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 'american college'. Sat, 03 Sep 2011 02:02:45 +0100 http://www.medworm.com/index.php?rid=5169546&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fresearch-shows-decrease-in-time-from-hospital-arrival-to-heart-attack-treatment%2F2011.08.27 Heart attack patients are now being treated on average 32 minutes faster than they were five years ago, and medical societies are touting it as evidence of the success of national campaigns to treat heart attacks more quickly. The study, “Improvements in Door-to-Balloon Time in the United States: 2005-2010,” found that the average time from hospital arrival to treatment declined from 96 minutes in 2005 to just 64 minutes in 2010. In addition, more than 90% of heart attack patients who required emergency angioplasty in 2010 received treatment within the recommended 90 minutes, up from 44% in 2005. Also, the study reported that (more…) *This blog post was originally published at ACP Hospitalist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5169546 Sat, 27 Aug 2011 18:15:00 +0100 5169546 http://www.medworm.com/index.php?rid=5077689&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-case-for-mammograms-friends-and-family-might-be-a-greater-influence-than-doctors%2F2011.07.28 Most women in their 40′s believe they should have annual mammograms, regardless of what screening regimen their doctor might recommend. So say researchers in Massachusetts who surveyed women (primarily white, highly educated) ages 39-49 presenting for annual checkups. They gave the women a fact sheet about the new USPSTF guidelines on mammogram screening in their age group, and asked them to read one of two articles either supporting or opposing the guidelines. The researchers then asked women about their beliefs, concerns and attitudes about breast cancer and mammogram screening. Here’s what they found - Women overwhelmingly want annual mammograms – Close to 90% of women surveyed felt they should have annual mammograms, regardless of what their doctor might recommend. Women... Better Health blogs http://www.medworm.com/rss/comments.php?id=5077689 Thu, 28 Jul 2011 21:00:16 +0100 5077689 http://www.medworm.com/index.php?rid=5028573&cid=t_311271_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fradiology-needs-reassert-their-it-leadership Radiology groups and imaging centers have been on the leading technology edge for many years. The leadership principles of radiology CEOs and CIOs shine in how they approach: Documenting and streamlining workflows Selecting and implementing technology to enable the workflows Measuring the results and focusing on how to continue to enhance the workflows read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5028573 Mon, 11 Jul 2011 13:50:18 +0100 5028573 http://www.medworm.com/index.php?rid=5028033&cid=t_311271_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2011%2F07%2Fradiation-exposure-heart-tests-increasing-future-cancer-risks-worrisome%2F Dr. Jersey Chen of Yale University and his colleagues have published a study in the Journal of the American College of Cardiology documenting the signficant increase in the number of ionizing radiation tests being administered each year and the unknown risk of possible increased cancer rates because of it. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=5028033 Sun, 10 Jul 2011 08:29:22 +0100 5028033 http://www.medworm.com/index.php?rid=4968486&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprimary-care-is-undervalued-what-should-be-done%2F2011.06.26 An article by Brian Klepper and Paul Fischer at Health Affairs has me all fired up. Finally these two health experts are calling it like it is. The Wall Street Journal, New York Times and EverythingHealth have written before about the way primary care is undervalued and underpayed in this country and how it is harming the health and economics of the United States. A secretive, specialist-dominated panel within the American Medical Association called the RUC has been valuing medical services for decades. They divvy up billions of Medicare and Medicaid dollars and all insurance payers base their reimbursement on these values also. The result has been gross overpayment of procedures and medical specialists and underpayment of doctors who practice primary care in internal medicine, family medi... Better Health blogs http://www.medworm.com/rss/comments.php?id=4968486 Sun, 26 Jun 2011 16:00:00 +0100 4968486 http://www.medworm.com/index.php?rid=4952849&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcdc-reports-that-salmonella-is-still-a-major-problem%2F2011.06.20 Salmonella food infections continue despite success reducing disease caused by other pathogens, the Centers for Disease Control and Prevention reports. Salmonella should be targeted because while infection rates have not declined significantly in more than a decade, they are one of the most common, the CDC reports in its latest Vital Signs. Contaminated food causes approximately 1,000 reported disease outbreaks and an estimated 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths annually in the U.S. Salmonella causes 1 million foodborne infections annually, incurring an estimated $365 million in direct medical costs. Salmonella infections in 2010 increased 10% from 2006-2008. The same prevention measures that reduced Escherichia coli infections to less than 1 case per 100,000 ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4952849 Mon, 20 Jun 2011 12:00:00 +0100 4952849 http://www.medworm.com/index.php?rid=4821100&cid=t_311271_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2011%2F05%2F13%2Fova1-blood-test-detects-ovarian-cancer-in-women-with-a-known-ovarian-mass-more-accurately-than-ca-125%2F A study published online in Obstetrics & Gynecology reports that the OVA1 blood test detects ovarian cancer in women with a previously discovered ovarian mass more accurately than the CA-125 blood test. The study also considers OVA1′s place in future surgical referral guidelines. A study published online ahead of print in the June 2011 edition of [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=4821100 Fri, 13 May 2011 15:11:11 +0100 4821100 http://www.medworm.com/index.php?rid=4775390&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbig-brother-taken-to-another-level-physician-movements-tracked-with-rfid-tags-at-medical-conferences%2F2011.05.02 Not everything that counts can be measured. Not everything that can be measured counts. -Albert Einstein Recently, a disturbing trend of monitoring physician quality and accountability has taken another ominous turn: tracking physician’s movements at scientific conferences (so called “tag and release”) using RFID tags imbedded in attendees name badges at national scientific sessions. Having had personal experience with the recent American College of Cardiology meeting, this technology will also be imbedded in the name badges for attendees at the upcoming Heart Rhythm Society meeting to be held in San Francisco in May. On first blush, it shouldn’t be such a big deal, right? It was all just a great way for companies to obtain, for a fee, the names and institutions of ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4775390 Mon, 02 May 2011 16:00:00 +0100 4775390 http://www.medworm.com/index.php?rid=4762769&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsome-older-male-physicians-dont-even-realize-when-theyre-being-inappropriate%2F2011.04.28 A few days ago I read that Dr. Lazar Greenfield, Professor Emeritus at the University of Michigan, resigned as the president-elect of the American College of Surgeons over flak for authoring a Valentine’s Day-pegged, tacky, tasteless and sexist piece in Surgery News. The February issue is mysteriously absent in the pdf-ied archives. According to the Times coverage: “The editorial cited research that found that female college students who had had unprotected sex were less depressed than those whose partners used condoms. From Pauline Chen, also in the Times: It begins with a reference to the mating behaviors of fruit flies, then goes on to discuss studies on the menstrual cycles of heterosexual and lesbian women who live together. Citing the research of evolutionary psychologists at the... Better Health blogs http://www.medworm.com/rss/comments.php?id=4762769 Thu, 28 Apr 2011 13:00:47 +0100 4762769 http://www.medworm.com/index.php?rid=4753627&cid=t_311271_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2011%2F04%2F27%2Fhow-a-valentines-editorial-about-chocolate-semen-lead-to-the-resignation-of-top-surgeon-greenfield%2F Dr. Lazar Greenfield, recently won the election as the new President of  ACS (American College of Surgeons). This position would crown his achievements. For Greenfield was a truly pre-eminent surgeon. He is best known for his development of an intracaval filter bearing his name. This device probably has saved many lives by preventing blood clots from going into the [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=4753627 Tue, 26 Apr 2011 23:51:44 +0100 4753627 http://www.medworm.com/index.php?rid=4723737&cid=t_311271_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2011%2F04%2Fdr-lazar-greenfield-resigns-board-regents-american-college-surgeons%2F Dr. Lazar Greenfield has resigned as President-elect and Board Member of the American College of Surgeons in the face of burgeoning criticism of a recent editorial he wrote in Surgery News that many College members found offensive and sexist. Drs. Barbara Bass and Diane M. Simone comment. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4723737 Mon, 18 Apr 2011 00:59:52 +0100 4723737 http://www.medworm.com/index.php?rid=4709205&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fkudos-to-acog-a-moral-victory-for-pregnant-women%2F2011.04.13 This post is written as a follow-up to The Hijacking of Pregnant Women. It is said that sometimes you have to rock the boat in order to shift the course of progress. Well today pregnant women have reason to celebrate. The winds of change are apparent. Bowing under pressure, K-V Pharmaceutical Company reduced the price of Makena from $1500 to $690. Makena is the trade name for hydroxyprogesterone caproate or 17OHP. It is a drug recently approved by the Federal Drug Administration (FDA) to reduce premature deliveries before 37 weeks if it is given before 21 weeks gestation.  It has been used for years as an off-label drug and costs approximately $10 to $20 to make by compound pharmacists. When the FDA gave K-V an exclusive right to manufacture the drug, their integrity flew out the window.... Better Health blogs http://www.medworm.com/rss/comments.php?id=4709205 Wed, 13 Apr 2011 17:00:38 +0100 4709205 http://www.medworm.com/index.php?rid=4693232&cid=t_311271_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2011%2F04%2Fdr-larry-bramlage-wins-top-orthopedic-surgery-award-horses%2F Equine orthopedic surgeon Dr. Larry Bramlage of Rood and Riddle Equine Hospital has won the American College of Veterinary Surgeons Foundation Legends Award. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4693232 Fri, 08 Apr 2011 00:20:51 +0100 4693232 http://www.medworm.com/index.php?rid=4684319&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsurgeons-criticize-medical-tourism-you-cant-sue-if-things-go-awry%2F2011.04.06 In an earlier post, DrRich offered several potential strategies for doctors and patients to consider should healthcare reformers ultimately succeed in their efforts to make it illegal for Americans to seek medical care outside the auspices of Obamacare. To those readers who persist in thinking that DrRich is particularly paranoid in worrying about such a thing, he refers you to his prior work carefully documenting the efforts the Central Authority has already made in limiting the prerogatives of individual Americans within the healthcare system, and reminds you that in any society where social justice is the overriding concern, individual prerogatives such as these must be criminalized. Indeed, whether individuals will retain the right to spend their own money on their own healthcare is ul... Better Health blogs http://www.medworm.com/rss/comments.php?id=4684319 Wed, 06 Apr 2011 20:00:54 +0100 4684319 http://www.medworm.com/index.php?rid=4653602&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FdtWgguerbvk%2F Yet another study has found a conflict of interest among doctors. This time, conflicts were reported by 56 percent of 498 docs who helped write 17 guidelines for the American Heart Association and American College of Cardiology between 2003 through 2008, according to the study published today in the Archives of Internal Medicine (see the abstract). And this finding matters because these panels typically wield considerable influence. “Panels are the select groups of experts who are assigned to evaluate science independently and issue their advice to other doctors on what to do in clinical practice,” the researchers write. Guidelines “play an important role in synthesizing information for clinicians, as well as increasing uniform practice to certain standards and avoiding t... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4653602 Tue, 29 Mar 2011 20:15:11 +0100 4653602 http://www.medworm.com/index.php?rid=4600536&cid=t_311271_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=4600538&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcolon-cancer-screening-guideline-truths-and-myths%2F2011.03.16 Colon cancer screening has a particular personal interest for me — one of my colleagues in residency training had her father die of colon cancer when she was a teenager. No one should lose a loved one to a disease that, when caught early, is often treatable. But for both men and women, colon cancer is the third most common cancer behind lung cancer and prostate cancer in men, and behind lung cancer and breast cancer in women, it’s the second most lethal. The problem is that patients are often confused about which test is the right one. Is it simply a stool test? Flexible sigmoidoscopy? Colonoscopy? Virtual colonoscopy? Isn’t there just a blood test that can be done? (No.) In simple terms, this is what you need to know: All men and women age 50 and older should be scr... Better Health blogs http://www.medworm.com/rss/comments.php?id=4600538 Wed, 16 Mar 2011 13:00:00 +0100 4600538 http://www.medworm.com/index.php?rid=4592401&cid=t_311271_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=4575009&cid=t_311271_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2011%2F03%2Facs-operation-giving-assessing-situation-japan%2F The Operation Giving Back section of the American College of Surgeons is currently gathering information about the on-the-ground status and the need for surgeon and physician volunteers in the earthquake and tsunami affected regions of Japan. At this time, they are recommending that those who wish to help can donate to one of the following aid organizations: The American Red Cross Global Giving Save the Children (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4575009 Fri, 11 Mar 2011 17:56:23 +0100 4575009 http://www.medworm.com/index.php?rid=4570547&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbehavior-vs-disease-a-new-way-to-look-at-health%2F2011.03.10 What is the leading cause of death in the United States? Heart disease? Cancer? No, it’s smoking. Smoking? Yes, depending on how you ask the question. In the early 90s, McGinnis and Foege turned the age-old question of what people die of on its head by asking not what diseases people die of but rather what the causes of these are. Instead of chalking up the death of an older man to say lung cancer, they sought to understand the proximate cause of death, which in the case of lung cancer is largely smoking. Using published data, the researchers performed a simple but profound calculation — they multiplied the mortality rates of leading diseases by the cause-attributable fraction, that proportion of a disease that can be attributed to a particular cause (for example, in lung can... Better Health blogs http://www.medworm.com/rss/comments.php?id=4570547 Thu, 10 Mar 2011 16:00:06 +0100 4570547 http://www.medworm.com/index.php?rid=4570548&cid=t_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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=4512392&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-first-emergency-physician-elected-to-congress%2F2011.02.23 I was unaware that Dr. Joe Heck of Nevada is the first emergency physician to be elected to Congress. Good for him! From the American College of Emergency Physicians (ACEP): In one of the closest congressional races of 2010, Republican challenger and ACEP member Dr. Joe Heck upset Rep. Dina Titus in Nevada’s third Congressional District.  Dr. Heck is the first ACEP member and emergency physician to be elected to Congress. I suppose that leaves me to be the first for the Senate… *This blog post was originally published at GruntDoc* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4512392 Wed, 23 Feb 2011 20:00:39 +0100 4512392 http://www.medworm.com/index.php?rid=4501585&cid=t_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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=4433103&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fno-more-cameras-in-the-delivery-room%2F2011.02.03 Most of our posts here deal with gadgets physicians or other medical professionals would use, but the New York Times has published an article about issues stemming from the patient or the family bringing cameras into the delivery room. Now, as anyone who’s been made to watch a video of a friend’s delivery during a party can attest, this isn’t a new phenomenon. However, since almost any device can record video now and it’s easiest to share the video online, medical-legal considerations are leading some hospitals to restrict any and all recordings of live births. We’d be interested to know what our readers think. Do you let patients film you while you work? New York Times article: Rules on Cameras in Delivery Rooms Stir Passions… *This blog post... Better Health blogs http://www.medworm.com/rss/comments.php?id=4433103 Thu, 03 Feb 2011 18:00:28 +0100 4433103 http://www.medworm.com/index.php?rid=4424235&cid=t_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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=4331013&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftired-surgeons-how-long-was-the-patient-asleep%2F2011.01.10 In a recent New England Journal of Medicine, a perspective piece on what to do with fatigued surgeons is generating debate. The issue of work-hour restrictions has been a controversial issue when it comes to doctors in training, something that I wrote about earlier in the year in USA Today. But once doctors graduate and practice in the real world, there are no rules. As summarized in the WSJ’s Health Blog, the perspective piece argues for more regulation for tired surgeons: … self-regulation is not sufficient. Instead, “we recommend that institutions implement policies to minimize the likelihood of sleep deprivation before a clinician performs elective surgery and to facilitate priority rescheduling of elective procedures when a clinician is sleep-deprived,” they write. For exampl... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331013 Mon, 10 Jan 2011 20:00:40 +0100 4331013 http://www.medworm.com/index.php?rid=4331015&cid=t_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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=4277831&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fgoing-against-medicine-courageous-or-foolish%2F2010.12.21 Every once I awhile a story catches my eye as I scan the news websites. There was one this morning on CNN with this catchy title: “Mom Defies Doctor, Has Baby Her Way.” The article describes a story where a mother was going to have her fourth baby. Her previous three were born via C-section. Mom did not want another C-section done, and “defied” her doctor’s order for the procedure. “You’re being irresponsible,” the patient was told. The middle of the article talks about the current thinking and statement of the American College of Obstetrics and Gynecology saying that “it’s reasonable to consider allowing women who’ve had two C-sections to try to have a vaginal delivery.” Of course, there’s risks with proceeding... Better Health blogs http://www.medworm.com/rss/comments.php?id=4277831 Tue, 21 Dec 2010 22:00:00 +0100 4277831 http://www.medworm.com/index.php?rid=4275325&cid=t_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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=4214113&cid=t_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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_311271_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=4040501&cid=t_311271_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F10%2Ftrauma-surgeon-dr-adil-haider-finds-atv-accidents-deadly-motorcycle-accidents%2F Although it seems counterintuitive, new research being presented at the American College of Surgeons annual Clinical Congress is showing that accidents involving all terrain vehichles are 50% more deadly than accidents involving motorcycles. The data were presented by Johns Hopkins trauma surgeon Dr. Adil Haider. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4040501 Thu, 07 Oct 2010 23:00:19 +0100 4040501 http://www.medworm.com/index.php?rid=4040566&cid=t_311271_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=4036567&cid=t_311271_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F10%2Fsurgery-gaining-popularity%2F Dr. Edward Chin of Mt. Sinai hospital in New York City is presenting data this week at the Clinical Congress of the American College of Surgeons showing his center’s expanding use of laparoendoscopic single site surgery for removal of the gallbladder. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4036567 Wed, 06 Oct 2010 01:04:40 +0100 4036567 http://www.medworm.com/index.php?rid=4003257&cid=t_311271_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=3993914&cid=t_311271_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=3961815&cid=t_311271_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=3957916&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F906%2F0%2Fsuddendeathathletes.mp3 It’s the dog days of what seems to have been an unusually hot summer (though DrRich does not know whether it has been sufficiently warm to affect the global cooling trend we’ve been in for the past decade), and as is all too common at this time of year, we are seeing extraordinarily heartbreaking stories (like this one) about healthy, robust young athletes dying suddenly on the practice fields. Most of these tragic sudden deaths are due to a heart condition called hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy often does not produce any symptoms prior to causing sudden death. But it can be easily diagnosed, before exercise-induced sudden death occurs, by screening young athletes with electocardiograms (ECGs) and echocardiography. A couple of summers ago, the New York Times wr... Better Health blogs http://www.medworm.com/rss/comments.php?id=3957916 Fri, 10 Sep 2010 14:00:38 +0100 3957916 http://www.medworm.com/index.php?rid=3929271&cid=t_311271_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F09%2F02%2Fstatistics-about-college-depression%2F Since it is going back-to-school season, I thought I’d educate you on some alarming statistics about depression among college students. Here are the facts, just the facts: One out of every five young people and one out of ever four college students or adults suffers from some form of diagnosable mental illness. About 19 precent of young people contemplate or attempt suicide each year. Suicide is the third leading cause of death among people ages 15-24, and the second leading cause of death in college students ages 20-24. Over 66 percent of young people with a substance use disorder have a co-occurring mental health problem. Teens diagnosed with depression are five times more likely to attempt suicide than adults. Over two-thirds of young people do not talk about or seek help for men... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3929271 Thu, 02 Sep 2010 10:42:34 +0100 3929271 http://www.medworm.com/index.php?rid=3907601&cid=t_311271_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=3907642&cid=t_311271_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F08%2F26%2Fthe-transition-year-an-interview-with-courtney-knowles%2F Earlier this year, The Jed Foundation and the American Psychiatric Foundation launched one of the newest mental health resources on the Web, The Transition Year. Recently, I was able to talk with Courtney Knowles, the Executive Director of The Jed Foundation, to get the skinny on this one-stop shop and why its contents are so beneficial for both students and parents before, during, and even after the college years. There’s a never-ending line at the bookstore. Posters announcing football schedules and Greek rush events are posted every couple of feet. Meal cards are being swiped every few minutes and music is blasting down the hall from the room where two longtime roommates are, once again, haggling over who’s in charge of buying the toilet paper. Yep, it’s that time of year again: ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3907642 Thu, 26 Aug 2010 12:36:42 +0100 3907642 http://www.medworm.com/index.php?rid=3902899&cid=t_311271_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=3876650&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-in-cubicles-a-barrier-to-patient-care%2F2010.08.17 I present interesting cases to colleagues often because it’s educational and good for patient care and because I like to. But it has been many years since I was mandated to present a case. It seems that I’m not the only doctor exasperated by a pesky new barrier to patient care: Doctors in cubicles. An old friend and mentor, Dr. Richard Kovacs, now chair of the American College of Cardiology’s Board of Governors (and IU guy), has written about these same pre-certification barriers. Dr. Kovacs, being a professor and distinguished ACC official, kindly terms these obstructionists “radiology benefit managers” (RBMs). (more…) *This blog post was originally published at Dr John M* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3876650 Tue, 17 Aug 2010 22:00:00 +0100 3876650 http://www.medworm.com/index.php?rid=3858153&cid=t_311271_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_311271_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_311271_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_311271_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=3798560&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-pap-smear-guidelines-the-right-care-or-rationed-care%2F2010.07.28 The American College of Obstetricians and Gynecologists (ACOG) recently reiterated their position that Pap smears should be performed on healthy women starting at age 21. This is different from the past which recommended screening for cervical cancer at either three years after the time a woman became sexually active or age 21, whichever occurred first. How will the public respond to this change? Over the past year there have been plenty of announcements from the medical profession regarding to the appropriateness of PSA screening for prostate cancer and the timing of mammogram screening for breast cancer. Understandably, some people may view these changes in recommendations as the rationing of American healthcare. (more…) *This blog post was originally published at Saving Mo... Better Health blogs http://www.medworm.com/rss/comments.php?id=3798560 Wed, 28 Jul 2010 20:00:00 +0100 3798560 http://www.medworm.com/index.php?rid=3790706&cid=t_311271_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=3786132&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpregnant-women-and-caffeine%2F2010.07.24 The American College of Obstetricians and Gynecologists has issued a statement that moderate caffeine consumption (<200mg/day — about a cup of coffee) does not increase a woman’s risk for miscarriage or preterm birth. The review of recent studies was published in Obstetrics and Gynecology and should reassure women about drinking coffee when pregnant. Caffeine does cross the placenta, but there was no difference found between the moms who drank caffeine while pregnant and those who did not. If you wonder how much caffeine is in certain drinks or foods, click here. One fact the study did not mention is that many women have a natural aversion to coffee when they are pregnant. Maybe nature knows best. *This blog post was originally published at EverythingHealth* (Sourc... Better Health blogs http://www.medworm.com/rss/comments.php?id=3786132 Sat, 24 Jul 2010 16:00:00 +0100 3786132 http://www.medworm.com/index.php?rid=3776318&cid=t_311271_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F07%2Fexperts-rethink-practice-banning-vaginal-delivery-caesarian-section%2F Experts at the American College of Gynecology (ACOG) have issued guidelines that state that women should be allowed to attempt vaginal delivery after a previous caesarian section or C section. Dr. William Grobman of Northwestern University comments. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=3776318 Wed, 21 Jul 2010 22:18:05 +0100 3776318 http://www.medworm.com/index.php?rid=3767077&cid=t_311271_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=3733295&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FtiZRdI29YBA%2F Here’s a lesson in social media. A number of rheumatologists are battling with URL Pharma over its new Colcrys med for treating gout, which is essentially a version of a very old drug called colchicine. Specifically, they complained about pricing on an online message board, and the drugmaker’s general counsel responded by sending letters to some docs about the “potential risks and liabiilty” of using unapproved versions, The Wall Street Journal writes. URL Pharma didn’t threaten to sue, but warned the docs their comments expose them to liability lawsuits from injured patients. “These are shake-down letters to silence” critics, John Goldman, an Atlanta rheumatologist, tells the paper. He criticized URL in his postings for conducting limited research... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3733295 Wed, 07 Jul 2010 21:23:26 +0100 3733295 http://www.medworm.com/index.php?rid=3726595&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-its-wrong-to-call-drug-seekers-a-micropopulation%2F2010.07.05 I don’t know what’s going on with American College of Emergency Physicians (ACEP) lately, but it’s disheartening. Their abdication of responsibility and engagement during the healthcare reform debate was depressing. Then there was a rigged poll designed to elicit a predetermined result. Now I see a bizarre op-ed piece in USA Today entitled “Opposing view on drug addiction: Don’t make us ‘pain police’” and authored by ACEP President Angela Gardener. An excerpt: The patient-physician relationship is sacrosanct, demanding candor and trust. In the emergency department, trust is built in nanoseconds because patients and doctors do not have prior relationships. Knowing that any pain prescription will be entered into a large, public database might p... Better Health blogs http://www.medworm.com/rss/comments.php?id=3726595 Mon, 05 Jul 2010 22:00:00 +0100 3726595 http://www.medworm.com/index.php?rid=3726596&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Femergency-medicine-dilemma-risk-malpractice-or-overtesting%2F2010.07.05 Emergency physicians are in a dilemma. Risk missing a diagnosis and be sued, or be criticized for overtesting. Regular readers of this blog, along with many other physicians’ blogs, are familiar with the difficult choices facing doctors in the emergency department. The Associated Press, continuing its excellent series on overtesting, discusses how lawsuit fears is a leading driver of unnecessary tests. Consider chest pain, one of the most common presenting symptoms in the ER: Patients with suspected heart attacks often get the range of what the ER offers, from multiple blood tests that can quickly add up in cost, to X-rays and EKGs, to costly CT scans, which are becoming routine in some hospital ERs for diagnosing heart attacks … … and the battery of testing may be paying off: A few... Better Health blogs http://www.medworm.com/rss/comments.php?id=3726596 Mon, 05 Jul 2010 20:00:59 +0100 3726596 http://www.medworm.com/index.php?rid=3718398&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealth-highlights-from-the-new-media-academic-summit%2F2010.07.01 I recently spoke at the panel on transparency at Edelman’s New Media Academic Summit. Ben Boyd was the moderator and Ellen Miller from the Sunlight Foundation was my fellow panelist. Reviewing some of the #nmas10 tweets from the audience, I figured I should provide some links for the anecdotes I mentioned: Beth Israel Deaconess Medical Center CEO Paul Levy’s blog is still the starting point when talking about transparency in medicine today. I had the chance to speak with him a few years ago. Ed Bennett has done an extraordinary job following hospital social media adoption and highlights effective new media policies as well. Hospitals are using twitter and billboards to broadcast emergency department waiting room times. This is not without risk, as billboards may not clarif... Better Health blogs http://www.medworm.com/rss/comments.php?id=3718398 Thu, 01 Jul 2010 16:00:00 +0100 3718398 http://www.medworm.com/index.php?rid=3714188&cid=t_311271_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_311271_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=3690837&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysician-burnout-when-being-a-doctor-makes-you-sick%2F2010.06.23 Do doctors take care of themselves? Sometimes patients may better follow the advice of physicians who aren’t obese and don’t smoke. That was a question asked in a post last year, entitled “When fat doctors talk to obese patients.” According to studies, as reported in the Wall Street Journal, it’s a mixed bag: Physicians as a group are leaner, fitter and live longer than average Americans. Male physicians keep their cholesterol and blood pressure lower. Women doctors are more likely to use hormone-replacement therapy than their patients. Doctors are also less likely to have their own primary care physician—and more apt to abuse prescription drugs. Clearly there’s room for improvement. (more…) *This blog post was originally published at KevinMD.com* ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3690837 Wed, 23 Jun 2010 20:00:31 +0100 3690837 http://www.medworm.com/index.php?rid=3690838&cid=t_311271_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_311271_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=3671851&cid=t_311271_115_f&fid=38592&url=http%3A%2F%2Fwww.radiolopolis.com%2Findex.php%2Fmy-profile%2Fmy-blog%2Fafip-closes-acr-launches-american-institute-for-radiologic-pathology.html New Radiologic Pathology Course Continues Resident Training After AFIP Closure  The American College of Radiology (ACR) has launched the American Institute for Radiologic Pathology (AIRP), which will provide a four-week Radiologic-Pathology Correlation Course, given five times per year, beginning in January 2011.   The new AIRP course fulfills all requirements for more than 310 residency programs previously satisfied by the Radiologic-PatRead More... (Source: Radiolopolis Blogs) Radiolopolis Blogs blogs http://www.medworm.com/rss/comments.php?id=3671851 Wed, 16 Jun 2010 16:37:26 +0100 3671851 http://www.medworm.com/index.php?rid=3658952&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fproposed-sgr-fix-an-interesting-twist%2F2010.06.14 This is something I haven’t seen reported on elsewhere, but according to the ACEP 911 Legislative Network Weekly Update, there was an interesting twist in the Democrats’ proposed SGR fix: The latest plan increases physician payments by 1.3% for the remainder of this year and by an additional 1% in 2011. In 2012 and 2013, physician services would be separated into two categories, or “buckets.” One bucket would be for E&M services (including emergency department, primary and preventive care) and the other group would include all other services. The E&M bucket would increase at the same rate as the U.S. gross domestic product (GDP) plus 2%, while the other group would receive a payment increase of GDP plus 1%.After 2013, the payment formula would revert back t... Better Health blogs http://www.medworm.com/rss/comments.php?id=3658952 Mon, 14 Jun 2010 14:00:00 +0100 3658952 http://www.medworm.com/index.php?rid=3625502&cid=t_311271_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_311271_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=3611907&cid=t_311271_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fteaching-til-the-very-end-carol-rivers-md%2F2010.05.29 To those who haven’t heard, an icon of emergency medicine has passed away. Carol Rivers, M.D. died last week following a cardiac procedure. Carol was an outstanding clinician and educator, and one of the founders of modern emergency medicine as we’re fortunate to know it today. Carol was perhaps best known for her board preparation guides, which helped many a terrified physician to navigate his or her emergency medicine board exams. I know her expertise helped me when I took my first American Board of Emergency Medicine (ABEM) exam. (more…) *This blog post was originally published at edwinleap.com* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3611907 Sat, 29 May 2010 22:00:07 +0100 3611907 http://www.medworm.com/index.php?rid=3617800&cid=t_311271_87_f&fid=34872&url=http%3A%2F%2Fblisstree.com%2Ffeel%2Ffitness-and-sleep-whats-the-real-connection%2F photo: Thinkstock If you complain about having trouble sleeping, one of the first things most people will tell you is to get more exercise. The more we ramp up our fitness routine, the more our bodies will tire, and we’ll sleep more soundly, right? Not necessarily. The thing that may eliminate the hour you spend staring at the ceiling every night may just be thinking that you get enough exercise. In a study by the American College of Sports Medicine in Switzerland, 862 college students were asked to record how much they exercise, how physically fit they think they are, and how well they sleep. There was no correlation between a large amount of exercise and a good night’s sleep, but there was a correlation between how fit students perceive themselves to be and a good night&#8217... Healthbolt blogs http://www.medworm.com/rss/comments.php?id=3617800 Wed, 26 May 2010 21:26:20 +0100 3617800 http://www.medworm.com/index.php?rid=3581610&cid=t_311271_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_311271_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_311271_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=3494549&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Faw9XrFxnwoI%2F The Council of Medical Specialty Societies, which includes 32 physician groups with some 650,000 members, has adopted a new ethics code designed to limit the influence that drug and device makers have over patient care. Among the groups represented are the American College of Cardiology, the American Society of Clinical Oncology, the American Academy of Pediatrics and the American College of Physicians. In doing so, the CMSS addresses an issue that has roiled the pharmaceutical industry and attracted withering attention from consumer groups and government officials, who have increasingly complained that conflicts can skew patient treatment. In recent years, the concerns have led to scrutiny of freebies, continuing medical education, research grants and fees for speaking and consulting. In ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3494549 Thu, 22 Apr 2010 12:38:34 +0100 3494549 http://www.medworm.com/index.php?rid=3416323&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FL5JLqz1QWAQ%2F File this under fabulous marketing. The recently launched Multaq drug for atrial fibrillation received some unusual treatment from the American College of Cardiology and the Heart Rhythm Society, which teamed to launch a new web site devoted to treating atrial fibrillation. As noted by CardioBrief, the Sanofi-Aventis logo appears in the lower right hand corner under “site sponsors” and no other companies are listed, but there is no specific mention of sponsorship, or the role of the sponsor. Here’s where it gets interesting. Last week, the site featured a “Learn From The Experts” lecture by Eric Prystowsky who showed slides on managing atrial fibrillation and made a case for off-label and off-guideline use of Multaq, CardioBrief writes. He “relies on subgroup a... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3416323 Mon, 29 Mar 2010 13:47:50 +0100 3416323 http://www.medworm.com/index.php?rid=3378605&cid=t_311271_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FHGMTOL6R3Gs%2F Today, in honor of both Brain Awareness Week (March 15-21) and Brain Injury Awareness Month (March), it is my pleasure to interview Patrick Donohue, founder of the Sarah Jane Brain Project, a foundation launched in 2007 with the explicit aim to create a model system for children suffering from all Pediatric Acquired Brain Injuries, and an implicit potential, in my view, to fundamentally transform medical research through the use of neuroinformatics and standarized systems of care. The Foundation: Story and Objectives Alvaro Fernandez: Patrick, thank you very much for your time today. Can you please provide an overall perspective into what you are doing and why? Patrick: Of course. The Sarah Jane Brain Project, named after my daughter Sarah Jane, started when she was shaken by her baby nurs... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=3378605 Thu, 18 Mar 2010 14:22:13 +0100 3378605 http://www.medworm.com/index.php?rid=3374158&cid=t_311271_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F03%2Fcould-this-be-acc-meeting-of-future.html Click image to enlargeI couldn't help but notice the "Heart Hub" at the American College of Cardiology Meeting this year, pictured above. There were doctors nicely nuzzled up to a bar in a relaxed atmosphere where a bartender served cranberry juice, soft drinks and perhaps a small snack, as doctors watched and interacted with any of four talks occurring simultaneously at the meeting. Some were interesting case discussions with a question and answer format where you could text message your answer to a multiple-choice question on your cell phone and, like American Idol, the results would be instantly displayed on the screen for the audience to view before the correct answer was given.Which made one wonder, with all the concern about industry influence that was aired publicly at the meeting w... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3374158 Wed, 17 Mar 2010 13:03:00 +0100 3374158 http://www.medworm.com/index.php?rid=3374378&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FqUrzDZcDUAE%2F While speaking at the American College of Cardiology yesterday, Steve Nissen criticized the American Heart Association for its financial relationship with Coca-Cola. Why? He said their ties influenced AHA statements that a tax on sugar-sweetened drinks needs more study and the findings of a study linking sodas to obestiy weren’t conclusive, the Associated Press reports. Nissen blamed the AHA position on Diet Coke’s involvement in the AHA’s red dress campaign to raise awareness of heart disease among women. “Our societies have been bought, and it’s time to draw the line,” Nissen said. “When you take the money, you better accept the taint that goes with it.” However, the AP points out Nissen had the wrong red dress. The campaign he cited is cal... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3374378 Wed, 17 Mar 2010 12:13:23 +0100 3374378 http://www.medworm.com/index.php?rid=3370445&cid=t_311271_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F03%2Fback-by-popular-demand-sex-heart-and-ed.html Today, I proved what I suspected: if you want readership, write or Tweet about sex and the heart. Needless to say, in a little over 30 minutes, I garnered 30 new Twitter followers by live-tweeting what I learned in the "Sex, the Heart, and Erectile Dysfunction (ED)" session at the American College of Cardiology meeting in Atlanta. For those who might have missed it, I have organized the tweets in chronicalogical order for your enjoyment benefit:Okay, at Sex/Heart session: Standing room only. Docs, pharma here. Um, will doctors attending please stand up? #acc10NEWS! Most people with CAD have ED! Up next: Cardiac response to sexual activity... #acc10 10 healthy married couples studied: all kinds of positions and O2 consumption measured. #acc10 orgasm rocks the heart rate up 72%!Guys on top: ... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3370445 Mon, 15 Mar 2010 21:39:00 +0100 3370445 http://www.medworm.com/index.php?rid=3366223&cid=t_311271_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F03%2Fboston-scientific-issues-new-icd.html Despite the excitement of the American College of Cardiology meeting in Atlanta, Boston Scientific issued a self-reported advisory about all of their high-voltage defibrillators (pacers are not affected) stopping sales until "administrative issues" regarding a change in manufacturing processes and changes of their IS-4 lead connector. This advisory does NOT affect existing implanted devices, but rather halts the sales of further devices:The Company has determined that some manufacturing process changes were not submitted for approval to the U.S. Food and Drug Administration (FDA). At this time, the company has identified two instances of changes that, while successfully validated, were not submitted to the FDA. Boston Scientific has informed the FDA and plans to work closely with the agenc... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3366223 Mon, 15 Mar 2010 15:44:00 +0100 3366223 http://www.medworm.com/index.php?rid=3366224&cid=t_311271_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F03%2Fhow-to-follow-acc-meeting-in-near-real.html Both Sarah Clarke, MD (@doctorsarah), pictured above, and I (@doctorwes) will be trying to Twitter (is that a verb?) several of the ACC Sessions while providing running commentary on the meeting today. (Stopping to open a laptop as I run from session to session just isn't realistic, I'm finding.)If you have no idea how to get set up on Twitter, I explain it here. Also, comments made by ourselves and others in attendance can be viewed by searching for the hashtag "#ACC10" or "#acc10".See you there.-WesMusings of a cardiologist and cardiac electrophysiologist. (Source: Dr. Wes) Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3366224 Mon, 15 Mar 2010 11:17:00 +0100 3366224 http://www.medworm.com/index.php?rid=3366226&cid=t_311271_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F03%2Facc10-march-14-2010-few-noteable.html "If we're going to count radiation exposure an adverse event, perhaps we should consider sternotomy one, too."-Ted Feldman, MDPrinciple Investigator of the Everest II Trial, responding to a critique of minimally invasive mitral valve repair compared to open chest valve repair surgery."This is one of the most amazing things I've ever done in medicine."Cardiologist - (Sorry, missed his name)Maine Medical Center investgiator from the Everest II trial "What 22 year-old wants to rack up $300,000 in debt to pursue medicine just to become a government employee?"-U.S. Congressman Paul Ryan"It is an outrage we keep doing this year after year, but the SGR (physcian payment formula) will NOT be fixed this year."Chris JenningsPresident, Jennings Policy Strategies, Inc.Former Senior Health Care Adviser... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3366226 Mon, 15 Mar 2010 02:54:00 +0100 3366226 http://www.medworm.com/index.php?rid=3366228&cid=t_311271_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F03%2Fwhy-acc-meeting-is-great.html The ACC Meeting in Atlanta is great because when you sit down for lunch, you get to meet nice people fresh off the treadmill with EKG stickers all over their, um, torso:Claire Nicholson, fitness model for Welsh Allen, having lunchYep, great meeting.Learning a lot.Really.-WesMusings of a cardiologist and cardiac electrophysiologist. (Source: Dr. Wes) Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3366228 Mon, 15 Mar 2010 01:09:00 +0100 3366228 http://www.medworm.com/index.php?rid=3363664&cid=t_311271_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F03%2Fblogging-acc-note-from-unwashed.html Forgive me Lord, for I have sinned...I was a speaker for Medtronic a while back, I'm not sure when. I was paid a fee to do this, but I can't recall exactly how much. (No doubt Senator Grassley knows by now.) I'm not even sure if my contract with Medtronic is still in effect, but I disclosed that former relationship to the American College of Cardiology before their upcoming meeting since I am blogging the conference this year.And I was shunned.Oh sure, they paid my registration fee - that was the original agreement (my "pay" if you will) - but because of my unwashed status as a former speaker for a company, there will be no coffee and donuts, no access to cell phone rechargers, no sit-down laptop computer space, and no early access to press releases and interviews with investigators. *Sigh... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3363664 Sat, 13 Mar 2010 20:13:00 +0100 3363664 http://www.medworm.com/index.php?rid=3359026&cid=t_311271_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F03%2Fwaning-popularity-of-scientific.html What has the been the marketing impact of the American College of Cardiology's Scientific Sessions been each year?Just turn to Google Trends to see the answer:Click image to enlargeIt appears the search spikes for the American College of Cardiology" each March are shrinking in amplitude significantly while the news reference volume spikes are increasing as marketers try as hard as they can to ensure doctors get their message anyway. One wonders, given all that is transpiring in health care today, what it would take to reverse the trend? -WesMusings of a cardiologist and cardiac electrophysiologist. (Source: Dr. Wes) Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3359026 Fri, 12 Mar 2010 12:09:00 +0100 3359026 http://www.medworm.com/index.php?rid=3342782&cid=t_311271_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2010%2F03%2F08%2Fcelebrate-your-prosthodontist%2F The American College of Prosthodontists has designated the week of March 7-13 as National Prosthodontics Awareness Week. This event was established to raise public awareness about the importance of a healthy mouth and of replacing missing teeth. To show our appreciation, Bibby library has prepared gift bags for each of our prosthodontic residents. Stop in this week [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=3342782 Mon, 08 Mar 2010 14:08:26 +0100 3342782 http://www.medworm.com/index.php?rid=3201718&cid=t_311271_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F01%2Ftrauma-surgeon-dr-brent-eastman-deploys-haiti%2F Prominent surgeon Dr. A. Brent Eastman is reportedly leaving for Haiti today and will be in country on Sunday, January 24 to begin aiding the medical relief efforts. He will be carrying a satellite phone to be used in providing regular field updates to the American College of Surgeons. Dr. Eastman is Chair of the Board of Regents of the ACS. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=3201718 Sat, 23 Jan 2010 17:24:11 +0100 3201718 http://www.medworm.com/index.php?rid=3149052&cid=t_311271_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FQDm6axTmfiA%2F The following guest post on the subject of cervical cancer screening guidelines is written by Susan Wysocki, WHNP-BC, FAANP, president and CEO of the National Association of Nurse Practitioners in Women’s Health and Susan Scanlan, chair of the National Council of Women’s Organizations. The article below initially appeared on America Media Forum’s website. It’s not surprising that women are confused about the recently changed recommendations for cancer screening and prevention. New guidelines from the American College of Obstetricians and Gynecologists (ACOG) – the leading medical group that provides health care for women – say women should wait longer to begin cervical-cancer screening and that they should be screened less frequently. On the heels of si... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3149052 Thu, 07 Jan 2010 14:01:10 +0100 3149052 http://www.medworm.com/index.php?rid=3126634&cid=t_311271_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F12%2Fwhen-cardiologists-sue.html It's sad that cardiologists have had to sue as their last resort to save their practices:"Heart specialists on Monday filed suit against Secretary of Health and Human Services Kathleen Sebelius in an effort to stave off steep Medicare fee cuts for routine office-based procedures such as nuclear stress tests and echocardiograms.The lawsuit, filed in U.S. District Court for the Southern District of Florida, charges that the government's planned cutbacks will deal a major blow to medical care in the USA, forcing thousands of cardiologists to shutter their offices, sell diagnostic equipment and work for hospitals, which charge more for the same procedures.Perhaps other professional organizations will be forthcoming with similar suits as private doctors and their patients pay dearly for the ref... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3126634 Mon, 28 Dec 2009 23:48:00 +0100 3126634 http://www.medworm.com/index.php?rid=3067068&cid=t_311271_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F12%2Fgetting-ready-for-cardiology-cuts.html There are potentially plenty of ways cardiologists will see their payments decline next year: from the loss of Medicare inpatient consultation code payments to the 2010 physician fee final rule issued last week by the Centers for Medicare & Medicaid Services (CMS) which threatens to cut to cardiology practice procedural payments an average of 27 percent.For those who want to calculate the potential impact to their practice, the American College of Cardiology has prepared a nifty Practice Impact Calculator that contains two worksheets: one for your practice and the other for the impact that loss of consultation codes will impart. Just enter this year's volumes and the calculator will do the rest.Try not to get too depressed filling it out and consider sending your results to the ACC.Oh, and... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3067068 Tue, 08 Dec 2009 04:14:00 +0100 3067068 http://www.medworm.com/index.php?rid=3035869&cid=t_311271_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=2610914&cid=t_311271_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F07%2Fagain-logical-fallacies-in-defense-of.html In conclusion, the first published rebuttal of Rothman and colleagues' suggestions for ensuring the independence of professional medical associations from outside vested interests was not based on evidence, but on logical fallacies rather than clear reasoning, and failed to disclose its authors' relevant financial relationships. We will see if anyone can make a better attempt.References1. Rothman DJ, McDonald WJ, Berkowitz CD et al. Professional medical associations and their relationships with industry. JAMA 2009; 301: 1367-1372. (Link here.)2. Bove AA. President's page: relations with industry: thoughts on claims of a broken system. J Am Coll Cardiol 2009; 54: 177-179. (Link here.)3. Somers VK, White DP, Amin R et al. Sleep apnea and cardiovascular disease: an American Heart Association/... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2610914 Thu, 16 Jul 2009 17:12:00 +0100 2610914 http://www.medworm.com/index.php?rid=2442555&cid=t_311271_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2009%2F05%2F24%2Fgenetic-testing-for-hereditary-breast-and-ovarian-cancers-greatly-underutilized-by-high-risk-women%2F A women’s lifetime breast cancer risk is approximately 13 percent, and her ovarian cancer risk is less than 2 percent.  But women with BRCA1 (BReast CAncer 1) or BRCA2 (BReast CAncer 2) gene mutations may be 3 to 7 times more likely to develop breast cancer, and 9 to 30 times more likely to develop [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=2442555 Mon, 25 May 2009 01:03:00 +0100 2442555 http://www.medworm.com/index.php?rid=2405975&cid=t_311271_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2009%2F05%2F14%2Fhusbands-love-for-wife-inspires-a-9000-mile-bike-trek-to-raise-money-for-ovarian-cancer-awareness-cancer-prevention%2F On May 15, 2009, Craig Broeder Ph.D., FACSM, FNAASO will embark upon a 100-day bike trek that will take him to 32 U.S. cities as part of  a 9,000 mile circumnavigation of the U.S.  Since July 2008, Craig has been planning this trip to honor his wife, Kay, in her 20th year of surviving clear [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=2405975 Thu, 14 May 2009 23:13:35 +0100 2405975 http://www.medworm.com/index.php?rid=1990725&cid=t_311271_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=1969321&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F457238595%2F …you’ve seen them all? A review for the American College of Physicians finds that there is no clinically significant difference in efficacy, effectiveness, or quality of life among different antidepressants - SSRIs, SNRIs, SSNRIs, or other second-generation pills - for treating an acute bout of major depressive disorder. Just think of all the marketing money spent to differentiate one pill from another. The findings, which were compiled after reviewing 200 studies and are published in the Annals of Internal Medicine this week, form the basis for new guidelines for physicians, who are advised to select a second-generation antidepressant on the basis of adverse effects, cost, and patient preferences. And what about suicidality? The review found that “no particular drug has... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1969321 Tue, 18 Nov 2008 14:38:09 +0100 1969321 http://www.medworm.com/index.php?rid=1847902&cid=t_311271_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2008%2F10%2Fanother-industry-supported-physician.html The President of the American College of Cardiology (ACC), W Douglas Weaver MD, has written a second editorial on relationships between the ACC and industry, continuing medical education, and conflicts of interest. In his first editorial [ Weaver WD. President's page: disclosures, transparency, and firewalls protect integrity. J Am Coll Cardiol 2008; 52(11): 964-965. Subscription required.] his major points were:Major activities of the ACC require industry funding - "the Annual Scientific Session would not be possible in its current form if it were not for industry grants and fees from the Exposition.""Firewalls" provided by the society prevent influence by industry on educational or scientific programs -Let me assure you that we have very strong firewalls around industry support.As part o... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=1847902 Thu, 02 Oct 2008 15:36:00 +0100 1847902 http://www.medworm.com/index.php?rid=1347619&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F263262512%2F Harlan Krumholz made quite an impression at the American College of Cardiology meeting on Sunday. As the head of a four-doctor panel assembled to review the controversial Enhance trial, the Yale University professor recommended Vytorin should not be used as a first or second-line therapy, spooking investors. Schering-Plough ceo Fred Hassan is lashing out. Last night, he told analysts “we were very disappointed with the way ACC unfolded. We hoped to see an open and balanced scientific discussion, and this did not happen.” Hassan hoped for debate and questions. In response to criticism that he unfairly dominated the proceedings, Krumholz wrote us last night to say: “It is so interesting that they call the recommendations biased - they are simply that we should stick with dr... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1347619 Thu, 03 Apr 2008 11:09:09 +0100 1347619 http://www.medworm.com/index.php?rid=1346249&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F262770902%2F The answer may not be known for weeks, even months, but already one big insurer is pulling back and two big pharmacy benefits managers will review their reimbursement policies. In other words, the money machine that was Vytorin may be on the verge of unraveling. For instance, Cigna will no longer recommend Vytorin as an alternative for patients who currently use higher-priced cholesterol drugs that aren’t covered. “That particular step therapy is being suspended,” a Cigna spokeswoman tells The Star-Ledger of New Jersey. The insurer’s pharmacy and therapeutics committee will decide later about any further changes. And UnitedHealth will also conduct a review. “As of now we aren’t making any changes but we’ll clearly review the evidence as it’s ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1346249 Wed, 02 Apr 2008 16:44:21 +0100 1346249 http://www.medworm.com/index.php?rid=1344610&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F262602842%2F Over the past several years, a big stink has been raised about conflicts of interest, such as when doctors write papers about a particular drug and also serve as a consultant in some fashion to the company who makes the medicine. Right or wrong, pharma regularly defends such situations by explaining that the best specialists are in demand. Generally, drugmakers shrug off the criticism. Now, though, Fred Hassan is trying to use such a situation to his advantage to deflect the controversy over the Vytorin cholesterol pill. A panel at the American College of Cardiology conference on Sunday was largely dominated by Yale University’s Harlan Krumholz, who skewered the results of the controversial Enhance trial by saying the drug shouldn’t be used as a first or second-line therapy. Th... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1344610 Wed, 02 Apr 2008 11:36:06 +0100 1344610 http://www.medworm.com/index.php?rid=1340924&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F261580582%2F As part of its ongoing investigation into the Vytorin controversy, the Senate Finance Committee is disclosing angry notes written by John Kastelein, who was the primary investigator for the Enhance trial, which found the cholesterol pill was something of a dud. The costly combination of Merck’s Zocor and Schering-Plough’s Zetia failed to show a benefit over the much cheaper Zocor in reducing plaque in the carotid artery, and even showed a statistically insignificant buildup, although it did a better job of lowering LDL in patients with an inherited form of high cholesterol. In other words, Vytorin may not be of much use as a first or second-line therapy, a fact underscored by several prominent docs when the complete Enhance data was dissected at the American College of Cardiolo... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1340924 Mon, 31 Mar 2008 23:09:57 +0100 1340924 http://www.medworm.com/index.php?rid=1208100&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F229576175%2F Maybe before the American College of Cardiology meeting in late March? The bottom-line results, of course, were released on Jan. 14, and set off a firestorm - the pricey cholesterol med failed to show any benefit over the much cheaper Zocor in reducing plaque in the carotid artery, and even showed a statistically insignificant buildup, even though the pill did a better job of lowering LDL. Then there was the way Schering-Plough and Merck, which jointly market Vytorin, handled the trial. The results of the study, known as Enhance, were delayed nearly two years; the primary endpoint was briefly changed without consulting the lead investigator, and an independent panel tapped to review the data wasn’t really independent - three members have financial ties to the drugmakers but nobody kn... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1208100 Tue, 05 Feb 2008 13:08:16 +0100 1208100 http://www.medworm.com/index.php?rid=1177893&cid=t_311271_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F223033612%2F In an e-mail to its 34,000 members, the American College of Cardiology tries to walk a fine line. In its statement last week, the ACC urged doctors and patients not to panic over the results of the controversial Vytorin trial, which found no statistical difference in plaque in arteries being measured. Since then, the ACC has become ensnared in investigations by the House Energy and Commerce Committee and the Senate Finance Committee as they probe how Schering-Plough and Merck handled the release of Vytorin trial data and the marketing of the widely promoted and expensive cholesterol med. In particular, the committees want to know the interplay between the drugmakers and the ACC, as well as the American Heart Association, both of which receive support from pharma. Among those involved in dr... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1177893 Fri, 25 Jan 2008 17:34:53 +0100 1177893