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 'care'. Sat, 03 Sep 2011 01:51:37 +0100 http://www.medworm.com/index.php?rid=5181683&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FgnsYa2Sw0c4%2Fmoney-physician-practice-running.html “Doc, it’s only $10.  I can’t believe you’re throwing me out of the practice for a measly $10.  You, docs, are all the same.  It’s all about the money!”Unfortunately, the money is important.  It costs money to keep a practice running.  It costs money just to collect the money owed to the practice.So, let’s look at some simple facts.  Your physician’s office is one of the few places where you can receive advice, services, and materials without payment at the time of receiving them.  Can you imagine leaving Jewel without paying for your groceries or picking up your car from the mechanic without settling the bill?  Of course not.Read the rest of Money keeps a physician practice running on KevinMD.com.Category: Physician | Tags: Patients, Primary care | No comme... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5181683 Fri, 02 Sep 2011 15:00:24 +0100 5181683 http://www.medworm.com/index.php?rid=5181754&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FiE-w4yBV7BI%2F By Ilya ShapiroOver the last year and a half, I’ve blogged many times about Berkeley law professor Goodwin Liu, the controversial nominee to the Ninth Circuit, the federal appellate court with jurisdiction over the western states and territories.  Here’s an op-ed I published in the wake of that nomination — which happened to coincide with Obamacare’s enactment.  And here’s a taste of what I wrote when Republicans filibustered Liu, which ultimately led him to withdraw: I’m not going to weigh in here on the issue of whether judicial nominees ought to be filibustered in general . . . but if ever there were an “extraordinary circumstance” fitting into the Gang of 14agreement that broke the judicial logjam under President Bush, this is it. As I blog... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5181754 Fri, 02 Sep 2011 12:42:28 +0100 5181754 http://www.medworm.com/index.php?rid=5181862&cid=t_101667_105_f&fid=39191&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fblogspot%2FMwTK%2F%7E3%2FkIES8IMyeag%2Flong-time-no-see.html Here are a few of the tough questions I have faced in the last few days: What do you do when you walk in an exam room and a patient hands you a newly removed body part? And then another, from a different part of the body?What do you do when you run out of pretzels and you're running an hour late, and your coffee gave out several hours ago when you stopped drinking it because if you kept drinking it you'd never sleep and you hardly sleep as it is? And your next patient is on 24 medications?With what do you follow when you're trying to establish that mythical rapport with a new patient when you ask, "Where are you from?" and the patient answers, "Yes, yes, I work very hard."When a very large woman says to you during a discussion about her weight "I never eat candy" and you can see the Reese'... Medical Marginalia blogs http://www.medworm.com/rss/comments.php?id=5181862 Fri, 02 Sep 2011 00:48:00 +0100 5181862 http://www.medworm.com/index.php?rid=5181798&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-features-of-a-bundled-payment-for-care-improvement-project%2F2011.09.01 Many health care provider organizations have not been overly eager to jump onto the Accountable Care Organization (ACO) bandwagon, citing high startup costs and uncertain returns on investment given the complexity of the program.  Well, recently, the CMS Center for Innovation has announced the Bundled Payment for Care Improvement initiative.  This initiative incorporates elements of earlier CMS demonstration projects — the gainsharing demos and ACE (acute care episode) bundled payments demonstrations which the HealthBlawger has helped a number of clients around the country qualify for in the past — and builds on the broad authority granted to the CMS Center for Innovation under health reform. The advantages to proceeding with a Bundled Payment for Care Improvement project inc... Better Health blogs http://www.medworm.com/rss/comments.php?id=5181798 Thu, 01 Sep 2011 21:00:08 +0100 5181798 http://www.medworm.com/index.php?rid=5181799&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fimproving-doctor-patient-communication-to-provide-patient-centered-care%2F2011.09.01 The first experience patients are likely to have with your hospital is not in an ER visit or inpatient stay.  A patient’s first experience will most likely be in one of your primary-care physician offices.  That because a person is 10 times more likely during a year to end up in the physician’s office for a routine visit than they are to require an overnight hospital stay. As a hospital marketer or patient experience officer this should raise an interesting question. How well do your physicians–particularly your primary-care physicians–represent your brand? Take “patient-centeredness.” Lots of hospitals these days are promoting themselves as providing patient-centered care.  You know … when the hospital and its staff try where possible to be sensitive to and honor the wish... Better Health blogs http://www.medworm.com/rss/comments.php?id=5181799 Thu, 01 Sep 2011 18:00:05 +0100 5181799 http://www.medworm.com/index.php?rid=5181810&cid=t_101667_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FsuwvoByosDQ%2F Do you work in an emergency department? Or maybe in an ICU? Or perhaps the prehospital environment? Regardless, of where you look after critically ill patients you MUST click on this LINK now! What will you find there? Two things: The first part of a talk by ‘Early Goal Directed Therapy’ legend Dr Manny Rivers on [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5181810 Thu, 01 Sep 2011 17:38:31 +0100 5181810 http://www.medworm.com/index.php?rid=5182233&cid=t_101667_136_f&fid=39025&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Feverythingchangesbook%2F%7E3%2FKHUrL5uVSuA%2Fsupport-group-tips By Kairol Rosenthal During my stint with cancer, I’ve attended both thyroid cancer and young adult cancer groups.  They ranged from excellent to abysmal.  Here are six tips I’ve come up with for making the most out of a support group experience. I’m curious if you’ve ever tried them: 1. Contact the leader first to see if it’s a good match for you. Ask if participants have a similar disease type or variation as you, what stage of their disease are they in, if the focus is emotional support or swapping practical medical coping strategies. If age, relationship status, race and ethnicity and other personal factors are important to you, ask about the demographics of the group. 2. Try a few meetings. Sometimes groups vary hugely from meeting to meeting depending on who is... Everything Changes blogs http://www.medworm.com/rss/comments.php?id=5182233 Thu, 01 Sep 2011 16:11:17 +0100 5182233 http://www.medworm.com/index.php?rid=5181811&cid=t_101667_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FTmWWsO6C2Iw%2F A modified mnemonic for recalling the key issues in the supportive care of critically ill patients. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5181811 Thu, 01 Sep 2011 16:07:16 +0100 5181811 http://www.medworm.com/index.php?rid=5181736&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F09%2F01%2Fberwick-to-keynote-health-affairs-briefing%2F Don Berwick, the Administrator of the Centers for Medicare and Medicaid Services, will keynote Health Affairs’ September 8 briefing on controlling health care costs. At the briefing, Health Affairs will release its September 2011 issue, “The New Urgency To Lower Costs.” Topics to be discussed include chronic disease costs and opportunities for savings through prevention; who bears [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181736 Thu, 01 Sep 2011 14:09:50 +0100 5181736 http://www.medworm.com/index.php?rid=5181802&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmisdiagnosis-happens-all-the-time-tips-to-avoid-it%2F2011.09.01 Billionaire Teddy Forstmann has apparently been diagnosed with a serious form of brain cancer.  There’s a tragic twist to the story: according to Fox Business News, Forstmann believes that for more than a year, he had been misdiagnosed with meningitis. ABC News wonders: How could such a misfortune befall a billionaire —- a man able to afford the best doctors, best technology and the most sophisticated diagnostic tests? They’re missing the point.  Misdiagnosis happens with shocking regularity – as much as (more…) *This blog post was originally published at BestDoctors.com: See First Blog* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5181802 Thu, 01 Sep 2011 12:00:03 +0100 5181802 http://www.medworm.com/index.php?rid=5181737&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F31%2Fthe-challenges-of-payment-reform-and-administrative-simplification%2F As both a Canadian and an analyst who focuses on US healthcare, I have an abiding curiosity in comparisons between the US and Canadian systems, so it was with great interest that I read the recent Health Affairs article by Dante Morra and coauthors entitled “US Physician Practices Versus Canadians: Spending Nearly Four Times As Much Money [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181737 Wed, 31 Aug 2011 16:57:12 +0100 5181737 http://www.medworm.com/index.php?rid=5182361&cid=t_101667_158_f&fid=38949&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAgingWithGraceCareconnection%2F%7E3%2FBK8O3tQ88rY%2Fdepressed-housing-market-puts-pressure.html After four years of depressed home values, experts say thousands of seniors remain unable to move into senior housing because they can’t sell their homes quickly enough or for the price they need reports Kaiser Health News. This has lead to greater pressure on families to pay for parent’s and grandparents’ placements, or to care for them themselves. “We see people coming in much older and frailer because they’re taking a longer time to make the decision,” says Donna Taylor, executive vice president for the nonprofit Arizona Baptist Retirement Centers in Phoenix. “They don’t know how long it will take to sell their house, and in some cases they’re reluctant to sell because of the lower price.” Arizona Baptist, a continuing care retirement community (CCRC), offers a spe... Aging with Grace CareConnection blogs http://www.medworm.com/rss/comments.php?id=5182361 Wed, 31 Aug 2011 13:16:00 +0100 5182361 http://www.medworm.com/index.php?rid=5181849&cid=t_101667_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F08%2Fsystematic-review-of-therapeutic.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5181849 Wed, 31 Aug 2011 12:06:00 +0100 5181849 http://www.medworm.com/index.php?rid=5181771&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FOQfxnCT1GtU%2F By Michael F. CannonHere are a few takeaways from the Kaiser Family Foundation’s most recent monthly poll. 1. Nearly Two Thirds of ObamaCare’s Supposed Beneficiaries Think It Won’t Help Them. ObamaCare‘s actual beneficiaries are politicians, government bureaucrats, insurance companies, drug manufacturers, etc.—but that’s another blog post for another time. The law’s supposed beneficiaries are the uninsured. Yet 61 percent of them think the law will either not help them or will hurt them (see pie chart below). The main takeaway: Congress can repeal ObamaCare and its supposed beneficiaries won’t even care.   2. Some of the Uninsured Who Think ObamaCare Will Help Them Are Wrong. One respondent said that under ObamaCare, you “can go to ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5181771 Tue, 30 Aug 2011 18:56:48 +0100 5181771 http://www.medworm.com/index.php?rid=5181772&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FLbNhcRAIVCE%2F By Michael F. CannonFrom time to time, I’ve posted Pollster.com’s trend estimate of all polls gauging public opinion on ObamaCare.  It’s a great little tool.  But recently, I noticed something. The Kaiser Family Foundation’s monthly tracking poll not only finds the most support for ObamaCare, but it also gets disproportionate weight in the Pollster.com trend estimate, simply because KFF polls the public on ObamaCare more frequently than others.  Since President Obama signed the law on March 23, 2010, KFF has polled this question more often than the next two most frequent polls combined.  That makes the gap between opposition and support smaller than it would be if KFF conducted its poll as frequently as other groups conduct theirs (or vice versa). To illustrate,... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5181772 Tue, 30 Aug 2011 18:54:32 +0100 5181772 http://www.medworm.com/index.php?rid=5181738&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F30%2Fwhere-to-for-hospice%2F A column by New York Times columnist David Brooks titled “Death and Budgets,” read in combination with a recent report from the Office of the Inspector General (OIG) at the U.S. Department of Health and Human Services (“Medicare Hospices that Focus on Nursing Facility Residents”), makes painfully clear how urgently America must rethink the way [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181738 Tue, 30 Aug 2011 18:02:55 +0100 5181738 http://www.medworm.com/index.php?rid=5181960&cid=t_101667_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FGFmRr9VJvx8%2F Chuck Podesta is Fletcher Allen Health Care’s chief information officer. ICD-10 would not be so daunting if the deadline was not occurring during the rush to get EHRs for meaningful use. Add in value-based purchasing, bundled payments and transitioning to ACOs, and you can see why many CIOs are retiring early or migrating to the vendor or consulting world. We are just over two years away from the October 2013 deadline, and there is much work to be done. ICD-10 contains 68,000 codes, as opposed to the 13,000 currently used in the ICD-9 world. There is a code for every condition that exists on the planet. The revenue cycle system, which includes registration, HIM and billing/AR, will be the lynch pin to ICD-10 readiness. Having a solid vendor partner and a strong product is key to a succ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5181960 Tue, 30 Aug 2011 17:56:35 +0100 5181960 http://www.medworm.com/index.php?rid=5182205&cid=t_101667_136_f&fid=35283&url=http%3A%2F%2Fwww.cancer.org%2FAboutUs%2FDrLensBlog%2Fpost%2F2011%2F08%2F30%2FCrizotinib-Approval-For-Lung-Cancer-Shows-Our-Miracles-Arent-Getting-Less-Expensive.aspx   Today I would like to share with you some thoughts on the topic of the costs of cancer treatments. It is the result of a moment on Saturday morning while, in the midst of listening to hurricane coverage on television, I was scanning the pages of my morning paper. There in the headlines was the comment that the Food and Drug Administration on Friday-presumably a bit later in the day, since the article was posted online at 8PM-approved a new drug called crizotinib (Xalkori®) for the treatment of lung cancer.   The news didn't get much attention, likely because it was overwhelmed by the hurricane. But at any other time, I suspect it would have been all over the media since this drug in fact represents a breakthrough treatment for some patients with lung cancer (more on th... Dr. Len's Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5182205 Tue, 30 Aug 2011 16:00:00 +0100 5182205 http://www.medworm.com/index.php?rid=5181790&cid=t_101667_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FFSpBgAwfDVs%2F By Mary Grealy. When we talk about people who don’t have access to healthcare, there’s a natural assumption that it’s because they can’t afford it.  A new study shows that’s not necessarily the case. According to the study published in the journal Health Services Research, 21 percent of American adults said they had delayed care for non-financial reasons compared to 19 percent that cited cost as the primary reason for not seeking healthcare. Those non-financial reasons included not being able to get to a doctor’s office during working hours, long commutes to the medical office, or not being able to get an appointment soon enough.  As the study’s lead author said, “In reality, there are all kinds of reasons why people can’t get the care they need when they need it.” Th... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=5181790 Tue, 30 Aug 2011 13:16:36 +0100 5181790 http://www.medworm.com/index.php?rid=5181751&cid=t_101667_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FQa2nPPR_42c%2F “Niche Blockbusters”: Pfizer’s newly approved lung-cancer therapy crizotinib, to be sold under the brand name Xalkori, represents a relatively new tack for the pharma giant: a drug aimed at a small group of patients with a serious disease whom tests show will likely benefit from the treatment, the WSJ reports. Drug makers can bring these potential “niche blockbusters” to market quickly and more cheaply than drugs aimed at a mass audience, and because the medical need is dire, insurers will pay up for them. Xalkori will sell for $115,200 per year. Asking the Uninsured: The Kaiser Family Foundation’s latest tracking poll finds only 31% of uninsured people think the health-care overhaul law will help them get coverage, NPR’s Shots blog reports. A full 37% of... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5181751 Tue, 30 Aug 2011 12:20:05 +0100 5181751 http://www.medworm.com/index.php?rid=5174604&cid=t_101667_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fwidely-used-acne-treatments-lack-evidence-says-new-study.html Most teenagers experience at least some degree of acne, and the problem sometime extends into adulthood. When it’s severe (or even when it’s not) it can lead to low self-esteem, depression, and diminished quality of life. Yet despite the scads of prescription and over-the-counter treatments marketed for acne, very little is known about their comparative effectiveness—that is, which of them works best, and for whom, according to a review published today in the journal Lancet. Researchers at the University of Nottingham in the United Kingdom and other institutions undertook a comprehensive review of the scientific literature on acne causes, treatments, and management dating back to 1999. The treatments they examined included topical ones, such as benzoyl peroxide (Clearas... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5174604 Mon, 29 Aug 2011 23:31:00 +0100 5174604 http://www.medworm.com/index.php?rid=5174586&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F29%2Faco-101-the-basics-of-accountable-care%2F Regarding the subject of “health care reform” during the past year, it is certain that more has been written about, more conferences have been devoted to, and more consultants have been engaged for the topic of “accountable care organizations” (ACOs) than any other.  ACOs are in the spotlight both because of several provisions in the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5174586 Mon, 29 Aug 2011 18:51:11 +0100 5174586 http://www.medworm.com/index.php?rid=5174613&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fafter-one-year-the-mayo-clinic-center-for-social-media-is-still-going-strong%2F2011.08.29 I’ve always been a great fan of what Mayo Clinic has been doing on social media. Then after Mayo Clinic Center for Social Media was launched, I became a member of the international external advisory board which I’m very proud of. I reported when they launched a patient community and also discussed how well they did this. Now the Center is 1 year old and still performs perfectly. An excerpt form their previous entry: Here’s a sneak peek of a few topics that were discussed during Mayo’s retreat: (more…) *This blog post was originally published at ScienceRoll* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5174613 Mon, 29 Aug 2011 16:00:38 +0100 5174613 http://www.medworm.com/index.php?rid=5174566&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FzhPqqwFGuPc%2Fsecret-patient-care-time.html Lets face it — the system of primary care medicine in the United States is broken. Even in Boston, the mecca of medicine, patients struggle hard to find an accessible doctor. And when they finally land an appointment, their well-intentioned internist, pediatrician or family physician often seems overworked, rushing from patient to patient, with little time to really listen to details.As a primary care family physician for 20 years, I hear my colleagues saying, “I went into medicine to put the whole clinical picture together. I really care and want to know my patient — but the system doesn’t give me the time to do it!”Read the rest of The secret to better patient care is time on KevinMD.com.Category: Physician | Tags: Primary care | No comment (Source: Kevin, M.D. ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5174566 Mon, 29 Aug 2011 16:00:07 +0100 5174566 http://www.medworm.com/index.php?rid=5174692&cid=t_101667_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F08%2Fputting-end-to-didnt-ask-didnt-tell.html This is a guest post from a clever medical student , Muthukar Ramanathan. If there are more like him, the future of medical practise holds a lot of promise ! ---------------- How many times have you felt that you forgot to mention something important after leaving your doctor’s clinic ? Unable to ask an embarrassing question or to did not remember to discuss your recent allergy? This familiar problem of "Didn't Ask Didn't Tell" among patients is due to multiple reasons - chiefly lack of recollection, stress or even laziness. But this inability to communicate well with physicians ultimately hurts patients due to incorrect diagnosis or treatment. As a medical student sitting as an observer in physician's office, I noticed that many times patients could not accurately provide much needed... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5174692 Mon, 29 Aug 2011 14:59:00 +0100 5174692 http://www.medworm.com/index.php?rid=5174599&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F1CUaz70JSQk%2F By Ilya ShapiroSCOTUSblog’s symposium on the constitutionality of Obamacare — to which I contributed, as did Bob Levy – provides a glimpse at the astonishing views of the law’s supporters.  It particularly shows how divorced the legal academy’s leading lights are not only from basic constitutional text and structure, but from jurisprudential reality. Most prominently, in responding to the Eleventh Circuit’s decision striking down the individual mandate (and to Richard Epstein’s symposium essay), storied Harvard professor Laurence H. Tribe criticizes the court for “reflecting what appears to be a widely held public sentiment” that Congress cannot “mandate that individuals enter into contracts with private insurance companies for the purchase o... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5174599 Mon, 29 Aug 2011 12:45:41 +0100 5174599 http://www.medworm.com/index.php?rid=5174623&cid=t_101667_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Ft2VfNF7BdPo%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5174623 Mon, 29 Aug 2011 02:06:00 +0100 5174623 http://www.medworm.com/index.php?rid=5174617&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-history-found-to-be-key-element-in-making-a-diagnosis%2F2011.08.28 Four out of five doctors agree that they don’t need scans to make the right diagnosis. It’s an old-fashioned concept frequently discussed among ACP members, but the history and physical combined with basic tests is way more important to diagnosis than ordering scans and advanced tests. A recent research letter in the Archives of Internal Medicine makes the case. In the letter, Israeli researchers described a prospective study of 442 consecutive patients admitted from the emergency department in 53 days. A senior resident examined all patients within 24 hours of admission (mean=14), including a history, physical, and review of ancillary test findings done at the emergency department, such as blood and urine tests, electrocardiography, and chest radiography. The resident also rev... Better Health blogs http://www.medworm.com/rss/comments.php?id=5174617 Sun, 28 Aug 2011 18:30:00 +0100 5174617 http://www.medworm.com/index.php?rid=5174713&cid=t_101667_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fend-beginning-and-launch-i2o When Dr. Farzad Mostashari, the national coordinator for health information technology, addresses more than 4,700 healthcare professionals at the Allscripts Client Experience in Nashville on Monday morning, Aug. 29, he’s likely to discuss one of the most exciting developments in healthcare today – and perhaps surprisingly, it won’t be the meaningful use of electronic health records.  read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5174713 Sun, 28 Aug 2011 16:48:46 +0100 5174713 http://www.medworm.com/index.php?rid=5169545&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-physicians-have-a-role-in-controlling-healthcare-costs%2F2011.08.27 The Role of Physicians in Controlling Medical Care Costs and Reducing Waste by the RAND Corporation and David Geffen, University of California Los Angeles School of Medicine, Santa Monica was just published in the Journal of the American Medical Association (JAMA).  I do not think the JAMA should have published this article. 1.Why would the JAMA publish such an article? 2. Why are physicians blamed for all the waste in the system? 3. Why is it the physicians’ responsibility to eliminate waste when they are not the cause of the greatest percentage of the waste? “The amount of money spent on medical care is increasing faster than the gross domestic product (GDP), and the federal deficit is increasing.” The initial statement assumes that the government deficit is increasing because phy... Better Health blogs http://www.medworm.com/rss/comments.php?id=5169545 Sat, 27 Aug 2011 21:05:19 +0100 5169545 http://www.medworm.com/index.php?rid=5169503&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FwpbvAv8XtcY%2Fintuition-saved-patient-potentially-fatal-diagnosis.html I was working in a rural health clinic when I went into to see a new patient.  Amy was 18 years old, with her 6 day old newborn son by her side.I introduced myself and then asked, “what brings you into the clinic?”Amy responded, “Shortly after giving birth, I started having problems with shortness of breath, ankle swelling, and high blood pressure.  I told the OB residents and they brushed it off, said it would go away.”“So what happened after you went home?”Read the rest of Intuition saved this patient from a potentially fatal diagnosis on KevinMD.com.Category: Conditions | Tags: Heart, Primary care | 4 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5169503 Sat, 27 Aug 2011 13:00:18 +0100 5169503 http://www.medworm.com/index.php?rid=5169511&cid=t_101667_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fwill-hired-executives-let-healing.html Hospital - noun, 1.  a charitable institution for the needy, aged, infirm or young  2.  an institution where the sick or injured are given medical or surgical care, Merriam-Webster             - noun.  1.  an institution providing medical and surgical treatment and nursing care for sick or injured people, Oxford DictionaryTwo recent NY Times articles raise concerns that changes in leadership may cause hospitals to stray from their original purpose.  Cook County Health and Hospitals SystemThe first NY Times article discussed leadership of Cook County Health and Hospitals System (in the Chicago, IL area). This is a public health system whose mission was traditionally "to serve Cook County... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5169511 Fri, 26 Aug 2011 18:20:00 +0100 5169511 http://www.medworm.com/index.php?rid=5169531&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FtpVlZ8rFxyc%2F By Michael F. CannonThe federal government, four states, and a whistleblower have extracted a $154 million settlement from Par Pharmaceuticals for fraudulently inflating the prices it charges Medicaid, according to the Associated Press. With Medicare and Medicaid losing roughly $100 billion each year to fraud and other improper payments, however, the fact that a paltry $154 million settlement is news can only mean that federal and state governments are not even trying to combat fraud in any serious way.   As I explain in this video, that’s because politicians have almost zero incentive to do so — which makes massive amounts of fraud an inherent part of these programs: Under ObamaCare, Medicare and Medicaid fraud will only get worse. $154 Million Medicaid Fraud Settlement a... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5169531 Fri, 26 Aug 2011 14:58:12 +0100 5169531 http://www.medworm.com/index.php?rid=5169553&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fgreat-clinical-care-and-excellent-bedside-manner-are-they-mutually-exclusive%2F2011.08.26 The New York Times recently published an article titled, Finding a Quality Doctor, Dr. Danielle Ofri an internist at NYU, laments how she was unable to perform as well as expected in the areas of patient care as it related to diabetes.  From the August 2010 New England Journal of Medicine article, Dr. Ofri notes that her report card showed the following – 33% of patients with diabetes have glycated hemoglobin levels at goal, 44% have cholesterol levels at goal, and a measly 26% have blood pressure at goal.  She correctly notes that these measurements alone aren’t what makes a doctor a good quality one, but rather the areas of interpersonal skills, compassion, and empathy, which most of us would agree constitute a doctor’s bedside manner, should count as well. Her articl... Better Health blogs http://www.medworm.com/rss/comments.php?id=5169553 Fri, 26 Aug 2011 14:00:00 +0100 5169553 http://www.medworm.com/index.php?rid=5158936&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FzFTVxpvSy4g%2F By Ilya ShapiroMy colleagues and I have covered the substance of the Eleventh Circuit ruling that two weeks ago struck down the individual mandate, but where do we go from here?  Why hasn’t the Supreme Court yet resolved the conflict between that ruling and the Sixth Circuit’s from earlier in the summer?  When will it do so?  A few points: The government is now likely to seek en banc review, meaning that they want the entire 10-judge court to review the 3-judge panel’s ruling.  It’s extremely unlikely that the Eleventh Circuit would grant such a motion because the panel is already 2-1 against and the members of the court not on the panel are a 4-3 Republican-appointed majority.  You need a majority (6 of 10) to get en banc review, which means the dissenting J... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5158936 Thu, 25 Aug 2011 21:50:00 +0100 5158936 http://www.medworm.com/index.php?rid=5159277&cid=t_101667_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fw2QBei4mkwo%2F For years, we’ve heard about how much clinical information is locked away in payer databases. Payers have offered to provide clinical summaries, electronic and otherwise, The problem is, it’s potentially inaccurate clinical information because it’s all based on billing claims. (Don’t believe me? Just ask “E-Patient” Dave de Bronkart.) It is for this reason that I don’t much trust “quality” ratings based on claims data. Just how much of a difference there was between claims data and true clinical data hasn’t been so clear, though. Until today. A paper just published online in the Journal of the American Medical Association found that searching EMRs with natural-language processing identified up to 12 times the number of pneumonia c... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5159277 Thu, 25 Aug 2011 21:47:57 +0100 5159277 http://www.medworm.com/index.php?rid=5158834&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FS5iyuYJIMyY%2Fphysician-guidance-patients-medical-decisions.html As access to medical information has become more common, patients are gaining empowerment in their medical care.And rightly so. Gone are the days where medical decisions are paternalistic in nature, with the physician leading, and the patient following. Today, an ideal medical decision has input from both patient and provider.But, have we gone too far the other way?Read the rest of How much physician guidance do patients want with medical decisions? on KevinMD.com.Category: Pho | Tags: Patients, Primary care, Specialist | 3 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5158834 Thu, 25 Aug 2011 20:00:46 +0100 5158834 http://www.medworm.com/index.php?rid=5158835&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FXBC_0R5oapY%2Fspecialists-join-primary-care-ruc.html The old doctors know.  The practice of medicine has changed in a very basic way over the last 20 years.  Physician relationships have lost their civility and have been replaced by a level of tension that takes the fun out of collegial interactions.  I remember my first year of family medicine as the only doctor in Weeping Water, Nebraska.  My personal medical community had gone from an entire medical school campus with limitless lectures and many physicians to share in “interesting cases” to an occasional phone call with a consultant in Omaha.  These contacts became my primary source for medical education and updates for Weeping Water’s health care.  The phone calls were collegial, respectful, and focused on what was best for my patients.Read the rest of Why specialists should ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5158835 Thu, 25 Aug 2011 19:00:26 +0100 5158835 http://www.medworm.com/index.php?rid=5158836&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2Fn-Ujqs5rBoE%2Fpatients-trust-sociable-humanoid-robots.html Within in five years primary care providers will begin being replaced by sociable humanoid robots, avatars, and computer programs. Within ten years you will no longer hear any complaints about medical students choosing specialty residencies over family practice because the role of the physician will be completely redefined to complement a rules based approach to the diagnosis and treatment of many diseases. This transformation is inevitable because of demographics, economics, and progress in artificial intelligence, but the academic leaders of medical education and health policy are largely ignorant and unprepared for this massive disruption.Read the rest of Will patients trust sociable humanoid robots? on KevinMD.com.Category: Tech | Tags: Health IT, Primary care | 2 comments (Source: K... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5158836 Thu, 25 Aug 2011 18:00:43 +0100 5158836 http://www.medworm.com/index.php?rid=5158837&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F1SA0c9LfsH4%2Fconverting-practice-insurance-accepted-model.html Not long ago, I was working for a pain management firm with 19 clinics scattered throughout three states. I was fast approaching my three year mark as the travel PA and more recently, the compliance officer. Little did I know that my career path was about to go off-road, into a new world of clinic ownership coupled with the unchartered territory of no-insurance accepted.What a difference a few months can make. I was approached by our family physician to take over his practice as he was considering taking a full time job with the VA. He had been deployed to Iraq twice with the Reserves in the last few years and his practice had suffered for it. My initial deer-in-the-headlights reaction gave way to a growing enthusiasm to create an affordable, slower paced practice where I could enjoy medic... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5158837 Thu, 25 Aug 2011 17:00:50 +0100 5158837 http://www.medworm.com/index.php?rid=5158977&cid=t_101667_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FuWUbQhdO2ls%2F Yesterday, Healthcare IT News reported that a study due out later this month found that the addition of social media tools to online health programs seemed to positively influence the effectiveness of the programs. The study, which is being published in the Journal of Medical Internet Research, found that “adding an interactive online community to an Internet-based walking program significantly decreased the number of participants who dropped out.” This is just the latest in eHealth innovations – from mobile health apps to electronic medical records and so, so, so much more – leaving the medical community wondering how eHealth will fare moving forward. How do you feel about health-related social networking? Would you join an online health program? What concerns – privacy, quality... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=5158977 Thu, 25 Aug 2011 13:15:49 +0100 5158977 http://www.medworm.com/index.php?rid=5159351&cid=t_101667_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FdflHJn4aeTM%2Fbundled-payments-for-care-improvement-initiative-announced-by-cms-center-for-innovation.html Many health care provider organizations have not been overly eager to jump onto the Accountable Care Organization (ACO) bandwagon, citing high startup costs and uncertain returns on investment given the complexity of the program.  Well, recently, the CMS Center for Innovation has announced the Bundled Payment for Care Improvement initiative.  This initiative incorporates elements of earlier CMS demonstration projects -- the gainsharing demos and ACE (acute care episode) bundled payments demonstrations which the HealthBlawger has helped a number of clients around the country qualify for in the past -- and builds on the broad authority granted to the CMS Center for Innovation under health reform. The advantages to proceeding with a Bundled Payment for Care Improvement project include the... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5159351 Thu, 25 Aug 2011 11:17:08 +0100 5159351 http://www.medworm.com/index.php?rid=5159350&cid=t_101667_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D337 Medical Home is a reimbursable approach to managing patient care, and CMS has financially supported the approach with steady physican payment increases. First studied as a tool for managing patients with chronic illness, it has transitioned to inpatient care with the intent of lowering costs and reducing readmissions. One survey on the Society of Hospital Medicine’s website indicated that 78% of billed services by hospitalist and primary care physicians fall under codes CPT codes 99221-23, 99231-33, and 99238-9. These evolve around evaluating a patient’s inpatient care and discharge. What’s promising is in the last five years, these have seen increases ranging from 40% to 50%, which is pretty significant since other areas have seen mandated cuts. I asked Dr. Chunliu Zhan, MD, PhD, ... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=5159350 Wed, 24 Aug 2011 22:11:50 +0100 5159350 http://www.medworm.com/index.php?rid=5158921&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F24%2Fmedicares-looming-risk-transfer%2F Editor’s Note: Below, Jaan Sidorov analyzes the risk-shifting inherent in proposals for Medicare reform. Today, Health Affairs Blog is also publishing the first installment of a two-part post by Troyen Brennan and Thomas Lee, which addresses risk-shifting in the health care system as well. Suppose, despite my good health and lifelong habit of avoiding doctors, [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5158921 Wed, 24 Aug 2011 15:53:07 +0100 5158921 http://www.medworm.com/index.php?rid=5158922&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F24%2Frisk-shifting-in-health-care-and-its-implications-part-one%2F Editor’s Note: Below, in the first installment of a two-part Health Affairs Blog post, Troyen Brennan and Thomas Lee discuss the shifting of risk they see taking place in the health care system, from insurers and employers to provider and patients. In part two tomorrow, Brennan and Lee will discuss the implications of this shift [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5158922 Wed, 24 Aug 2011 15:50:18 +0100 5158922 http://www.medworm.com/index.php?rid=5158999&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fare-patients-considering-the-idea-of-medical-tourism-to-receive-health-care%2F2011.08.24 I must confess that I have a weakness for medical tourism. Patients have always been ready to go on a pilgrimage to find the world’s leading expert (we call it ‘key opinon leader’ now) hoping to find a cure. As long as traditional leaders in the field of Medicine have been the Germans, the French and the English -with some occasional Austrian and Spanish name in the mix- traffic of wealthy patients across Europe is nothing new. Since we entered the antibiotics era, these leaders started to be located mainly in the United States, the cradle of modern, technology-driven Medicine. Thus hi-tech centers got ready to welcome foreign patients, building strong International Customer Support departments. A random example -by no means the only one- would be the Mayo Clinic. On their website y... Better Health blogs http://www.medworm.com/rss/comments.php?id=5158999 Wed, 24 Aug 2011 14:00:07 +0100 5158999 http://www.medworm.com/index.php?rid=5159299&cid=t_101667_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FWP26N28MUOk%2F This afternoon CMS announced the Bundled Payments for Care Improvement Initiative (BPCII). For details, start reading here. Here are six quick first impressions: 1. It’s very creative and innovative. CMS has demonstrated out-of-the-box thinking and leaves a lot of room for applicants to propose their own approaches. Expect to have to read the materials 2-3 times to wrap your thinking around it. Unlike the Medicare Shared Savings ACO rule, the BPCII is flexible.  Anticipate some innovative and non-traditional proposals from diverse applicants. Unlike the Medicare ACO Shared Savings rule, the BPCII invites flexibility in: Definition of care bundles Proposal of specific financial terms Participation by diverse care providers (see below) Risk adjustment of beneficiaries (more&#8230... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=5159299 Wed, 24 Aug 2011 00:14:11 +0100 5159299 http://www.medworm.com/index.php?rid=5159102&cid=t_101667_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F08%2Fmanagement-of-accidental-hypothermia.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5159102 Tue, 23 Aug 2011 14:04:00 +0100 5159102 http://www.medworm.com/index.php?rid=5158857&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fhow-to-guide-improving-transitions-from-the-hospital-to-post-acute-care-settings-to-reduce-avoidable-rehospitalizations%2F Scan or click to download 'How-to Guide Improving Transitions from the Hospital to Post-Acute Care Settings to Reduce Avoidable Rehospitalizations' Title: How-to Guide Improving Transitions from the Hospital to Post-Acute Care Settings to Reduce Avoidable Rehospitalizations The Skinny: Guide from Institute for Health Improvement on avoiding avoidable rehospitalisations as a result of poor co-ordination of care settings. Avoiding this is a key step toward achieving broader delivery system transformation. Based on the healthcare system of the USA this guide is of use to those looking at intermediate care/rehabilitation settings. Publisher: Institute for Health Improvement Published: August 2011 Size: 144p. Filed under: Ooops Missed Category! Tagged: Clinical Governance, finance, Gr... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158857 Tue, 23 Aug 2011 08:27:37 +0100 5158857 http://www.medworm.com/index.php?rid=5158859&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fhow-to-guide-improving-transitions-from-the-hospital-to-a-skilled-nursing-facility-to-reduce-avoidable-rehospitalizations%2F Scan or click to download 'How-to Guide: Improving Transitions from the Hospital to a Skilled Nursing Facility to Reduce Avoidable Rehospitalizations ' Title: How-to Guide: Improving Transitions from the Hospital to a Skilled Nursing Facility to Reduce Avoidable Rehospitalizations The Skinny: Guide from Institute for Health Improvement on avoiding avoidable rehospitalisations as a result of poor co-ordination of care settings. Avoiding this is a key step toward achieving broader delivery system transformation. Based on the healthcare system of the USA this guide is of use to those looking to aviod rehospitalisation from a residentia care/nursing home and rehabilitation setting.   Publisher: Institute for Health Improvement Published: August 2011 Size: 60p. Filed under: Ooops... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158859 Tue, 23 Aug 2011 07:35:32 +0100 5158859 http://www.medworm.com/index.php?rid=5159258&cid=t_101667_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F08%2Fhow-can-we-get-patients-to-take-more.html It's extremely easy to criticize doctors for the sad state of health care today. Most patients are very articulate about the fact that their doctor spends very little time with them ; that he makes them wait unnecessarily for long hours ; and that he provides them with precious little information about their illness. This causes a lot of heartburn and frustration ; and many people believe that doctors are now behaving more like businessman rather than professionals. While there may be some truth in this criticism , it is also equally true that doctors are soft and easy targets. In fact , the press has played a major role in bashing doctors , and while it's true that stories about unethical doctors who indulge in corrupt acts help them to sell more newspapers , sadly all these stories also... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=5159258 Tue, 23 Aug 2011 04:38:00 +0100 5159258 http://www.medworm.com/index.php?rid=5159010&cid=t_101667_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FYnCNffSklNA%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5159010 Mon, 22 Aug 2011 15:32:21 +0100 5159010 http://www.medworm.com/index.php?rid=5159301&cid=t_101667_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F6e23a3ZIUP8%2F by Jaan Sidorov MD, MHSA, FACP and Vince Kuraitis JD, MBA Physicians face great uncertainty. According to a survey conducted by The Physicians Foundation, the great majority of physicians (89%) believe the traditional model of independent private practice is either “on shaky ground” or “is a dinosaur soon to go extinct.” In the face of this uncertainty, many physicians are jumping to a conclusion that “I have to sell my practice to the hospital.” In this post of our series on The 100 Year Shift, we will examine physician practice.  We’ll show that the economic and clinical environment  is changing rapidly and that selling to the hospital is one option. However, it is not the only option. (more…) Article Series - The 100 Year Shift? Strategic ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=5159301 Mon, 22 Aug 2011 15:26:12 +0100 5159301 http://www.medworm.com/index.php?rid=5158860&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F22%2Fthe-future-of-cancer-networks-policy-recommendations-as-a-result-of-a-joint-seminar-held-at-the-kings-fund%2F Title: The future of cancer networks: Policy recommendations as a result of a joint seminar held at the Kings Fund Scan or click to download ‘The future of cancer networks: Policy recommendations as a result of a joint seminar held at the Kings Fund’ The Skinny: Report that recommends: Networks need to be strengthened by expanding and diversifying the mix of professionals involved, including primary care, community services, public health and social care Patients need to be involved through the creation of structures that are internal to the network A single clinical network (ie covering multiple clinical areas) is an option to meet the challenges posed by the current financial climate as it can generate efficiencies from sharing services and learning, and consistency ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158860 Mon, 22 Aug 2011 14:52:02 +0100 5158860 http://www.medworm.com/index.php?rid=5159206&cid=t_101667_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F08%2F21%2Fthe-other-side-of-the-placebo-effect%2F This is the second in a pair of articles on the placebo effect. Nocebo is sometimes referred to as “placebo’s evil twin,” or the “negative placebo effect.”  It’s also sometimes described as “the other side of placebo.”   The nocebo effect can be defined as a negative effect that occurs after receiving treatment (therapy, medication), even when the treatment is inert (inactive, sham). It is important to note that negative effects seen when taking active substances, reported as drug side effects, can often be at least partly attributed to a a combination of effects from the substance’s constituents (specifics), and those from nocebo effects (non-specifics). Studies suggest that nocebo effects can contribute appreciably to a variety of medic... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=5159206 Sun, 21 Aug 2011 12:47:27 +0100 5159206 http://www.medworm.com/index.php?rid=5158958&cid=t_101667_87_f&fid=36941&url=http%3A%2F%2Fwww.mazecordblood.com%2Fblog%2F%3Fp%3D463 For years, we’ve been told that a woman may experience dental problems during pregnancy.  But popular wisdom has held that any extensive dental care to resolve a problem during pregnancy should be put on hold till after the baby is born to avoid any unanticipated issues with the treatment. Now a study reports that it is imperative to resolve dental problems when they happen and not to wait till post-delivery.  Apparently, the bacteria that may form as a result of dental problems can be transmitted to newborns in a number of ways common to mothering (you know, kissing your baby, feeding your baby, etc).  Infants are not born with bacteria in their mouths and the transmission of such can create “rampant tooth decay” in the child as he or she grows. So don’t avoid t... Cord Blood News blogs http://www.medworm.com/rss/comments.php?id=5158958 Sat, 20 Aug 2011 16:09:24 +0100 5158958 http://www.medworm.com/index.php?rid=5139588&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FD316k-meqTw%2Fcutting-medicaid-cost-long-run.html I usually write about healthcare reform from a pediatrician’s viewpoint, but what grabbed my attention recently was a story my husband, Randy, told me about an adult in his practice – a patient on Medicaid.Randy is a neurologist in a private practice, and Medicaid patients come from every corner of Rhode Island to see him. They make this cumbersome pilgrimage because he is a member of a dying breed: Randy still accepts Medicaid. He does this for $27.  That is not a copay; that is the total per patient reimbursement he gets from the state. It is clearly not a good deal for Randy, who will start losing money about 10 minutes into the visit.  And it is often not a good deal for his patients, who may have to travel a very circuitous route to receive simple, appropriate care. But it is al... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5139588 Fri, 19 Aug 2011 11:00:58 +0100 5139588 http://www.medworm.com/index.php?rid=5139647&cid=t_101667_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F08%2Fbest-and-brightest-behaving-badly.html To err is human, and any group of humans can be expected to include those who stray.  However, the constant spin that surrounds most top leaders of health care organizations seems to suggest that these people are different.  In particular, the lavish compensation given leaders of health care organizations is often justified by claims that those in leadership positions are the best and the brightest.  Catching up after a vacation afforded me the opportunity to go through a large volume of news stories, leading to a collection of those from the last year that showed the contrast between such compensation and behavior that was far from the "best and the brightest. "North Memorial Health Care CEO Pleads Guilty to Engaging in ProstitutionAs reported by the Minneapo... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=5139647 Thu, 18 Aug 2011 21:02:00 +0100 5139647 http://www.medworm.com/index.php?rid=5139591&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FCq0ENCN9sGM%2Fwives-mens-health-suffers.html I was working as a PA in an internal medicine office seeing patients.  One afternoon, I was in the clinic hallway when I saw an elderly looking wife in her 60s actually pushing her husband into the next exam room.  He had his heels dug into the floor, but she was winning, due to his obvious shortness of breath and audible wheezing.I walked in behind the medical assistant who took his vitals, as I listened to his lungs.  I asked the assistant to get the nebulizer and bring it back into the room for the patient to use.Read the rest of Without wives, men’s health suffers on KevinMD.com.Category: Patient | Tags: Patients, Primary care | 1 comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5139591 Thu, 18 Aug 2011 17:00:26 +0100 5139591 http://www.medworm.com/index.php?rid=5139593&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FkCOLS6ZSHE0%2Fsocial-media-changed-medical-practice.html Last summer, I joined millions of others in the deluge of social media. I committed one year of effort to see if social would enhance or distract from my pediatric practice.That was my goal, just one year.At that time, I wanted to dip my foot in the pool, and see if it made any ripples. The unexpected consequence was how much social media has changed my medical practice, and me. Ripples have returned as tidal waves.My practice has seen tangible, real valuable benefits. I have been intellectually challenged, and have professionally grown.Read the rest of How social media has changed my medical practice on KevinMD.com.Category: Social media | Tags: Facebook, Primary care, Twitter | 4 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5139593 Thu, 18 Aug 2011 15:00:55 +0100 5139593 http://www.medworm.com/index.php?rid=5139672&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F18%2Fimplementing-health-reform-informing-consumers%2F One of the most important innovations of the Affordable Care Act (ACA) is that it dramatically increases and improves the information that consumers have available about health insurance and health care.  HHS has already implemented provisions of the ACA requiring insurers to disclose information regarding their medical loss ratios and to publicly justify unreasonable rate [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139672 Thu, 18 Aug 2011 14:49:06 +0100 5139672 http://www.medworm.com/index.php?rid=5139606&cid=t_101667_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FkXBEdmSDhWU%2F As individuals and small groups, physicians have proved to be an independent lot — “herding cats” a common metaphor for getting the profession to toe the line, even on matters beneficial to them. Once they have been herded under one roof, however, the job of controlling and coercing them becomes far easier. Ever hear the term “ACO”? No? Better get familiar with it, because this is your future. Accountable Care Organizations are the government’s new carrot & stick to control costs and micromanage the health care profession and industry. Those of you who’ve been around a while may remember HMOs — the insurance industry’s innovation in the late 80′s to get control of spiraling health care costs. Using a mechanism called capitati... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=5139606 Thu, 18 Aug 2011 13:24:05 +0100 5139606 http://www.medworm.com/index.php?rid=5139689&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FsxIfq6yuuwg%2F By Ilya ShapiroI’m glad Trevor Burrus took the laboring oar in pointing out highlights from an Eleventh Circuit opinion that, as he put it, “is not only exhaustive, it is convincing.”  I’ve been swamped with editing the Cato Supreme Court Review and preparing for our Constitution Day conference, so have had little time to put words on paper (or even on screen) after my initial statement. I did put together one op-ed, however, that ran today in Politico.  Here’s an excerpt: By [striking down the individual mandate], the court — including, for the first time, a judge appointed by a Democratic president — reaffirmed that the Constitution places principled limits on federal power. It rejected the government’s argument for a situational limit on Congress�... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5139689 Thu, 18 Aug 2011 12:42:10 +0100 5139689 http://www.medworm.com/index.php?rid=5139827&cid=t_101667_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F08%2Fearly-goal-directed-therapy-in-er-is.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5139827 Thu, 18 Aug 2011 11:29:00 +0100 5139827 http://www.medworm.com/index.php?rid=5139595&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FcBOyWL7JxV0%2Fmedical-school-rotation-free-clinic-uninsured.html My patient had onychomycosis – toenail fungus.  Not a devastating disease.  The treatment for this fungus is a 12-week course of terbinafine.  About $50 for a month’s supply … $150 for 3 months.  Terbinafine’s potential side effects include liver toxicity.During my primary care clerkship at the Bronx VA Hospital, I treated several patients who had onychomycosis and had undergone the antifungal treatment.  One patient declined treatment with terbinafine because of the possible risk to his liver.My patients at the VA Hospital had a choice.  They were able to choose treatment or no treatment for this relatively benign condition.Read the rest of Medical school rotation at a free clinic for the uninsured on KevinMD.com.Category: Education | Tags: Medical school, Primary care |... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5139595 Thu, 18 Aug 2011 11:00:40 +0100 5139595 http://www.medworm.com/index.php?rid=5139745&cid=t_101667_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F5sSY0OCxWR8%2F The Unites States appears to be falling behind other nations when it comes to providing affordable health care for its population (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5139745 Thu, 18 Aug 2011 03:32:28 +0100 5139745 http://www.medworm.com/index.php?rid=5139596&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FIfhLC8Mj508%2Fdoctors-understand-business-side-medicine.html What do you regret about your medical training or specialty selection?Anything?One thing I regret is not taking advantage of the Masters degree in Health Administration program at my medical school. At the time, I was focused solely on medicine and on being a doctor. I didn’t think the business side of medicine was all that important. In fact, I didn’t consider the business side of medicine at all.I regret that.Read the rest of How can doctors understand the business side of medicine? on KevinMD.com.Category: Physician | Tags: Primary care, Specialist | 9 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5139596 Wed, 17 Aug 2011 19:00:29 +0100 5139596 http://www.medworm.com/index.php?rid=5139673&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F17%2Fnarrative-matters-eleanor-clift-on-her-husbands-death-and-end-of-life-issues%2F In the newest Health Affairs Narrative Matters essay, prominent journalist Eleanor Clift writes about her husband Tom Brazaitis and his death from metastatic cancer at age 64. Clift describes the multiple ways in which she and her husband benefited from hospice care, in which Brazaitis spent the last four months of his life. Clift uses [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139673 Wed, 17 Aug 2011 18:19:54 +0100 5139673 http://www.medworm.com/index.php?rid=5139627&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F17%2Flocal-square-table-learning-and-evaluation-report%2F Title: Local square table learning and evaluation report Scan or click to download 'Local square table learning and evaluation report' The Skinny: Reports on the findings of open and honest discussion and increased understanding between those who provide children’s palliative care, those who experience it and those that play a wider part in supporting children, young people and families in a particular community. Finds that: Awareness and language is seen as a barrier to service access Parents say they struggle with the current assessment process Partnership working is seen as key to ensuring the best outcomes for lifelimited and life-threatened children and young people Workforce training and development is considered a priority by parents and professionals Parents f... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5139627 Wed, 17 Aug 2011 15:43:14 +0100 5139627 http://www.medworm.com/index.php?rid=5139831&cid=t_101667_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F08%2Fmanagement-of-cardiac-arrest-in.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5139831 Wed, 17 Aug 2011 14:57:00 +0100 5139831 http://www.medworm.com/index.php?rid=5139832&cid=t_101667_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F08%2Fpoint-of-care-echo-to-evaluate-for.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5139832 Wed, 17 Aug 2011 14:55:00 +0100 5139832 http://www.medworm.com/index.php?rid=5139630&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F17%2Fpct-estate-future-ownership-and-management-of-estate-in-the-ownership-of-primary-care-trusts-in-england-2%2F Title:PCT Estate: future ownership and management of estate in the ownership of Primary Care Trusts in England Scan or click to download 'PCT Estate: future ownership and management of estate in the ownership of Primary Care Trusts in England' The Skinny: Updates and supersedes the FAQs relating to the future ownership and management of PCT-owned estate by aspirant Community Foundation Trusts (CFTs), published on 16 February 2011. Publisher: DH Published: 04/08/11 Size: 27p. Filed under: Ooops Missed Category! Tagged: Cost control, Estate management, Facilities management, Financial Management, Grey Literature, Land, NHS Foundation Trusts, NHS Trusts, Organisational Change, Primary care organisations, Property management, Reorganisation, Structural change (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=5139630 Wed, 17 Aug 2011 14:49:28 +0100 5139630 http://www.medworm.com/index.php?rid=5139639&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F17%2Fnational-cancer-patients%25e2%2580%2599-experience-survey-programme-2011%2F Title: National Cancer Patients’ Experience Survey programme 2011 Scan or click to download ‘National Cancer Patients’ Experience Survey programme 2011 ‘ The Skinny: Dear Colleague letter that announces the launch of the 2011 Cancer Patient Experience Survey, and informs that the Review of Central Returns steering committee has approved this survey in all trusts offering adult acute in-patient cancer services. This is a priority in Improving Outcomes: A Strategy for Cancer, and the NHS Operating Framework 2011/12 recognises the value of patient surveys for measuring performance and driving improvement in NHS services. Publisher: DH Published: 21/07/11 Size: 3p. Additional Document:  Annex A National Cancer Patients’ experience survey programme 2011 – survey ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5139639 Wed, 17 Aug 2011 07:26:40 +0100 5139639 http://www.medworm.com/index.php?rid=5139679&cid=t_101667_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FrLMzI7Yssdo%2F Just as you might look at the label on the side of a cereal box to check its sugar content, starting next year you’ll be able to look at a summary of insurance-plan information to learn about the deductible or out-of-pocket spending limit — before you buy the policy. As the WSJ reports, the proposed summary form, which was part of the health-care overhaul law, could be unveiled as soon as tomorrow. It will be open to public comment before it’s finalized. (Update: here’s the proposed template.) And admittedly, the form isn’t going to be as compact as that nutrition label. The  summary will get into the nitty gritty of plan details, including deductibles for specific categories and an explanation of what a consumer would end up spending on three common medical ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5139679 Tue, 16 Aug 2011 21:06:23 +0100 5139679 http://www.medworm.com/index.php?rid=5139696&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FySYnjbBACN4%2F By Trevor BurrusOn Friday, when the 11th Circuit struck down the individual mandate portion of ObamaCare, a trip to the Supreme Court became all but assured. Previously, although Supreme Court review was highly probable even if a circuit split didn’t develop, there was still an outside chance that the Court would deny review if all circuit courts upheld the law. Now, the Court is essentially obliged to take the case. This is reason enough to be happy about the decision. As I work my way through the opinion, I become even happier. The opinion is not only exhaustive, it is convincing. If Congress oversteps the outer limits of its power, the court explains, then “the Constitution requires judicial engagement, not judicial abdication.” Thus, we are given over 200 pages of “judicial en... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5139696 Tue, 16 Aug 2011 20:00:57 +0100 5139696 http://www.medworm.com/index.php?rid=5139938&cid=t_101667_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FYKYYdrcHm4s%2F I recently came across this really interesting Wall Street Journal blog post. In it a recent college graduate gives a nice rendition of the challenge of changing from student to employee. Turns out, this newly minted graduate has found work at the popular healthcare IT software company: Epic. Of course, the fact that Epic is hiring a recent college graduate should come as no surprise to anyone in the EMR and healthcare IT field. Epic has long been a haven for new graduates since their hiring practices seem to favor training new blood as opposed to hiring experienced EMR practitioners. However, reading the above post made me think back to when I first got hired for a job working with an electronic medical record. This part of the blog post really hit home (emphasis mine): Starting Aug 1, I ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5139938 Tue, 16 Aug 2011 16:12:04 +0100 5139938 http://www.medworm.com/index.php?rid=5140332&cid=t_101667_158_f&fid=38949&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAgingWithGraceCareconnection%2F%7E3%2FkHsZjP0QEn4%2Fsenior-boom-creates-demand-for-home.html At her home health care agency here, Venus Ray quizzes 65 job applicants assembled before her: Can they cook? Do they know the right way to wash their hands? Can they safely transfer patients into wheelchairs? If they give wrong answers, speak English poorly or — God forbid — forget to turn off their cell phones, she asks them to leave. Francess Sillah helps to transfer Tanya Pittman out of an imaginary wheel chair while role playing during a group interview at Health Management Inc. Venus Ray, the agency's executive director, looks on and assesses their skills to be a home health aide. (Photo by Jessica Marcy) By the end of the session, Ray has dismissed 42 of the applicants, almost two-thirds, even though she's in dire need of employees. Ray is executive director of Health Managem... Aging with Grace CareConnection blogs http://www.medworm.com/rss/comments.php?id=5140332 Tue, 16 Aug 2011 15:08:00 +0100 5140332 http://www.medworm.com/index.php?rid=5130851&cid=t_101667_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FVRZhTjLQxpc%2Fmasimo-reintroduces-pronto-7-finger-sensor-after-recall.html We reported on the introduction of Masimo‘s Pronto 7 back in June 2010. To review, this handheld, noninvasive device provides a spot-check of hemoglobin (SpHb), SpO2, pulse rate, and perfusion index.  Since then, Masimo voluntarily recalled the sensors associated with this device due to problems with reliability of data at low ambient temperatures.  The company has subsequently redesigned the sensors and re-validated the data with thousands of patients. With the new sensors validated, Masimo has initiated international availability of Pronto-7 in Europe, Middle East, Africa, South America, and Asia (except for countries requiring clearance, such as Japan). As far as the U.S. is concerned, FDA 510(k) clearance is pending at this time. Masimo Founder and CEO, Joe Kiani, stated: &#822... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5130851 Mon, 15 Aug 2011 15:29:56 +0100 5130851 http://www.medworm.com/index.php?rid=5130647&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Fthe-functions-of-gp-commissioning-consortia-a-working-document%2F Scan to download 'The functions of GP commissioning consortia: a working document' Title: The functions of GP commissioning consortia: a working document The Skinny: Document that describes the proposed statutory functions of GP consortia to support GPs in establishing consortia (as a summary of the content of the Health and Social Care Bill 2011and providing illustrative examples), it identifies: the proposed key statutory duties of consortia (the ‘must dos’) the proposed key statutory powers (the things consortia have the freedom to do, if they wish, to help meet these duties) illustrative examples of what this could look like in the future Filed under: Ooops Missed Category! Tagged: Audit, Clinical Audit, Commissioning, Grey Literature, Health care, Health servic... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130647 Mon, 15 Aug 2011 15:16:35 +0100 5130647 http://www.medworm.com/index.php?rid=5130654&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Fthe-queen%25e2%2580%2599s-ambulance-service-medal-qam%2F Scan or Click to Download 'The Queen’s Ambulance Service Medal (QAM)' Title: The Queen’s Ambulance Service Medal (QAM) The Skinny: Details the issue of a Queen’s Ambulance Service Medal (QAM) to recognise distinguished service by the ambulance service. The Command Paper [Cm 8140] was laid before Parliament on 11 July 2011 instituting the QAM. A copy of the Command Paper is available with further information on the criteria for eligibility, along with details on how to nominate individuals for the Medal. Publisher: DH Published: 11/07/11 Size: 5p. Additional Documents: The Queen’s Ambulance Service Medal (QAM) Guidance Filed under: Ooops Missed Category! Tagged: Ambulance care assistants, Ambulance Services, Ambulance staff, Ambulance technicians, Awards, Control assistant... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130654 Mon, 15 Aug 2011 14:21:38 +0100 5130654 http://www.medworm.com/index.php?rid=5130661&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Fevaluation-of-learning-resources-for-end-of-life-care-in-extra-care-settings-executive-summary%2F Title: Evaluation of learning resources for end of life care in Extra Care Settings: Executive Summary Scan or click to download 'Evaluation of learning resources for end of life care in Extra Care Settings: Executive Summary' The Skinny: Summarises experiences from the use of learning resources developed to support end of life care in an “extra care” setting. Publisher: The University of York, Centre for Housing Policy Published: 13/07/11 Size: 6p. Filed under: Ooops Missed Category! Tagged: Behavioural sciences, Education, End of Life Care, Grey Literature, Medical Treatment, Palliative Care, Terminal illness, Training (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130661 Mon, 15 Aug 2011 13:43:26 +0100 5130661 http://www.medworm.com/index.php?rid=5130748&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-pros-and-cons-of-ipab-and-why-it-shouldnt-be-repealed%2F2011.08.15 In recent weeks, several Democrats and some health reform advocates including the AMA have joined Republicans in calling for a repeal of provisions in the new health law that create the Independent Payment Advisory Board (IPAB). For these people, IPAB represents the worst aspects of the new law–an unelected, centralized planning authority empowered by government to make decisions about the peoples’ health care. Arbitrary cuts to providers, short-sighted decisions that stifle innovation and rationing of care are sure to follow, they claim. While it’s true that the rules governing IPAB are flawed and should be fixed, eliminating IPAB altogether would be a mistake. (more…) *This blog post was originally published at Pizaazz* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5130748 Mon, 15 Aug 2011 12:00:44 +0100 5130748 http://www.medworm.com/index.php?rid=5130664&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Fnhs-reforms-in-england-managing-the-transition%2F Scan to download 'NHS reforms in England managing the transition' Title: NHS reforms in England: managing the transition The Skinny: Nuffield Trust report that assesses the 2011/12 Operating Framework for the NHS together with guidance on the operation of Payment by Results (PbR) in 2011/12. Establishes the key challenges associated with managing the transition to a reformed NHS, as envisaged in the White Paper: Equity and Excellence: Liberating the NHS, and proposes ways in which the risks associated with transition might be mitigated. It suggests there is a need for clear guidance on the governance and structural arrangements for emerging GP consortia, to ensure adequate local and national accountability for quality, financial control and value for money. The report also identi... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130664 Mon, 15 Aug 2011 08:16:29 +0100 5130664 http://www.medworm.com/index.php?rid=5130665&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Fperinatal-mental-health-of-black-and-minority-ethnic-women-a-review-of-current-provision-in-england-scotland-and-wales%2F This report aims to: map current/ proposed perinatal mental health provision for BME women identify gaps in provision identify and share good practice. Publisher: DH Size: 63p. Published: 08/02/11 Filed under: Ooops Missed Category! Tagged: African people, Asian people, Black people, Depression, Ethnic Groups, Ethnic minorities, Grey Literature, Maternity care, Mixed race people, Postnatal Care, Postnatal depression, West Indian people (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130665 Mon, 15 Aug 2011 08:12:56 +0100 5130665 http://www.medworm.com/index.php?rid=5130666&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Ftransforming-community-services-transformational-guides%2F Scan or click to download 'Transforming Community Services: Ambition, Action, Achievement Transforming Rehabilitation Services' Title: Transforming Community Services: Ambition, Action, Achievement Transforming Rehabilitation Services The Skinny: Guide for use by frontline clinicians, commissioners and providers a based around a framework of ambition, action and achievement: Clearly setting out your ambition Taking action to deliver the ambition using the best available evidence (high impact changes) Demonstrating and measuring achievement (using quality indicators) The guidance also includes six transformational attributes which practitioners and teams need to demonstrate in order to meet the requirements of the high performing practitioner-partner-leader roles. Publisher: DH ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130666 Mon, 15 Aug 2011 08:09:01 +0100 5130666 http://www.medworm.com/index.php?rid=5130757&cid=t_101667_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fkeul9R00j44%2F The LITFL weekly review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5130757 Mon, 15 Aug 2011 02:56:21 +0100 5130757 http://www.medworm.com/index.php?rid=5182056&cid=t_101667_118_f&fid=34852&url=http%3A%2F%2Fwww.joepaduda.com%2Farchives%2F002147.html As the economy started to recover and health reform measures began to be implemented in Q1 2011, health plans benefited with increased enrollment. According to industry analysts Mark Farrah Associates, "The Commercial sector saw a net gain of 1.6 million... (Source: Managed Care Matters) Managed Care Matters blogs http://www.medworm.com/rss/comments.php?id=5182056 Sun, 14 Aug 2011 23:00:00 +0100 5182056 http://www.medworm.com/index.php?rid=5130872&cid=t_101667_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FX8JuuH6We8U%2Fpartners-health-care-acquiring-neighborhood-health-plan-the-800-pound-gorilla-and-the-fig-leaf.html Partners Health Care (the dominant provider network in Greater Boston) and Neighborhood Health Plan (a local mostly-Medicaid HMO) just announced that the former intends to acquire the latter, and maintain it as a separate operating entity.  No money will change hands between the parties, but an unspecified amount of money will be given by Partners as grants to community health centers where NHP members receive much of their health care services. Gary Gottlieb, CEO of Partners, graciously allowed that it would not seek to interfere with the current referral patterns of NHP members to the two local safety-net hospitals (which get disproportionate share hospital payments; Partners hospitals do not). The deal is contingent on several layers of regulatory review, including review by the Commo... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5130872 Sun, 14 Aug 2011 20:35:15 +0100 5130872 http://www.medworm.com/index.php?rid=5130642&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F9W5BEeQDrMI%2Falzheimers-inevitably-leads-loss-financial-capacity.html “Mom’s been writing goofy checks…” “Dad stopped paying his bills….” “Grandma wired her savings to Nigeria…”Have you heard these phrases from the family caregivers of your elderly patients?  Have you ever been concerned that your patient may lack capacity for financial decision making?  How do you decide if they lack capacity?  What is the clinician’s role in making these decisions?  What is their responsibility?Read the rest of Alzheimer’s inevitably leads to loss of financial capacity on KevinMD.com.Category: Conditions | Tags: Patients, Primary care | No comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5130642 Sun, 14 Aug 2011 13:00:06 +0100 5130642 http://www.medworm.com/index.php?rid=5125711&cid=t_101667_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FofPXtZsx9AQ%2F Two U.S. appeals courts are now at loggerheads over the constitutionality of the health-care overhaul law. As the WSJ reports, the U.S. Court of Appeals for the 11th Circuit in Atlanta ruled 2-1 that the individual mandate to purchase health insurance (or, of course, face a penalty), violates the Constitution. The court did say the law could go forward without the mandate, however — the whole thing doesn’t have to be thrown out if that provision goes. Here’s the decision. The court’s ruling butts up against a June decision by the U.S. Court of Appeals for the Sixth Circuit in Cincinnati, which upheld the law 2-1. And that conflict, as our colleagues at the WSJ’s Law Blog note, underlines the notion (in black Sharpie pen) that this matter will eventually be set... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5125711 Fri, 12 Aug 2011 20:11:03 +0100 5125711 http://www.medworm.com/index.php?rid=5125713&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FFA7J41kQ6F0%2F By Michael F. CannonHere’s the meat of the majority opinion: We first conclude that the Act’s Medicaid expansion is constitutional. Existing Supreme Court precedent does not establish that Congress’s inducements are unconstitutionally coercive, especially when the federal government will bear nearly all the costs of the program’s amplified enrollments. Next, the individual mandate was enacted as a regulatory penalty, not a revenue-raising tax, and cannot be sustained as an exercise of Congress’s power under the Taxing and Spending Clause. The mandate is denominated as a penalty in the Act itself, and the legislative history and relevant case law confirm this reading of its function. Further, the individual mandate exceeds Congress’s enumerated commerce power and is ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5125713 Fri, 12 Aug 2011 19:02:34 +0100 5125713 http://www.medworm.com/index.php?rid=5125683&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FImwRIkS6-ug%2Fearly-closure-doctors-misdiagnose.html I had a patient once—a fellow physician—who came to see me complaining of mid-back pain.  When I examined him, I found I could reproduce his pain by pressing firmly on the spot he said was hurting him.  He said pressing there also made the pain radiate around to his stomach, a phenomenon known as “referred pain” that meant his pain was almost certainly caused by a trigger point.  I offered to inject it with a mixture of lidocaine and cortisone, a procedure that’s been shown in the medical literature to be helpful, but he declined, preferring instead to use over-the-counter pain relievers.Read the rest of How early closure can cause doctors to misdiagnose on KevinMD.com.Category: Physician | Tags: Malpractice, Patients, Primary care | 2 comments (Source: Kevin, M.D. - Medical W... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5125683 Fri, 12 Aug 2011 19:00:41 +0100 5125683 http://www.medworm.com/index.php?rid=5125714&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FbgTalQD13HY%2F By Ilya ShapiroToday is a great day for liberty.  By striking down the individual mandate, the Eleventh Circuit has reaffirmed that the Constitution places limits on the federal government’s power.  Congress can do a great many things under modern constitutional jurisprudence, but, as the court concludes, “what Congress cannot do under the Commerce Clause is mandate that individuals enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die.”  Indeed, just because Congress can regulate the health insurance industry does not mean it can also require people to buy that industry’s products. One of the striking things about today’s ruling is that, for the first time in one of these cases, a Dem... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5125714 Fri, 12 Aug 2011 18:56:04 +0100 5125714 http://www.medworm.com/index.php?rid=5125684&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FPvtE1Xqxp6Q%2Fdoctors-stop-wearing-ties.html I stopped wearing a tie to work at the start of 2004. It was summer and I was hot.Its much more comfortable working without a tie, particularly in my job. Its easier to examine patients, its easier when I need to perform a medical procedure. I’m sure you can see how a dangling tie would get in the way.I’ve also lost quite a few ties, sadly enough, to spillage, followed by dry cleaning. Dry cleaning and silk ties don’t mix well. The tie comes out worse for wear and never again, does it look quite right.Read the rest of Why doctors should stop wearing ties on KevinMD.com.Category: Physician | Tags: Primary care, Specialist | 16 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5125684 Fri, 12 Aug 2011 18:00:35 +0100 5125684 http://www.medworm.com/index.php?rid=5125740&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysician-compares-ablation-techniques-for-barretts-esophagus%2F2011.08.12 The first cases of Barrett esophagus (BE) ablation in the late 1980s used YAG and Argon laser. Since then, a myriad of ablation techniques have been described, including multipolar electrocautery (MPEC), argon plasma coagulation (APC), cryotherapy, radiofrequency ablation (RFA), and endoscopic mucosal resection (EMR). Each technique has had its advocates, and some of the techniques appear to have certain advantages in certain types of BE: e.g., long segment, nodular, etc. Most cases of BE are short segment, and most neoplastic cases do not have nodules or erosions. So the question I would like to see discussed is: In a patient with 1–2 cm of otherwise featureless flat but neoplastic BE: What ablation technique would you use, and what do you feel makes this technique advantageous? (more&#... Better Health blogs http://www.medworm.com/rss/comments.php?id=5125740 Fri, 12 Aug 2011 18:00:10 +0100 5125740 http://www.medworm.com/index.php?rid=5125824&cid=t_101667_113_f&fid=34625&url=http%3A%2F%2Ftraffic.libsyn.com%2Fnversel%2FVi_Shaffer_AMDIS_2011.mp3 Back in June, I covered the Wisconsin Technology Network’s Digital Healthcare Conference in Madison. That conference featured a panel with Vi Shaffer, research vice president and industry services director for healthcare providers at Gartner, Judy Murphy, vice president of information services at Aurora Health Care in Milwaukee, and Epic Systems CEO Judy Faulkner, based in nearby Verona, Wis. The panel discussed the question, “Is meaningful use a floor or a ceiling?” as I reported for WTN News. The conference also featured several sessions on how business intelligence and health information exchange can support Accountable Care Organizations. A month later, I saw Shaffer again at AMDIS Physician-Computer Connection meeting in Ojai, Calif. There, she presented preliminary ... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=5125824 Fri, 12 Aug 2011 17:24:05 +0100 5125824 http://www.medworm.com/index.php?rid=5125685&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FUCt0JNYtQOU%2F6-reasons-doctors-call-patients.html Patients want to know why they can’t get a return call from their doctor’s office – here are six reasons why the calls have increased and physician offices are having trouble meeting the needs of their patients.Read the rest of 6 reasons why doctors won’t call patients back on KevinMD.com.Category: Physician | Tags: Primary care, Specialist | 1 comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5125685 Fri, 12 Aug 2011 17:00:44 +0100 5125685 http://www.medworm.com/index.php?rid=5125823&cid=t_101667_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FHryk4-WPp3g%2Fworldheart-corporation-ends-its-levacor-ventricular-assist-device-program-to-focus-on-next-generation-miflow-vads.html World Heart Corporation (WorldHeart) announced on July 29th, 2011 that it shall no longer pursue commercialization of their Levacor Ventricular Assist Device (VAD) technology and will focus on a smaller, new-generation MiFlow VAD.  WorldHeart’s investor page notes that with continued delay of their Bridge-To-Transplant Study and associated device refinements they no longer see Levacor as a commercially competitive product.  The Levacor VAD, a centrifugal pump that is completely magnetically levitated unlike other assist devices with mechanical or blood-lubricated bearings, is designed for adults with late-stage heart failure as a bridge to transplant. The company plans to focus on next generation technology such as the MiFlow VAD, a device designed to provide cardiac output flow up to ... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5125823 Fri, 12 Aug 2011 15:43:40 +0100 5125823 http://www.medworm.com/index.php?rid=5125687&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FsT9pAserm8Q%2Fcomplete-physical-examination.html A reader writes, “Can you do a post on what procedures constitute a thorough physical, in your opinion? I haven’t had one in several years and thinking of making an appointment now. The last doctor I went to didn’t even listen to my heart or go though the motions with feeling my belly and that stuff. And of the last 3 doctors I went to, I realized they didn’t bring up my immunization records. Is this usually left for the patients to bring up on their own?”Good question. What exactly is a physical? Does it include blood work? What about an EKG? Cardiac stress test? Is the “Executive Physical”, an orgy of “more is better” previously paid lavishly, really better than a “camp physical”?Read the rest of There is no such thing as a complete physical examination on K... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5125687 Fri, 12 Aug 2011 15:00:20 +0100 5125687 http://www.medworm.com/index.php?rid=5125693&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F12%2Fnursing-times-2011-vol-107-no-28%2F This article discusses the importance of hydration and the health implications of dehydration and over-hydration. Contact the Library for a copy of this article Filed under: Journals Tagged: Dehydration, Fluid Balance Care, Input, Output, Over-Hydration (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=5125693 Fri, 12 Aug 2011 14:59:18 +0100 5125693 http://www.medworm.com/index.php?rid=5125742&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fincreased-number-of-antidepressants-prescribed-to-patients-without-a-psychiatric-diagnosis%2F2011.08.12 Prescriptions for antidepressants given by nonpsychiatrists to patients without a specific psychiatric disorder increased more than 12% in 12 years, leading to the drug class becoming the third most commonly prescribed, a study found. A study in the August issue of Health Affairs reported that antidepressant prescriptions by doctors who didn’t record a specific psychiatric disorder increased from 59.5% of all prescriptions by nonpsychiatrists in 1996 to 72.7% in 2007. Researchers reviewed data on patients age eighteen or older from the 1996-2007 Centers for Disease Control and Prevention’s National Ambulatory Medical Care Surveys, a national sample of more than 233,000 office-based visits. The proportion of antidepressants prescribed for patients without a psychiatric diagnosis... Better Health blogs http://www.medworm.com/rss/comments.php?id=5125742 Fri, 12 Aug 2011 14:00:00 +0100 5125742 http://www.medworm.com/index.php?rid=5118556&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2Fu5VfMqHhvh4%2Fdoctor-learned-patient.html Doctor D has been blogging about the  doctor-patient relationship for a while now. It’s sort of the thing I’m known for. I’ve usually been on the doctor side of this equation. Most of my blogging, however, is to help patients figure out the weird world of medicine.Doctor D recently found himself on the patient side of a nasty injury.Even as Doctor D looked down and realized his leg wasn’t supposed to be that shape he said to himself, “Self, take mental notes! The readers of Doctor D’s Clinic of Doctor-Patient Relational Awesomeness will want to know about this.”Read the rest of What this doctor learned when he was a patient on KevinMD.com.Category: Physician | Tags: Patients, Primary care | No comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5118556 Thu, 11 Aug 2011 20:00:30 +0100 5118556 http://www.medworm.com/index.php?rid=5118590&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F11%2Fhealth-spending-projection-spin-cycle-rinse-and-repeat-or-reset%2F One of the annual rituals of Washington’s health policy calendar involves the release of projections for the next ten years of national health spending by actuaries at the Centers for Medicare and Medicaid Services (CMS). It then is followed immediately by desperate efforts by various interest groups and advocacy “analysts” to spin the new numbers [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5118590 Thu, 11 Aug 2011 16:41:21 +0100 5118590 http://www.medworm.com/index.php?rid=5118642&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpediatric-physician-joins-collaborative-network-and-sees-improvement-in-his-work%2F2011.08.11 I never thought I’d change the way I practice medicine.  But I recently enrolled as a provider in the Improved Care Now (ICN) collaborative network and I’m already working differently. ICN is an alliance of gastroenterologists and patients working in a new model of pediatric inflammatory bowel disease care based on the analysis of thousands of doctor–patient visits as well as the latest studies and treatments.  Doctors and patients apply this information, experiences are tracked in an open registry, the results are then shared and refined to improve care.  I can see what I’m doing well and where I’m falling short relative to other clinics and pediatric gastroenterologists. ICN is under the direction of Dr. Richard Colletti of the University of Vermont.  ICN is supported by t... Better Health blogs http://www.medworm.com/rss/comments.php?id=5118642 Thu, 11 Aug 2011 16:00:26 +0100 5118642 http://www.medworm.com/index.php?rid=5118563&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FibB2_688t1c%2Ffever-children-5-facts.html A recent issue of Pediatrics includes a new report detailing the need for doctors to improve patient teaching about fever and fever-reducing drugs.Many parents fear their child getting a fever, or have “fever phobia.” I certainly can understand why. Kids can do crazy things when they get fevers. They don’t sleep well, eat poorly, and behave strangely. Some children can even have seizures due to a quick spike in body temperature. So it isn’t surprising that beginning as early as the pre-natal consultation, parents ask questions about what to do when their child gets a fever.Read the rest of Fever in children: 5 facts you must know on KevinMD.com.Category: Conditions | Tags: Patients, Primary care | 1 comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5118563 Thu, 11 Aug 2011 14:00:30 +0100 5118563 http://www.medworm.com/index.php?rid=5118646&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Findividualizing-the-fight-against-cancer%2F2011.08.10 You have heard it countless times, “The War on Cancer.” President Nixon announced it. The National Cancer Institute has spearheaded what TV and radio commercials always talk about as “the fight against cancer.” Singular. But we really need to start thinking about it as a plural.  Wars on cancer. Fights against cancer. Taking it one step further, we need to see each person’s fight as an individual battle.  Not just individualized to the patient’s spirit or age or sense of hope, but individualized to his or her particular biology, matched up with the specific cancer and available treatments. That is the nature of “personalized medicine” applied to cancer. We’ve been talking about it for a few years around here, but what’s exciting now is that even more super smart peopl... Better Health blogs http://www.medworm.com/rss/comments.php?id=5118646 Wed, 10 Aug 2011 18:00:06 +0100 5118646 http://www.medworm.com/index.php?rid=5118591&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F10%2Fhealth-affairs-briefing-confronting-costs%2F On September 8, Health Affairs will release its September 2011 issue, “Confronting Costs.” The issue explores the third element of the famed Three-Part Aim for health care: namely, the objective of lowering costs. Topics to be discussed include chronic disease costs and opportunities for savings through prevention; who bears the burden of health costs; the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5118591 Wed, 10 Aug 2011 15:36:17 +0100 5118591 http://www.medworm.com/index.php?rid=5118917&cid=t_101667_136_f&fid=35283&url=http%3A%2F%2Fwww.cancer.org%2FAboutUs%2FDrLensBlog%2Fpost%2F2011%2F08%2F10%2FWelcome-to-the-World-Rayna-Analiese-and-Looking-Forward-to-Many-Happy-Birthdays%21.aspx (A letter to my newborn granddaughter)   Good morning, Rayna Analiese. Welcome to the world!   You are a teeny 8 pound 8 ounce bundle of beauty and joy who arrived yesterday afternoon at 1:32 PM CDT--100 years (almost to the very day) after one of your great grandmothers was born.    Grandpa--who is normally not a big lover of babies--went gaga over you. "So cute! So cute!" is about all he could say as he snuggled you in his tall arms--afraid all the while that he might drop this football-size bundle of love.   You have lots of people who love you, and lots more who are going to love you--not to mention all the people who love you who haven't had a chance to meet you in person yet. You have aunts and uncles and great aunts and uncles and grandmothers and grandfathe... Dr. Len's Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5118917 Wed, 10 Aug 2011 14:22:00 +0100 5118917 http://www.medworm.com/index.php?rid=5118571&cid=t_101667_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F10%2Fpct-estate-future-ownership-and-management-of-estate-in-the-ownership-of-primary-care-trusts-in-england%2F Title: PCT Estate: future ownership and management of estate in the ownership of Primary Care Trusts in England Scan or click to download 'PCT Estate: future ownership and management of estate in the ownership of Primary Care Trusts in England' The Skinny: Updates and supersedes the FAQs relating to the future ownership and management of PCT-owned estate by aspirant Community Foundation Trusts (CFTs), published on 16 February 2011. Publisher: DH Published: 04/08/11 Size: 27p. Filed under: Ooops Missed Category! Tagged: Cost control, Estate management, Facilities management, Financial Management, Grey Literature, Land, NHS Foundation Trusts, NHS Trusts, Organisational Change, Primary care organisations, Property management, Reorganisation, Structural change, Structural changeCost ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5118571 Wed, 10 Aug 2011 06:45:38 +0100 5118571 http://www.medworm.com/index.php?rid=5118613&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FR7dzspykaNU%2F By Michael F. CannonThe debt deal was none too kind to ObamaCare. Here’s more bad news for this misguided law: Kansas becomes the second state (after Oklahoma) to return to the federal government one of ObamaCare’s lavish “Early Innovator Grants.” Coming from Secretary of Health and Human Services Kathleen Sebelius’s home state, that’s gotta hurt. The latest ObamaCare eruption shows the law could cost $50 billion more per year than advertised. If anyone but the government sold you something like this, we’d put them in jail. Many of the same Democrats who said it wasn’t a benefit cut when ObamaCare ratcheted down the price controls that government uses to pay health care providers now say it is a benefit cut when states do that. Kansas Retur... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5118613 Tue, 09 Aug 2011 20:21:48 +0100 5118613 http://www.medworm.com/index.php?rid=5107477&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F09%2Fjulys-most-read-ha-blog-posts%2F Timothy Jost’s series of posts on proposed new federal rules for state health insurance exchanges leads July’s list of most-read Health Affairs Blog posts. Jon Kingsdale’s article on Massachusetts’ efforts to control health care costs is also featured on the list, as are Jeff Goldsmith’s discussion of the effect of health reform on employer-based health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5107477 Tue, 09 Aug 2011 13:44:43 +0100 5107477 http://www.medworm.com/index.php?rid=5107445&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FDoqTJCeZQG0%2Flife-medicine.html Why would anyone want to become a physician?Good question, given the current atmosphere of doom and gloom amongst my colleagues and peers.Like most folks, when one has worked at the same job for 10, 20, 30, and even 40 years, the human spirit does need replenishment. Many pubic servants (and that is what we are), police, fire department personnel, correction officers have some things very much in common. Stress. Stress-related disability is actually a compensated employment related disability category.Medicine is stressful, but not so much about the art and science of  medical practice.  Some things are life threatening, but for most MDs, the day is routine. Perhaps in some specialties such as cardiology, surgery, ophthalmology where the outcomes are critical to life and function, stress... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5107445 Tue, 09 Aug 2011 13:00:31 +0100 5107445 http://www.medworm.com/index.php?rid=5107892&cid=t_101667_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fk0gsqWimymU%2F A bill in New York to prohibit health insurers from requiring their customers use mail-order pharmacies was criticized by the Federal Trade Commission as a well-intentioned effort that, nonetheless, could have an anti-competitive outcome, according to a letter written by the agency to one of the sponsors of the legislation. The bill has passed both the state senate and assembly, and awaits a signature from New York Governor Andrew Cuomo. In explaining its position, the FTC acknowledged that the bill (which you can read here) was designed to increase consumer choice and limit the ability of pharmacy benefit managers, or PBMs, from penalizing consumers who do not purchase their meds from mail-order pharmacies. You may recall that the largest PBMs, including CVS/Caremark, Express Scripts and ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=5107892 Tue, 09 Aug 2011 12:09:09 +0100 5107892 http://www.medworm.com/index.php?rid=5107446&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FopMnNahOokE%2Finsensitivity-kids-food-allergies.html Dear Members of the Illinois State Board of Education,As a parent of a child attending Illinois Public Schools, a taxpayer, and a board-certified pediatric allergist and immunologist, I was distressed to hear of the irresponsible comments made by Illinois State Board of Education (ISBE) Members Catherine Campbell and Lawrence Gregorash regarding the requirement for Illinois schools to have a food allergy policy in place by 2011.When the parents of children with severe food allergies send their children to school, they place immense trust in our school system – not only to educate their children, but to keep them safe while in its care.Read the rest of The insensitivity towards kids with food allergies on KevinMD.com.Category: Patient | Tags: Patients, Primary care | No comment (Sourc... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5107446 Tue, 09 Aug 2011 11:00:09 +0100 5107446 http://www.medworm.com/index.php?rid=5107448&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2Fe2rEnVfCIwI%2Fachievement-culture-problem-country.html My friend Nancy went for physical therapy for her back pain the other day, and was really surprised by what she saw there: the place was full of kids.“Yeah, it’s like this now,” said the therapist when Nancy asked about it. “It’s the sports.”It’s not that kids are getting clumsier or having more accidents. The injuries that are sending kids to physical therapy are overuse injuries. Kids these days are specializing in a sport as early as elementary school, and spending many more hours a week in practice than we ever did as kids—and we’re seeing the consequences.Read the rest of The achievement culture problem in our country on KevinMD.com.Category: Patient | Tags: Patients, Primary care | No comment (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5107448 Mon, 08 Aug 2011 19:00:09 +0100 5107448 http://www.medworm.com/index.php?rid=5118748&cid=t_101667_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FjLM8hRYzQbY%2F Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts. At last week’s HIT Policy Committee meeting, Robert Tagalicod, (the new director of the Office of E-Health Standards & Services), presented an analysis of the attestation experience to-date [See John's previous Meaningful Use Details post for the slides and report]. The results lend themselves to some interesting observations—admittedly preliminary findings, but revealing nonetheless:  The ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5118748 Mon, 08 Aug 2011 18:58:10 +0100 5118748 http://www.medworm.com/index.php?rid=5107478&cid=t_101667_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F08%2Fpatients-getting-antidepressants-more-often-from-nonpsychiatrists-without-psychiatric-diagnoses%2F More doctors who aren’t psychiatrists are offering antidepressants to patients, making these drugs the third most commonly prescribed group of medications in the United States, according to a study in the August issue of Health Affairs. A look at twelve-year trends shows that the percentage of visits in which antidepressants were prescribed to patients by [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5107478 Mon, 08 Aug 2011 18:41:29 +0100 5107478 http://www.medworm.com/index.php?rid=5107449&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F07MQj9HDCnY%2Fprimary-care-frustration-outweighed-relationships-patients.html I love my job as a primary care doctor, and I enjoy sharing the joy with students who visit me at the community health  center where I work. It is terrible to read in the press (and to hear from students) that angst and frustration are the  predominant emotions associated with primary care. While there are sources of frustration in what I do, these are  overwhelmingly outweighed by the satisfaction of building relationships with my patients. Truth be told, these relationships  also improve my life, as I see the difference that a caring, careful physician can make in the lives of patients and impart that  sense of purpose to my students.  Last summer, I had one of my most rewarding teaching experiences.Read the rest of My primary care frustration is outweighed by my relationships with... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5107449 Mon, 08 Aug 2011 18:00:34 +0100 5107449 http://www.medworm.com/index.php?rid=5107518&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fplastic-surgeon-weighs-in-on-anti-aging-medicine%2F2011.08.08 Reader Question: Do you do anti-aging medicine? I do not see it on your web site. If not, what is your opinion of it? I am not a fan or follower of the anti-aging medicine fad in so much that it promotes what I believe to be a false concept. An older person cannot be made into a younger version of herself by boosting certain hormones. There is really no good evidence that it works. Patients don’t live any longer. It might also be found to be harmful in the long run. Plastic surgeons will differ in their opinions as to what works with low risk to improve things. To me (more…) *This blog post was originally published at Truth in Cosmetic Surgery* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5107518 Mon, 08 Aug 2011 16:00:57 +0100 5107518 http://www.medworm.com/index.php?rid=5107451&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F6zWb78Sh-Hk%2Fmedical-information-private-sold-routinely.html Privacy, is it important to you?  Do you believe that your medical and personal information should be kept in strict privacy?  Do you expect your doctor to keep your information private? What is the cost of privacy?The computer I am typing this article on is protected by Norton’s Security Suite and by Comcast’s Constant Guard.  My friends, family, and patients invest a small fortune every year to keep their computers secure.  Their computers contain highly private information:  important information like their emails, contact lists, and passwords.Read the rest of Your medical information is not private, and it’s sold routinely on KevinMD.com.Category: Patient | Tags: Patients, Primary care | 9 comments (Source: Kevin, M.D. - Medical Weblog) Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5107451 Mon, 08 Aug 2011 16:00:17 +0100 5107451 http://www.medworm.com/index.php?rid=5107452&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F7yTe9wRJhF4%2Facp-copd-guideline-addresses-important-health-issue.html A guest column by the American College of Physicians, exclusive to KevinMD.com.It is easy to continue practice patterns we establish over the years. In my daily life as a general internist I am more likely to look for more information on a condition I don’t see regularly than on one that I see all the time. While we want to provide the best care for every condition we treat we may have more opportunities to impact the lives of those we care for by paying special attention to the latest evidence-based guidelines on common conditions we see every day.In that spirit, the American College of Physicians (ACP), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and European Respiratory Society (ERS) have released a joint clinical practice guideline on diagnosing and ... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5107452 Mon, 08 Aug 2011 15:00:45 +0100 5107452 http://www.medworm.com/index.php?rid=5107493&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FH_7njf0d_Wg%2F By David BoazA letter in the Washington Post from Dale Everett of Ashburn, Va., makes a point about the sustainability of our entitlements programs: At 80, I am a “poster boy” for what is wrong with Medicare and Social Security. I worked full time from 1950 until 1993, when I retired. I paid the maximum amount annually required by law. My payment from Social Security in 1993 was $1,170 per month, and it now exceeds $1,500. I paid $47,377 into the fund and have so far received more than $288,000 from it. As for Medicare I paid $14,350 into the fund from 1966 to 1993. I have been very healthy but had cancer several years ago and a craniotomy five years ago. The costs of those exceeded $1 million. Even minor surgery would far exceed what I paid to the fund. Please tell me how such a syste... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5107493 Mon, 08 Aug 2011 14:19:01 +0100 5107493 http://www.medworm.com/index.php?rid=5107509&cid=t_101667_87_f&fid=38368&url=http%3A%2F%2Fstevereads.com%2Fpapers_to_read%2Funcertainty_and_the_welfare_economics_of_medical_care.pdf The following is a post by Dr. Jessie Gruman from the Center for Advancing Health. This blog post was originally published at Prepared Patient Forum: What It Takes Blog. “There is a better way – structural reforms that empower patients with greater choices and increase the role of competition in the health-care marketplace.” Rep. Paul Ryan (R-WI)August 3, 2011 The highly charged political debates about reforming American health care have provided tempting opportunities to rename the people who receive health services.  But because the impetus for this change has been prompted by cost and quality concerns of health care payers, researchers and policy experts rather than emanating from us out of our own needs, some odd words have been called into service.  Two phrases commonly used ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=5107509 Mon, 08 Aug 2011 13:28:10 +0100 5107509 http://www.medworm.com/index.php?rid=5107483&cid=t_101667_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FzI5sxWjKWVE%2F Reversal of Course: The federal government won’t try to force the resignation of Forest Laboratories CEO Howard Solomon after the company last year plead guilty to drug-marketing misdemeanors, the WSJ reports. Solomon wasn’t named in the criminal action but the government had sought to exclude him from doing business with the government under a clause of the Social Security Act. Bad Habit: New research shows that when it comes to lung-cancer risk, smoking within 30 minutes of waking up in the morning is worse than waiting at least an hour before lighting up, the BBC reports. It’s not clear why, but one possible explanation is that people suck in smoke more intensely when they smoke first thing in the morning, increasing exposure to chemicals. Unclear Effectiveness?: The U... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5107483 Mon, 08 Aug 2011 12:40:52 +0100 5107483 http://www.medworm.com/index.php?rid=5107513&cid=t_101667_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1727%2F0%2Fepiphany.mp3 Podcast: DrRich’s recent posts on the death of primary care medicine elicited several responses from readers, not all of them positive. Most of the complaints DrRich harvested from these posts had to do with his suggestion that the physicians formerly known as PCPs ought to drop out of the dysfunctional healthcare system altogether (the system that has, purposefully and with malice aforethought, wrecked their chosen careers), then strike out instead on their own, and establish private practices in which they are paid directly by their patients. This suggestion creates, among many in our society (and apparently, among many of DrRich’s readers), a viscerally negative reaction. Many people believe that DrRich is exhorting doctors to embrace their inner greed, and abandon the grea... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=5107513 Mon, 08 Aug 2011 10:56:04 +0100 5107513 http://www.medworm.com/index.php?rid=5107526&cid=t_101667_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F15W16oOgdJ8%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5107526 Mon, 08 Aug 2011 00:35:15 +0100 5107526 http://www.medworm.com/index.php?rid=5103336&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealth-care-attorney-discusses-the-use-of-disclaimers-on-facebook-pages%2F2011.08.06 This is the third part of a three part post addressing the legal concerns of social networking in the health care arena. In part one, legal expert David Harlow, Esq., Health Care Attorney and Consultant at The Harlow Group, LLC in Boston, answered questions regarding “The Legal Implications for Doctors, Nurses and Hospitals Engaging in Social Media?” In part two, Mr. Harlow answered questions related to the Pharma industry;  “Legal Concerns: What Steps can Pharma Take to Engage in Social Media?” The third part addresses a question from a follower on Facebook about the use of disclaimers. Q:  Barbara: A Healthin30 reader on Facebook writes:  “I’m looking for a good disclaimer to put on a couple of medical practices’ Facebook pages. The AMA social media guidelines aren’t h... Better Health blogs http://www.medworm.com/rss/comments.php?id=5103336 Sat, 06 Aug 2011 21:00:47 +0100 5103336 http://www.medworm.com/index.php?rid=5103306&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FIUi8Nw2LnSI%2Fsmog-affects-human-body.html We all know that outdoor aerobic exercises like running and biking are good for your health. But during the hottest days of summer, it’s not just excess heat we have to worry about, but smog, the concentrated air pollution you can often see hovering over the cityscape. During the hot summer months, smog can become a serious health problem in the Boston area. We are often downwind from the Midwest’s coal-fired power plants as well as the East Coast’s major cities.Among air pollution’s cast of characters, ground-level ozone gas and the tiniest air pollution particles called PM2.5 play leading roles. While the PM2.5 particles come directly from our car exhaust, factories and distant coal-fired electric plants, irritating ozone gas builds up in the afternoon when sunlight chemically re... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5103306 Sat, 06 Aug 2011 18:00:47 +0100 5103306 http://www.medworm.com/index.php?rid=5107507&cid=t_101667_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fone-in-three-teens-in-us-got-sunburned-last-year.html That’s the suggestion of a new report from the Centers for Disease Control and Prevention. It asked how often, over a 12-month period in 2009 and 2010, teens got a burn that turned their skin red or hurt, and lasted for 12 or more hours. Among white, non-Hispanic teens ages 14 to 17, nearly half reported a sunburn. Avoiding sunburns starts with wearing protective clothing and limiting time in the sun. It also means using the right sunscreen. Your sunscreen should be water resistant, with an SPF of at least 30. Above 30, there's not much more protection. And you need to use it properly, too. That means reapplying it every 2 hours or so and after swimming or sweating. Use 2 to 3 tablespoons of a lotion on most of your body. For details, see our updated sunscreen Ratings. Source Q... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5107507 Fri, 05 Aug 2011 22:15:00 +0100 5107507 http://www.medworm.com/index.php?rid=5103333&cid=t_101667_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fone-in-three-teens-in-us-got-sunburned-last-year.html That’s according to a new report from the Centers for Disease Control and Prevention. Among white, non-Hispanic teens ages 14 to 17, nearly half got a burn that turned their skin red or hurt and lasted for 12 or more hours. Avoiding sunburns starts with wearing protective clothing and limiting time in the sun. It also means using the right sunscreen. Your sunscreen should be water resistant, with an SPF of at least 30. Above 30, there's not much more protection. And you need to use it properly, too. That means reapplying it every 2 hours or so and after swimming or sweating. Use 2 to 3 tablespoons of a lotion on most of your body. For details, see our updated sunscreen Ratings. Source QuickStats: Percentage of Teens Aged 14 to 7 Years Who Had a Sunburn During the Preceding 12 M... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5103333 Fri, 05 Aug 2011 22:15:00 +0100 5103333 http://www.medworm.com/index.php?rid=5103342&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-should-people-receiving-health-care-be-called-empowered-patient-vs-health-care-consumer%2F2011.08.05 “There is a better way – structural reforms that empower patients with greater choices and increase the role of competition in the health-care marketplace.” Rep. Paul Ryan (R-WI) August 3, 2011 The highly charged political debates about reforming American health care have provided tempting opportunities to rename the people who receive health services.  But because the impetus for this change has been prompted by cost and quality concerns of health care payers, researchers and policy experts rather than emanating from us out of our own needs, some odd words have been called into service.  Two phrases commonly used to describe us convey meanings that mischaracterize our experiences and undervalue our needs: “empowered patient” and “health care consumer.” As one who has done ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5103342 Fri, 05 Aug 2011 21:00:35 +0100 5103342 http://www.medworm.com/index.php?rid=5103526&cid=t_101667_167_f&fid=38271&url=http%3A%2F%2Frebeccascritchfield.wordpress.com%2F2011%2F08%2F05%2Fareyou-a-healthy-woman%2F I’m attending blogger 11 in San Diego. I’m here wearing many “faces”. I’m a blogger, registered dietitan, and speaker. But lately, I think my most important role is an organizer. I’m a passionate advocate for self-care, making sure every day there is time for “me”. We do so much for everyone else that we tend to fall off our own to-do list. Am I right? Been there, Done That This is how I lived most of my life. “is everyone happy? What can I do for you? Yes. Yes. Yes. Of course. Yes. Ok!” What I learned is that I did a lot despite my willingness to focus on me. I was young but felt old. Tired. I wanted to change things. So I did one step at a time.That was Over a decade ago. I changed my perceptive and changed my life. A the end of... Balanced Health and Nutrition Rebecca Scritchfield's Blog blogs http://www.medworm.com/rss/comments.php?id=5103526 Fri, 05 Aug 2011 18:35:59 +0100 5103526 http://www.medworm.com/index.php?rid=5103313&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2F3SagvyKr9p0%2Fbanned-boston-access-psychiatric-care.html Imagine you have severe depression and go to a Boston emergency room for treatment. You are told to follow up with a psychiatrist within two weeks. You have good health insurance, so this shouldn’t be a problem, right?Wrong. In a new study just published in the Annals of Emergency Medicine, we found quite the opposite. Access to outpatient psychiatric care in the greater Boston area is severely limited, even for those with excellent private insurance.We posed as patients insured by Blue Cross Blue Shield of Massachusetts PPO, the largest insurer in the state. We called every BCBS in-network mental health facility within a 10-mile radius of downtown Boston, reporting that we had been evaluated in an emergency department for depression and discharged with instruction to obtain a psychiat... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5103313 Fri, 05 Aug 2011 18:00:34 +0100 5103313 http://www.medworm.com/index.php?rid=5103344&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstrokes-are-quite-common-in-pregnant-women-how-can-they-be-prevented%2F2011.08.05 According to CDC, there has been a 54 percent increase in the number of pregnant women who’ve had strokes in 1995 to 1996 and in 2005 to 2006. While this may surprise some researchers, it certainly would not surprise clinicians who take care of pregnant women who have risk factors such as obesity, chronic hypertension or a lack of prenatal care. Ten percent of strokes occur in the first trimester, 40 percent during the second trimester and more than fifty percent occur during the post partum period and after the patient has been discharged home. Hypertension was the cause of one-third of stroke victims during pregnancy and fifty percent in the post partum period. Hypertension accounted for one-third of stroke cases during pregnancy and fifty percent in the post partum period. Many stroke... Better Health blogs http://www.medworm.com/rss/comments.php?id=5103344 Fri, 05 Aug 2011 16:00:21 +0100 5103344 http://www.medworm.com/index.php?rid=5096086&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FyhPZVxXmy_M%2Fspecialists-practice-primary-care.html Recently a good friend asked me to recommend an excellent primary care physician in New York City. When no one immediately came to mind, I asked a couple of doctor-friends who trained in New York. One friend, a cardiologist, gave me two names—one was a rheumatologist, who also practices general medicine, and the other an infectious disease doctor by training. My initial reaction to my cardiologist friend’s suggestion that a patient should see a subspecialist for primary care was one of slight annoyance.In my view generalism is a specialty in its own right, and the concept that primary care would be as well-delivered by a physician whose main field of interest is a medical subspecialty seemed flawed. Sure, medical subspecialists go through training in Internal Medicine just as general i... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5096086 Fri, 05 Aug 2011 14:00:56 +0100 5096086 http://www.medworm.com/index.php?rid=5096462&cid=t_101667_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fopen-letter-onc-certification-program One of the foundational elements of the CMS EHR Incentive Program is the use of certified EHR technology. On June 18, 2010 HHS issued a final rule to create a Temporary Certification Program “for purposes of testing and certifying health information technology.” This rule also outlined how organizations can apply, meet stringent requirements, and become ONC Authorized Testing and Certification Bodies. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5096462 Fri, 05 Aug 2011 13:20:32 +0100 5096462 http://www.medworm.com/index.php?rid=5096192&cid=t_101667_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FC8uUKj_w1Lo%2F The latest video from the Alliance for Health Reform is now available. It  features Karen Davis, president of The Commonwealth Fund. Health care spending will be a target of efforts to cut the federal deficit. The best way to reduce unnecessary spending, Dr. Davis says, is to make sure everyone gets the right care, using new provider payment mechanisms such as bundled payment and value-based purchasing. In this video, Dr. Davis describes some of these payment reforms and lays out the case for greater use of comparative effectiveness research to learn “what really works.” This video is part of a series produced by the Alliance and supported by the Robert Wood Johnson Foundation. (Source: Disruptive Women in Health Care) Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=5096192 Fri, 05 Aug 2011 13:07:01 +0100 5096192 http://www.medworm.com/index.php?rid=5107648&cid=t_101667_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Fneil%2F2011%2F08%2F04%2Frandom-thoughts-emr-projects-decentralized-problems-persist-despite-solutions%2F Once in a while, I run out of Big Ideas to share and resort to a rundown of short items. This is one of those times. Often, though, that approach turns out to be more interesting than a well-thought-out commentary. (Thus, the popularity of Twitter, right?) Speaking of Big Ideas, I’m thinking that the age of the massive EMR project may be coming to an end. You may have seen my piece in InformationWeek today about the reported end of the national EMR in England. London’s The Independent reported earlier this week that the Cameron government will announce next month that it will scrap the national strategy in favor of allowing local hospitals and trusts to make independent EMR purchasing and implementation decisions. This news comes on the heels of a decision by the government of ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5107648 Thu, 04 Aug 2011 22:22:35 +0100 5107648 http://www.medworm.com/index.php?rid=5096092&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FBxKb0TPGGaQ%2Fhope-warnings-states-california-family-physicians.html A guest post from the California Academy of Family Physicians, exclusive to KevinMD.com.Despite the slight upward tick in medical students opting for careers in family medicine over the last two years, efforts aimed at solving the primary care physician shortage are often thwarted by state and federal policy decisions.There is reason for hope, however: The number of medical school applications in California is extraordinarily high. A higher proportion of U.S. medical school graduates have helped to fill all of the available 2011 family medicine slots here. And a successful new “teaching health centers” model of family medicine residency training has been funded by the U.S. Department of Health and Human Services (HHS) to train physicians for work in underserved areas, with one of the... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5096092 Thu, 04 Aug 2011 17:00:10 +0100 5096092 http://www.medworm.com/index.php?rid=5096163&cid=t_101667_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FAOgPxXQoppA%2F By Ilya ShapiroThat’s how I describe the individual mandate in my contribution to SCOTUSblog‘s online symposium on Obamacare, which Trevor Burrus has already highlighted.  Here’s an excerpt: All the Obamacare legal challenges boil down to Congress’s authority – or lack thereof – to require people to buy private insurance.  Although unfortunately not dispositive of modern judicial decisions, the text of the Constitution demands that the Supreme Court strike down the individual mandate as an unconstitutional exercise of Congress’s power to regulate interstate commerce.  Finding the mandate constitutional would be the first interpretation of the Commerce Clause to permit the regulation of inactivity – in effect requiring an individual to engage in an economi... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=5096163 Thu, 04 Aug 2011 16:00:47 +0100 5096163 http://www.medworm.com/index.php?rid=5096094&cid=t_101667_85_f&fid=34587&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FKevinMd-MedicalWeblog%2F%7E3%2FfL9DjUAYae8%2Fdoctors-diagnose-diabetes-10-years-disease-warrants.html I like my patients vertical.  Not horizontal.If I can help it, I want to make sure that nobody gets a disease that could have been prevented.  Sure, accidents happen.  And illnesses show up every day in the lives of people who did nothing to deserve them, and who could have done nothing to prevent them.  But not all illnesses.Physicians know that newly diagnosed diabetic patients present to the doctor with about 10 years worth of damage to their blood vessels.  What does that mean?  That we diagnose diabetes 10 years later than the disease warrants.  It means that the symptoms we learn to identify come about 10 years after the disease begins.Read the rest of Doctors diagnose diabetes 10 years later than the disease warrants on KevinMD.com.Category: Conditions | Tags: Diabetes, Patie... Kevin, M.D. - Medical Weblog blogs http://www.medworm.com/rss/comments.php?id=5096094 Thu, 04 Aug 2011 15:00:00 +0100 5096094 http://www.medworm.com/index.php?rid=5096193&cid=t_101667_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FN-g7Cqy56zw%2F By Robin Strongin. In the 1993 movie Dave, the temp agency owner posing as the President of the United States (if you haven’t seen the film, just trust me on this) is determined to come up with the funding to save a federal homeless shelter program.  Gathering all of the cabinet officials together with pencils, legal pads and calculators, they brainstorm different wasteful programs that can be cut, totaling numbers as they go, until they come up with the necessary $350 million. A bit of Hollywood silly escapism?  No doubt.  But, you can say this for President Dave and his fictional cabinet.  At least they approached the budget process with a constructive purpose and vision. We can only hope that the same holds true for the supercommittee, the panel of 12 Senators and Representatives ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=5096193 Thu, 04 Aug 2011 13:36:23 +0100 5096193 http://www.medworm.com/index.php?rid=5097137&cid=t_101667_158_f&fid=38949&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAgingWithGraceCareconnection%2F%7E3%2F-13FLjWmKhw%2Fstretching-prescription-medication-can.html Whether you're treating a chronic condition or trying to stock your medicine cabinet with the basics, medications can be pricey. To cut costs, you may be considering splitting pills or taking a medication after it has expired (though staring down a bottle of Tylenol purchased during the Clinton administration can make even staunch stomachs uneasy). You may well be wondering if cutting pills or ignoring use-by dates is really safe. As if often the case in medicine, that's a simple question with a long answer. Pill Splitting It's basic math: Cutting pills in half can make a bottle of medication last twice as long. And if you only need half a pill to get the job done, splitting seems to make sense. Some medications lend themselves to being halved, but certain others should never be split... Aging with Grace CareConnection blogs http://www.medworm.com/rss/comments.php?id=5097137 Thu, 04 Aug 2011 00:11:00 +0100 5097137 http://www.medworm.com/index.php?rid=5096208&cid=t_101667_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fan-alternative-to-a-colonoscopy%2F2011.08.03 Most of us born several decades ago, recall the futuristic book Fantastic Voyage by Isaac Asimov, where a miniaturized crew traveled through a human body to cure a scientist who has a blot clot lodged in his brain. Ironically, miniaturized medical care is now upon us while books are at risk of becoming obsolete. I hope that gastroenterologists won’t become obsolete, at least until my last kid graduates from college. I perform an amazing diagnostic procedure called wireless capsule endoscopy (WCE), when patients swallow a camera. Once swallowed, this miniaturized camera takes its own fantastic voyage through the alimentary canal. The test is used primarily to identify sources of internal bleeding within the 20 feet of small intestine, which are beyond the reach of gastroenterologists’ c... Better Health blogs http://www.medworm.com/rss/comments.php?id=5096208 Wed, 03 Aug 2011 22:30:00 +0100 5096208 http://www.medworm.com/index.php?rid=5096097&cid=t_101667_85_f&fid=34967&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fdocisinblog%2FwNlq%2F%7E3%2FJj4POHfFcZQ%2F Well, now, isn’t that special… Forbes reports on a new investment vehicle, tailor-made for the get-rich-quick crowd: Playing The Odds: Hedge Funds Finance Medical Malpractice Claims: An entirely new industry has cropped up in recent years as trial lawyers set their sights on making money off physicians, corporations and other targets–particularly financing malpractice suits through hedge funds. In 2010, hedge funds invested $1 billion in these types of suits, much of it for medical malpractice cases… … the rewards can be remarkable for investors, which is why dollars are flowing into these hedge funds. Payouts can result in tens of millions of dollars. George Soros, call your office… Having milked all the money they can from sub-prime mortgages, deriva... The Doctor Is In blogs http://www.medworm.com/rss/comments.php?id=5096097 Wed, 03 Aug 2011 21:27:09 +0100 5096097 http://www.medworm.com/index.php?rid=5096467&cid=t_101667_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Funitedhealth-improving-rural-healthcare The UnitedHealth Center for Health Reform and Modernization released a white paper on Modernizing Rural Health Care. To quote from the UHG presser: read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5096467 Wed, 03 Aug 2011 13:18:59 +0100 5096467 http://www.medworm.com/index.php?rid=5096266&cid=t_101667_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F08%2Freduction-of-central-line-infections.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5096266 Wed, 03 Aug 2011 11:55:00 +0100 5096266 http://www.medworm.com/index.php?rid=5097033&cid=t_101667_147_f&fid=39202&url=http%3A%2F%2Fnicolaziady.com%2F2011%2F08%2Finternets-impact-on-healthcare%2F Fifty five percent of patients use the internet to find treatment information according to a 2010 U.S. Survey of Health Care Consumers According to the Deloitte Center for Health Solutions survey, fifty three percent  of seniors, fifty five percent of baby boomers, fifty seven percent of Generation X and fifty six percent of Generation Y research treatment information online. Patients are knowledgeable and informed The Deloitte survey found 25% of participants reported searching online for physician and quality information. Twenty percent of consumers want to access health records by a secure Internet connection. 1 in 5 patients say they would switch physicians to obtain access and would  use a mobile communication device to maintain these records .. however, contrary to this data &#821... Nicola Ziady blogs http://www.medworm.com/rss/comments.php?id=5097033 Wed, 03 Aug 2011 03:55:32 +0100 5097033