While the book sold over 100 million copies worldwide and has been heralded as an erotic romance novel that is sexually liberating, the nature of the protagonists’ relationship is troubling because of its multiple aspects of domestic violence. Domesti...
Source: Disruptive Women in Health Care - May 5, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Women's Health Source Type: blogs

Health Affairs May Issue: Variety Issue Includes Focus On Affordable Care Act
This study is part of Health Affairs’ DataWatch series. (Source: Health Affairs Blog)
Source: Health Affairs Blog - May 4, 2015 Category: Health Management Authors: Tracy Gnadinger Tags: Elsewhere@ Health Affairs Featured Health Professionals Hospitals Insurance and Coverage ACA 5th anniversary California hospital closures hospital networks HPV vaccine pediatric psychiatry physician training Source Type: blogs

Baltimore
I think the facts of The Freddie Gray case, the false arrest, the brutal ride in the paddy wagon are a surprise to most white Americans. The fact that police authority in this case has been subject to a flanking attack by a Pennsylvania state attorney will open up more hope to black people and together these events are the most positive for interracial comity in many years. We love you, poor Freddie. (Source: a psychiatrist who learned from veterans)
Source: a psychiatrist who learned from veterans - May 3, 2015 Category: Psychiatry Source Type: blogs

The Armstrong v Exceptional Child Inc. Medicaid Payment Case: Now What?
In its recent decision in Armstrong v. Exceptional Child, the United States Supreme Court held that providers (and, by implication, beneficiaries as well) may not turn to the courts for help in requiring that states live up to the minimum legal terms of the Medicaid statute. Although the decision was not unexpected (the Court decided to hear the case only three years after considering a similar suit), it nonetheless represents a fundamental shift in public policy. Over the half century of Medicaid’s existence, the courts have played a crucial role in ensuring that Medicaid’s words mean what they say. In this post, we ...
Source: Health Affairs Blog - April 30, 2015 Category: Health Management Authors: Sara Rosenbaum Tags: Featured Medicaid and CHIP Payment Policy Access Health Law Supreme Court Source Type: blogs

Mental health for medical professionals deserves more attention
Every year roughly 400 physicians take their lives: a group of physicians greater than the size of two graduating classes at my medical school. Let’s be clear, physician suicide and medical professional mental health awareness is a neglected issue in medicine. We are twice as likely to commit suicide than our non-physician counterparts. Women physicians are up to three times as likely to take their lives than their non-physicians peers. Medical students have rates of depression 15 to 30 percent higher than the general population. A 2009 study by the AAMC reported that 9.4 percent of fourth-year medical students and ...
Source: Kevin, M.D. - Medical Weblog - April 27, 2015 Category: Journals (General) Authors: Tags: Education Medical school Psychiatry Source Type: blogs

Hillary Clinton’s hormones have nothing to do with her qualifications
Time magazine published this article about why Hillary Clinton is the perfect age to run for president. The author, Dr. Holland who is a psychiatrist, chose not to focus on Ms. Clinton’s vast political experience or her education but rather on Ms. Clinton’s menopausal status. Yes, you read that right, when it comes to qualifications for president of the United States menopause trumps a Yale law degree, eight years as a senator from New York, and four years as Secretary of State. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how...
Source: Kevin, M.D. - Medical Weblog - April 27, 2015 Category: Journals (General) Authors: Tags: Physician OB/GYN Source Type: blogs

What is mental illness? Words matter.
I’ve been invited to speak to a group of attorneys who work at the interface of psychiatry and the law. The topic of my talk? “Psychiatry 101.” A psychiatrist who gave this talk to a similar group a few years ago advised me: “You should assume that lawyers are laymen. It’s surprising how little they know, given the work that they do.” This teaching opportunity to teach has given me pause: What is mental illness? Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - April 25, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

The Unbefriended – NYC HHC Annual John Corser Ethics Conference
Conclusion and Attendee Evaluation (Source: blog.bioethics.net)
Source: blog.bioethics.net - April 25, 2015 Category: Medical Ethics Authors: Thaddeus Mason Pope Tags: Health Care medical futility blog syndicated Source Type: blogs

Integrating Behavioral Medicine Into Primary Care GME: A Necessary Paradigm For 21st Century Ambulatory Practice
Limited access to child and adolescent, adult, and geriatric psychiatry, as well as other mental health providers, has a large impact on the capacity of our health care system to address mental health needs, particularly in underserved urban and rural areas. A major determinant of this limited access is an under-supply of mental health providers. The recently developed Teaching Health Center Graduate Medical Education (THCGME) program provides a promising resource to address this problem because of its unique educational setting, which could facilitate integration of behavioral medicine into primary care graduate medical e...
Source: Health Affairs Blog - April 24, 2015 Category: Health Management Authors: Alan Axelson Tags: Health Policy Lab Health Professionals Organization and Delivery Population Health Behavioral Health GME Primary Care Source Type: blogs

Teaching Health Centers: Targeted Expansion For Immediate GME Reform
We describe examples of current or proposed programs which illustrate the potential of these modifications. Need for Immediate Targeted GME Expansion in Primary Care There is broad agreement on the need for adequate numbers of physicians prepared to work in primary care, geriatrics and psychiatry in urban and rural underserved areas. A 12,000-31,000 shortage over current primary care physician supply in the next ten years is anticipated, depending on modeling considerations such as physician retirement rates and entrance of advanced practice nurses to take up some of the duties physicians currently perform. Regional and st...
Source: Health Affairs Blog - April 24, 2015 Category: Health Management Authors: Richard Rieselbach Tags: Costs and Spending Health Policy Lab Health Professionals Organization and Delivery Graduate medical education teaching health centers THCGME Source Type: blogs

Law, Religion, and Health in America
Discussion E. J. Dionne, Jr., Columnist, The Washington Post; Senior Fellow, The Brookings Institution Diane L. Moore, Senior Lecturer on Religious Studies and Education and Senior Fellow at the Center for the Study of World Religions, Harvard Divinity School Charles Fried, Beneficial Professor of Law, Harvard Law School Frank Wolf, Representative, Virginia’s 10th Congressional District, U.S. House of Representatives, 1981-2015 (retired) Moderator: Daniel Carpenter, Freed Professor of Government, Harvard University and Director, Center for American Political Studies at Harvard University&...
Source: blog.bioethics.net - April 24, 2015 Category: Medical Ethics Authors: Thaddeus Mason Pope Tags: Health Care medical futility blog syndicated Source Type: blogs

Research and Reviews in the Fastlane 080
This study calls into question the current guidelines and will hopefully lead to more evidence-based recommendations in the future.Recommended by: Zack RepanshekRead More: Antibiotics for community-acquired pneumonia: Is azithromycin out? (Pulm CCM)The Best of the RestOphthalmology, Ultrasound Vrablik ME et al. The diagnostic accuracy of bedside ocular ultrasonography for the diagnosis of retinal detachment: a systematic review and meta-analysis. Ann Emerg Med 2015; 65(2):199-203. PMID: 24680547Nice meta-analysis of bedside US for retinal detachment in Annals of EM showing 97-100% sensitivity, 83-100% specificity, based...
Source: Life in the Fast Lane - April 23, 2015 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Cardiology Education Emergency Medicine Infectious Disease Intensive Care Ophthalmology Psychiatry and Mental Health Resuscitation Trauma critical care R&R in the FASTLANE recommendations research and reviews Source Type: blogs

Doctor’s death an “inconvenience” for patients
An investigation is underway after a Chicago-area doctor is found dead — a suicide according to the medical examiner. What demands investigation is the callousness with which the this doctor’s death was reported by the media — and received by neighbors, many health care professionals themselves.   I’m alerted to the death initially by a Facebook friend: “Pamela, check this out!” Headline: Police: Doctor found dead near hospital in Berwyn. The facts: On Thursday, April 16, a maintenance worker calls the police to request a well-being check on a tenant, Dr. Jon Azkue, a 54-year-old physician employed...
Source: Kevin, M.D. - Medical Weblog - April 21, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

How far is too far? A response to Dr. Fredric Brandt’s suicide.
As someone involved in both the medical and acting world, I was tremendously saddened to read about Dr. Fredric Brandt’s recent suicide, which is presumed to be in response to an impersonation of him on the Netflix’s series, The Unbreakable Kimmy Schmidt.  Project Casting, a website offering free casting calls and auditions, posted a link on their website asking, “Did Netflix go too far” and I was shocked by people’s comments. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - April 21, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

The House of God brought attention to medical slang
An excerpt from The Secret Language of Doctors: Cracking the Code of Hospital Culture. When it comes to modern medical slang, there’s Before Shem and After Shem. Shem refers to Samuel Shem, the pen name of Dr. Stephen Bergman, psychiatrist and author of the blockbuster novel The House of God, which introduced millions of readers — and generations of doctors — to the argot that is the lingua franca of residents and interns then and now. I call Bergman the Slangmeister because until he arrived on the scene in 1978 with his satirical novel, little had been published about medical slang. Continue reading ... Yo...
Source: Kevin, M.D. - Medical Weblog - April 21, 2015 Category: Journals (General) Authors: Tags: Physician Hospital Source Type: blogs

Can suicide be prevented?
A pilot deliberately flying a plane full of passengers into a mountain is horrific, unbelievably sad, and, thankfully, very rare. But suicide is far from rare. Tragically, those usually lonely acts of despair are rising.    But can they be prevented? Someone in this country dies by suicide every 12.8 minutes. The national suicide rate has increased to 12.6 suicide deaths per 100,000 and for ages 18 to 35 — the prime of one’s life — only unintentional injuries account for more deaths. Continue reading ... Your patients are rating you online: How to respond. Manage your online rep...
Source: Kevin, M.D. - Medical Weblog - April 21, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Pay no attention to the man behind the curtain
No doubt you have heard about the physicians who wrote to Columbia University's  dean of the medical faculty demanding that the school fire Mehmet Oz. The university responded with some banalities about academic freedom.The physicians who wrote the letter seem a bit dodgy; some of them have ties to the GMO industry and the letter seemed to focus inordinately on that subject. But that's neither here nor there. The question is, should Columbia remove Oz from the faculty.Honestly, I'm of two minds about this. It is generally against my religion to see professors fired because of controversial public statements. Free inqu...
Source: Stayin' Alive - April 20, 2015 Category: American Health Source Type: blogs

When relationship therapy acts as a powerful anti-depressant
Many people know what it feels like to be depressed. It’s hard to go through life without at some point experiencing that helpless/hopeless feeling. Some people, however, stay stuck in this painful state. In my family therapy practice, I frequently get calls from people seeking help for depression. Sometimes their depression is self-diagnosed, reflecting their experience of ongoing distress.  Other times they’ve been referred by their family doctor.  It’s common for depressed people to worry that  they have a “chemical imbalance”. They often feel burdened and alone, solely responsible for their mood state. Con...
Source: Kevin, M.D. - Medical Weblog - April 19, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Mental illness: Is it organ dysfunction like any other?
I often get referrals from the town’s free clinic.  As you would imagine, the patients often have a unique set of problems, coming as they do from the underserved segment of society. One such patient, Julia, was a fiftyish-year-old woman who had recently moved to town from California. She went to the free clinic (not really sure what the original complaint was) and ended up getting a physical exam that revealed a breast mass, which precipitated a mammogram, and then a biopsy, and a breast cancer diagnosis. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A soc...
Source: Kevin, M.D. - Medical Weblog - April 19, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Surgery Source Type: blogs

The road to health care for veterans is baroque
Read the voices of Service: this discussion  thread is a show and tell of what women veterans have to go through to get care. It also demonstrates some traits of women warriors: generosity, tenacity , wisdom , guts and extreme moxie. It is unconscionable that those who served have to come home and fight more battles. Shame on us. Alana Vollmer-Bland Question…..I have a 30% rating for PTSD from Afghanistan. I told the shrink at the VA at the beginning of the claims process and then another counselor at the VA here about the sexual assault while I was on active duty. She spent 6 weeks doing intake on me and waffled be...
Source: Disruptive Women in Health Care - April 17, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Women Veterans Source Type: blogs

Reducing Inappropriate Psychotropic Prescribing For Children And Youth In Foster Care
There is currently a much-needed national spotlight on the high rates of psychotropic medication use among children and youth in foster care, most of whom receive health coverage through Medicaid. This high-risk population is far more likely to receive psychotropic medications, including antipsychotics---a class of medication with serious side effects---than the Medicaid child population overall. While there are certainly some children and youth who should receive these medications, states must have oversight and monitoring mechanisms to determine when this is---or is not---the case. Many of these children and youth exp...
Source: Health Affairs Blog - April 17, 2015 Category: Health Management Authors: Kamala Allen Tags: Equity and Disparities Medicaid and CHIP Access Children drugs foster care Pharma Source Type: blogs

Should there be zero tolerance for depression in the cockpit?
The recent Germanwings tragedy has called commercial aviation’s concept of fitness for flight into question.  Although the official mishap investigation has not yet concluded, available information at the time of this writing points to an intentional crashing of the plane by the 27-year-old co-pilot, Andreas Lubitz. Reports from the co-pilot’s medical records allege he had previously experienced episodes of depression and carried diagnoses for other psychosomatic disorders.  Antidepressants and torn medical memorandums stating that he was not fit for flight were apparently found at the home of Lubitz by invest...
Source: Kevin, M.D. - Medical Weblog - April 16, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Healthcare Update Satellite – 04-15-2015
You’ve heard of a CAT scan? Get ready for the dog sniff. Dogs can identify bladder and prostate cancer with a 98% accuracy rate when smelling male urine samples. Not into the whole dog sniffing thing as a screen for prostate cancer? A $1 screening test using gold nanoparticles 10,000 times smaller than a freckle is more accurate than PSA screenings and gives results in minutes. When blood is mixed with the nanoparticles, tumor biomarkers cling to the surface and cause clumping. I’m guessing the test will cost consumers several hundred dollars. Doctors are using scorpion venom to create “tumor paint”...
Source: WhiteCoat's Call Room - April 16, 2015 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs

A psychiatrist.  Undercover. 
My husband was in the aisle seat, I was in the middle seat, and The Man was in the window seat. The Man had one white earbud in his ear; the other one was dangling in his lap. His right thumb swiped through several screens of his smartphone in less than a second. He heaved a sigh. “This is f*cking lame,” he muttered. The plane was supposed to take off 15 minutes ago. At that time, the captain had announced that the plane had technical difficulties, but he anticipated that we would be up in the air soon. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social me...
Source: Kevin, M.D. - Medical Weblog - April 13, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

ED Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.....
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4)    Reed MJ.  The ROSE (Risk Stratification of syncope in the emergency department) Study.  J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049  Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - April 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.....
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4)    Reed MJ.  The ROSE (Risk Stratification of syncope in the emergency department) Study.  J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049  Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - April 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

Targeting Suicide
The recent tragedy with the Germanwings crash in the Alps has started a worldwide discussion about mental illness and suicide. We don’t yet know what happened on this flight and we certainly don’t have access to the medical history of the copilot who is now the focus of the investigation, but this heartbreaking news from France, and the debate that it has spawned, illustrates the difficulties of understanding suicidal behavior, much less predicting it. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - April 3, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Binge eating disorder: Real or disease mongering?
A drug company recently received FDA approval to peddle its speed-like pill for “binge eating disorder” (the very same pill that is already widely overused for ADHD). And it is sparing no expense pushing the drug — a former world tennis champ is the shill and commercials are everywhere. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - April 2, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Surprising no one
So I was sitting at the dining room table, feverishly always-sometimes-rarely-nevering, when Paul asked me if I wanted something to drink. "Please," I said distractedly, gesturing over into the kitchen. "I already have one started." I meant the half-finished cup of coffee right there on the counter, but bless that man: instead he brought a half-finished bottle of wine. ... The pediatrician had been kind of tenacious about it. "Have you had Charlie evaluated?" Yes, but the verdict was inconclusive. "Have you had him evaluated recently?" No, because we think we know, and we doubt it wi...
Source: a little pregnant - April 2, 2015 Category: Child Development Authors: Julie Tags: Charles in charge Source Type: blogs

ADHD and early death: We often miss the story
Alarming headlines, based on a recent study, declare that diagnosis with ADHD doubles the risk of early death. Psychiatrist Stephen Faraone, commenting on the original study published in the Lancet, concludes that: “for clinicians early diagnosis and treatment should become the rule rather than the exception.” This conclusion represents a false assumption that the deaths occurred in cases that were not treated. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - April 1, 2015 Category: Journals (General) Authors: Tags: Conditions Pediatrics Psychiatry Source Type: blogs

Testifying in support of medical student mental health
The following is Dr. Pamela Wible’s testimony in support of medical student mental health to the Missouri State Legislature for House Bill 867. I’m Dr. Pamela Wible, a family physician in Oregon. I’ve submitted my CV, witness form, and transcript of my testimony to Chairman Frederick. My schedule prevents me from traveling to Missouri for today’s hearing; however, I thank Vice Chairman Morris and the Committee for allowing me to testify remotely in support of House Bill 867, legislation that would require Missouri medical schools to screen students for depression and offer mental health referrals for those at r...
Source: Kevin, M.D. - Medical Weblog - April 1, 2015 Category: Journals (General) Authors: Tags: Physician Medical school Psychiatry Source Type: blogs

Judge Dismisses Off-Label and Kickback Allegations Against Bristol-Myers Squibb, But BMS Must Face Whistleblower Retaliation Suit
District Court Judge William Bertelsman recently dismissed False Claims Act (FCA) allegations against Bristol-Myers Squibb and Otsuka Pharmaceuticals brought by two former BMS sales reps. Despite finding the whistleblowers failed to show that the company engaged in either off-label promotion or kickbacks in violation of the FCA, however, Judge Bertelsman held that the whistleblowers adequately pled wrongful retaliation claims. According to the former sales reps, they tried to bring their compliance concerns up the company chain, but were instead punished with poor performance reviews. Both employees were terminated s...
Source: Policy and Medicine - April 1, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Mental health is a basic human right to fight for
Disruptive Women is embarking on an exciting week…Tuesday we head to NYC where we will be emceeing XX in Health as their retreat takes over the boy’s club (The Harvard Club). Then on Thursday we will be talking to women in tech at MassMEDIC. So as we interact with new disruptive women this week we wanted to reflect back and run some powerful posts from the past. Be sure to check the blog all this week for some of our favorites. The following post by Dr. Agnes Binagwaho, Permanent Secretary of the Ministry of Health of Rwanda, is part of Disruptive Women’s “The Value of Health: Creating Economic Security in ...
Source: Disruptive Women in Health Care - March 31, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Mental Health Source Type: blogs

Neglecting Our Own: Well-Being Disparities in Sexual Minority Medical Students
By: Andrés F. Sciolla, MD Dr. Sciolla is an associate professor at the Department of Psychiatry and Behavioral Sciences, University of California, Davis, co-director of the Doctoring 2 course at the University of California, Davis, School of Medicine, and medical director of a community mental health clinic, the Northgate Point Regional Support Team, in Sacramento, California. He graduated from the University of Chile School of Medicine and is a board-certified psychiatrist. When it comes to psychological distress, individuals who aspire to a career in medicine are a queer lot. At matriculation, the average medical studen...
Source: Academic Medicine Blog - March 30, 2015 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective medical student wellness psychological well-being self-rated health sexual and gender minorities Source Type: blogs

Did Andreas Lubitz Have Lyme Disease?
Although the editors of InsideSurgery.com did not participate in the care of Andreas Lubitz, we are following news reports closely. Multiple sources today are reporting that he was under continuing care of a physician who recommended that he stop flying as a commercial airline pilot for Lufthansa controlled Germanwings air service. Lubitz seems to be a well-liked, non-controversial young man from a stable upbringing who by all accounts loved being a pilot. What could have caused him to fly his airliner with another 149 people aboard to their certain annihilation into a French mountainside? One wonders what medical conditi...
Source: Inside Surgery - March 27, 2015 Category: Surgery Authors: Editor Tags: Infectious Disease andreas lubitz crash germanwings Lyme disease pilot Source Type: blogs

A Plan for Changing Times
When I first determined back in 2013 that it was time for NIMH to update its Strategic Plan, I envisioned a simple “tune-up” and quick turnaround. It quickly became apparent that the mental health research landscape had seen vast changes since we published our plan in 2008. Instead of a tune-up we embarked on a complete re-examination of our priorities and the scientific opportunities that challenged us to look forward into the future. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - March 27, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Two New Independent Reports on the Death of Dan Markingson, But Now What Will Happen?
This report is the first step toward accountability.'The Minnesota Post added the response of Professor Elliott and a colleague,'It’s nice to have an independent confirmation of what we’ve been telling the university for five years, but which they have refused to listen to,' he told MinnPost on Thursday.Elliott said he is not convinced, however, that Kaler and other university leaders are going to take responsibility for what happened in the Markingson case — or take the necessary steps to fix the problem going forward.'One of the most worrying findings in the report was the widespread belief on campus that the unive...
Source: Health Care Renewal - March 25, 2015 Category: Health Management Tags: anechoic effect AstraZeneca atypical anti-psychotics clinical trials conflicts of interest manipulating clinical research research subjects suppression of medical research University of Minnesota Source Type: blogs

Heal the ill but don’t hound the well
An iconoclast must not only have abundant common sense but the gift of the gab to state the obvious. Simply stating won’t do. You must rub it in. My favorite iconoclasts are Peter Skrabanek and Thomas Szasz. Skrabanek was a general practitioner who authored Death of Humane Medicine and Rise of Coercive Healthism. Szasz, a psychiatrist, who volunteered that he entered psychiatry to unveil its pseudoscience, is the Voldermort of psychiatry — he who must not be named (maybe Voldermort is the Szasz of muggles). He wrote several books including Myth of Mental Illness. Neither believed in nominative subtlety. The title o...
Source: Kevin, M.D. - Medical Weblog - March 25, 2015 Category: Journals (General) Authors: Tags: Physician Primary care Source Type: blogs

One of the greatest rewards in health care
When he and I first met, he told me that he had a doctoral degree in psychology, was the CEO of the jail, and could speak 13 languages. To demonstrate, he said, “Hong tong ching chong lai tai!” He then punched the door to his cell and shouted, “GET THE F-CK OUT OF HERE, B-TCH!” I did. The next week, he answered my questions about the pencil drawings on his walls. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - March 24, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs