MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'acp'. Sat, 03 Sep 2011 02:22:39 +0100 http://www.medworm.com/index.php?rid=4902420&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysician-professional-associations-are-not-ivory-tower-elites%2F2011.06.06 “We can destroy ourselves by cynicism and disillusionment, just as effectively as by bombs.” This observation, from the late, great British historian Kenneth Clark, could be a warning sign to the medical profession. Some of the more incendiary commentary in blogs, editorials, and medical publications today display the classic characteristics of cynicism, which is a profound pessimism accompanied by a deep distrust and even the disparagement of the motivations of others. Physician cynics not only direct their anger at the usual suspects – members of Congress, insurance companies, and government “bureaucrats”—but even at their own colleagues, including the leadership of their own professional societies. Now, to be clear, I am not talking about principled disagreement and deba... Better Health blogs http://www.medworm.com/rss/comments.php?id=4902420 Mon, 06 Jun 2011 11:00:00 +0100 4902420 http://www.medworm.com/index.php?rid=4862550&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Forganized-medicine-is-out-of-touch-with-how-practicing-physicians-feel-about-obamacare%2F2011.05.24 There is a widespread discrepancy between the opinions of organized medical group leaders in the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), and  practicing physicians.  AMA, AAFP, and ACP are part of organized medicine. These organizations supported the healthcare reform law in 2010 and continue to support the legislation. I believe they have taken this position because they want a seat at the table as implementation of the legislation moves forward. President Obama has not paid attention to them so far and there is little evidence that he will in the future. In March of 2010, Speaker of the House Nancy Pelosi famously said, “We have to pass the [health care] bill so that you can find out what is i... Better Health blogs http://www.medworm.com/rss/comments.php?id=4862550 Tue, 24 May 2011 16:00:17 +0100 4862550 http://www.medworm.com/index.php?rid=4747724&cid=t_159932_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F04%2F20%2Frural-vs-city-medical-record-perspective%2F While at the ACP conference in San Diego (yes, it’s fun for a tech person to attend a medical conference), I had a really interesting conversation with a medical records lady from Cardone EHR Solutions. In our discussion she highlighted an interesting difference between the rural and city perspectives on a medical record. In essence… Rural clinics want to keep the medical record forever. City clinics want to get rid of as soon as possible. When she said this idea, it really rang true to me. Of course, the real issue has to do with liability. The real issue is how litigious our society has become and I think it’s fair to say that those in the urban environment are more litigious than those in the rural setting. That’s why clinics in a city generally want to dispose o... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4747724 Wed, 20 Apr 2011 17:07:43 +0100 4747724 http://www.medworm.com/index.php?rid=4600536&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fobesity-beats-adiposity-for-cardiovascular-risk%2F2011.03.16 Obesity contributes to cardiovascular risk no matter where a person carries the weight, concluded researchers after looking at outcomes for nearly a quarter-million people worldwide. Body mass index, (BMI) waist circumference, and waist-to-hip ratio do not predict cardiovascular disease risk any better when physicians recorded systolic blood pressure, history of diabetes and cholesterol levels, researchers reported in The Lancet. The research group used individual records from 58 prospective studies with at least one year of follow up. In each study, participants were not selected on the basis of having previous vascular disease. Each study provided baseline for weight, height, and waist and hip circumference. Cause-specific mortality or vascular morbidity were recorded according to well d... Better Health blogs http://www.medworm.com/rss/comments.php?id=4600536 Wed, 16 Mar 2011 17:00:00 +0100 4600536 http://www.medworm.com/index.php?rid=4592401&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnearly-12-million-cancer-survivors-in-the-u-s%2F2011.03.14 The number of cancer survivors in the United States increased to 11.7 million in 2007, according to a report released by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). Women survive more often, and survive longer, according to the report. There were 3 million cancer survivors in 1971 and 9.8 million in 2001. Researchers attributed longer survival to a growing aging population, early detection, improved diagnostic methods, more effective treatment and improved clinical follow-up after treatment. The study, “Cancer Survivors in the United States, 2007,” is published today in the CDC’s Morbidity and Mortality Weekly Report. To determine the number of survivors, the authors analyze... Better Health blogs http://www.medworm.com/rss/comments.php?id=4592401 Mon, 14 Mar 2011 13:00:00 +0100 4592401 http://www.medworm.com/index.php?rid=4570548&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F5-avoidable-air-travel-health-risks%2F2011.03.10 For those of you planning air travel to your next medical conference (and ACP Internist isn’t too shameless to plug Internal Medicine 2011 — we hope to see you there), TIME reports that there are five health risks that are rare yet have recently happened. Tips on avoiding these maladies include: – E. Coli and MRSA on the tray table. Microbiologists found these two everywhere when they swabbed down flights. Bring your own disinfecting wipes. – Bedbugs in the seat. British Airways fumigated two planes after a passenger posted pictures online about her experience. Wrap clothes in plastic and wash them. – Sick seatmates. Everyone has experienced (or been) this person. Wash your hands. – Deep vein thrombosis (DVT). Tennis star Serena Williams experienced a p... Better Health blogs http://www.medworm.com/rss/comments.php?id=4570548 Thu, 10 Mar 2011 14:00:00 +0100 4570548 http://www.medworm.com/index.php?rid=4560275&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Flying-a-way-of-life-in-the-medical-profession%2F2011.03.07 In his last post, DrRich analyzed whether the young Wisconsin doctors who stood out on street corners proudly offering fake “sick excuses” to protesting teachers were engaging in an act of civil disobedience. DrRich respectfully kept an open mind on this question, but after careful deliberation concluded that it is very unlikely that their actions constituted classic civil disobedience as espoused by Thoreau or Gandhi. Instead, these doctors were, in a professional capacity, lying. They did not lie in any truly malicious way, however. They lied because they have been trained to believe in a higher cause than mere professional ethics, namely, the cause of social justice. They lied in full confidence that telling lies to advance such a noble cause is a natural duty of the medical profess... Better Health blogs http://www.medworm.com/rss/comments.php?id=4560275 Mon, 07 Mar 2011 21:00:13 +0100 4560275 http://www.medworm.com/index.php?rid=4560277&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-reform-continues-as-judge-relents%2F2011.03.07 A federal judge who’d ruled healthcare reform was unconstitutional and that his decision as a federal judge was the equivalent of an injunction has relented. Healthcare reform can continue in the states, pending appellate and Supreme Court review. “The sooner this issue is finally decided by the Supreme Court, the better off the entire nation will be,” wrote federal judge Roger E. Vinson, who’d decided that the healthcare reform act’s mandate that people buy insurance or face penalties overextended Congress’ powers under the commerce clause of the constitution. One reason for granting a stay, despite his previous clear intent that healthcare reform cease, includes his statement (on page 18) that: “Can (or should) I enjoin and halt implementation of... Better Health blogs http://www.medworm.com/rss/comments.php?id=4560277 Mon, 07 Mar 2011 17:00:00 +0100 4560277 http://www.medworm.com/index.php?rid=4544970&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcdc-campaign-hasnt-slowed-inappropriate-antibiotic-use%2F2011.03.03 High rates of inappropriate antibiotic use continued despite a 15-year campaign by the Centers for Disease Control and Prevention (CDC) aimed at Michigan physicians and consumers on the dangers of antibiotic overuse. The Center for Healthcare Research & Transformation (CHRT) released an issue brief detailing overall antibiotic prescribing for adult Blue Cross Blue Shield of Michigan (BCBSM) members. (The project is a non-profit partnership between the University of Michigan and BCBSM.) While antibiotic prescribing in adults decreased 9.3 percent from 2007 to 2009, it increased 4.5 percent for children during the same time period. The studies found significant differences in prescribing patterns between rural southeast Michigan and the rest of the state, particularly for children. Chi... Better Health blogs http://www.medworm.com/rss/comments.php?id=4544970 Thu, 03 Mar 2011 16:00:00 +0100 4544970 http://www.medworm.com/index.php?rid=4532208&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-garments-and-bacterial-contamination%2F2011.03.01 Bacterial contamination of physicians’ newly laundered uniforms occurs within three hours of putting them on, making them no more or less dirty than the traditional white coats, researchers reported. Researchers sought to compare bacterial and methicillin-resistant Staphylococcus aureus contamination of physicians’ white coats to freshly laundered short-sleeved uniforms, and to determine the rate at which bacterial contamination happens. They reported results in the Journal of Hospital Medicine. ACP Internist‘s blog recently took up the debate as well. The issue has cropped up over the years, assessing not only the cleanliness but the professionalism inherent in the white lab coat. Researchers conducted a prospective, randomized, controlled trial among 100 residents and h... Better Health blogs http://www.medworm.com/rss/comments.php?id=4532208 Tue, 01 Mar 2011 14:00:00 +0100 4532208 http://www.medworm.com/index.php?rid=4527735&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftop-5-most-expensive-classes-of-prescription-drugs%2F2011.02.27 The top five therapeutic classes ranked by total expense are metabolic, central nervous system, cardiovascular, gastrointestinal, and psychotherapeutic, altogether totaling $155.7 billion, or two-thirds of prescription drug expenses by U.S. adults in 2008. Two-thirds of American adults use a prescription drug, totaling the $232.6 billion in expenses. The Agency for Healthcare Research and Quality compiled a statistical brief showing that drug classes varied widely in how they made the top five list. While 46 percent of adults with a prescribed drug expense bought a central nervous system agent, they are relatively cheaper on average. Gastrointestinal agents had the highest average expense per prescription ($133), or more than three times the average expense of the cheapest class, which wa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4527735 Sun, 27 Feb 2011 15:00:00 +0100 4527735 http://www.medworm.com/index.php?rid=4522106&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-thank-you-a-day%2F2011.02.25 This is a guest post by Dr. John Schumann. ********** I just read the book “365 Thank Yous” by John Kralik. I heard an interview with the author on NPR and it caught my attention. Kralik had been down on his luck in 2007: Divorced twice, overweight, with a struggling law firm that he’d started, he was also failing in a new romantic relationship. He was worried about losing his seven-year-old daughter, too, in a custody dispute. He made a momentous decision: Instead of feeling sorry for himself (easy to do given his predicaments), he decided to be grateful for what he had. To show it, he vowed to write a thank-you note every day for the next year. What do you think happened? His life changed for the better. His relationship improved. His clients started paying their bills... Better Health blogs http://www.medworm.com/rss/comments.php?id=4522106 Fri, 25 Feb 2011 18:00:00 +0100 4522106 http://www.medworm.com/index.php?rid=4512395&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcoronary-stent-thrombosis-and-your-body-clock%2F2011.02.23 Add coronary stent thrombosis to the list of cardiac events influenced by circadian rhythms, with more events occurring during the early morning hours and in a summertime window of late July and early August. Coronary stent thrombosis joins several other adverse cardiac events that also follow a circadian pattern, such as stroke, unstable angina pectoris, acute myocardial infarction and sudden cardiac death, according to researcher published in JACC: Cardiovascular Interventions. Most studies that addressed circadian variations in cardiovascular disease were done before the advent of stents, so, researcher from Mayo Clinic-Rochester conducted a retrospective analysis of medical records and the clinic’s registry, finding 124 patients who presented with coronary stent thrombosis betwee... Better Health blogs http://www.medworm.com/rss/comments.php?id=4512395 Wed, 23 Feb 2011 14:00:00 +0100 4512395 http://www.medworm.com/index.php?rid=4501585&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmore-physician-temps-needed-for-doctor-shortage%2F2011.02.21 The use of temporary physicians is rising, filling in until permanent physicians can be hired amid the ongoing shortage of doctors nationwide, a locum tenens firm has found. The company estimates between 30,000 and 40,000 physicians worked on a locum tenens basis in 2010. The survey, by Staff Care, polled hospital and medical group managers about their use of locum tenens. Eighty-five percent said their facilities had used temporary physicians sometime in 2010, up from 72 percent in 2009. Psychiatrists and other behavioral health specialists were the most sought-after specialty (22 percent of all requests), followed by primary care physicians, defined as family physicians, general internists and pediatricians (20 percent) and internal medicine subspecialists (12 percent). Hospitalists... Better Health blogs http://www.medworm.com/rss/comments.php?id=4501585 Mon, 21 Feb 2011 14:00:00 +0100 4501585 http://www.medworm.com/index.php?rid=4489672&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fadult-vaccines-most-doctors-dont-stock-all-of-them%2F2011.02.17 Less than one in three primary care practices offer all 10 recommended adult vaccines, citing a variety of financial and logistical reasons. Researchers sponsored by the Centers for Disease Control and Prevention sampled 993 family physicians and 997 general internists. Of the respondents, 27 percent (31 percent of family practitioners and 20 percent of internists) stocked all 10. Results appear in the Feb. 17 issue of the journal Vaccine. The 10 vaccines were hepatitis A; hepatitis B; human papillomavirus vaccine (HPV); combined measles, mumps, and rubella (MMR); meningococcal conjugate vaccine (MCV4); pneumococcal polysaccharide (PPSV23); tetanus diphtheria (Td); combined tetanus, diphtheria, and pertussis (Tdap); varicella; and zoster. Of the responding practices, two percent plan... Better Health blogs http://www.medworm.com/rss/comments.php?id=4489672 Thu, 17 Feb 2011 19:00:00 +0100 4489672 http://www.medworm.com/index.php?rid=4482759&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-cost-of-treating-kidney-disease%2F2011.02.15 Medical spending to treat kidney disease totaled on average $25.3 billion annually from 2003 to 2007 (in 2007 dollars). Almost half of the expenditures ($12.7 billion) were spent on ambulatory visits. On average, 3.7 million adults (1.7 percent of the population) annually reported getting treatment for kidney disease, reports a statistical brief from the Agency for Healthcare Research and Quality. During 2003-2007, for those ages 18 to 64, more than half of the total kidney disease expenditures were from ambulatory visits (53.1 percent) compared with about one third (30.3 percent) from inpatient visits. Among those age 65 and older, ambulatory visits accounted for 46 percent of the total kidney disease expenditures and hospital stays were 43 percent. Similar amounts were spent on prescri... Better Health blogs http://www.medworm.com/rss/comments.php?id=4482759 Tue, 15 Feb 2011 18:00:00 +0100 4482759 http://www.medworm.com/index.php?rid=4459957&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-and-patients-wish-their-relationship-was-better%2F2011.02.10 Physicians said in a survey that noncompliance with advice or treatment recommendations was their foremost complaint about their patients. Most said it affected their ability to provide optimal care and more 37 percent said it did so “a lot.” Three-quarters of patients said they were highly satisfied with their doctors. But they still had complaints ranging from long wait times to ineffective treatments. Those are just some of the findings from two surveys, the first a poll of 660 primary care physicians conducted by the Consumer Reports National Research Center in September 2010 and the second a poll of 49,000 Consumer Reports subscribers in 2009. The magazine reported its results online. In the doctors’ poll, physicians named these top challenges: – 76 percent o... Better Health blogs http://www.medworm.com/rss/comments.php?id=4459957 Fri, 11 Feb 2011 00:00:00 +0100 4459957 http://www.medworm.com/index.php?rid=4450294&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdifficult-patients%2F2011.02.08 Physicians see nearly one in five patients as “difficult,” report researchers. Not surprisingly, these patients don’t fare as well as others after visiting their doctor. Researchers took into account both patient and clinician factors associated with being considered “difficult,” as well as assessing the impact on patient health outcomes. They reported results in the Journal of General Internal Medicine. Researchers assessed 750 adults prior to their visit to a primary care walk-in clinic for symptoms, expectations, and general health; for how they functioned physically, socially and emotionally; and whether they had mental disorders. Immediately after their visit, participants were asked about their satisfaction with the encounter, any unmet expectations, and... Better Health blogs http://www.medworm.com/rss/comments.php?id=4450294 Tue, 08 Feb 2011 16:00:00 +0100 4450294 http://www.medworm.com/index.php?rid=4441974&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fputting-your-heart-into-the-super-bowl%2F2011.02.06 Sports fans may literally live and die on their team’s victories, according to researchers who examined cardiac mortality rates after the home team won and lost the Super Bowl. Total and cardiac mortality rates in Los Angeles County increased after the football team’s 1980 Super Bowl loss but overall mortality fell after the 1984 the team’s Super Bowl win, researchers concluded from a review of death certificates reported in Clinical Cardiology. First, authors gave a clinical review. Stress causes a cardiac cascade. The sympathetic nervous system increases and releases catecholamines. This triggers a rise in heart rate and blood pressure, and ventricular contractility increases oxygen demand, causing blood the sheer against and fracture atherosclerotic plaque, the authors... Better Health blogs http://www.medworm.com/rss/comments.php?id=4441974 Sun, 06 Feb 2011 16:00:00 +0100 4441974 http://www.medworm.com/index.php?rid=4433102&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Faccountable-care-act-unconstitutional-the-fate-of-americans-health%2F2011.02.03 A Florida’s judge’s ruling that the Accountable Care Act (ACA) is unconstitutional doesn’t resolve the underlying constitutional issue (which will ultimately have to be decided by the U.S. Supreme Court) but it has introduced new uncertainty for the $2.3 trillion health care industry, and emboldened the law’s critics to push even harder for repeal (not that they weren’t trying already). The Wall Street Journal’s (WSJ) health blog reports that “states and companies that are supposed to be implementing the law trying to figure out what to do next. The WSJ reports that the 26 states that are parties to the suit are considering whether to ask the Supreme Court to take up the case now, before it has fully wended its way through the legal system. The New York Times (NYT) quotes the... Better Health blogs http://www.medworm.com/rss/comments.php?id=4433102 Thu, 03 Feb 2011 20:00:00 +0100 4433102 http://www.medworm.com/index.php?rid=4424235&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcardiovascular-care-costs-could-triple-by-2030%2F2011.02.01 Real total direct medical costs of cardiovascular disease (CVD) could triple, from $273 billion to $818 billion (in 2008 dollars) by 2030. Real indirect costs, such as lost productivity among the employed and unpaid household work, could increase 61 percent, from $172 billion in 2010 to $276 billion. Results appeared in a policy statement of the American Heart Association. CVD is the leading cause of mortality and accounts for 17 percent of national health expenditures, according to the statement. How much so? U.S. medical expenditures rose from 10 percent of the Gross Domestic Product in 1985 to 15 percent in 2008. In the past decade, the medical costs of CVD have grown at an average annual rate of 6 percent and have accounted for about 15 percent of the increase in medical spending... Better Health blogs http://www.medworm.com/rss/comments.php?id=4424235 Tue, 01 Feb 2011 18:00:00 +0100 4424235 http://www.medworm.com/index.php?rid=4419143&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshiver-yourself-thin%2F2011.01.30 British researchers are trying to causally link raising the thermostat to obesity prevalence. “Domestic winter indoor temperatures” appear to be rising, the researchers wrote, as is obesity. They focused on a causal link, focusing on acute and long-term effects of being comfortable in the winter. They write: “Reduced exposure to seasonal cold may have a dual effect on energy expenditure, both minimizing the need for physiological thermogenesis and reducing thermogenic capacity. Experimental studies show a graded association between acute mild cold and human energy expenditure over the range of temperatures relevant to indoor heating trends.” They also look at brown adipose tissue (BAT), aka “brown fat,” the type of fat that actually consumes energy inste... Better Health blogs http://www.medworm.com/rss/comments.php?id=4419143 Sun, 30 Jan 2011 17:00:00 +0100 4419143 http://www.medworm.com/index.php?rid=4405776&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstate-of-healthcare-in-the-union%2F2011.01.27 Short and sweet. That’s how President Obama addressed healthcare reform in his State of the Union address [Tuesday] night. In less than 700 words, he outlined how he’d improve but not retreat on what’s been enacted into law. He’s willing to work on changes, he said, naming malpractice reform and reducing onerous paperwork burdens for small businesses. But, he cautioned, “What I’m not willing to do is go back to the days when insurance companies could deny someone coverage because of a pre-existing condition.” President Obama had invited two real people to his address to highlight the law’s successes. One is a brain cancer survivor who can access health insurance through high-risk pools created by the law. The other is a small business owner w... Better Health blogs http://www.medworm.com/rss/comments.php?id=4405776 Thu, 27 Jan 2011 16:00:00 +0100 4405776 http://www.medworm.com/index.php?rid=4399529&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Feffect-of-autism-vaccine-fraud-not-easily-undone%2F2011.01.24 Eighteen percent of American believe that vaccines can cause autism, 30 percent remain unsure, and 52 percent of Americans don’t think vaccines can cause autism, according to public opinion polling done after research linking vaccines to the condition was reported as fraudulent. While 69 percent of respondents said they had heard about an association between vaccination and autism, 47 percent knew that the original Lancet study had been retracted, and that recently the research is reported as being fraudulent. The poll also found that 86 percent of parents who have doubts about the vaccine said that their children were fully vaccinated, compared to 98 percent of parents who believe vaccines are safe, and that 92 percent of children are fully vaccinated. The poll was conducted... Better Health blogs http://www.medworm.com/rss/comments.php?id=4399529 Mon, 24 Jan 2011 22:00:00 +0100 4399529 http://www.medworm.com/index.php?rid=4394443&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Famericans-are-quickly-rethinking-the-autism-vaccine-link%2F2011.01.24 Eighteen percent of American believe that vaccines can cause autism, 30 percent remain unsure, and 52 percent of Americans don’t think vaccines can cause autism, according to public opinion polling done after research linking vaccines to the condition was reported as fraudulent. While 69 percent of respondents said they had heard about an association between vaccination and autism, 47 percent knew that the original Lancet study had been retracted, and that recently the research is reported as being fraudulent. The poll also found that 86 percent of parents who have doubts about the vaccine said that their children were fully vaccinated, compared to 98 percent of parents who believe vaccines are safe, and that 92 percent of children are fully vaccinated. The poll was conducted... Better Health blogs http://www.medworm.com/rss/comments.php?id=4394443 Mon, 24 Jan 2011 22:00:00 +0100 4394443 http://www.medworm.com/index.php?rid=4389182&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbaby-boomers-2011-a-new-frontier-with-few-guideposts%2F2011.01.23 This is a guest post by Dr. John Schumann. ********** In 2011, the first wave of baby boomers will turn 65 years old. Sixty-five still has currency because that’s the age at which non-disabled Americans are eligible to be covered under the Medicare program (now itself having reached middle age). As our economy continues to recover (hopefully) from the Great Recession, the entrance of millions of Americans to the Medicare rolls over the next decade and a half will be a formidable planning challenge. Look at this chart to see how the baby boomers population has surged: So is the promise of healthcare reform (the “PPACA“), which will enlarge Medicaid by an additional 16 million Americans — about half of the projected growth in coverage for those currently uninsured.... Better Health blogs http://www.medworm.com/rss/comments.php?id=4389182 Sun, 23 Jan 2011 20:00:00 +0100 4389182 http://www.medworm.com/index.php?rid=4377570&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhos-more-pessimistic-about-healthcare-reform-physicians-or-patients%2F2011.01.20 While public opposition to healthcare reform has diminished since its passage, physician opinions are still negative, especially among specialists who see their value to the healthcare system decreasing as reform emphasizes primary care. A survey reports that 65 percent of nearly 3,000 physicians in all specialties said the quality of healthcare in the country will deteriorate in the next five years. Seventeen percent of respondents believe the quality of healthcare will stay the same and 18 percent believe it will improve. Meanwhile, 30 percent of healthcare consumers believe that the quality of healthcare will improve. Physicians cited as reasons for their pessimism personal political beliefs, anger at insurance companies and a lack of accurate planning in the reform act. Other reas... Better Health blogs http://www.medworm.com/rss/comments.php?id=4377570 Thu, 20 Jan 2011 18:00:00 +0100 4377570 http://www.medworm.com/index.php?rid=4372047&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-doctors-be-allowed-to-self-refer%2F2011.01.19 Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue — a practice called “self-referral” — unless the facility is located in their own practice. This exemption exists to allow patients with access to a laboratory test, X-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less inconvenience and speeder diagnosis and treatment — what could be wrong with that? Much, say the critics, if it leads to overutilization and higher costs and doesn’t really represent a convenience to patients. This is the gist of two studies by staff employed by the American College of Radiology, published in the December issue of Health Affa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4372047 Wed, 19 Jan 2011 16:00:00 +0100 4372047 http://www.medworm.com/index.php?rid=4360984&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcancer-treatments-to-cost-158-billion-by-2020%2F2011.01.17 Medical expenditures for cancer are projected to reach at least $158 billion in today’s dollars by 2020. That’s a 27 percent increase, assuming that incidence and treatment costs remain at 2010 levels, according to a National Institutes of Health (NIH) analysis of growth and aging of the U.S. population. But new diagnostic tools and treatments could raise medical expenditures as high as $207 billion, assuming that the costs of new treatments increases 5 percent, said the researchers from the National Cancer Institute (NCI), part of the NIH. The analysis appears in the Journal of the National Cancer Institute. Recent trends reflect a 2 percent annual increase in medical costs in the initial and final phases of care, which would boost projected 2020 costs to $173 billion.Projec... Better Health blogs http://www.medworm.com/rss/comments.php?id=4360984 Mon, 17 Jan 2011 20:00:00 +0100 4360984 http://www.medworm.com/index.php?rid=4349515&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Freferral-communication-what-happens-to-handoffs-between-primary-care-physicians-and-specialists%2F2011.01.14 Far more primary care doctors report detailed referrals than do specialists report receiving them. The same applies in reverse. Specialists report returning quality consultations, while primary care physicians report receiving them far less often. Researchers reported in Archives of Internal Medicine that perceptions of communication regarding referrals and consultations differed widely. While 69.3 percent of primary care physicians reported “always” or “most of the time” sending a patient’s history and the reason for the consultation to specialists, only 34.8 percent of specialists said they “always” or “most of the time” received the information. And, while 80.6 percent of specialists said they “always” or “most o... Better Health blogs http://www.medworm.com/rss/comments.php?id=4349515 Fri, 14 Jan 2011 18:00:00 +0100 4349515 http://www.medworm.com/index.php?rid=4337939&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-repeal-how-would-it-affect-coverage-and-cost%2F2011.01.11 [Soon] the new GOP-controlled House of Representatives will be voting on and is expected to pass a bill to repeal the Affordable Care Act (ACA) – lock, stock, and barrel. There is virtually no chance the repeal bill will get through the Senate, though, which maintains a narrow Democratic majority, and President Obama would veto it if it did. But let’s say that the seemingly impossible happened, and the ACA was repealed. What would the impact be on healthcare coverage, costs, and the federal deficit? In a letter to Speaker John Boehner (R-OH), the Congressional Budget Office (CBO) released its preliminary estimates of the impact of repeal on the deficit, uninsured, and costs of care, and found that it would make the deficit worse, result in more uninsured persons, and higher premiu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4337939 Tue, 11 Jan 2011 22:00:00 +0100 4337939 http://www.medworm.com/index.php?rid=4331015&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Frepealing-healthcare-reform-to-gain-campaign-ammunition%2F2011.01.10 Repealing healthcare reform has become a way of stockpiling ammunition for the campaign trail. The Republican-led House has scheduled a repeal of healthcare reform for Wednesday, Jan. 12, and they’d garner as allies some but not all 13 Democrats that voted against healthcare reform to begin with. The House’s quixotic vote would then promptly die in the Democrat-held Senate. But recording votes on repeal would put pressure on already vulnerable lawmakers, as well as give a quick boost to incoming ones. A Gallup poll shows 46 percent of Americans want healthcare reform to be repealed, 40 percent don’t want repeal. Unfortunately, not only can’t the law be passed, it would add $230 billion to the federal debt by 2021, according to the Congressional Budget Office. Hous... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331015 Mon, 10 Jan 2011 16:00:00 +0100 4331015 http://www.medworm.com/index.php?rid=4318333&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-spending-slowest-growth-since-the-great-depression%2F2011.01.06 Healthcare spending grew in 2009 at its slowest rate since 1938, according to a report published in Health Affairs. The last time America saw such a slow growth rate on health spending it was still emerging from the Great Depression and hadn’t yet entered World War II. The most recent recession is also the cause for the health spending figures, according to the annual report, released by the Centers for Medicare and Medicaid Services. The report shows that the recession left a deeper impact than previous ones. Healthcare spending grew 4 percent to $2.5 trillion, outpacing the rest of the still recovering economy. Authors wrote that the recession contributed to slower growth in private health insurance spending and out-of-pocket spending by consumers, as well as a reduction in capita... Better Health blogs http://www.medworm.com/rss/comments.php?id=4318333 Thu, 06 Jan 2011 18:00:00 +0100 4318333 http://www.medworm.com/index.php?rid=4314007&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-year-begins-with-a-baby-boom%2F2011.01.05 On January 1, Kathleen Casey-Kirschling became the first of the baby-boom generation to qualify for Medicare. She’s hardly alone: The baby-boom generation will cause enrollment in Medicare to soar. According to the Kaiser Family Foundation, Medicare enrollment will increase from 47 million today to 64 million in 2020 to 80 million people by 2030. At the same time, the ratio of workers paying into the program to support each Medicare enrollee will drop from 3.4 (2010) to 2.8 (2020) and then to 2.3 workers per beneficiary in 2030, denying the program the tax revenue needed to sustain it. What happens then? Well, the President and Congress would have a dismal menu of political and policy choices. They could impose huge tax increases, inflicting great harm on working families and the economy... Better Health blogs http://www.medworm.com/rss/comments.php?id=4314007 Wed, 05 Jan 2011 18:00:00 +0100 4314007 http://www.medworm.com/index.php?rid=4309612&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmaking-2011-meaningful%2F2011.01.03 Today, $27 billion in incentives begin for using electronic medical records, as office- and hospital-based providers begin to register for meaningful use criteria. Providers must use a certified system according to Centers for Medicare and Medicaid meaningful-use guidelines for 90 consecutive days within the first year of the program to qualify. Eligible professionals can receive up to $44,000 over five years under the program. There’s an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area. To get the most money, Medicare-eligible professionals must begin by 2012. By 2015, Medicare-eligible professionals and hospitals that do not demonstrate meaningful use get punished. (more…) *This blog post was originally publis... Better Health blogs http://www.medworm.com/rss/comments.php?id=4309612 Mon, 03 Jan 2011 20:00:00 +0100 4309612 http://www.medworm.com/index.php?rid=4300551&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fremembering-gene-goldwasser-discoverer-of-epo-a-cure-for-anemia%2F2010.12.30 Gene Goldwasser died last week. He was 88, and he was my friend. I wrote previously about a series of conversations I conducted with Gene and Rabbi A.J. Wolf a few years ago. I met Gene one spring day after calling to invite him to sit in on a class I was teaching to a small group of medical students about social issues in healthcare. I’d read about him in a book called “The $800 Million Pill,” by Merrill Goozner. In the book, Goozner writes the story of Gene’s two-decade hunt to isolate the hormone erythropoietin (EPO). Part of the story relates how Gene tried to interest traditional big pharma companies in his discovery, only to be brushed aside. Instead, Gene wound up sharing his discovery with what became Amgen. The company went on to make a windfall from recomb... Better Health blogs http://www.medworm.com/rss/comments.php?id=4300551 Thu, 30 Dec 2010 16:00:00 +0100 4300551 http://www.medworm.com/index.php?rid=4294629&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-business-of-anticoagulation%2F2010.12.28 This is a guest post by Dr. Juliet Mavromatis: ********** The emergence of a new generation of anticoagulants, including the direct thrombin inhibitor, dabigatran and the factor Xa inhibitor, rivaroxaban, has the potential to significantly change the business of thinning blood in the United States. For years warfarin has been the main therapeutic option for patients with health conditions such as atrial fibrillation, venous thrombosis, artificial heart valves and pulmonary embolus, which are associated with excess clotting risk that may cause adverse outcomes, including stroke and death. However, warfarin therapy is fraught with risk and liability. The drug interacts with food and many drugs and requires careful monitoring of the prothrombin time (PT) and international normalized ratio (IN... Better Health blogs http://www.medworm.com/rss/comments.php?id=4294629 Tue, 28 Dec 2010 15:00:00 +0100 4294629 http://www.medworm.com/index.php?rid=4287416&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-twelve-days-of-healthcare-reform%2F2010.12.24 Today’s blog will be my last for 2010, as I will be taking a break to spend the Christmas and New Year’s holidays with family and friends. In keeping with a tradition I started two years ago, I again have taken the liberty of mangling a beloved holiday song, story, or rhyme to give a humorous (I hope!) perspective on current politics. In December, 2008, I adapted “Twas the Night Before Christmas” to convey President-elect Obama as being a not-so-jolly old elf besieged by lobbyists demanding stimulus gifts. Last year, I depicted the GOP as the Grinch trying to stop “ObamaCare” from coming. Today, I’ve re-written the “Twelve Days of Christmas” carol so that it is the government bestowing “gifts” (based on actual provisions of the Affordable Care Act) that the new Co... Better Health blogs http://www.medworm.com/rss/comments.php?id=4287416 Fri, 24 Dec 2010 14:00:00 +0100 4287416 http://www.medworm.com/index.php?rid=4275325&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Freassuring-patients-about-ct-scans-and-radiation-risks%2F2010.12.20 Emergency patients with acute abdominal pain feel more confident about medical diagnoses when a doctor has ordered a computed tomography (CT) scan, and nearly three-quarters of patients underestimate the radiation risk posed by this test, reports the Annals of Emergency Medicine. “Patients with abdominal pain are four times more confident in an exam that includes imaging than in an exam that has no testing,” said the paper’s lead author. “Most of the patients in our study had little understanding of the amount of radiation delivered by one CT scan, never mind several over the course of a lifetime. Many of the patients did not recall earlier CT scans, even though they were listed in electronic medical records.” Researchers surveyed 1,168 patients with non-traum... Better Health blogs http://www.medworm.com/rss/comments.php?id=4275325 Mon, 20 Dec 2010 22:00:00 +0100 4275325 http://www.medworm.com/index.php?rid=4265735&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fleading-healthcare-systems-collaborate-on-best-practices-for-common-conditions%2F2010.12.17 Six of the nation’s leading healthcare systems will collaborate on outcomes, quality, and costs across eight common conditions or procedures in an effort to share best practices and reduce costs with the entire healthcare system. Cleveland Clinic, Dartmouth-Hitchcock, Denver Health, Geisinger Health System, Intermountain Healthcare, and Mayo Clinic will to share data among their 10 million patients with The Dartmouth Institute, which will analyze the data and report back to the collaborative and the rest of the country, according to a press release. The collaborative will focus on eight conditions and treatments for which costs have been increasing rapidly and for which there are wide variations in quality and outcomes across the country. The first three conditions to be studies are ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4265735 Fri, 17 Dec 2010 22:00:00 +0100 4265735 http://www.medworm.com/index.php?rid=4258866&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fjudge-rules-healthcare-reform-unconstitutional%2F2010.12.14 A federal judge in Virginia has ruled that healthcare reform is unconstitutional and expects the Obama administration to honor that ruling while it’s being appealed. But states and private companies are continuing to plan and budget for it nonetheless. The court ruled that Congress exceeded its constitutional powers in compelling Americans to buy health insurance. Judges elsewhere have ruled the law is valid or dismissed the cases on procedural grounds, while a judge in Florida will hear another case later this week. In the meantime, though, employers and healthcare companies have to continue adjusting to the reform law’s many provisions. States will continue to set up their health insurance exchanges, and they’ve already budgeted for the additional 16 million people who ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4258866 Tue, 14 Dec 2010 17:00:00 +0100 4258866 http://www.medworm.com/index.php?rid=4253136&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Frationed-care-denied-treatment-and-%25e2%2580%259cdeath-panels%2F2010.12.13 One of the canards slung at the Affordable Care Act is that it creates “death panels” that would allow the government to deny patients lifesaving treatments, even though two independent and non-partisan fact-checking organizations found it would do no such thing. I don’t bring this up now to rehash the debate, but because the New York Times had a recent story on Arizona’s decision to deny certain transplants to Medicaid enrollees — “death by budget cuts” in the words of reporter Marc Lacey. His story profiles several patients who died when they were unable to raise money on their own to fund a transplant. Lacey quotes a physician expert on transplants who flatly states: “There’s no doubt that people aren’t going to make it because of this decision.” Arizona Medic... Better Health blogs http://www.medworm.com/rss/comments.php?id=4253136 Mon, 13 Dec 2010 15:00:00 +0100 4253136 http://www.medworm.com/index.php?rid=4237893&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-food-allergy-guidelines%2F2010.12.07 The National Institute of Allergy and Infectious Diseases (NIAID) issued comprehensive food allergy guidelines to help primary care physicians and subspecialists diagnose and manage patients. The guidelines were published online at the NIAID food allergy guidelines portal, which also has a frequently asked questions section. The agency will release a patient synopsis early next year. The guidelines establish consistent terminology and definitions, diagnostic criteria and patient management practices. Additional topics covered by the guidelines include the prevalence of food allergy and management of acute allergic reactions to food, including anaphylaxis. The report also identifies gaps about what is known about food allergy. NIAID Director Anthony S. Fauci, MACP, said, “Because thes... Better Health blogs http://www.medworm.com/rss/comments.php?id=4237893 Tue, 07 Dec 2010 21:00:00 +0100 4237893 http://www.medworm.com/index.php?rid=4225247&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Faddressing-healthcare-spending-%25e2%2580%259ccowardice%25e2%2580%259d-or-bravery%2F2010.12.03 In assessing the “best and worst” of the recommendations from the National Commission on Fiscal Responsibility, Washington Post blogger Ezra Klein accuses the Commission of “cowardice” in addressing healthcare spending: “The plan’s healthcare savings largely consist of hoping the cost controls . . . and various demonstration projects in the new healthcare law work and expanding their power and reach. . . In the event that more savings are needed, they throw out a grab bag of liberal and conservative policies . . . but don’t really put their weight behind any. . .[their] decision to hide from the big questions here is quite disappointing . . . ” Pretty harsh words, considering that in other respects Klein gives the Commission high marks. But I think there is a lot mo... Better Health blogs http://www.medworm.com/rss/comments.php?id=4225247 Fri, 03 Dec 2010 21:00:00 +0100 4225247 http://www.medworm.com/index.php?rid=4219744&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedicares-deficit-effect-on-the-economy%2F2010.12.01 Medicare poses a deficit problem, note some very influential analysts. A former Congressional Budget Office head and a former Medicare chief chime in on the scope of the program’s impact on the economy, and the difficulties of trying to scale it back. Yet, a presidential commission is considering just that among other measures. The 18-member, bipartisan commission released its report weeks ago and was scheduled to have voted today on a shocking scope of deficit-trimming measures that included changes to military spending, Social Security and Medicare, among other areas. But they deferred the vote until Friday to try to garner more votes from members who are also currently elected officials. The panel needs 14 votes and substantive approval from its roster of Congress members to gain ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4219744 Wed, 01 Dec 2010 23:00:00 +0100 4219744 http://www.medworm.com/index.php?rid=4214113&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbend-the-healthcare-cost-curve-by-preventing-diabetes%2F2010.11.29 By 2020, an estimated 15 percent of adults will have diabetes and 37 percent will have prediabetes, a total of 39 million people, compared with rates of 12 percent and 28 percent today, respectively. Today, more than 90 percent of people with prediabetes, and about a quarter of people with diabetes, are unaware of it, according to a report from UnitedHealth Group, the provider of insurance and other health care services. The health savings alone of preventing diabetes would bend the cost curve of health care spending in the country. Health spending associated with diabetes and prediabetes is about $194 billion this year, or 7 percent of U.S. health spending, the report said. That cost is projected to rise to $500 billion by 2020, or a total of almost $3.4 trillion on diabetes-related... Better Health blogs http://www.medworm.com/rss/comments.php?id=4214113 Mon, 29 Nov 2010 17:00:00 +0100 4214113 http://www.medworm.com/index.php?rid=4205937&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fare-airport-security-pat-downs-unhealthy%2F2010.11.26 Potential health effects of airport security are being questioned for their possible health consequences, from spreading germs to radiation exposure to the stress that being searched induces. With cheaper flights available this year and the need for security in air travel, the Transportation Security Administration (TSA) is justifying its full body scans and its pat-downs that rise up travelers’ legs — all the way up. The scanners use microwaves, leading some to question whether people may be receiving too much radiation. It’s also a concern to activists who may have already undergone a lot of radiation for existing condition, or who have other conditions for which TSA agents may not be trained. (Read one seasoned traveler’s personal experience here.) The TSA report... Better Health blogs http://www.medworm.com/rss/comments.php?id=4205937 Fri, 26 Nov 2010 22:00:00 +0100 4205937 http://www.medworm.com/index.php?rid=4197067&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Finner-ear-infections-still-no-need-for-antibiotics%2F2010.11.23 Kids get inner ear infections and then they get antibiotics, despite a long-standing knowledge that it’s not always best. Any physician knows this, but who hasn’t faced an irate or anxious parent in the exam room insisting on a prescription, whether the evidence warrants it or not? Reuters reports that the tally for all those antibiotics is $2.8 billion dollars, or $350 per child annually. And there’s only a slight benefit to them. While hardly comforting to the parents, physicians can add more heft to their argument that antibiotics are only modestly more effective than nothing, and they can avoid the rashes and diarrhea that antibiotics incur. (more…) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4197067 Tue, 23 Nov 2010 21:00:00 +0100 4197067 http://www.medworm.com/index.php?rid=4190154&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealth-reform-compete-and-succeed-or-repeal-or-replace%2F2010.11.22 Senator Scott Brown (R-MA) thinks so. So does Senator Ron Wyden (D-OR). And Senator Bernie Sanders (I-VT). Senators Brown, Wyden and Sanders have introduced the “Empowering States to Innovate Act.” Ezra Klein blogs that the Senators may have found a way forward on health reform. “If a state can think of a plan that covers as many people, with as comprehensive insurance, at as low a cost, without adding to the deficit, the state can get the money the federal government would’ve given it for health-care reform but be freed from the individual mandate, the exchanges, the insurance requirements, the subsidy scheme and pretty much everything else in the bill,” Ezra Klein writes. “If conservative solutions are more efficient, that will be clear when their ben... Better Health blogs http://www.medworm.com/rss/comments.php?id=4190154 Mon, 22 Nov 2010 13:00:00 +0100 4190154 http://www.medworm.com/index.php?rid=4183297&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Femployers-up-the-ante-for-workers-health%2F2010.11.19 More than half of employers are likely to keep offering insurance rather than use state health insurance exchanges when they become available under health care reform in 2014, reported a survey by an insurance broker. Willis Human Capital Practice released results of its Health Care Reform Survey 2010, which showed 55 percent of employers would keep their health plans in 2014 even if the new state exchanges offer competitive prices. The survey sampled 1,400 employers of varying sizes, industry sectors and geographies whose plans cover more than 9 million employees and dependents (including retirees). Key findings from the survey include: • 88 percent believe that group health plan costs will increase as a result of health care reform; • 76 percent expect administrative compliance co... Better Health blogs http://www.medworm.com/rss/comments.php?id=4183297 Fri, 19 Nov 2010 15:00:00 +0100 4183297 http://www.medworm.com/index.php?rid=4172060&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcaregivers%2F2010.11.16 It was a straightforward phone message (names changed): “Hey Dr. S., this is Bobbie Jones, April Dixon’s granddaughter. I was calling to inform you that April passed away today at City Hospital. They said she was bleeding in her stomach or something. I’m not quite what sure what happened, but she got real sick. But she’s gone, so, thanks so much. You’ve been a real neat doctor, and it’s been good working with you through the years taking care of my grandmother. Take care. Bye.” Bobbie Jones is a saint. Pure and simple. She took care of her 88-year-old grandmother with tender, loving care. I am certain if left to the vagaries of the “healthcare system” that her grandmother would have died at least three years ago, maybe earlier. Ms. Jone... Better Health blogs http://www.medworm.com/rss/comments.php?id=4172060 Tue, 16 Nov 2010 17:00:00 +0100 4172060 http://www.medworm.com/index.php?rid=4167958&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhappy-birthday-baby-boomers-one-more-eligible-for-medicare-every-8-seconds%2F2010.11.15 Today begins a lame duck session of Congress before it breaks for Thanksgiving. It’s the final chance to work out a temporary patch to Medicare reimbursement before a 23 percent cut takes effect Dec. 1. Doctors are going to stop taking new Medicare patients if the cuts happen. And, as one breast cancer surgeon explains, if Medicare stops paying, so to private insurers and even military health programs. Congress will meet in December, but the damage will be done. This all is happening two weeks before the baby boomers become eligible for Medicare. That populous generation starts to turn 65 beginning on Jan. 1, which means they become eligible for Medicare on Dec. 1, which, as we mentioned, is the day the 23 percent Medicare pay cut kicks in. Boomers will continue to become eligible ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4167958 Mon, 15 Nov 2010 19:00:00 +0100 4167958 http://www.medworm.com/index.php?rid=4159241&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmore-doctors-are-refusing-industry-perks-and-gifts%2F2010.11.12 Physicians and particularly primary care doctors are reporting fewer industry ties than five years ago, according to a survey. While 94% of doctors reported some type of perk from a drug or device maker in 2004, 83.8% did in 2009, researchers reported in the Nov. 8 Archives of Internal Medicine. Researchers surveyed a stratified random sample of 2,938 primary care physicians (internal medicine, family practice, and pediatrics) and specialists (cardiology, general surgery, psychiatry and anesthesiology) with a 64.4% response rate. (more…) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4159241 Fri, 12 Nov 2010 15:00:00 +0100 4159241 http://www.medworm.com/index.php?rid=4151791&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcuring-the-common-cold-from-the-inside-out%2F2010.11.09 Antibodies can fight viruses from within infected cells, reported researchers who now believe that treatments could be applied to viral diseases like the common cold, “winter vomiting,” and gastroenteritis. Previously, scientists thought that antibodies could only reduce infection by attacking viruses outside cells and by blocking their entry into cells. Once inside the cell, the body’s only defense was to destroy the cell. But protection mediated by antibodies doesn’t end at the cell membrane. It continues inside the cell to provide a last line of defense against infection. Researchers at the U.K.’s Medical Research Council’s Laboratory of Molecular Biology showed that cells possess a cytosolic IgG receptor, tripartite motif-containing 21 (TRIM21), whic... Better Health blogs http://www.medworm.com/rss/comments.php?id=4151791 Tue, 09 Nov 2010 21:00:00 +0100 4151791 http://www.medworm.com/index.php?rid=4139237&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-reform-and-a-divided-congress%2F2010.11.05 Republicans who had opposed healthcare reform before the election are now elected officials with a say in how the programs are funded. At federal and state levels, the program’s opponents either have a larger voice or are now in charge of implementing elements of reform. Sen. Majority Leader Harry Reid said he’d consider adjustments to healthcare reform. Frightened seniors flipped toward opposition to healthcare reform, while flipping on the issue may have saved a few Democrats. Exit polling showed 48 percent would repeal healthcare reform, 16 percent would leave it as is, and 31 percent would expand it. Now that Republicans have a larger say in the matter, take a look at their plan for healthcare in A Pledge to America, starting on page 25, and decide for yourself. (New Yor... Better Health blogs http://www.medworm.com/rss/comments.php?id=4139237 Fri, 05 Nov 2010 14:00:00 +0100 4139237 http://www.medworm.com/index.php?rid=4121852&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsugar-consumption-a-deliciously-disgusting-ad-campaign%2F2010.10.31 New York City’s war on sugary soft drinks had to balance evidence-based medicine with a short, simple message that would go viral in the community. Going viral won, according to e-mails of internal discussions between the city’s health commissioner, his staff, and the ad agency that crafted the campaign. The statement that soda would cause a person to gain 10 pounds a year is contingent upon many factors, argued the staff, but the desire to produce a media message with impact overruled the details. One nutritionist called the campaign “deliciously disgusting.” Chocolate may moderate HDL cholesterol in type 2 diabetics, according to the November issue of Diabetic Medicine. High polyphenol chocolate increased HDL cholesterol in diabetics without affecting weight, insu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4121852 Sun, 31 Oct 2010 12:00:00 +0100 4121852 http://www.medworm.com/index.php?rid=4118930&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fteen-pregnancy-decline-is-likely-as-low-as-it-will-go%2F2010.10.29 Teen pregnancy rates have declined, but likely bottomed out, according to a report by the Centers for Disease Control and Prevention (CDC). Teen births dropped by a third between 1990 to 2005, but rose again in 2006 and 2007. The latest figures for 2008 show a decline of 2.4 percent, to 41.5 pregnancies per 1,000 teenagers. Experts told My Health News Daily/MSNBC the dropping rates have bottomed out, and that new strategies are needed to deglamorize teen pregnancy. Teen birth rates were consistently highest in states across the South and Southwest, and lowest in the Northeast and upper Midwest. In 2008, state-specific teenage birth rates varied widely, from less than 25.0 per 1,000 15-19 year olds (Connecticut, Massachusetts, New Hampshire, and Vermont), to more than 60.0 per 1,000 (Arkans... Better Health blogs http://www.medworm.com/rss/comments.php?id=4118930 Fri, 29 Oct 2010 16:00:00 +0100 4118930 http://www.medworm.com/index.php?rid=4105665&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnurse-anesthetists-allowed-to-work-without-doctor-supervision%2F2010.10.25 New Jersey’s state health department is considering a rule that would allow nurse anesthetists to work without a doctor’s supervision, as long as there’s a plan to reach one in case of an emergency. New Jersey would join the 30 states that allow nurse anesthetists to work without direct supervision. On the other end of the country, a California court upheld the state’s decision to opt out of a Medicare requirement that doctors be present while a nurse anesthetist works in order to be reimbursed. The Centers for Medicare and Medicaid Services have allowed states to opt out of that requirement since 2001. Since then, there has been no evidence of increased inpatient deaths or complications, researchers reported in the August 2010 issue of Health Affairs. Earlier this ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4105665 Mon, 25 Oct 2010 22:00:00 +0100 4105665 http://www.medworm.com/index.php?rid=4105670&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealth-insurance-new-survey-reveals-record-number-of-uninsured%2F2010.10.24 Last month the U.S. Census Bureau released its annual survey on health insurance coverage. The results were startling, yet few politicians seemed to take notice: – The number of people with health insurance declined for the first time ever in almost two decades. In fact, as reported by CNN this is the first time since the Census Bureau started collecting data on health insurance coverage in 1987 that fewer people reported that they had health insurance: “There were 253.6 million people with health insurance in 2009, the latest data available, down from 255.1 million a year earlier.” The percentage of the population without coverage increased from 15.4 percent to 16.7 percent. – Almost 51 million U.S. residents had no health insurance coverage at all, a record high, ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4105670 Sun, 24 Oct 2010 22:00:00 +0100 4105670 http://www.medworm.com/index.php?rid=4097942&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprescriptions-on-the-rise-so-look-out-for-the-side-effects%2F2010.10.22 Eighty eight percent of Americans 60 years or older take at least one prescription drug and more than two-thirds of this age group take five or more, according to a report by the National Center for Health Statistics. Spending for prescription drugs totaled $234.1 billion in 2008 — more than double what was spent in 1999. The National Center for Health Statistics excerpted elements of its National Health and Nutrition Examination Surveys to prepare the report: Other key findings include: – Over the last 10 years, the percentage of Americans who took at least one prescription drug in the past month increased from 44 percent to 48 percent. The use of two or more drugs increased from 25 percent to 31 percent. The use of five or more drugs increased from 6 percent to 11 percent.... Better Health blogs http://www.medworm.com/rss/comments.php?id=4097942 Fri, 22 Oct 2010 14:00:00 +0100 4097942 http://www.medworm.com/index.php?rid=4082090&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpracticing-medicine-it-pays-well-but-how-meaningful-is-it%2F2010.10.19 Doctors are the top six best-paid careers (based on median and top pay), with anesthesiologists being the best-paid, primary care being the sixth-best and nurse anesthetists the seventh best-paid, according to a survey by CNN/Money magazine and PayScale.com. But not one of the physician careers landed on the top lists for job growth or quality of life. The title of best job went to software architect and the second-best job went to physician assistant. Take heart, though. When asked about having the most meaningful work (based on the percentage who think their job makes the world a better place), the top spot went again to anesthesiologists, and second through ninth went to some kind of medical provider or healthcare administrator. Social workers rounded out the tenth spot. (CNN/Money) ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4082090 Tue, 19 Oct 2010 14:00:00 +0100 4082090 http://www.medworm.com/index.php?rid=4077245&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedicare-should-it-pay-less-for-less-effective-care%2F2010.10.18 From its inception, Medicare has been agnostic about the effectiveness of different treatments when it sets payment rates. Once a treatment is found to be “reasonable and necessary,” Medicare establishes a payment rate that takes into account complexity and other “inputs” that go into delivering the service. But it is prohibited by law from varying payments based on how well an intervention works. This would change under a “dynamic pricing” approach proposed by two experts in this month’s issue of Health Affairs. The article itself is available only to Health Affairs subscribers, but the Wall Street Journal health blog has a good summary. The researchers propose that Medicare pay more for therapies with “superior” results and the same f... Better Health blogs http://www.medworm.com/rss/comments.php?id=4077245 Mon, 18 Oct 2010 13:00:00 +0100 4077245 http://www.medworm.com/index.php?rid=4074066&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-twice-as-likely-to-e-mail-another-provider-than-a-patient%2F2010.10.14 Only 6.7 percent of office-based physicians routinely e-mailed patients about clinical information in 2008, according to an issue brief from the Center for Studying Health System Change. Only 34.5 percent of office-based, ambulatory care physicians reported that information technology for communicating with patients about clinical issues via e-mail was available in their practice in 2008. Of that third, 19.5 percent routinely e-mailed patients, or 6.7 percent overall, while the rest were split between occasional use or non-use. The study sample was restricted to 4,258 office-based physicians and the response rate was 62 percent. In contrast, twice as many physicians spent at least some time each work day e-mailing physicians and other clinicians. (more…) *This blog post w... Better Health blogs http://www.medworm.com/rss/comments.php?id=4074066 Thu, 14 Oct 2010 20:00:00 +0100 4074066 http://www.medworm.com/index.php?rid=4060592&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fin-the-news-political-doctors-antibiotic-resistance-and-stem-cell-research%2F2010.10.11 Medical organizations are donating heavily to doctors running for the U.S. House. Dentists, ophthalmologists, radiologists, surgeons, neurologists and ENTs have contributed heavily. The goal is to get doctors onto committees where they can have the most impact. So far, the candidates have trended heavily Republican and have, in at least one campaign, vowed to overturn healthcare reform. The stakes are high if opposing legislators succeed, because they could underfund or block portions of reform to the point that it works poorly or not at all. (Politico, New England Journal of Medicine) Spurred by antibiotic resistance seen in almost every drug class, FDA Commissioner Margaret Hamburg, FACP, is turning the agency’s attention toward animal feed. With little to no development of new ant... Better Health blogs http://www.medworm.com/rss/comments.php?id=4060592 Mon, 11 Oct 2010 22:00:00 +0100 4060592 http://www.medworm.com/index.php?rid=4053288&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsnorin-in-the-usa%2F2010.10.10 Guest post by Dr. John Henning Schumann I’m not a drum banger for the latest “epidemics” to come to media attention, whether it’s H1N1, Vitamin D, or getting your kids CAT-scanned routinely. But there comes a time in every blogger’s life when he must comment on something that does bubble up into consciousness a tad, shall we say, often. I’m talking here about an epidemic that we are learning more about each passing day. Something that you or someone you know or sleep with may be diagnosed with, and ultimately treated for (an interesting national problem in its own right): Obstructive sleep apnea (OSA). What is it, you ask? A new national scourge? Stop the presses! Can I catch it? (more…) *This blog post was originally published at ACP Hospi... Better Health blogs http://www.medworm.com/rss/comments.php?id=4053288 Sun, 10 Oct 2010 17:00:00 +0100 4053288 http://www.medworm.com/index.php?rid=4040566&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-and-fred-flintstone%2F2010.10.06 Like most kids who grew up in the 1960s, I spent many a night watching the adventures of Fred, Wilma, Barney and Betty, the coolest cavemen ever (sorry, GEICO). It is hard to explain the appeal of the Flintstones, which [recently] celebrated the 50th anniversary of its first broadcast. Its animation was primitive, the stories campy and cliché, and it was horribly sexist — but the characters were lovable, the dialogue funny, and who couldn’t love the way it depicted “modern conveniences” (like washing machines) using only stone-age technologies (bones, stones and dino-power?) What does Fred Flintstone have to do with healthcare? Not much, really, although Fred was the victim of a medical error. According to Answers.com: “A 1966 episode had Fred can’t st... Better Health blogs http://www.medworm.com/rss/comments.php?id=4040566 Thu, 07 Oct 2010 01:00:00 +0100 4040566 http://www.medworm.com/index.php?rid=4031245&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealth-care-reform-plain-and-simple%2F2010.10.04 The Kaiser Family Foundation has produced an informative and entertaining short animated movie that explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014. Narrated by newscaster Cokie Roberts (a member of Kaiser’s Board of Trustees), the nine-minute animation explains plainly how health care hadn’t worked in the past, addresses the controversies surrounding its passage, and outlines what will happen in the near future and in 2014. *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4031245 Mon, 04 Oct 2010 13:00:00 +0100 4031245 http://www.medworm.com/index.php?rid=4025618&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fadhd-is-it-genetic%2F2010.10.02 British scientists announced that attention-deficit/hyperactivity disorder (ADHD) has been linked to deleted or duplicated DNA segments (copy number variants), which leads to developmental difference in the brains of children with the condition. Researchers scanned genomes of 366 children with ADHD and compared them with 1,047 unrelated, ethnically matched control subjects. They reported full results in The Lancet. Rare copy number variants were almost twice as common in children with ADHD compared to the other children. Researchers commented to Reuters that there was a significant overlap between copy number variants found in ADHD and elements of the genome linked to autism and schizophrenia, specifically in a region on chromosome 16. *This blog post was originally published at AC... Better Health blogs http://www.medworm.com/rss/comments.php?id=4025618 Sat, 02 Oct 2010 19:00:00 +0100 4025618 http://www.medworm.com/index.php?rid=4018178&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-governments-involvement-in-new-primary-care-models%2F2010.09.30 Government healthcare reform efforts are picking up the pace to roll out new reimbursement and practice models for primary care. Medicare is giving out $10 billion for pilot projects encouraging new models of primary care, including the patient-centered medical home. New Jersey just passed legislation to explore the patient-centered medical home. Now, Massachusetts, the early adopter of mandatory health insurance, is now ambitiously planning how to take on the fee-for-service reimbursement system and moving toward accountable care organizations. Under discussion are the scope of power for state regulators, what rules will apply to accountable care organizations, and how to get rid of the existing fee-for-service system. Blogger and pediatrician Jay Parkinson, MD, MPH, comments about the &#... Better Health blogs http://www.medworm.com/rss/comments.php?id=4018178 Thu, 30 Sep 2010 12:00:00 +0100 4018178 http://www.medworm.com/index.php?rid=4003257&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnational-prescription-drug-take-back-day%2F2010.09.27 The Drug Enforcement Administration (DEA) coordinat[ed] “National Prescription Drug Take-Back Day” this [past] Saturday [September 25th], encouraging people to turn in their unused prescription drugs. The agency hopes the event will help decrease rates of crime and addiction linked to prescription drug abuse, the New York Times reports. From the DEA press release: This initiative addresses a vital public safety and public health issue. Many Americans are not aware that medicines that languish in home cabinets are highly susceptible to diversion, misuse, and abuse. Rates of prescription drug abuse in the U.S. are increasing at alarming rates, as are the number of accidental poisonings and overdoses due to these drugs. Studies show that a majority of abused prescription drugs are obtain... Better Health blogs http://www.medworm.com/rss/comments.php?id=4003257 Mon, 27 Sep 2010 14:00:00 +0100 4003257 http://www.medworm.com/index.php?rid=4001687&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmy-patient-the-health-nut%2F2010.09.25 A version of the following post, by Kimberly Manning, FACP, appeared on the blog “Life at Grady.” “My blood pressure is still borderline? Man!” “Yeah…and from looking through the chart, it was 150/96 on your admission. It’s pretty much been that since you’ve been here, give or take a few points. That’s a little more than borderline, actually.” I paused for a moment, realizing that I sounded a bit discouraging. “I don’t think this would be hard to get under control at all, sir. I mean…you’re such a motivated patient, you know?” I studied my patient carefully. He was in his late thirties, although he could totally pass for a twenty-something all day, every day. His skin looked like someone had grabbed ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4001687 Sat, 25 Sep 2010 17:00:00 +0100 4001687 http://www.medworm.com/index.php?rid=3998990&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-old-age-be-a-cause-of-death%2F2010.09.24 The Washington Post asks whether “old age” should be reconsidered as a legitimate cause of death for the elderly. Because more people are dying at very advanced ages with multiple system failure, it’s often harder for physicians to pinpoint the specific underlying cause, but using “old age” as a catch-all term could make mortality data less meaningful, the article said. An upcoming revision of the International Classification of Diseases might provide some guidance: “Each revision of the ICD is the right moment to reconsider this question,” the co-head of the ICD’s mortality statistics committee told the Post. (Washington Post) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3998990 Fri, 24 Sep 2010 12:00:00 +0100 3998990 http://www.medworm.com/index.php?rid=3993914&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprimary-care-has-it-been-oversold%2F2010.09.21 Citing a new study by the Dartmouth Atlas, the Wall Street Journal’s health blog provocatively asks: “Has the notion of ‘access’ to primary care been oversold?” The Dartmouth researchers found “that there is no simple relationship between the supply of physicians and access to primary care.” That is, they found that having a greater supply of primary care physicians in a community doesn’t mean that the community necessarily has better access to primary care. Some areas of the country with fewer primary care physicians per population do better on access than other areas with more primary care physicians. The researchers also report that the numbers of family physicians is more positively associated with better access than the numbers of internists... Better Health blogs http://www.medworm.com/rss/comments.php?id=3993914 Tue, 21 Sep 2010 10:00:00 +0100 3993914 http://www.medworm.com/index.php?rid=3987056&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdebunking-fake-diseases%2F2010.09.20 Ever heard of adrenal fatigue? Wilson’s temperature syndrome? If not, there’s a good reason: They exist only on the Internet. The Hormone Foundation, an affiliate of the Endocrine Society, recently issued two fact sheets for patients debunking these so-called conditions, which were “apparently conceived only in an effort to sell products promoted to treat them,” the LA Times reported. No medical evidence supports either faux disease and there are no tests or treatments for them, but patients still try to alleviate them with supplements, some of them potentially dangerous, the Times said. Adrenal fatigue is characterized by such “symptoms” as having salt and sugar cravings and needing coffee to get you through the day, while the man who discovered Wilson&... Better Health blogs http://www.medworm.com/rss/comments.php?id=3987056 Mon, 20 Sep 2010 20:00:00 +0100 3987056 http://www.medworm.com/index.php?rid=3972917&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpractice-medicine-for-a-year-rack-up-a-half-million-in-overhead%2F2010.09.15 Newly minted MDs face student loans the sizes of mortgages and might go 18 months without an income if they try to start up their own practice. And although in the words of one student, “Medicine shouldn’t be treated like a business,” physicians still have to operate their practices like one. That’s resulted in one doctor facing a half-million in operating expenses every year in Manhattan. A half-dozen other new physicians describe their first years in practice in these two profiles, while a third details how Leslie Saltzman, ACP Member, took advantage of some resources on hand and guidance from ACP’s “Running a Practice” section to quickly grow her solo practice into a full-service resource for women’s health. (New York Post, Kaiser Health News, ACP... Better Health blogs http://www.medworm.com/rss/comments.php?id=3972917 Wed, 15 Sep 2010 12:00:00 +0100 3972917 http://www.medworm.com/index.php?rid=3961815&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Flocally-grown-medical-students-more-likely-to-stick-around%2F2010.09.12 Nearly a third of medical graduates at the University of North Dakota continue in primary care, down from nearly half just two years ago. This is the university that leads the nation for the percentage of students (about 20 percent) choosing family medicine. North Dakota overall will be short about 160 physicians by 2025, and the need is now affecting urban areas as well as rural ones, said Joshua Wynne, FACP, dean of the university’s School of Medicine and Health Sciences. Keeping medical students interested in practicing primary care in rural America depends upon whom medical schools choose to admit. For example, one-fourth of the University of North Dakota’s student population hails from small towns, and 80 percent are in-state. More and more medical schools are looking at ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3961815 Sun, 12 Sep 2010 15:00:00 +0100 3961815 http://www.medworm.com/index.php?rid=3935798&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Frectal-cancer-becoming-more-common-in-younger-people%2F2010.09.05 Rates of rectal cancer in those younger than 40 have been increasing, the LA Times reported recently. Researchers studied data from the Surveillance, Epidemiology and End Results (SEER) Registry and looked at the change in rectal and colon cancer incidence in those under 40 from 1973 to 2005. Overall rates were low, but while colon cancer incidence remained constant, rectal cancer incidence increased by an average of 3.8 percent annually, the authors reported in the journal Cancer. The authors didn’t advocate routine screening in those under 40, but did recommend that physicians be more alert to the possibility of rectal cancer in those presenting with symptoms such as rectal bleeding, according to the Times. (LA Times) *This blog post was originally published at ACP Internist* ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3935798 Sun, 05 Sep 2010 18:00:00 +0100 3935798 http://www.medworm.com/index.php?rid=3929230&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatients-are-splitting-pills-to-cut-healthcare-costs%2F2010.09.02 Patients are pill-splitting more to trim back healthcare costs, according to a poll by Consumer Reports. In the past year, 39 percent took some action to cut costs. The poll of more than 1,100 people found that 45 percent of people take at least one prescription drug and average four. But 27 percent said they didn’t always comply with a prescription, and 38 percent of those younger than 65 without drug coverage didn’t fill prescriptions at all. Just over half of patients felt that doctors didn’t consider their ability to pay when prescribing a drug, while nearly half blamed drugmaker’s influence for physicians’ prescribing habits. (HealthLeaders Media) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3929230 Fri, 03 Sep 2010 01:00:00 +0100 3929230 http://www.medworm.com/index.php?rid=3929235&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-bill-of-rights-what-ever-happened-to-it%2F2010.09.02 One of the more surprising twists and turns in the continuing debate over healthcare reform is that many physicians who now object to the Affordable Care Act (ACA) were just a few years back advocates for more federal regulation. In fact, in the early 2000s, more than 200 “provider” and consumer groups — including many state medical and national medical specialty societies that now oppose the ACA because of concerns about “excessive regulation” — were among the fiercest champions of federal legislation to mandate that health insurers comply with a Patient Bill of Rights. A bipartisan bill introduced by Senator John McCain (R-AZ) and the late Senator Ted Kennedy (D-MA) would have ensured that patients have the “right” to appeal insurance compa... Better Health blogs http://www.medworm.com/rss/comments.php?id=3929235 Thu, 02 Sep 2010 11:00:00 +0100 3929235 http://www.medworm.com/index.php?rid=3914998&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcharitable-hospitals-being-sold-to-for-profits-to-survive%2F2010.08.30 More than one-fifth of hospitals are government-owned, but states and counties are out of cash to keep them open. So, charitable hospitals are being sold to for-profit groups or facing closures. Rising costs and more uninsured patients run smack into falling Medicare and Medicaid reimbursement. When bonds come due, there’s little chance of states and counties paying them back. And the facilities are often standalones, and they can’t fall back on corporate backing. This year, 53 hospitals have been sold in 25 arrangements. While the deals often stipulate that care for the poor continues, no one is certain exactly how or even whether such services will continue. That said, other charitable hospitals are making big profits. What are they doing differently? First, they’re co... Better Health blogs http://www.medworm.com/rss/comments.php?id=3914998 Mon, 30 Aug 2010 16:00:00 +0100 3914998 http://www.medworm.com/index.php?rid=3907601&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-and-their-smartphones%2F2010.08.26 An eye-popping statistic shows that 94 percent of doctors have adopted smartphones, in part to keep up with an information glut. A consulting group released results of 100 in-depth interviews with physicians working in acute and ambulatory care environments in numerous specialties nationwide. The physicians used the phones to communicate, manage personal/business workflows, and access information, including medical reference materials. (In case you’re curious about what your peers are using, 44 percent use an iPhone and 25 percent use a BlackBerry.) This growth in adoption — a 60 percent increase since 2006 — isn’t surprising, since the same survey reported that doctors’ biggest challenges are communicating with colleagues in a timely manner, the volume of... Better Health blogs http://www.medworm.com/rss/comments.php?id=3907601 Thu, 26 Aug 2010 18:00:00 +0100 3907601 http://www.medworm.com/index.php?rid=3902899&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-gift-of-being-a-doctor-what-are-you-going-to-do-with-it%2F2010.08.25 I’m going to do something unusual: Reprint in its entirety a commentary from a fourth-year medical student, Jonathan. He posted it in response to comments from other readers to my blog about Dr. Berwick’s commencement address to his daughter’s medical school class. I tweeted about Jonathan’s post, calling it a needed voice of idealism at a cynical time. This is what Jonathan had to say to his physician colleagues: “To begin, I am a fourth-year medical student going into primary care and this directly applies to me. We have two options when reading [Dr. Berwick's] address. We can take, in my opinion, the weak road or the strong road. Our new generation, as well as the one that raised us, is one of apathy and selfishness. We are only concerned about how changes ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3902899 Wed, 25 Aug 2010 18:00:00 +0100 3902899 http://www.medworm.com/index.php?rid=3890478&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpregnant-women-and-vitamin-d%2F2010.08.21 A new study in the American Journal of Obstetrics & Gynecology reports that low levels of vitamin D may be linked to early-onset preeclampsia in pregnant women. The trial found that the average vitamin D level in 50 pregnant women with preeclampsia was 18 ng/mL, compared with 32 ng/mL in 100 women with healthy pregnancies. No casual relationship was proven, and the study’s lead author told Reuters Health that the recommended vitamin D intake in pregnant women hasn’t changed, but the study results raise yet more questions about this much-discussed nutrient. ACP Internist covered the pros and cons of vitamin D in its November 2009 issue. (Reuters, ACP Internist) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3890478 Sat, 21 Aug 2010 12:00:00 +0100 3890478 http://www.medworm.com/index.php?rid=3858153&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffixing-up-primary-care-is-anyone-home%2F2010.08.11 By John Henning Schumann, M.D. The Patient Protection and Affordable Care Act (aka “Health Care Reform”) signed by President Obama in March will revolutionize primary care in the United States. By 2014 tens of millions of uninsured people will “enter” the system by being granted insurance, either through expansion of the Medicaid program or through mandated purchasing of insurance via state pools or the private market. This alone will have a profound impact, straining the capacity of our already frayed system. Therefore, embedded in the law are funds to encourage growth and improvement in primary care: Incentives to encourage graduates to enter primary care fields (family medicine, internal medicine, and pediatrics) and practice in underserved areas (through scholar... Better Health blogs http://www.medworm.com/rss/comments.php?id=3858153 Thu, 12 Aug 2010 01:00:00 +0100 3858153 http://www.medworm.com/index.php?rid=3848870&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-reform-will-keep-medicare-afloat%2F2010.08.09 One of the more effective criticisms of the health reform law (Affordable Care Act, or ACA) is that it hurts Medicare. It also is wrong. Effective, in that it has been widely reported that seniors are more likely to express negative views of the ACA than other age groups. (Although the Kaiser Family Foundation’s Drew Altman, citing the group’s most recent tracking polls, writes that seniors’ opposition to health reform “is at least somewhat over played.”) Effective, but wrong: The ACA actually helps Medicare in three important ways. (more…) *This blog post was originally published at The ACP Advocate Blog by Bob Doherty* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3848870 Mon, 09 Aug 2010 18:00:00 +0100 3848870 http://www.medworm.com/index.php?rid=3822920&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-a-68-chevy-impala-can-tell-us-about-primary-care%2F2010.08.04 When I was a much younger man I had a 1968 Chevy Impala. I loved its V-8 engine and spaciousness, but I paid a steep price for it. It consumed gas like a drunk on a binge. It was prone to breakdowns, usually in the left lane of a busy highway. Even as it consumed my limited financial resources, I couldn’t count on it to reliably get me to where I wanted to be. Yet I held onto it. One day, though, its transmission gave out, and I finally had to resign myself to buying a new, more reliable, more modern, and efficient vehicle. Yet to this day, I miss my clunker. I am reminded of this when I think about the state of primary care today. Many of us are attached to a traditional primary care model that may no longer be economically viable — for physicians, for patients, and for purcha... Better Health blogs http://www.medworm.com/rss/comments.php?id=3822920 Wed, 04 Aug 2010 16:00:00 +0100 3822920 http://www.medworm.com/index.php?rid=3812976&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fadvances-in-telemedicine-ease-patient-care%2F2010.08.02 Monitoring vital signs remotely saves time and money for everyone: patients, physicians, facilities and insurers. Heart failure is a particular target because its increasingly common, its easily triggered (by as little as too much salt on food, for example), it costs so much to manage in the hospital, and it’s so easily avoided. Remote monitoring equipment made even easier with wireless connections can take vital signs, and even ask standard questions every morning. The equipment puts patients in contact with nurses once they detect warning signs. That human touch is key. Case managers can screen out false alarms (avoiding alert fatigue) and can direct patients to the physician when needed. ACP Internist covered remote monitoring technology in its March issue. (Wall Street Journal, A... Better Health blogs http://www.medworm.com/rss/comments.php?id=3812976 Mon, 02 Aug 2010 20:00:00 +0100 3812976 http://www.medworm.com/index.php?rid=3790706&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpublic-service-does-having-an-opinion-disqualify-you%2F2010.07.26 Many conservatives are up-in-arms about President Obama’s decision to appoint Don Berwick, a pediatrician and renowned expert in quality improvement and patient safety, to lead the Center for Medicare and Medicaid Services (CMS). They object to Dr. Berwick’s views on a range of issues, and to Obama’s decision to use his office’s authority to appoint Dr. Berwick while the Senate was out on a short Independence Day holiday recess. As a “recess appointment,” Dr. Berwick was able to take office without Senate hearings and confirmation, but he can only serve through the end of the 111th Congress — that is, until the end of 2011 — unless ratified by the Senate. Berwick, though, also has many supporters. Maggie Mahar articulates the “pro&#8221... Better Health blogs http://www.medworm.com/rss/comments.php?id=3790706 Mon, 26 Jul 2010 12:00:00 +0100 3790706 http://www.medworm.com/index.php?rid=3767077&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmeaningful-use-does-what-you-do-qualify%2F2010.07.19 One doesn’t usually look to the Federal Register to define meaning or purpose (philosophers, yes, but bureaucrats?), but the federal government has officially ruled on what constitutes “meaningful use” — for the purposes of distributing dollars to clinicians for electronic health records. The Wall Street Journal’s health blog has an excellent synopsis of the rule and the reaction from different interest groups and experts, and the New England Journal of Medicine has a very clear explanation and summary of its key elements by David Blumenthal, M.D., F.A.C.P., the federal government’s coordinator of health information technology. (more…) *This blog post was originally published at The ACP Advocate Blog by Bob Doherty* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3767077 Mon, 19 Jul 2010 16:00:00 +0100 3767077 http://www.medworm.com/index.php?rid=3714188&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsocial-mission-a-primary-care-score-for-medical-schools%2F2010.06.30 Medical schools are traditionally ranked on criteria like research funding and technological innovation. These rankings are highly significant. A place on the U.S. News‘ annual “Best Medical School” list  is a coveted spot indeed. So that’s why there was some media attention paid to a recent study from the Annals of Internal Medicine, which ranked medical schools according to their “social mission” — a phrase that defines a school’s commitment to primary care, underserved populations and workforce diversity. Using this new criterion, some of the traditionally high ranking schools fell significantly. (more…) *This blog post was originally published at KevinMD.com* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3714188 Wed, 30 Jun 2010 12:00:17 +0100 3714188 http://www.medworm.com/index.php?rid=3706674&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhoop-de-do-to-the-medicare-physician-pay-cut-problem%2F2010.06.28 After months of dithering, delaying, denying, and defaulting on a decision, Congress ended up…doing as little as possible to address the Medicare physician pay cut problem. Thursday night the House of Representatives acceded to the Senate’s bill to provide physicians with a 2.2 percent update retroactive to June 1. This respite, though, lasts only through the end of November, when physicians and patients will again face another double-digit cut. And if the past is prologue, a lame-duck Congress then will wait until the very last minute to enact another short-term patch, or worse yet, allow the cut to go into effect on December 1 and then pass some kind of retroactive adjustment. You know that the situation has gotten ridiculously bad when the President says this about the bill he ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3706674 Mon, 28 Jun 2010 18:00:00 +0100 3706674 http://www.medworm.com/index.php?rid=3690838&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedical-schools-why-do-some-do-primary-care-better%2F2010.06.23 A new study published in the Annals of Internal Medicine, ACP’s flagship journal, finds that medical schools vary greatly in producing more primary care physicians and getting them into underserved communities. - “Public schools graduate higher proportions of primary care physicians” than private schools. - “The 3 historically black colleges and universities with medical schools (Morehouse College, Meharry Medical College, and Howard University) score at the top” in training primary care physicians who then go on to practice in underserved communities. (Click here for an interview with two recent graduates of historically black colleges and with Wayne Riley, MD, FACP, who is the president and CEO of Meharry Medical College in Nashville, Tennessee and a regent ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3690838 Wed, 23 Jun 2010 18:00:00 +0100 3690838 http://www.medworm.com/index.php?rid=3683622&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-reform-digging-out-of-the-sgr-hole%2F2010.06.21 Friday, the Senate — in a rare stroke of bipartisanship — voted by unanimous consent to reverse the 21 percent SGR cut and provide positive updates of 2.2 percent through November 2010. The legislation is fully paid for by offsets in other spending programs. Unfortunately, though, the cut remains in effect and claims are being processed at reduced rates, because the House of Representatives has recessed for the weekend and won’t be back until Tuesday. At that time, I expect that the House will pass the Senate’s six-month reprieve and Medicare will make doctors “whole” for the period of time that the cut was in effect. Not that any of this is a cause for celebration. In the meantime, claims still are being paid at reduced rates, creating havoc for physicians... Better Health blogs http://www.medworm.com/rss/comments.php?id=3683622 Mon, 21 Jun 2010 12:00:00 +0100 3683622 http://www.medworm.com/index.php?rid=3625502&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoc-fix-blamed-on-doctors%2F2010.06.02 The American Medical Association will launch a multi-million-dollar ad campaign tomorrow to heighten pressure on Congress for a doc-fix bill. The American College of Physicians (ACP) reacted by calling for doctors to contact their member of Congress directly to let their voices be heard. Robert Centor, FACP, called for doctors to protest as well. (American Medical Association, American College of Physicians, DB’s Rants) Meanwhile, a Florida medical society predicts a crisis in that senior-laden state. The society cited but did not name eight primary care doctors who’ve stopped accepting Medicare patients this year, and 12 cardiologists who left private practice for employment elsewhere because of already reduced payments. Unbelievably, business columnist Steven Pearlstein sorte... Better Health blogs http://www.medworm.com/rss/comments.php?id=3625502 Wed, 02 Jun 2010 18:00:00 +0100 3625502 http://www.medworm.com/index.php?rid=3621684&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedicare-cut-effective-today-who-should-doctors-be-angry-at%2F2010.06.01 Instead of blogging (again) about Congress’s failure to stop the 21% Medicare SGR cut, which went into effect today, I could just re-run my April 16 post. I wrote then: “It is the failure of both political parties, over many years, to honestly deal with the SGR, including the cost of getting rid of it, which has resulted in the current ongoing SGR farce. And yet members of Congress wonder why the public holds them in such low regard.” Blogging in DB’s Medicare Rants, Dr. Bob Centor captures the outrage felt by most physicians: “I am mad. Every physician I know is mad. Patients should join us in expressing anger. Physicians cannot trust Congress if they cannot repair this absurdity.” (Bob references ACP’s statement, released on Friday; click here to... Better Health blogs http://www.medworm.com/rss/comments.php?id=3621684 Tue, 01 Jun 2010 20:00:00 +0100 3621684 http://www.medworm.com/index.php?rid=3592209&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-tests-ehrs-and-medical-homes-the-price-isnt-right%2F2010.05.24 Healthcare reform is forcing medical students to learn about the financial costs of the tests they order, as well as their clinical importance. Once a taboo topic, it’s being openly taught to students to prepare them for practice. At Harvard, one physician in training duplicated television’s “The Price is Right” to keep his peers guessing at the costs of tests on a patient’s bill. Molly Cooke, FACP, a Regent of the College, encourages doctors to consider the value of the tests they order as they deliver care. (Kaiser Health News, New England Journal of Medicine) The price isn’t right for electronic medical records. Even $44,000 in stimulus money isn’t enough to make doctors jump into using computers. (more…) *This blog post was origin... Better Health blogs http://www.medworm.com/rss/comments.php?id=3592209 Mon, 24 May 2010 14:00:00 +0100 3592209 http://www.medworm.com/index.php?rid=3581610&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-team-approach-to-primary-care-why-some-doctors-may-resist%2F2010.05.19 What if some physicians actually like the way primary care is currently practiced? It’s hard to believe, considering the majority of studies suggest marked dissatisfaction among primary care doctors, and an increasing prevalence of physician burnout. The ACP’s Bob Doherty recently summarized an epic Health Affairs article devoted to fixing primary care. The bottom line was that paying primary care doctors better isn’t enough. The whole field needs to be re-invented. (more…) *This blog post was originally published at KevinMD.com* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3581610 Wed, 19 May 2010 16:00:07 +0100 3581610 http://www.medworm.com/index.php?rid=3560236&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsaving-primary-care-what-will-it-take%2F2010.05.12 “Bold changes are needed in how the United States delivers and pays for primary care if the key goals of national health reform are to be achieved,” according to the health policy journal Health Affairs, which has released a thematic issue devoted entirely to the crisis in primary care. (The complete articles are available only to subscribers, but Health Affairs’ blog has a good summary.) I have spent much of the day reading the journal — 47 articles, and a combined 300 pages of text. Here are my “take-home” messages from the articles. (more…) *This blog post was originally published at The ACP Advocate Blog by Bob Doherty* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3560236 Wed, 12 May 2010 16:00:00 +0100 3560236 http://www.medworm.com/index.php?rid=3526743&cid=t_159932_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmost-people-arent-angry-about-healthcare-reform%2F2010.05.03 I just got back from a wonderful week in Toronto, Canada. No, I wasn’t up there to take tips on how to impose socialized medicine on an unsuspecting public, notwithstanding what some of you may incorrectly-surmise about my political leanings. Rather, I was there to attend ACP’s annual scientific meeting, during which I had the opportunity to serve as faculty for three separate scientific sessions that discussed the impact of the new Patient Protection and Affordable Care Act (PPACPA) of 2010 on internists and their patients. Several hundred ACP members attended these sessions. And guess what? Rather than encountering doctors who were angry at the new law and ACP’s support for it, I instead found an engaged and curious group of internists who are looking at health reform i... Better Health blogs http://www.medworm.com/rss/comments.php?id=3526743 Mon, 03 May 2010 12:00:00 +0100 3526743 http://www.medworm.com/index.php?rid=3035869&cid=t_159932_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2009%2F11%2F27%2Ffollowfriday-ff-the-ebm-skeptics-cochranecollab-evidencematters-oracknows-acpinternists%2F FollowFriday is a twitter tradition in which twitter users recommend other users to follow (on Friday) by twittering their name(s), the hashtags #FF or #FollowFriday, and the reason for their recommendation(s). Since the roll out of Twitter lists I add the #FollowFriday Recommendations to a (semi-)permanent #FollowFriday Twitter list: @laikas/followfridays-ff This week I have added 4 people to [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=3035869 Fri, 27 Nov 2009 22:54:01 +0100 3035869 http://www.medworm.com/index.php?rid=2141594&cid=t_159932_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F01%2Fplavix-plavix-plavix.html I just finished up giving a Yale Affiliated Hospitals Lecture to a bunch of residents on the topic of pharmacogenomics. Not to toot my own horn, but several residents came up to me and asked......"Why didn't I learn this in medical school?" Even better was the 3rd year medical students who just finished up Pharmacology last year....they said "The EXACT SAME THING".......Ok, so here's my beef. Why in the hell aren't we teaching this in medical school. I know I have said this before......but what in the hell is going on here? We have data and not just data , but DAMN GOOD data....and instead we are still pumping JakStat pathways down the throats of our second year medical students.....I have a very big problem here and I need it fixed. Why can't we get physicians who study PgX to teach this?... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2141594 Wed, 28 Jan 2009 16:29:00 +0100 2141594 http://www.medworm.com/index.php?rid=2134886&cid=t_159932_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F01%2Fharsh-on-all-fronts.html I am often accused of being overly critical....whether it is of the Genetic Counselors, or the Physicians, or maybe the Scientists. I am definitely critical of DTC and even more so of the Medical Geneticists....In fact, I praise each of these groups at such a low rate, that many think I am looking to isolate myself from the entire field.....I am not. I just point out problems in our backyards so that we can clean them up.....I was told the other day by a senior Geneticist that what I had done to the Genetic Counselors had then questioning their roles. I had thrown academic genetic departments up in arms, trying to now figure out how to bill legally for what they are doing....Is that such a bad thing? To make people accountable for what they do.....to help motivate them to lobby extra hard ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2134886 Mon, 26 Jan 2009 11:45:00 +0100 2134886 http://www.medworm.com/index.php?rid=2107698&cid=t_159932_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F01%2Fout-of-ruc-american-college-of.html We and the other bloggers have been trying to provoke an open discussion of the secretive, unrepresentative, unaccountable process which the US Center for Medicare and Medicaid Services (CMS) uses to fix payments to physicians. That process may largely be responsible for the implosion of primary care in this country, and substantially responsible for how we manage to pay so much for health care, yet have worsening problems with access and quality.See our previous discussions of the process, and the central role of the RBRVS Update Committee (RUC), most recently here, and in earlier posts (here, here, here, here, and here) and important articles by Bodenheimer et al,(1) and Goodson.(2)The ACP Advocate blog, the apparently official voice of the American College of Physician on its advocacy e... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2107698 Thu, 15 Jan 2009 15:48:00 +0100 2107698 http://www.medworm.com/index.php?rid=1990725&cid=t_159932_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F11%2F26%2Facp-guideline-for-medication-depression-treatment%2F Last week, the American College of Physicians (ACP) released a practice guideline in the treatment of depression through the use of medications. MedPage Today covered some reaction to it from some psychiatrists, who lamented the lack of a comprehensive treatment approach guideline to depression (the ACP guideline focused only on the use of medications). While I agree, in theory, that any guideline that focuses solely on one treatment method for a common mental disorder such as depression, while completely ignoring other treatment options, is a bad thing, I’m not sure we could’ve expected anything different from this physicians group. After all, physicians treat medical diseases, not mental disorders, and have no training or background in anything other than diseases and medi... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1990725 Wed, 26 Nov 2008 10:54:09 +0100 1990725 http://www.medworm.com/index.php?rid=1329093&cid=t_159932_131_f&fid=34989&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FGeneticsHealth%2F%7E3%2F258561327%2F Following my article on GINA (Genetic Information Nondiscrimination Act), the influential doctors’ group, the American College of Physicians (ACP), wants the GINA to become law. The ACP does not directly address the concerns of employers or health insurance companies, but sides with the GINA supporters on individual rights to insurance protections. The ACP agrees that insurance providers should not be able to use an individual’s genetic information to deny or limit health coverage or establish eligibility, enrolment, or to set requirements. In addition, ACP said insurers should be prohibited from setting different premium rates based on an individual’s genetic information. ACP also said it should be illegal for employers and insurers to require individuals or their families to ... Genetics and Health blogs http://www.medworm.com/rss/comments.php?id=1329093 Wed, 26 Mar 2008 21:20:31 +0100 1329093