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 'doctors'. Sat, 03 Sep 2011 01:50:45 +0100 http://www.medworm.com/index.php?rid=5181815&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1841 : ‘Not now.’ (This column first appeared in the Greenville News, but I re-wrote and expanded  it for my EMN readers in the September edition.  So here it is with a few special thoughts for the medical community.) Here’s the link to the EMN online edition as well: http://journals.lww.com/em-news/Fulltext/2011/09000/Second_Opinion__Two_of_the_Worst_Words_of_All__Not.8.aspx If you were watching me, secretly, you would see that I sometimes do things that are decidedly non-adult. I can be seen dancing across the hardwood floor with my daughter, with no music audible (except inside her lovely head). She apparently aspires to be a choreographer, and though I am no dancer, I am the only male in the house who will dance with her. When she asks, what can I say? I know many l... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5181815 Thu, 01 Sep 2011 13:02:36 +0100 5181815 http://www.medworm.com/index.php?rid=5181802&cid=t_100730_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=5181816&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1837 I think a lot about the slow, certain dissolution of medicine as we know it.  Mental health issues crowd emergency departments, as few mental health clinics are available.  Psychiatrists are in short supply.  Drug abuse overwhelms the medical system, with either patients seeking pills or patients families hoping to get them off of pills. Persons with little interest in their own health continue to smoke and drink, use Meth and eat poorly.  Disability claims are skyrocketing as younger and younger individuals confabulate their misery in hopes of attaining a check, paid for by someone else. The poor, with genuine medical problems, have increasing difficulty finding care as jobs, and insurance, fade away.  Politicians, eager to be re-elected, eager to be loved, promise more and supply le... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5181816 Wed, 31 Aug 2011 14:14:08 +0100 5181816 http://www.medworm.com/index.php?rid=5158992&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmanaging-information-overload-in-the-age-of-unlimited-information%2F2011.08.25 Perhaps the biggest challenges facing the next generation of physicians is information overload.  The problem: Unlimited information on limited human bandwidth.  There’s simply too much to read and see.  For physicians the problem is compounded by a perceived responsibility to keep up. But the idea that we actually can have our hands around everything is reflective of a time when doctors actually could know all there was to know.  Many of today’s physicians were raised at a time when a paper inbox and a pile of journals represented their only information inputs.  But things are very different now. Here are a few ideas on controlling your inputs: (more…) *This blog post was originally published at 33 Charts* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5158992 Thu, 25 Aug 2011 22:15:32 +0100 5158992 http://www.medworm.com/index.php?rid=5158984&cid=t_100730_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F08%2Fphysician-communities.html How would you describe the universe of online physician communities? Up until today, there were two historic categories, those  launched within the borders of one country and those, generally more recent, that were launched with a global perspective. This of course can change through acquisitions, and one such acquisition was posted today. One of the first communities to think beyond borders was DocCheck who created a multi-country network in Europe. This was followed by Medting  from Spain which integrates Google Translate,  Doc2Doc from BMJ in English, and most recently VoxMed which operates in 8 languages. We could also talk about specialties. Specialties tend to think more globally and work in English, even i... Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5158984 Tue, 23 Aug 2011 23:00:00 +0100 5158984 http://www.medworm.com/index.php?rid=5158985&cid=t_100730_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F08%2Finternet-evaluations-healthservices.html While internet rating sites for physicians in the US have been around for a number of years and a number of specialized sites are now part of the online health landscape (HealthGrades, RateMDs, and others), this is not the case in Europe in general, and France in particular, despite the presence of Yelp, GoogleMaps, and other US-based sites that allow for physician ratings. Health care professionals in France believe that physician rating will lead to either a) friendly reciprocal reviews amongst professionals (I'll evaluate you, you'll evaluate me, and we'll all evaluate each other) or b) unjustifiedly negative patient reviews. There is simply insufficient trust in crowdsourcing re docs. While French sites such as Le Guide Santé and Hôpital.fr do allo... Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5158985 Mon, 22 Aug 2011 23:00:00 +0100 5158985 http://www.medworm.com/index.php?rid=5158974&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fmany-doctors-and-nurses-embrace-alternative-medicine.html Your doctor or nurse might be more likely than you to turn to dietary supplements and alternative therapies such as acupuncture and chiropractic care, according to a recent study in the journal Health Services Research. It found that 76 percent of health-care workers reported using alternative or complementary therapy in the preceding year compared with 63 percent of the general population. Researchers at the University of Minnesota and elsewhere analyzed data from the Centers for Disease Control and Prevention’s 2007 National Health Interview Survey, the most current nationally representative data available on the use of complementary and alternative medicine in U.S. households. The most common reason given by health-care professionals for use of complementary or alternative medici... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5158974 Mon, 22 Aug 2011 20:00:00 +0100 5158974 http://www.medworm.com/index.php?rid=5159689&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F08%2Fdont-call-me-mrs.html I have noticed in recent years, maybe its because I got married or maybe its because I have been going to the doctor so often, that they call me Mrs R at the doctor's offices. After 6 1/2 years of marriage (well really 5 years because it took me that long to get around to changing my name) I am Mrs R I am very rarely called Mrs R except at the doctor's office - by the person who greets me, by the nurse who calls me and by my doctor. And every single one of them mangles the pronunciation. (One 'e' can be pronounced as if it was 'ee'. The name isn't misspelled, you are saying it wrong - but that's another blog post.) I was going to ask my doctor's office to start using my first name instead. I might even respond to it a bit faster - Mrs R sometimes goes in one ear and out the other (how lon... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5159689 Mon, 22 Aug 2011 10:21:00 +0100 5159689 http://www.medworm.com/index.php?rid=5159690&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F08%2Fdoctors-as-human-beings.html Sometimes us patients may not believe it but our doctors are human beings. Well most of the time, some times they seem to be sadists as they perform 'medical adventures' on semi-sedated patients who should only feel a 'pinch' or 'some pressure'. Actually I do think they are caring human beings but sometimes their practice of medicine on my body isn't very fun from my point of view. As the patient, I think I should be the most important person in the room. There is no space for a doctor's ego, or anyone else's ego. But once you are sedated the doctor is in charge. They like to listen to music while they carve out little sections of your body. But I want to make a request - can I choose the music? I am going to be more relaxed if I listen to the music that I like - even if you have knocked ... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5159690 Sun, 21 Aug 2011 12:18:00 +0100 5159690 http://www.medworm.com/index.php?rid=5139757&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1811 On a scale of one to ten, What is your loneliness? Think of one as a day when your Family was out shopping, Laughing, going to movies, but You were sick in bed. Ten is Like everyone you knew Perished, or decided you were Worthless and abandoned you. What about your fear? Ten is the worst, one is the least. Be candid; maybe we can help. One is when you reach Into your desk drawer and Find a rubber spider, a ridiculous Fuzzy black joke that Makes you fall out of Your swivel chair while across The divider coworkers laugh. Five is the idea that everyone In the world knows your thoughts, Knows your hopes and how to Shatter them. Eight that everyone Knows what you think of them, Including her. Ten is that nothing about you Is a secret to anyone. Tell me about your sadness. Ten is the memory ... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5139757 Thu, 18 Aug 2011 15:28:20 +0100 5139757 http://www.medworm.com/index.php?rid=5140195&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F08%2Fwould-you-sue-your-doctor.html I don't think I would sue anyone unless I really felt they had done something wrong - like operated on the wrong body part. After I read this article I felt like I am the only one who wouldn't. These numbers amaze me 7.4% of all doctors face a lawsuit EACH year and 1.6% of all doctors face a payment EACH year. And we wonder why doctors charge so much because they have to pay so much malpractice insurance. I have never understood the American way of suing people. I have a friend who told me she wanted to sue her neighbor because they had cut down the trees on their property that were shading her property or something like that. She was mad that they didn't tell her first. Hello, they don't have to tell you what they want to do on their property. They could to be nicer about things but they... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5140195 Thu, 18 Aug 2011 10:40:00 +0100 5140195 http://www.medworm.com/index.php?rid=5139736&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-physician-ratings-arent-quite-adequate-yet%2F2011.08.17 “Most physicians are competent and able to take care of most of the problems patients present with.  The standards for getting into medical school are high and for getting out are higher.  I think this call for patients to become experts in picking their doctors is overstated.”  – David Rovner, MD, Professor Emeritus, Michigan State University Most?  What does “most” mean?  Can most doctors treat me for the flu?  How about pancreatic cancer? Must I conduct the same type of research to choose a doctor to set my broken arm that I do to find one to treat my mom’s congestive heart failure?   Is the same level and type of research necessary to find a good surgeon as for a primary care clinician? (more…) *This blog post was originally published at Prepared Pat... Better Health blogs http://www.medworm.com/rss/comments.php?id=5139736 Wed, 17 Aug 2011 21:00:37 +0100 5139736 http://www.medworm.com/index.php?rid=5140196&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F08%2Fits-time-to-work-on-delivery-again.html There are manufacturing shortages periodically for just about everything. They are worse now that most manufacturers are using the 'just in time' model where nothing sits on their shelves for any length of time. Then the problem becomes if anything does not show up as planned, anything breaks down, or an act of God occurs (think tornado, flood, earthquake, etc). Look at what happened to the Japanese car makers when their parts sources were hit by the earthquake earlier this year. We accept that something might be out of stock for a bit, we skip it or buy something different in the meantime but then it eventually comes in back in stock. Life goes on, no problem. But what if the problem is for something significant like a medication - maybe even a chemo treatment? The impact becomes a bit ... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5140196 Wed, 17 Aug 2011 10:20:00 +0100 5140196 http://www.medworm.com/index.php?rid=5139728&cid=t_100730_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F08%2Fpatient20-doctor20-where-do-we-stand.html Are e-patients, -- as for example, online patient bloggers or members of an online patient community -- attempting to serve as "amateur doctors" for other online patients? Those who read this blog know that that is not my perspective. I welcome the engaged, expert patient and wonder why it is taking us so long to give them their rightful place in health care. But many people are still uncomfortable with the online patient, even simply seeking information on the Web, let alone engaging with other patients. The Journal of Medical Internet Research has just published a very interesting research paper entitled "Managing the Personal side of health: How patient expertise differs from the expertise of clinicians" by Hartzler and Pratt at the University of Washington. Method... Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5139728 Tue, 16 Aug 2011 23:00:00 +0100 5139728 http://www.medworm.com/index.php?rid=5130747&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-doctors-want-their-patients-to-use-the-web-to-stay-informed%2F2011.08.15 Recently, I’ve had an interview with a national newspaper and the woman who performed the interview told me she was surprised that I seemed to be the first doctor in her life who was happy about patients using the internet. Well, she surprised me with this statement as I’ve never thought about that before. But she must be right. There are many doctors who get upset when they find out the patient tried to find information online. They are frustrated as they don’t even know how to use these online tools and have no idea how to help the patients in this perspective. Myself, I’m pretty much happy about it. I love to hear patients (more…) *This blog post was originally published at ScienceRoll* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5130747 Mon, 15 Aug 2011 14:00:41 +0100 5130747 http://www.medworm.com/index.php?rid=5118641&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbeing-a-doctor-is-a-lot-like-being-a-parent-you-cant-tap-out%2F2011.08.11 The American College of Graduate Medical Education has enacted further restrictions on resident work hours.  No more than 80 hours per week of work for resident physicians, averaged over one month.  And no more than 16 hours of continuous work for first year residents (24 after that), which includes patient care, academic lectures, etc. Whenever they do this sort of thing, everyone seems excited that it will make everyone safer.  After all, residents won’t be working as much, so they’ll be more rested and make much better decisions.  It’s all ‘win-win,’ as physicians in training and patients alike are safer. I guess.  The problem of course is that after training, work hours aren’t restricted.  There is no set limit on the amount of work a physician can be expected to do, ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5118641 Thu, 11 Aug 2011 18:05:30 +0100 5118641 http://www.medworm.com/index.php?rid=5118635&cid=t_100730_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F08%2Fhealthcare-socialmedia-internet.html At Doctors 2.0 & You, the "& You" referred  to the fact that the health care system is (or should be) a very, if not fully, interconnected world. However, this is still a work in progress. To connect  people within their own country, as most health care is still local, is already a challenge and to go beyond national borders presents an even greater challenge given language and travel requirements. Personal and collective resources both play a rôle. The advent of healthcare social media will help accelerate the connection, where basic resources are available. But much more needs to and will be done! However, the international language, despite  the improvement of automatic translation tools, tends to be English (or globish ;-) and, given as well, ... Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5118635 Wed, 10 Aug 2011 23:00:00 +0100 5118635 http://www.medworm.com/index.php?rid=5118634&cid=t_100730_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F08%2Fcatherine-cerisey-itw-patient-partner.html For today, Silber's blog presents Catherine Cerisey, a French patient advocate and author of her blog "after my breast cancer", « après mon cancer du sein ». Since we launched the health 2.0 chapter meetings, community, and blog in France, Catherine has been present  IRL and virtually via Twitter and tweet-ups #health20fr  #hcsmeufr #doctors20. This June, Catherine Cerisey participated in the French-language Doctors 2.0 workshop about patient expectations. Catherine and I had a rich exchange recently about the rôle of patients and I want to share with you her insights on "patient partner". Have as a well a look at this brief video animation called "Communicate" about the before and after of the Internet and its... Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5118634 Wed, 10 Aug 2011 23:00:00 +0100 5118634 http://www.medworm.com/index.php?rid=5118747&cid=t_100730_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F-wzekic95sE%2F Patient Doctor Relationship It seems like this topic keeps coming up in my online and social media reading. Basically, the discussion usually centers around the role the patient plays in healthcare. Many people like to discuss what has been called the ePatient. I instead want to talk about the motivations of patients and their ability to influence the healthcare system. Patients in healthcare are unlike “customers” in many other industries. I can’t think of a single patient that wants to go and see a doctor. Ok, maybe they like the doctor and they want to get whatever’s ailing them fixed, but to a person I’m sure we’d say that going to the doctor is the last place we want to be. It’s not like going shopping for a new pair of shoes. There’s no... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5118747 Tue, 09 Aug 2011 19:12:45 +0100 5118747 http://www.medworm.com/index.php?rid=5118629&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fbody-imaging-chain-hit-with-fines-for-unnecessary-medical-scans.html Colorado health officials levied a $3.2 million fine against Heart Check America for performing unnecessary X-rays and CT scans on consumers without a licensed doctor's request or oversight. The penalty—the largest ever imposed by the Colorado Department of Public Health and Environment—comes after months of investigation into alleged operating violations, including using "unfair and deceptive business practices" to sway consumers into committing to too many costly medical screenings. A recent Consumer Reports Health report on treating heart disease suggests that such scare tactics by clinics and medical groups are becoming more commonplace. Kimberly Lovett, M.D., a physician at Kaiser Permanente and a member of the San Diego Center for Patient Safety at the University of C... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5118629 Tue, 09 Aug 2011 18:00:00 +0100 5118629 http://www.medworm.com/index.php?rid=5107794&cid=t_100730_131_f&fid=34989&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FGeneticsHealth%2F%7E3%2F6pmycmcma9U%2F Almost 80% of antidepressants are prescribed by non-psychiatrists—and almost three-quarters of these prescriptions aren’t accompanied by a formal psychiatric diagnosis, Psych Central reports. Perhaps that sounds like cause for major alarm, but let’s remember that a) primary care doctors may not be psychiatric specialists, but they’re not clueless either, and b) many people don’t have access to, or can’t afford, specialized psychiatric care. For the uninsured, being able to get anti-depressants during a physician visit could be a godsend; even those with insurance may find the added expense of psychiatric care too much (especially if they’re under a plan without good mental health coverage). And what if you just plumb can’t get to a psychiatrist at a given time, but have a p... Genetics and Health blogs http://www.medworm.com/rss/comments.php?id=5107794 Mon, 08 Aug 2011 20:07:43 +0100 5107794 http://www.medworm.com/index.php?rid=5107601&cid=t_100730_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F08%2F08%2Fantidepressants-overprescribed-in-primary-care%2F Antidepressants have long enjoyed a reputation as being a quick and “easy” treatment for all types of depression — from a mild feeling of being a little down, all the way up to severe, life-debilitating depression. But like all medications, they have side effects and instances where they should not be prescribed. Hence their continued need for a prescription after seeing a doctor. So what does it mean when primary care physicians are handing them out like candy? It suggests that your family doctor doesn’t really understand how antidepressants work, or what they are approved to treat. In short, it suggests that antidepressant medications are being over-prescribed by well-meaning doctors who are simply not using very good judgment. Melissa Healy, writing for the LA T... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=5107601 Mon, 08 Aug 2011 10:35:31 +0100 5107601 http://www.medworm.com/index.php?rid=5103336&cid=t_100730_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=5103350&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1773 The American College of Graduate Medical Education has enacted further restrictions on resident work hours.  No more than 80 hours per week of work for resident physicians, averaged over one month.  And no more than 16 hours of continuous work for first year residents (24 after that), which includes patient care, academic lectures, etc. Whenever they do this sort of thing, everyone seems excited that it will make everyone safer.  After all, residents won’t be working as much, so they’ll be more rested and make much better decisions.  It’s all ‘win-win,’ as physicians in training and patients alike are safer. I guess.  The problem of course is that after training, work hours aren’t restricted.  There is no set limit on the amount of work physician c... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5103350 Sat, 06 Aug 2011 03:31:30 +0100 5103350 http://www.medworm.com/index.php?rid=5103325&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F7rtOjVhiExQ%2F The U.S. economy added more jobs than expected last month. And the health-care industry showed particular strength, with 31,300 new jobs — higher than the average monthly increase seen in 2007, before the recession hit. Here’s the Bureau of Labor Statistics chart showing sector-by-sector job growth, and here’s the overall report, which shows non-farm payrolls rose by 117,000 while the unemployment rate dropped slightly to 9.1%. As the WSJ reported last month, health-care employment had been robust during the recession, but showed some weakening in the June report. That changed in July. Hospitals alone added 14,000 new jobs after losing 2,000 jobs the previous month. Ambulatory care also added jobs — 6,300 in doctor’s offices and 3,100 in home health-care servi... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5103325 Fri, 05 Aug 2011 16:30:44 +0100 5103325 http://www.medworm.com/index.php?rid=5096221&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1769 We are called by Christ, among other things, to mourn with those who mourn, to weep with those who weep. This sometimes happens, suddenly and briefly, in the emergency room.  I was sitting at my desk one quiet morning recently.  EMS traffic caught my ear and I learned that there had been a terrible accident not far from the hospital.  However, far enough that the regional helicopter had been called to the scene. One patient would fly out.  One patient, one poor girl, one daughter, would not fly out.  And she would not come to me for care.  She died on the road at about 7:15 am.  She died on the road I sometimes drive to work, about 20 minutes after I would have passed the exact place she passed from this life. I was stricken, I was saddened.  Father of four, I was nauseated and hea... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5096221 Wed, 03 Aug 2011 02:42:20 +0100 5096221 http://www.medworm.com/index.php?rid=5097153&cid=t_100730_177_f&fid=38133&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTubalReversalBlog%2F%7E3%2FOXMO47aK_9o%2Fdiagnosing-and-fixing-blocked-tubes.html Diagnosing a blocked tube is easy by taking a careful medical history and obtaining an x-ray demonstrating blocking of the fallopian tubes. Fixing the tube is not always easy but advanced outpatient surgical techniques do exist which allow tubal repair surgeons to repair a patients blocked fallopian tubes. The tubal reversal doctors of Chapel Hill Tubal Reversal Center share with readers the solutions for diagnosing and fixing blocked tubes. Through these surgical techniques they are able to offer patients an alternative to in-vitro fertilization. (Source: Tubal Reversal Blog) Tubal Reversal Blog blogs http://www.medworm.com/rss/comments.php?id=5097153 Tue, 02 Aug 2011 16:48:33 +0100 5097153 http://www.medworm.com/index.php?rid=5107843&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F08%2Ftreatmemt-options.html In treating any kind of ailment, you always seem to start with a doctor. You hope the treatment will work but sometimes its not the treatment that is the problem, it could be your doctor. If you are suffering and in pain in any way, or you don't like them, or they don't listen to you, or they make you wait too long, it may be its time for a change.If its a specialist you are dealing with you may want to get a second opinion. If its your primary care, it may be time to find another one. I have a new primary care doctor and I feel I am finally getting attention. My last primary care doctor sent me for a mammogram one year and it was the 'bad' one. I was really upset and left her a note at her office. I never heard from her. That was the beginning of the end.There are lots of other reasons to... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5107843 Tue, 02 Aug 2011 11:25:00 +0100 5107843 http://www.medworm.com/index.php?rid=5096936&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F08%2Ftreatmemt-options.html In treating any kind of ailment, you always seem to start with a doctor. You hope the treatment will work but sometimes its not the treatment that is the problem, it could be your doctor. If you are suffering and in pain in any way, or you don't like them, or they don't listen to you, or they make you wait too long, it may be its time for a change.If its a specialist you are dealing with you may want to get a second opinion. If its your primary care, it may be time to find another one. I have a new primary care doctor and I feel I am finally getting attention. My last primary care doctor sent me for a mammogram one year and it was the 'bad' one. I was really upset and left her a note at her office. I never heard from her. That was the beginning of the end.There are lots of other reasons to... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5096936 Tue, 02 Aug 2011 11:25:00 +0100 5096936 http://www.medworm.com/index.php?rid=5096191&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F08%2Fa-quarter-of-heart-surgeons-are-above-average-in-updated-ratings.html Eighty-one of 323 surgical groups that perform heart bypass surgery got three stars (above average) in updated ratings published today by Consumer Reports and the Society of Thoracic Surgeons. In addition, 237 got two stars (average) and 5 received one star (below average). While several states require heart surgeons to report heart surgery data, many surgical groups—even some with just one star—voluntarily share that information with the public. Why? Because they know that ultimately translates into better care, as it helps surgeons identify the areas where they need to improve. In fact, the willingness of surgeons to track their performance has led to some important improvements, including a dramatic reduction in mortality over the past 10 years. For example, the differen... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5096191 Tue, 02 Aug 2011 11:01:00 +0100 5096191 http://www.medworm.com/index.php?rid=5086171&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-program-at-usf-health-hopes-to-mold-more-empathetic-physicians%2F2011.08.01 Can we teach empathy to the next generation of physicians?  The University of South Florida Health thinks so and they’re putting it on the line this week with the launch of the SELECT program, a new curriculum intended to “put empathy, communication and creativity back into doctoring.” The SELECT (Scholarly Excellence. Leadership Experiences. Collaborative Training.) program will offer 19 select students unique training in leadership development as well as the scholarly tools needed to become physician leaders and catalysts for change. During their first week on campus, instead of the old-style medical school tradition of heading to the gross anatomy lab, SELECT students are immersed in leadership training centered in empathy and other core principles of patient-centered care. The h... Better Health blogs http://www.medworm.com/rss/comments.php?id=5086171 Mon, 01 Aug 2011 12:00:15 +0100 5086171 http://www.medworm.com/index.php?rid=5086487&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F08%2Ffailure-to-communicate-and-why-does.html This story was told to me about a friend of a friend. This woman was suffering from back pain so she went to her doctor. The doctor said we can help you by putting rods in your back. Her surgery was scheduled and she showed up on the appointed day. The anesthesiologist asked about her medications and found she was using Fentanyl patches for pain. He said he couldn't sedate her until she was off the patches for two weeks. Her surgery was cancelled and rescheduled for two weeks later. She showed up Fentanyl patch free for the second surgery, was on the gurney being prepped and someone asked about her EKG. She hadn't had an EKG in two years so they postponed the surgery again so she could have one. At her EKG they found an irregularity which required treatment and was compared to her two year... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5086487 Mon, 01 Aug 2011 10:35:00 +0100 5086487 http://www.medworm.com/index.php?rid=5086174&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealth-care-attorney-warns-about-hipaa-privacy-issues-in-social-media%2F2011.07.31 This is the first of a three part post addressing the legal concerns of social networking in the health care arena. Legal expert, David Harlow, Esq., Health Care Attorney and Consultant at The Harlow Group, LLC in Boston, addresses the legal issues. Q:  Barbara: What are the legal implications for doctors, nurses and hospitals engaging in social media? A:  David: Health care providers are concerned about HIPAA privacy issues – HIPAA violations may occur as a result of staff posts, or as a result of patient, family or caregiver posts – as well as potential liability for medical advice provided on line.  Physicians and nurses have been sanctioned and fired for privacy breaches via social media, so these are real concerns.  Some communications that folks think are OK may in fact be v... Better Health blogs http://www.medworm.com/rss/comments.php?id=5086174 Sun, 31 Jul 2011 16:00:39 +0100 5086174 http://www.medworm.com/index.php?rid=5086165&cid=t_100730_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F07%2Finfographic-doctors.html ++ Click to Enlarge Image ++Image Source: Spina Bifida Info.com (Source: Denise Silber's eHealth) Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5086165 Sat, 30 Jul 2011 23:00:00 +0100 5086165 http://www.medworm.com/index.php?rid=5077966&cid=t_100730_136_f&fid=36032&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-breast-cancer%2Fyou-get-to-choose-your-doctors%2F I write often about how it is important to work with doctors you like and can trust. I was reminded of this last week when I had my four-month oncologist appointment. I love my oncologist, Dr. Khan. He has a gentle spirit, he is always cheerful, and he is always happy to see me. I spend much of the appointment asking about the chances of cancer returning and reviewing the effects of all the treatment I had. He in turn spends much of the appointment reassuring me and reminding me that although he can never say that breast cancer is completely cured, he is convinced that I will be around for a long, long time. He can be so confident because even his patients who have had cancer return or metastasize tend to live a long time with the chronic condition. Dr. Khan is very aggressive in treating ... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=5077966 Thu, 28 Jul 2011 16:22:26 +0100 5077966 http://www.medworm.com/index.php?rid=5069747&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F07%2Fdoctors.html Usually when you visit the doctor, the hospital personnel and medical staff all seem to be on the healthy side. There may be a few exceptions but hospitals seem to be full of doctors and nurses and other who have narrow waists, low BMI and you never catch a whiff of cigarette smoke near them. I can say that all my doctors are a healthy weight - except the pregnant ones. So when they start talking about weight and healthy eating and exercise, I do give them credit that they must follow that life style as well - they must walk the walk as well as talk the talk. I know about twenty years ago, I was treated by a nurse who had a pack of cigarettes in her pocket. I never see cigarettes around any more. The hospital now has a no smoking campus, so you see dwindling numbers of smokers hiding off t... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5069747 Wed, 27 Jul 2011 10:09:00 +0100 5069747 http://www.medworm.com/index.php?rid=5069485&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1750 Last night I was contacted by a physician in the local urgent-care.   I like him, and we made polite, but brief, conversation.  ‘So, are you guys busy?’ I gave him the status report.  ‘Well, yeah.  We have about 25 people waiting to be seen the waiting room is full and every patient room is full.  Also, we just received a gun-shot wound to the head by EMS.’ ‘Wow, sounds terrible!  So, here’s what I need to send you…’ What he sent was, in fact, reasonable.  A young woman with signs and symptoms of meningitis (who was treated earlier in the day for and upper respiratory virus…with Amoxicillin, of course.) She needed a lumbar puncture, which I performed and which was  negative. But I had this thought.  I could probably have said,... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5069485 Tue, 26 Jul 2011 14:35:39 +0100 5069485 http://www.medworm.com/index.php?rid=5069480&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-stories-in-medicine-that-need-to-be-told%2F2011.07.26 I can’t help but think that as time passes we’ll forget about how much medicine has changed with the introduction of the Internet.  We’re witnessing a transition that hasn’t been seen in generations.  We live with the end result but the memory of how we got here is fading quickly.  Like any kind of cultural shift, once we’ve arrived it’s hard to remember what it was like along the way. How did patients think before the information revolution?  And how did it go down when patients began to search?  How specifically did information clash with the old model of doctor and patient and how did we deal with it?  There are stories here that need to be told.  I think the real stories are in the small details of what went down between doctors and patients. But as early adopters, ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5069480 Tue, 26 Jul 2011 12:00:15 +0100 5069480 http://www.medworm.com/index.php?rid=5069468&cid=t_100730_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F07%2Fsurgery-journal-on-socialmedia.html My attention was drawn to a series of articles in the July 2011 subscriber-reserved issue of Surgery concerning the importance of social networks for the medical profession.  Each author explains why he or she considers social media  important and provides examples of their relevance  to doctors.Please read on for highlights   Social media in medical school education Katie M. Wells, MD, Macon, GA. Graduate from the Mercer University School of Medicine, Macon, GA; and General Surgery Resident, Department of Surgery, The Ohio State University, Columbus, OH Examples: Facebook for arranging meetings, sharing information YouTube for visual learning about complex science subjects, physical exam maneuvers, diagnostic procedures. YouTube, iTunes, for onl... Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5069468 Mon, 25 Jul 2011 23:00:00 +0100 5069468 http://www.medworm.com/index.php?rid=5062240&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhich-generation-of-physicians-uses-the-most-mobile-technology%2F2011.07.25 Smartphones and tablets have reached 80% of physicians across all practice types, locations and years in practice, and 25% of users are “Super Mobile” physicians who use both types of mobile devices. This is far beyond the general population’s 50% adoption of smartphones and 5% adoption of tablets. QuantiaMd, a free, online learning collaborative, released survey results that showed 44% of physicians who do not yet have a mobile device intend to buy one this year. While younger physicians have higher adoption rates than older ones, current use of mobile devices by physicians longest in practice is above 60%, the survey showed. Among physicians with 30 years or more of practice, almost 20% already use a tablet device for work, and another 25% say they are extremely likely ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5062240 Mon, 25 Jul 2011 18:00:00 +0100 5062240 http://www.medworm.com/index.php?rid=5062255&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1745 Good news on disability:  or should I say ‘disability.’ Anyone working in social services or medicine (well, anyone with half a cerebrum and some rational thinking capacity mixed in with their compassion) knows that the disability system in the US is completely out of control.  We routinely see patients who say, when queried about their disability, ‘well doc, honestly, I don’t know why I’m on disability!’  Which is fine if you’ve had a serious head injury or stroke, but if your complaint is ‘injured back while using chain-saw,’ maybe disability is a little generous. So, here’s some light in the darkness: http://lsolum.typepad.com/legaltheory/2011/07/pierce-on-administrative-law-judge-disability-decisionmaking.html Hallelujah! ... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5062255 Mon, 25 Jul 2011 17:03:37 +0100 5062255 http://www.medworm.com/index.php?rid=5062452&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F07%2Fso-whats-your-medical-history.html Do you even know your medical history? Could you write it down and give it to your doctor? I know the doctors always ask if you have had or if there is any family history of about twenty different things at one point or another when you first start seeing them. But then do they ever ask again? No.But you should tell them about significant health issues periodically. It is recommended this is done every five years. I am impatient. I tell my doctors more often. Every time I have aches and joint pain, I tell them how my mother has rheumatoid. Every time we talk about my bones and osteopenia, I tell them about the osteoporosis my mother, aunts, and grandmother had. If there is no medical history of a diagnosis in your family, it doesn't mean you can't get it. But if there is a medical history ... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5062452 Sun, 24 Jul 2011 11:37:00 +0100 5062452 http://www.medworm.com/index.php?rid=5057745&cid=t_100730_93_f&fid=36531&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FJeffreyMD%2F%7E3%2FlsnGA39Zfvc%2F Last week, in my post titled Doctors & Nurses, K8 left this comment/question: I’m about to start the journey of medical school. If you had to give advice to someone just starting, what would you say is the best way to appreciate and/or get along with the nursing staff?   I thought that was a great question. And if you glance back at that post, you’ll see that I said I’d answer her question in a separate post because I thought it was such a good question. Now, I still think it’s a good question, but I am struggling with coming up with a good answer — at least a good enough answer to justify writing a separate post for it. As I look back on my 3rd year rotations, I’d say most (probably 98%+) of my interactions with nurses have ranged from neutr... JeffreyMD.com blogs http://www.medworm.com/rss/comments.php?id=5057745 Sat, 23 Jul 2011 22:57:50 +0100 5057745 http://www.medworm.com/index.php?rid=5057746&cid=t_100730_97_f&fid=35606&url=http%3A%2F%2Fwww.theangriestpharmacist.com%2F2011%2F07%2F22%2Fthe-history-of-medicine%2F THE HISTORY OF MEDICINE 2000 B.C. - "Here, eat this root." 1000 B.C. - "That root is heathen, say this prayer." 20 A.D. - "That prayer is good, but you have to pray in my name me to get through to Dad." 1850 A.D. - "That prayer is a superstitious chant, drink this potion." 1940 A.D. - "That potion is merely snake oil, swallow this pill." 1970 A.D. - "That pill is ineffective, take this antibiotic four times a day." 1980 A.D. - "Bacteria aren't the problem. Viruses are enemy number 1! Get this vaccination, but you still better take our pills too!" 1990 A.D. - "Taking pills four times a day? That's ARCHAIC! Take this tablet once-a-day." 1999 A.D. - "That once-a-day tablet is cost prohibitive. Take this cheaper generic. It's the same thing." 1999 A.D. - "Their generic once-a-day tablet isn't ... The Angriest Pharmacist blogs http://www.medworm.com/rss/comments.php?id=5057746 Sat, 23 Jul 2011 05:46:34 +0100 5057746 http://www.medworm.com/index.php?rid=5057727&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-importance-of-social-media-in-the-medical-field%2F2011.07.22 Recently,  I had the pleasure of being surrounded by brilliant health care thought leaders.  First, I delivered a social media presentation at the Eyeforpharma conference.  Secondly, I sat in the audience at the Social Communications and Health Care 2011 conference to listen to others present on social media, and participate in a round-table discussion on social media. It’s clear from the personal discussion that followed with folks from the pharma industry, medical device companies, and hospitals, that they understand the need for social media (or social networking), but they are cautious to dive in. A few concerns I’ve heard:  “social media can be paralyzing,” “senior leadership in the pharma industry is looking for the FDA to make decisions because it’s such a highly reg... Better Health blogs http://www.medworm.com/rss/comments.php?id=5057727 Fri, 22 Jul 2011 16:00:49 +0100 5057727 http://www.medworm.com/index.php?rid=5050553&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fdoctors-are-better-at-spotting-skin-cancer-than-you-are.html Not only are doctors more likely to find melanoma than patients, but they tend to find them earlier, when they are easier to treat. That’s the finding of a study out this week in the Archives of Dermatology. Researchers at Memorial Sloan-Kettering Cancer Center in New York City looked at the records of 394 patients, who had a total of 527 melanomas. In patients who had been treated at the hospital for at least three months, 82 percent of the melanomas were found by doctors, not patients. In new patients, 63 percent were found by doctors. Cancers found by doctors also tended to be thinner, meaning that they were not as advanced. Skin cancer is the most commonly diagnosed cancer in the U.S. While melanoma accounts for only 5 percent to 6 percent of skin cancers, it causes roughly 75... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5050553 Fri, 22 Jul 2011 12:15:00 +0100 5050553 http://www.medworm.com/index.php?rid=5050570&cid=t_100730_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F07%2Ftwitterized.html (Source: Denise Silber's eHealth) Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=5050570 Thu, 21 Jul 2011 23:00:00 +0100 5050570 http://www.medworm.com/index.php?rid=5050955&cid=t_100730_129_f&fid=36035&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-chronic-pain%2Fcome-sit-in-my-seat-with-me%2F As most of you who read this blog regularly know, I am plagued by sacroiliac joint pain. I have other problems but today, since I am lying here on a painful behind and have been intensely trying to get out of this current flare, it is on my mind. I thought you might be interested in knowing what life is like in my shoes, my seat and my life right now. It’s been almost three months since I flew to California with my daughter to begin the process of cleaning out my mother-in-law’s house. I don’t fly well…at least without my wings. Even on an airplane I am bottom challenged and find them grossly uncomfortable. Three days after flying home I picked up our 31 pound rough-coated Jack Russell, Annie because she couldn’t get into the car to go to the vet’s. The combination of all of t... Life with Chronic Pain blogs http://www.medworm.com/rss/comments.php?id=5050955 Thu, 21 Jul 2011 20:27:49 +0100 5050955 http://www.medworm.com/index.php?rid=5050603&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1737 Leap’s quotient   The number of F-bombs used is inversely proportional to the chance of receiving narcotic analgesics in the emergency department.   That is,  # F-bomb=1/narcotic Rx (Source: edwinleap.com) edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5050603 Thu, 21 Jul 2011 14:50:28 +0100 5050603 http://www.medworm.com/index.php?rid=5051121&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F07%2Fpart-time-vs-full-time.html If you are a patient, you are a patient 24 hours a day. Your doctor works 8, 10, 12 hours a day, more or less. This leaves you with no way to contact your doctor for 12-16 hours a day - never mind weekends. And now, heavens above, doctors want to work part time? What is the craziness? Maybe they are looking for work/life balance and a bit of sanity. Well, some people have a problem with this. In general, more women and men are working part time while their children are young so they can be parents. So why shouldn't doctors? I don't see a problem with this - a doctor who is trying to be a professional and a parent who is allowed some flexibility in their schedule might actually be less stressed and more able to focus on the patient's needs.My oncologist is just back from maternity leave. Wh... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5051121 Wed, 20 Jul 2011 10:49:00 +0100 5051121 http://www.medworm.com/index.php?rid=5050519&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fr4jobby2deg%2F Neonatal intensive care units around the country are participating in quality programs to improve care for the most vulnerable babies, today’s Informed Patient column reports. But the quality-improvement movement is at the center of a dispute between some neonatologists and the American Board of Pediatrics, with the doctors protesting requirements that they demonstrate “meaningful participation” in quality-improvement activities as part of the board’s certification maintenance process. The rule applies to doctors who are to be newly certified, or were due to be re-certified anytime after 2010. The board has approved ten quality-improvement programs around the country that qualify for the process, including one sponsored by the large for-profit Pediatrix Medical Group — which empl... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5050519 Tue, 19 Jul 2011 14:44:25 +0100 5050519 http://www.medworm.com/index.php?rid=5050607&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1728 For years now, we’ve all heard the drum-beat.  Bill-boards in cities have proclaimed it.  Various medical associations have touted it’s importance.  Stroke symptoms have to be treated immediately!  Give clot-busting drugs, also known as ‘thrombolytics!’ Until, of course, those in favor of giving the drugs (namely neurologists)  realized that a)  Not everyone with a stroke, aka ‘brain attack’ has insurance and b) people have a very inconsiderate habit of having said strokes at the most inconvenient of hours.  For instance, after 5PM, on the weekend, on holidays.  The nerve! So across the country, physicians in emergency departments like mine are finding themselves expected by the court of public opinion to give a potentially dangerous drug (albeit... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5050607 Tue, 19 Jul 2011 01:27:57 +0100 5050607 http://www.medworm.com/index.php?rid=5050562&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fhospital-acquired-infections-common-and-deadly-in-trauma-patients.html In this study, researchers found that trauma patients who develop serious bloodstream infections are six times more likely to die during their stay than those without an infection. And people who develop other infections, such as pneumonia or MRSA, are 1.5 to 1.9 times more likely to die. Patients with infections also had hospital stays roughly twice as long and hospital costs roughly twice as high as those who didn’t have infections. In an editorial accompanying the article, H.Scott Bjerke, M.D., at the Research Medical Center in Kansas City, Mo., says: Infections make trauma patients sicker and sicker patients do worse; they die more, they consume more resources, and they stay longer. Or as my teenage son would say, ‘Duh, Dad, everyone knows that.’ So why do we need... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5050562 Mon, 18 Jul 2011 22:01:00 +0100 5050562 http://www.medworm.com/index.php?rid=5036232&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fteamwork-and-good-communication-make-everything-better%2F2011.07.16 What? Just what am I talking about? Give me a minute. More and more people are telling me too often they are encountering doctors who 1) don’t look them in the eye 2) don’t listen to them 3) don’t touch them or get anywhere near them and 4) stay focused on their a) computer b) smartphone or c) iPad. More of us are saying we are “mad as hell and are not going to take it anymore” just like the character in the movie “Network” years ago. We find another doctor. I am happy to report that an increasing number of the gray haired doctors who run medical schools are agreeing with us. Doctors need to be better communicators. They need to celebrate human contact rather than devote themselves to only technology and leading edge science. The professors also want tomorrow’s doctors to ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5036232 Sat, 16 Jul 2011 22:00:48 +0100 5036232 http://www.medworm.com/index.php?rid=5036235&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-you-find-a-new-doctor%2F2011.07.16 Come  on people… you know what I am talking about.  Sure you are comfortable with your current doctor… after all you are still alive and kicking.  Besides it has taken you years to figure out what you can safely tell your doctor and when it’s ok to speak up.  Yes the fact that your doctor is often late and never seems to listen to you bothers you just a little.  But you aren’t displeased enough to stop giving your doctor high satisfaction scores.  After all who wants to upset their doctor?   But admit it; you have wondered if there isn’t a doctor out there that would be a better fit with you.   I know I have. Doctors probably feel the same way about many of their patients.   It can’t be easy everyday trying to help patients that don’t seem to want to help themselv... Better Health blogs http://www.medworm.com/rss/comments.php?id=5036235 Sat, 16 Jul 2011 14:00:02 +0100 5036235 http://www.medworm.com/index.php?rid=5028213&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-age-of-medical-disconnect%2F2011.07.14 It’s the age of medical disconnect. The disconnect describes the emotional and intellectual detachment that physicians feel from their patients and patients from their doctors.  This disconnect is the result of a confluence of factors, some from within the profession itself, others are more broadly social and economic. To understand the disconnect you need look no further than your neighbor or your parents.  Dissatisfaction is evolving as the norm.  Patients feel increasingly marginalized in their experiences with physicians.  Shrinking length of visits, indifferent attitudes, poorly coordinated evaluations, difficulty obtaining test results, an institutional feel to the patient experience, and the overall sense of not feeling at all important. The truth is that many of us are really... Better Health blogs http://www.medworm.com/rss/comments.php?id=5028213 Thu, 14 Jul 2011 21:00:13 +0100 5028213 http://www.medworm.com/index.php?rid=5028129&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FnHGEBS4alg8%2F Accepting Facebook friend requests from current or former patients is a lousy idea, the British Medical Association is telling physicians. The group’s new social media guidance notes that “because of the power imbalance that can exist in any doctor-patient relationship,” it’s important to establish a professional boundary. And that can be tough to do given all the personal information a Facebook status-update stream can deliver. The BMA writes: Given the greater accessibility of personal information, entering into informal relationships with patients on sites like Facebook can increase the likelihood of inappropriate boundary transgressions, particularly where previously there existed only a professional relationship between a doctor and patient. Difficult ethical i... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=5028129 Thu, 14 Jul 2011 13:29:06 +0100 5028129 http://www.medworm.com/index.php?rid=5028187&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fcdc-releases-new-guide-on-preventing-infections-in-outpatient-clinics.html More than three-quarters of all operations in the U.S. are now done in outpatient clinics, not hospitals. But many of those clinics don’t adhere to standard infection-prevention practices. To help correct that problem, the Centers for Disease Control and Prevention today released new guidelines meant to prevent infections in in “ambulatory” surgery centers, primary-care offices, endoscopy clinics, and pain-management clinics. The new guide is based on existing CDC guidelines now used mostly in hospitals. The guide includes a checklist meant to prevent infections from injections, poor hygiene, and other causes. Among other recommendations, it suggests that all outpatient practices have at least one individual with specific training in infection control on staff or regular... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5028187 Wed, 13 Jul 2011 20:51:06 +0100 5028187 http://www.medworm.com/index.php?rid=5028219&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Funderstanding-us-healthcare-four-books-you-dont-want-to-miss%2F2011.07.13 I have had the privilege of working at an organization which is actively improving the lives of its members and also was mentioned by the President as a model for the nation.  Over the past few years, I have also demonstrated to first year medical students what 21st century primary care should look and feel like – a fully comprehensive medical record, secure email to patients, support from specialists, and assistance from chronic conditions staff. But as my students know, there are also some suggested reading assignments.  I’m not talking about Harrison’s or other more traditional textbooks related to medical education.  If the United States is to have a viable and functioning health care system, then it will need every single physician to be engaged and involved.  I&... Better Health blogs http://www.medworm.com/rss/comments.php?id=5028219 Wed, 13 Jul 2011 20:00:00 +0100 5028219 http://www.medworm.com/index.php?rid=5028193&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F07%2Fgoing-to-the-hospital-this-month-beware-the-july-effect.html Patients admitted to teaching hospitals in July are slightly more likely to die during their stay, and tend to have longer hospital stays and higher hospital charges, according to a study published online today by the Annals of Internal Medicine. Why? Possibly because July is when experienced trainees graduate and new, less experienced ones start. Researchers from the University of San Francisco School of Medicine reviewed 39 studies to determine the effect of trainee changeover on patient outcomes. They noted that while there was considerable variation among hospitals, overall patients tended to fare worse in the month of July. John Q. Young, M.D., co-author of the study, said in a press release, At year-end, teaching hospitals experience a massive exodus of highly experienced physic... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=5028193 Mon, 11 Jul 2011 22:01:00 +0100 5028193 http://www.medworm.com/index.php?rid=5008570&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F07%2Fgooglechondria-and-difficult-doctors.html If you have a new symptom, what should you do? Google it! Self diagnose yourself with mad cow, colon cancer, typhoid, or any other ailment. Then call your doctor, read your print out and tell them why you think you have it.Are you a hypochondriac? No, you aren't. You have Googlechondria. You google everything and find out you what is really wrong with you. Why do you need a doctor other than to prescribe the appropriate medication to cure you instantly? All you need to do is call them and they will call in a prescription. It is best to call daily to build good relationships with their office staff as well. They will learn to recognize the sound of your voice and get the doctor promptly as you deserve the attention. If you do this, you are not alone if you read this article. What you really... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5008570 Fri, 08 Jul 2011 10:11:00 +0100 5008570 http://www.medworm.com/index.php?rid=5008318&cid=t_100730_109_f&fid=35088&url=http%3A%2F%2Fqw88nb88.wordpress.com%2F2011%2F07%2F07%2Fsinging-teh-brain-dead-workin-hard-blues-remodeling%2F Had a migraine this morning Cancelled on my shrink. Need to clean and organise But I can’t even think. Moved bedrooms three days ago O where is my daily pill box? Boxes and piles everywhere O where are my clean socks? I need to go out and garden Weeds have eaten the side yard. I [...] (Source: Andrea's Buzzing About:) Andrea's Buzzing About: blogs http://www.medworm.com/rss/comments.php?id=5008318 Thu, 07 Jul 2011 03:13:50 +0100 5008318 http://www.medworm.com/index.php?rid=5008467&cid=t_100730_129_f&fid=27216&url=http%3A%2F%2Flifewithadhd.com%2Fadhd-research%2Ffacts-about-adhd-medications-doctors-never-mention.php One of the most respected researchers on ADHD, William Pelham has now come out strongly against ADHD medications and asserts that research shows they are practically useless in the long term. This is just one of the facts about ADHD medications which may or may not get publicity, depending whose website you happen to be visiting. He also claims that fellow scientists were unwilling to acknowledge that there was evidence which showed that the usefulness of ADHD medications was somewhat limited over a number of years. Alarmed by the number of doctors giving psychostimulants and antipsychotic drugs to children with ADHD which was not strictly necessary, the state of Florida decided to ask the doctors to go through a review process. The number of prescriptions dropped dramatically in a year. W... Life With ADHD blogs http://www.medworm.com/rss/comments.php?id=5008467 Tue, 05 Jul 2011 23:00:00 +0100 5008467 http://www.medworm.com/index.php?rid=5008713&cid=t_100730_177_f&fid=38133&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTubalReversalBlog%2F%7E3%2FWeZHXLXVpAs%2Freversing-blocked-tubes-after-sterilization-procedures.html The most common form of tubal blockage occurs after tubal sterilization. Reversing blocked tubes from tubal sterilization surgery can be done with one of two advanced surgical reversal procedures. These procedures provide patients and alternative to in-vitro fertilization and also with excellent chances of pregnancy after removal of the tubal blockage. (Source: Tubal Reversal Blog) Tubal Reversal Blog blogs http://www.medworm.com/rss/comments.php?id=5008713 Tue, 05 Jul 2011 18:21:27 +0100 5008713 http://www.medworm.com/index.php?rid=4992698&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1713 Today is the day that new resident physicians begin their training all across the United States.  Today, our future family physicians and pediatricians, neurosurgeons and emergency physicians, plastic surgeons and laser tattoo removal specialists (OK, not really a specialty, just a side-line) will begin learning how to be physicians, having completed four years of expensive college and four years of even more expensive medical school.  Anxiety-filled and debt-ridden, they will embark on four to seven (or even more) years of training to make them knowledgeable, technically proficient physicians. I will occasionally wax poetic and philosophical for their benefit.  But not today.  Today there are practical matters.  Today I want to give them a few pointers, to ease their transition into ... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4992698 Fri, 01 Jul 2011 23:49:38 +0100 4992698 http://www.medworm.com/index.php?rid=4992699&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1711 This is my column in July’s EM News.  Have a restful day! http://journals.lww.com/em-news/Fulltext/2011/07000/Second_Opinion__A_Rest_for_the_Heart.10.aspx We travel to Hilton Head, SC, every spring for an ‘end of school-year’ vacation. It is a tradition that started several years ago; one which our family treasures. We plan months ahead, when we arrange lodging. Then, as the date draws closer we have to restrain ourselves from jumping up and down at odd, inappropriate times. The beach calls to us in an inexplicable way. We live in a beautiful county, surrounded by mountains and lakes. It is, in itself, a worthy destination, perfect for biking, hiking, fishing and/or kayaking. But when May rolls around, our eyes turn to the east, and we long for the sand and sea. It is on... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4992699 Fri, 01 Jul 2011 22:24:09 +0100 4992699 http://www.medworm.com/index.php?rid=4992646&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FGBculZafxR8%2F The medical residents starting their training today belong to a generation that doesn’t think twice about broadcasting even intimate details of their lives via texts, Twitter and other social media. That can get tricky when those doctors’ lives begin to include patients. To help spark discussions of how residents can negotiate this new ground, the folks at the Mayo Clinic Center for Social Media have put together a video with advice from doctors who are active on Twitter, blogs, Facebook or other forms of social media. The project “was born from this idea that there are currently no well-defined guidelines about digital behavior” for physicians, says Bryan Vartabedian, a pediatric gastroenterologist at Texas Children’s Hospital in Houston who appears on the vi... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4992646 Fri, 01 Jul 2011 16:28:09 +0100 4992646 http://www.medworm.com/index.php?rid=4992691&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-be-a-good-doctor-10-rules-of-the-road%2F2011.07.01 He sat in a crisp white coat, staring at a computer screen, note cards in his lap. Occasionally, I noted him jot a note to himself as he compiled his list. A nurse sat next to him, pounding feverishly on the keyboard as she recorded her nurse’s note. He tentatively moved his mouse, then clicked, still staring. I recall my first day in clinical medicine: no computer, an ER rotation, a white board filled with names and abbreviated medical problems next to them with little magnetic color-coded labels nearby. Room 1: Head trauma. Room 2: Abscess. Room 3: UTI, Room 4: Rash. I got room 2. It was the biggest, bad-est infected sebaceous cyst on a guy’s back a newly minted doctor had ever seen. Can you say “softball?” “See one, do one,” they told me. And off I went. Much in medicine ha... Better Health blogs http://www.medworm.com/rss/comments.php?id=4992691 Fri, 01 Jul 2011 14:00:00 +0100 4992691 http://www.medworm.com/index.php?rid=4984447&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysicians-and-the-evolution-of-twitter%2F2011.06.30 There’s a temptation to think of Twitter as it once was.  As recently as 3 years ago there were very few physicians using Twitter.  Early physician adopters enjoyed a tighter experience than today.  Everyone followed everyone and actually finding another doctor was cause for celebration.  It was a cocktail party – less a tool as much as a place to goof off.  It was easier in many respects. But Twitter seems to be evolving from a curious toy to a more focused space of sharing among the like-minded.  I see new docs play out this broader evolution of Twitter:  near obsessive early preoccupation gives way to the question of how it can actually work for them.  Experimentation with relationships gives way to connections that are more likely to give us what we really need. We’ve hi... Better Health blogs http://www.medworm.com/rss/comments.php?id=4984447 Thu, 30 Jun 2011 12:00:59 +0100 4984447 http://www.medworm.com/index.php?rid=4975876&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1706 Trained as an emergency physician, my entire career has been spent pondering, searching for, often finding and managing the worst possible eventualities in my patients.  Chest pain is, first and foremost, a heart attack or pulmonary embolus.  Abdominal pain is appendicitis, a ruptured tubal pregnancy.  Fever with headache is meningitis.  And neck pain from a car wreck is an unstable cervical spine fracture. So it has taken enormous effort to ‘dial-down’ my response to my wife’s recent cancer, treatment and recovery.  I drive her to distraction with ‘how are you feeling?’  I pester her endlessly to eat.  I have imagined every bump or cough a metastasis.  I have envisioned all the worst outcomes imaginable.  I endlessly ‘catastrophize,’ as o... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4975876 Tue, 28 Jun 2011 21:01:30 +0100 4975876 http://www.medworm.com/index.php?rid=4975818&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FxGAgcGwnaZg%2F How’s the diabetes treatment in Wisconsin? Or the access to after-hours medical care in California? The Robert Wood Johnson Foundation has rolled out a new online directory of 224 health-care quality reports that compare local physicians and hospitals. The idea is that consumers can get localized, quantitative information on measures such as how often patients in a certain medical practice receive their recommended screening tests or how long mothers typically spend in a given hospital after a cesarean section. The specific measures will vary by report. Note the emphasis on “quantitative.” These reports, 197 of which cover specific states, all use performance data based on nationally recognized standards on quality and cost. All are freely available. The more subjective p... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4975818 Tue, 28 Jun 2011 16:57:01 +0100 4975818 http://www.medworm.com/index.php?rid=4975821&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FZzdnVg-ddDc%2F It’s no secret that there’s a shortage of physicians that will likely only get worse when the health-care overhaul law brings an estimated 33 million new people into the health-care system starting in 2014. To gauge the current access situation, the government is planning a mystery shopper program that is already raising the hackles of some physicians, the New York Times reports. Federal contractors will pose as potential patients and call more than 4,000 physicians to see if they are accepting patients, how long the wait for different types of care is and whether the answers vary depending on whether the “patient” has private or public insurance. (A fraction of the doctors will be called back by contractors asking similar questions but identifying themselves as HHS... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4975821 Mon, 27 Jun 2011 15:17:59 +0100 4975821 http://www.medworm.com/index.php?rid=4968505&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1704 Last night, working in the emergency department, I realized yet again that EMR is a problem.  While governmental bodies and consulting firms endlessly praise the utility and wonders of electronic medical records, the hard reality ‘on the ground’ is that entering electronic data, for every patient encounter, is a productivity killer. In fact, I realized that I spend far more time looking at the screen, clicking the mouse and typing the history for the patient counter than I ever spend actually talking to, and touching, the patient. I believe that EMR, while having some utility, has simply caused us to obtain and store more data than ever, most of which is unnecessary at best, and at worst, damning and confusing.  (Damning because if my vast chart conflicts with the nurse&#8217... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4968505 Thu, 23 Jun 2011 20:26:51 +0100 4968505 http://www.medworm.com/index.php?rid=4968679&cid=t_100730_117_f&fid=37824&url=http%3A%2F%2Fwww.doctorkalitenko.com%2Fblog%2Fbargain-shopping-doctor%2F   A recent article published on AOL discussed the new trend of pricing out doctors and services before heading out to get a procedure done. Several companies have recently been created to help patients become consumers instead when it comes to where they will get procedures done. So what do we think about this? Is bargain shopping OK when it comes to the health care you will get? Some people seem to think so. Just like shopping for a car, or clipping coupons, is health care on the verge of a completely different reform? Maybe we will start seeing patients in hospitals reviewing a menu of doctors and services before getting their gallbladders out, or have a c-section. The next step after that would be a list of medications that you need as well as a chart of what else can be offered a... Doctor Kalitenko antiaging blog blogs http://www.medworm.com/rss/comments.php?id=4968679 Thu, 23 Jun 2011 18:57:53 +0100 4968679 http://www.medworm.com/index.php?rid=4960327&cid=t_100730_150_f&fid=34889&url=http%3A%2F%2Fpharmamkting.blogspot.com%2F2011%2F06%2Fim-at-doctors-20-you-conference-in.html Yesterday, I presented a workshop at the Doctors 2.0 & You conference in Paris. Here's a photo taken by my friend Bertalan Mesko (@berci):You can find a link to my presentation here. (Source: Pharma Marketing Blog) Pharma Marketing Blog blogs http://www.medworm.com/rss/comments.php?id=4960327 Thu, 23 Jun 2011 10:29:00 +0100 4960327 http://www.medworm.com/index.php?rid=4960075&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1693 I haven’t worked a night shift in many months.  For a time, years ago, I worked full-time nights.  I did it for about seven years, at which time my wife told me I was acting depressed and should move to a daytime schedule.  Still, the vagaries of the ER require that we sometimes be here all night.  Blech.  So, I thought I’d take this opportunity to chronicle my thoughts through the night.  Please be patient if my thought processes seem to ramble. 1)  I had, in my lunch container, a cheeseburger, two packs of Swiss Cake Rolls, and a turkey, pepper-jack and honey-wheat bread sandwich.  I arrived at 2250.  It is 2330.  I have consumed one turkey sandwich and one pack of Swiss Cake Rolls.  It may be a long night. 2)  I came to work without sleeping much.  I simply coul... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4960075 Thu, 23 Jun 2011 04:26:16 +0100 4960075 http://www.medworm.com/index.php?rid=4960016&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FX65MzyNL6vY%2F Note to the competitors in the Nathan’s Famous Fourth of July International Hot Dog Eating Contest: the American Medical Association, officially, does not approve. In addition to resolutions backing the individual mandate to purchase health insurance and to adopt a bill of rights for medical residents, delegates to the AMA’s annual meeting have approved a resolution recognizing “competitive speed eating as an unhealthy eating practice with potential adverse consequences.” Admittedly, there’s not a whole lot of published research on this topic. One study published a few years back in the Journal of Roentgenology looked at the stomach of a competitive eater and found that it expanded “to form an enormous flaccid sac capable of accommodating huge amounts of... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4960016 Tue, 21 Jun 2011 21:24:00 +0100 4960016 http://www.medworm.com/index.php?rid=4953400&cid=t_100730_177_f&fid=38133&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTubalReversalBlog%2F%7E3%2F4oh4OHt_JCE%2Fexpert-tubal-reversal-surgeons.html Expert tubal reversal surgeons can be found at Chapel Hill Tubal Reversal Center. In the hands of Dr. Berger and Dr. Monteith women will have an excellent chance of having their tubes repaired and getting pregnant after tubal reversal. Don't get talked into in-vitro fertilization until you have had a chance to talk with the staff of these expert tubal reversal surgeons. (Source: Tubal Reversal Blog) Tubal Reversal Blog blogs http://www.medworm.com/rss/comments.php?id=4953400 Tue, 21 Jun 2011 17:35:31 +0100 4953400 http://www.medworm.com/index.php?rid=4953358&cid=t_100730_150_f&fid=34889&url=http%3A%2F%2Fpharmamkting.blogspot.com%2F2011%2F06%2Fi-am-off-to-paris-and-doctors-20-you.html For the next 2 weeks I will be in Europe speaking at two conferences. The first stop is Paris, France, where I will lead the "Essentials of an External Social Media Policy" workshop this Wednesday (see the meeting agenda here). I uploaded a slide deck I prepared for that workshop on SlideShare (here). These slides present data from surveys I have done and form just the basis for beginning the discussion at the workshop. I hope the discussion and debate at my workshop helps build a concise and organized set of Fair Social Media Practice Principles that I will publish for comment after the workshop. For background and to input your own suggestions, see "Fair Social Media Practice Principles: Rules for Third-Party Engagement in Patient/Physician Social Networks."Denise Silber (@health20Paris)... Pharma Marketing Blog blogs http://www.medworm.com/rss/comments.php?id=4953358 Mon, 20 Jun 2011 10:55:00 +0100 4953358 http://www.medworm.com/index.php?rid=4952864&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1681 For all of you fans of electronic books (which have finally out-sold print books), my latest book, The Practice Test, is available as an e-book.  Here’s the link! http://booklocker.com/books/5196.html Thanks for your support! Edwin (Source: edwinleap.com) edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4952864 Sat, 18 Jun 2011 17:18:09 +0100 4952864 http://www.medworm.com/index.php?rid=4952787&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fff5Ff0xfAp4%2F Heart Risk?: The FDA says that people who already have cardiovascular disease may see their chances of a heart attack rise if they take Pfizer’s Chantix smoking-cessation drug, the WSJ reports. The agency based its warning on a trial of 700 heart-disease patients, and says it will update the product’s label and medication guide. Pfizer notes there are big heart benefits to be gained by quitting smoking. No Change: The Centers for Medicare and Medicaid Services will leave the issue of reimbursement for Amgen’s Aranesp and Epogen and Johnson & Johnson’s Procrit up to regional contractors rather than making a so-called national coverage determination, Bloomberg News reports. An analyst says the decision on the anemia drugs will remove an “overhang” on A... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4952787 Fri, 17 Jun 2011 12:51:52 +0100 4952787 http://www.medworm.com/index.php?rid=4934161&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-boundaries-between-doctor-and-patient%2F2011.06.16 This post from Kelly Young on Howard Luks’ blog asks when patients cross the line with respect to their own advocacy.  It’s worth a peek. The question of boundaries between doctor and patient is interesting.  All of my patients are empowered in some way.  The extent and level of that empowerment is personal.  On our own there are few lines and little with respect to boundaries.  We have effectively unlimited access to information and resources.  And how far we go to look after ourselves and our kids has few limits. But when we enter into a relationship with a provider, we’re no longer alone.  It’s unreasonable for a provider to tell a patient (more…) *This blog post was originally published at 33 Charts* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4934161 Thu, 16 Jun 2011 12:00:58 +0100 4934161 http://www.medworm.com/index.php?rid=4934092&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FChMN5HMXPyg%2F Efforts to improve patient safety need to move beyond the hospital to outpatient settings such as doctors’ offices. That’s one of the takeaways from a new study published in the Journal of the American Medical Association that analyzes the malpractice claims paid on behalf of physicians. In 2009, there were 10,739 paid claims. In that year, the number of out- and in-patient claims was about the same (and both fell from 2005 levels), but the proportion of claims associated with outpatient care had edged up slightly. Counting events involving both settings, 52.5% involved outpatient care at least in part, resulting in about $1.5 billion in malpractice payments. (Malpractice claims are one of the ways to analyze medical errors, with the assumption that they represent only a small ... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4934092 Tue, 14 Jun 2011 20:27:39 +0100 4934092 http://www.medworm.com/index.php?rid=4934646&cid=t_100730_131_f&fid=34989&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FGeneticsHealth%2F%7E3%2FDwssmUnlML8%2F Photo Via Ragesoss When men are diagnosed with iron-deficiency anemia, the first thing doctors usually do is check for internal bleeding. When women are diagnosed with iron-deficiency anemia, they’re given an iron supplement and told to eat more broccoli. Why the discrepancy? The main cause of iron deficiency in men is upper-gastrointestinal bleeding, so it makes sense for doctors to rule this out first. However, a 1999 study on anemia in women found that “on women for whom a gynecological source was diagnosed by a specialist” — i.e., women whose anemia was blamed on their periods — 86 percent actually had a gastrointestinal disease. “The majority of the women in that study were bleeding internally, and no one had figured it out until then because they had periods,” writes Pr... Genetics and Health blogs http://www.medworm.com/rss/comments.php?id=4934646 Tue, 14 Jun 2011 16:35:04 +0100 4934646 http://www.medworm.com/index.php?rid=4921404&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fhip-and-knee-surgery-riskier-at-quieter-hospitals.html Hip and knee replacement surgery is riskier in hospitals that carry out fewer operations, researchers have found. People are more likely to get blood clots or die at quieter hospitals, compared with hospitals that perform the operations regularly. According to the American Academy of Orthopaedic Surgeons, around 800,000 hip and knee replacement surgeries are performed in the United States each year. A joint replacement can help people with severe arthritis move around more easily and have less pain, but it involves major surgery and things can sometimes go wrong. In the study, which looked at the medical records of around 30,000 people, hospitals that performed more than 200 hip or knee replacements each year had better results. Patients treated in hospitals that performed fewer operatio... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4921404 Sat, 11 Jun 2011 14:00:00 +0100 4921404 http://www.medworm.com/index.php?rid=4921409&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fhospitals-that-make-their-data-hard-to-find.html One of the most important things to know about a hospital is how many of its patients develop infections. But hospitals often don’t release that data. To help motivate them, we put together a list of teaching hospitals that haven't made their information on infections easily accessible to the public. “The best hospitals know that sunlight is the best disinfectant, so they are willing to publicly report even if their performance is not yet optimal,” said Leah Binder, chief executive officer of The Leapfrog Group, a nonprofit organization that focuses on improving health care in hospitals, in part by encouraging them to report information on infections and other measures. For this analysis, we focused on hospitals that are members of the Council of Teaching Hospitals, ex... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4921409 Fri, 10 Jun 2011 15:56:00 +0100 4921409 http://www.medworm.com/index.php?rid=4921377&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F1EmFLo4w4a4%2F Talk to anyone for very long about how to improve health care in the U.S. and you eventually hear something along the lines of: “We have to start paying physicians for getting and keeping people healthy instead of for doing as many procedures and tests as possible.” According to a report from Merritt Hawkins, a big physician search and consulting firm, that isn’t yet happening to a significant degree in the real world. The company’s annual report on recruiting incentives finds that 74% of the jobs they recruited for in the year ending March 31 featured a performance bonus. Of those that offered such a bonus, in 90% of the cases it was linked to “fee-for-service style volume.” Meantime, fewer than 7% of the jobs offering bonuses rewarded physicians for me... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4921377 Thu, 09 Jun 2011 19:16:22 +0100 4921377 http://www.medworm.com/index.php?rid=4921747&cid=t_100730_150_f&fid=34889&url=http%3A%2F%2Fpharmamkting.blogspot.com%2F2011%2F06%2Ffair-social-media-practice-principles.html Recently, there's been some discussion on Twitter and certain blogs about Sermo, the online physician community based in the U.S. When Sermo representative Thomas Rines (@tomrines) tweeted that "Sermo is an online community for US physicians. We provide our clients the ability to engage with the community" in a recent #MedDevice chat, he caused a "What? Wait!" doubletake (see "The Twitter Chat that Killed Sermo"). It seems that many physicians -- including some who are Sermo members -- are not aware of Sermo's business model, which is “Sermo is free to practicing physicians. Revenue is generated as healthcare institutions, financial services firms and government agencies purchase Sermo products to access this elite group of practitioners.”Here were some responses to Rines' tweet:"Sound... Pharma Marketing Blog blogs http://www.medworm.com/rss/comments.php?id=4921747 Thu, 09 Jun 2011 18:14:00 +0100 4921747 http://www.medworm.com/index.php?rid=4921428&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-physicians-wear-white-coats%2F2011.06.09 The Doctor’s white coat has been a symbol of the profession for decades.  In the 1800′s and up through the early 20th Century, doctors wore street clothes while performing surgery…rolling up their sleeves and plunging dirty hands into patient’s bodies.  They often were dressed in formal black, like the clergy to reflect the solemn nature of their role.  (And seeing a doctor was solemn indeed as it often led to death) A 1889 photograph from the Mass General Hospital shows surgeons in short sleeved white coats over their street clothes and in the early 20th Century the concept of cleanliness and antisepsis was starting to take hold in American medicine.  Both doctors and nurses started donning white garb as a symbol of purity.  The white coat took on more and mor... Better Health blogs http://www.medworm.com/rss/comments.php?id=4921428 Thu, 09 Jun 2011 16:00:00 +0100 4921428 http://www.medworm.com/index.php?rid=4921411&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fboston-beats-new-york-in-cr-hospital-ratings.html The Boston vs. New York rivalry isn’t just the Red Sox vs. the Yankees. It’s which city, each known for its prestigious hospitals, has better medical care. Well, when it comes to preventing hospital-acquired infections at least, Boston wins, according to our updated hospital Ratings. For this comparison, we looked at hospitals that are members of the Council of Teaching Hospitals (excluding Veteran Administration hospitals) that are in either the Boston hospital-referral region (Boston, Cambridge, and a few neighboring towns); or in the three New York City hospital-referral regions (the five boroughs plus certain neighboring suburbs). We looked at the two most serious kinds of infections: bloodstream infections in intensive-care units that are linked to central-line catheters... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4921411 Thu, 09 Jun 2011 13:00:00 +0100 4921411 http://www.medworm.com/index.php?rid=4911471&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fwhere-to-find-a-safe-hospital.html In which hospitals are you least likely to pick up an infection? Our updated hospital Ratings include eight elite ones that reported zero surgical-site infections and zero bloodstream infections. We also identified 36 hospitals with the enviable record of having no bloodstream infections in both our 2010 and 2011 Ratings. This year we were able to include Ratings on central-line bloodstream infections for 1,119 hospitals in the District of Columbia and every state except Arkansas, Hawaii, Montana, North Dakota, South Dakota, and West Virginia. Of those hospitals, 142 (almost 13 percent) reported zero infections, compared with 11 percent last year. Particularly impressive are the 36 hospitals that had zero bloodstream infections in two consecutive reports. For surgical-site infections,... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4911471 Wed, 08 Jun 2011 10:50:00 +0100 4911471 http://www.medworm.com/index.php?rid=4911485&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffive-fresh-medical-bloggers%2F2011.06.07 I love finding new physician voices.  Here are a few that I’ve been peeking at over the past couple months.  They’re worth checking out. Linda Pourmassina.  Linda is an internist in Seattle and one of the finest writers in the medical blogosphere.   You can find her over at Pulsus where she offers commentary on an eclectic mix of medical goodness ranging from social media to the subtleties of patient interaction.  Really good stuff.  Check out The Internet and Delusional Thinking.  Beyond her blog, Linda’s Twitter output is the perfect balance of valuable links and dialog.  Put her in your feed and she’ll bring you good things. Chris Porter.  Chris is a surgeon who has been writing at On Surgery, Etc. since April.  This guy has an incredible voice and offers rare insight... Better Health blogs http://www.medworm.com/rss/comments.php?id=4911485 Tue, 07 Jun 2011 16:00:52 +0100 4911485 http://www.medworm.com/index.php?rid=4911850&cid=t_100730_177_f&fid=38133&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTubalReversalBlog%2F%7E3%2FEtJ2BpKljX4%2Fis-ivf-better-than-tubal-ligation-reversal.html Is IVF better than tubal reversal surgery? Have you wondered why IVF was recommended or why you may have been talked out of a tubal ligation reversal? If you need answers, then this article may help provide them for you because in most cases tubal reversal will offer better chances at pregnancy than does IVF. (Source: Tubal Reversal Blog) Tubal Reversal Blog blogs http://www.medworm.com/rss/comments.php?id=4911850 Tue, 07 Jun 2011 11:16:41 +0100 4911850 http://www.medworm.com/index.php?rid=4911473&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fteaching-hospitals-not-always-best-for-patient-safety.html When you’re really sick you’re best off in a large teaching hospital in a big city, right? Not necessarily, at least when it comes to patient safety, according to our new hospital Ratings. What they found: While many well-established teaching hospitals do well at preventing potentially deadly hospital-acquired infections, others don’t. We looked at bloodstream infections that patients developed in intensive-care units while on central-line catheters, or tubes used to deliver fluids, medication, and nutrition to patients. The data came either from one of the 18 states that publicly report hospital-infection rates, or from The Leapfrog Group a nonprofit organization in Washington, D.C., that focuses on improving health care in hospitals. We focused on hospitals that are... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4911473 Tue, 07 Jun 2011 11:00:00 +0100 4911473 http://www.medworm.com/index.php?rid=4893450&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-york-state-wants-to-dictate-what-doctors-can-wear%2F2011.06.03 From AMA Medical News: New York physicians may have to take off their neckties, jewelry, wristwatches and long-sleeved white coats when caring for patients if a bill under consideration in the state legislature becomes law. The bill, proposed in April in the state Senate, calls for a “hygienic dress code council” within the New York Health Dept. to consider advancing a ban on neckties and requiring physicians and other health professionals to adopt a “bare below the elbow” dress code in an effort to slash hospital-acquired infections. Even though there’s no data that this does anything to reduce hospital acquired infections. But that doesn’t matter. So why stop there? I say, doctors should do the ultimate for their patients: the Full Monty. *Th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4893450 Fri, 03 Jun 2011 18:00:00 +0100 4893450 http://www.medworm.com/index.php?rid=4893592&cid=t_100730_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F06%2Fbetter-way-of-making-sure-doctors-learn.html If conferences are such a poor way of teaching doctors, then what can the profession do to ensure that doctors remain updated ? Is it possible to trust that all doctors are responsible professionals who will take the time and trouble to educate themselves on an ongoing continual basis ? Sadly, no. While most doctors are conscientious and will make a concerted effort to learn, not all will do so .So what's a better option which will ensure that doctors learn reliable, updated, accurate evidence based medicine, without wasting time and money ?The answer is surprisingly simple ! In medical college, doctors are used to memorising vast amounts of information from their medical textbooks, so that they can pass their examinations , qualify and start practise. Unfortunately, most of what they lear... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4893592 Fri, 03 Jun 2011 14:13:00 +0100 4893592 http://www.medworm.com/index.php?rid=4893434&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F06%2Fpatients-cell-phones-may-carry-dangerous-bacteria.html Hospital-acquired infections often stem from poor hand washing or a mishandled catheter, but there’s another culprit right at your fingertips—your cell phone, suggests a study published in the June issue of the American Journal of Infection Control. It found that cell phones used by patients and their visitors were twice as likely to be contaminated with potentially dangerous bacteria as those carried by people who worked in the hospital. Researchers looked at 200 cell phones from patients, visitors, and health-care workers at a hospital in Turkey, and took swabs of the phones’ keypad, mouth piece, and ear piece. Roughly 40 percent of the patient’s phones and close to 21 percent of health-care workers’ phones tested positive for pathogens. Seven of the patie... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4893434 Thu, 02 Jun 2011 21:20:00 +0100 4893434 http://www.medworm.com/index.php?rid=4883568&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F05%2Fare-doctors-overwhelmed-by-drug-warnings.html There are now so many warnings of potential side effects on drug labels that physicians may miss the important ones for their patients, researchers have warned. The lists of possible adverse effects on medication leaflets are a familiar sight for consumers. While it's important to know the risks as well as the benefits of a medication, it is easy to get overwhelmed by all the things that might go wrong. But what about doctors? Long lists of potential adverse effects are one thing. But they also need to think about whether the drug interacts with any other medications you take, whether it's suitable for someone of your age, with your medical conditions, and whether it contains anything that you're allergic to. Researchers set out to see what doctors have to contend with. They assessed al... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4883568 Tue, 31 May 2011 20:25:00 +0100 4883568 http://www.medworm.com/index.php?rid=4883609&cid=t_100730_97_f&fid=35606&url=http%3A%2F%2Fwww.theangriestpharmacist.com%2F2011%2F05%2F30%2Fvoicemail-prescription-on-memorial-day%2F Had a doctor call in a prescription today...on Memorial Day. I could tell from his tone on the voicemail he left that HE WAS PISSED. He was bothered. He was angry. He was leaving a prescription for, let's call him Cal Ripkin. Here is the message verbatim: "Prescription for Cal Ripkin. Zpak. No Refills. This is Dr. Johnson." Luckily, I knew who Dr. Johnson was because he did not say his first name. I could just hear it in his voice that Mr. Ripkin called him at home or through the exchange acting as if he would absolutely die without a ZPAK STAT! And, rather than tell Mr. Ripkin to stop being a pussy and take a nap and some Tylenol, he just called in the prescription. Is antibiotic begging becoming some sort of weird variation of drug seeking? Mr. Ripkin called me moments later and arrived ... The Angriest Pharmacist blogs http://www.medworm.com/rss/comments.php?id=4883609 Tue, 31 May 2011 04:43:38 +0100 4883609 http://www.medworm.com/index.php?rid=4876384&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-doctors-and-dentists-start-requiring-mutual-privacy-agreements-with-patients%2F2011.05.28 We (especially doctors themselves) like to think docs are smart. While all are very well educated in medicine, it doesn’t mean they’re actually smart at much else. Docs are well known to lose gobs of money in stupid ‘investements’ like Avacado farms and ostrich ranches (and yes, there are those with the chicken ranch problems, as well). Here’s a dumb thing some docs are adopting I hope goes away quickly, as it’s actually not in the best interest of medicine: When I walked into the offices of Dr. Ken Cirka, I was looking for cleaner teeth, not material for an Ars Technica story. I needed a new dentist, and Yelp says Dr. Cirka is one of the best in the Philadelphia area. The receptionist handed me a clipboard with forms to fill out. After the usual patient information form, there... Better Health blogs http://www.medworm.com/rss/comments.php?id=4876384 Sat, 28 May 2011 21:00:21 +0100 4876384 http://www.medworm.com/index.php?rid=4872089&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthree-good-reasons-for-healthcare-professionals-to-use-social-networks%2F2011.05.27 Social networking allows doctors, nurses and other health professionals to deeply connect and engage with the community and their colleagues. “We are standing at the precipice of a new online revolution in health care. As more and more health experts embrace the Internet and increase their social media activity, health information seekers will undoubtedly benefit in profound ways.” [Source: Mashable] Dynamic health and medical professionals engaged in social networking, using Twitter, Facebook, Blogs and YouTube are on the front-line of new modern medicine. Today’s modern medicine is all about the patient.  Participating, partnering and developing a professional relationship is paramount. While many health consumers are searching the web for support, reassurance and specific health ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4872089 Fri, 27 May 2011 21:00:03 +0100 4872089 http://www.medworm.com/index.php?rid=4872107&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1631 How many times have you heard this on the radio: Base, this is Medic 3, and we’re 15 minutes from your facility with a 38-year-old white male with, uh, some chest pain, numbness all over, headache, and anxiety, as well as some bruises from a fall. He says his pain radiates from his earlobes to his nipples, and well, we’ll just give you more details on arrival, base. This is Medic 3 clear. God love those paramedics. The truth is, if we doctors were on the truck ourselves, we still wouldn’t know what the diagnosis was. Frequently, when I discharge people from the emergency department, I still don’t know the diagnosis. Thank heavens for medical screening exams because that’s about the best I can do some nights. But I have come to realize that if the medics can&#8... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4872107 Fri, 27 May 2011 16:37:55 +0100 4872107 http://www.medworm.com/index.php?rid=4872473&cid=t_100730_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FliBV1h4EAXA%2F File this under sticking point. The Global Alliance for Vaccines and Immunizations is coming under fire because a large vaccine maker that provides most of its income is about to become a pharma representative on its board. The move is prompting concerns about conflicts of interest amid demands for lower vaccine prices, The Financial Times writes. In July, Johnson & Johnson’s recently acquired Crucell unit will replace GlaxoSmithKline on the GAVI board (see this), which next month meets in London in hopes of raising $3.7 billion. But some non-governmental organizations say GAVI, which last year sent $825 million in donor funds to vaccination programs in poor countries, is not doing enough to lower prices paid for vaccines. “We think some conflicts are too big to manage,”... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4872473 Fri, 27 May 2011 13:02:26 +0100 4872473 http://www.medworm.com/index.php?rid=4862495&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FVkx7FvYNZSM%2F Bad behavior in the health-care workforce “has been ignored for far too long, and it’s time to call attention to it,” Barry Silbaugh, CEO of the American College of Physician Executives, said last year. That seems to be happening. The ACPE and QuantiaMD, a mobile and online physician community, today released a new 840-participant survey on disruptive behavior by doctors. New York Times contributor and nurse Theresa Brown has recently written about two variations on the theme — doctors bullying nurses, and nurses bullying other nurses, attracting hundreds of comments. The online seminar by the Institute of Healthcare Improvement at which Silbaugh made his plea for change attracted 1,600 participants. What can be hardest for those of us who don’t work in health... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4862495 Wed, 25 May 2011 18:43:44 +0100 4862495 http://www.medworm.com/index.php?rid=4862898&cid=t_100730_147_f&fid=39273&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2FtDNz-X88Cuc%2Fhow-far-does-doctorpatient.html Dr. Bryan Vartabedian came across a conversation that occurred on Twitter between physicians about a specific patient’s unfortunate medical condition and the doctor’s embarrassment about the case. No names, hospitals or specific variables are easily identifiable but the posts certainly begin to cross the line of confidentiality inherent to this type of relationship. The American Medical Association has identified guidelines for the use of the platforms for physicians. Do you believe this a true violation of the guidelines? From the patient perspective, I'm not sure I'd like any of my medical details to be posted to Twitter to be the topic of conversation, but at what point is a doctor sharing patient information and just thoughts about their life like everyone else. Should the AMA se... ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=4862898 Wed, 25 May 2011 18:19:00 +0100 4862898 http://www.medworm.com/index.php?rid=4862502&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FcgbrDCumF4Q%2F What could primary-care physicians do differently to benefit patients’ health and cut risks, harms and costs? The National Physicians Alliance, a 22,000-member group of doctors that advocates for affordable, universal health care, came out with its own list — lists, actually, since there’s one each for family medicine, internal medicine and pediatrics. The group’s recommendations are published in the Archives of Internal Medicine. The suggestions reflect the consensus of the physician working groups that developed them. Field testers completed online surveys to rate each suggestion on the impact it would have on quality of care and cost, the strength of the supporting evidence and the ease of implementing the activity. Without further ado, here are the lists (stripp... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4862502 Mon, 23 May 2011 21:18:21 +0100 4862502 http://www.medworm.com/index.php?rid=4862537&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F05%2Fct-angiography-a-treatment-trap.html Many healthy patients undergoing CT angiography—a high-tech and widely advertised test increasingly being used to screen for heart disease—are being lured into a prevention trap. That’s one of the conclusions I draw from a major study and editorial being published online today by the Archives of Internal Medicine. Why? I’m concerned that people who undergo the test, which uses multiple CT scans to produce a three-dimensional image of the heart, often go away thinking either that they are free of the disease or, if the results are worrisome, that it saved their life by identifying heart disease early. But the study published today found that while people who got the test were more likely to be treated aggressively, including with invasive and potentially risky proce... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4862537 Mon, 23 May 2011 21:01:00 +0100 4862537 http://www.medworm.com/index.php?rid=4852863&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprediction-physicians-will-retire-earlier-and-earlier-because-medicine-is-no-longer-fun%2F2011.05.21 I wonder if we’re in danger of stifling fun in medicine. Certainly there are still fun things to do in medicine (ablating a pesky accessory pathway safely, for instance). But as I watch the newly-minted medical school graduates emerge from their long, sheltered educational cocoon, I wonder what their attrition rate will be from medicine once they see our new more-robotic form of health care community. There is a social camaraderie in medicine when you train. Maybe it’s the “misery loves company” syndrome. In medical school you stick together through thick and thin because few others understand what you’re going through. You strive for the day when, collectively, you earn the designation of “doctor of medicine.” There’s a strength in numbers. ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4852863 Sat, 21 May 2011 16:00:00 +0100 4852863 http://www.medworm.com/index.php?rid=4847955&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsurgeons-who-refuse-to-treat-obese-women-liability-containment-or-discrimination%2F2011.05.20 In a nation with 93 million obese people, a few ob-gyn doctors in South Florida now refuse to see otherwise healthy women solely because they are overweight. Fifteen obstetrics-gynecology practices out of 105 polled by the Sun Sentinel said they have set weight cut-offs for new patients starting at 200 pounds or based on measures of obesity — and turn down women who are heavier. Some of the doctors said the main reason was their exam tables or other equipment can’t handle people over a certain weight. But at least six said they were trying to avoid obese patients because they have a higher risk of complications. Source: visiontoamerica.org/719/report-doctors-refusing-to-treat-overweight-patients/ While I have not specifically “refused to treat” obese patients, I have in a few cas... Better Health blogs http://www.medworm.com/rss/comments.php?id=4847955 Fri, 20 May 2011 22:00:14 +0100 4847955 http://www.medworm.com/index.php?rid=4847967&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1610 Kindness as Medical Treatment (This originally appeared as one of my columns in Emergency Medicine News, in 2001.) Before me on the exam table was a young woman in her mid- to late 30s. She was a little anxious. Her chart indicated that she had back pain, neck pain, headache, chest pain, and insomnia. I took a deep breath, rolled my eyes, and began to take a history. I tried my best to tease out what things might be serious and what was not. No injuries, no weakness, no shortness of breath, no history of heart disease, no thunderclap headaches, no, no, no. Her exam was almost as unremarkable. Until we went a little further. As her history continued and she opened up, I learned that she was working third shift at a local factory, raising three small children and caring for a husband on dia... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4847967 Fri, 20 May 2011 03:09:05 +0100 4847967 http://www.medworm.com/index.php?rid=4841406&cid=t_100730_87_f&fid=35049&url=http%3A%2F%2Fwww.nakedmedicine.com%2Fcme-and-pharma-doctors-want-support-that-they-cant-trust “Doctors want CMEs paid for them but can’t trust the people they want to help pay for their continuing medical education.” That’s how I sum up the below survey published by Archives of Internal Medicine. Look at what the conclusion said: “Although the medical professionals responding to this survey were concerned about bias introduced from [...] (Source: NAKEDMEDICINE.COM) NAKEDMEDICINE.COM blogs http://www.medworm.com/rss/comments.php?id=4841406 Thu, 19 May 2011 18:51:53 +0100 4841406 http://www.medworm.com/index.php?rid=4841477&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-review-of-the-most-common-physician-errors-in-thinking-and-judgement%2F2011.05.19 In my recent review of Peter Palmieri’s book Suffer the Children I said I would later try to cover some of the many other important issues he brings up. One of the themes in the book is the process of critical thinking and the various cognitive traps doctors fall into. I will address some of them here. This is not meant to be systematic or comprehensive, but rather a miscellany of things to think about. Some of these overlap. Diagnostic fetishes Everything is attributed to a pet diagnosis. Palmieri gives the example of a colleague of his who thinks everything from septic shock to behavior disorders are due to low levels of HDL, which he treats with high doses of niacin. There is a tendency to widen the criteria so that any collection of symptoms can be seen as evidence of the condition. ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4841477 Thu, 19 May 2011 15:00:33 +0100 4841477 http://www.medworm.com/index.php?rid=4841903&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F05%2Fyesterday-was-bad-day-so-apparently-i.html I had a bad day yesterday. It was long, eventful, stressful, and tiring. My husband keeps telling the cat to avoid me because I am being crabby - even though I fed the cat and made lunch for my husband. Yesterday morning I woke up starving, wanting breakfast, and couldn't eat, even have coffee because I had a fasting blood test before my 830 doctor appointment. I got up, fed the cat and made lunch for my husband, and was starving. I finally took a shower before getting dressed. My big toe on my left foot has been bugging me for a few days so I took a look at it after getting out of the shower. It was infected. I mean there was (yucky) pus next to my toe nail. I don't consider that something one wants to see. Crap.I went to the hospital for my blood test and grabbed coffee and a banana (as ... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4841903 Thu, 19 May 2011 10:06:00 +0100 4841903 http://www.medworm.com/index.php?rid=4841490&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1599 Heck, if we have to see patients for free, at least we could bill for a dating service.  Couldn’t we? http://www.xtranormal.com/watch/11938527/emergidate-the-er-matchmaking-service (Source: edwinleap.com) edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4841490 Thu, 19 May 2011 03:11:49 +0100 4841490 http://www.medworm.com/index.php?rid=4841424&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FoYblPhSFjGs%2F Should electronic medical records be rolled out chiefly according to the needs of physicians and other providers? That’s the question debated by two physicians in this week’s Annals of Internal Medicine. Anwar Hussain, a physician at UHS Hospitals in Johnson City, NY, argues the affirmative in  his commentary. He writes that the government’s current policy — which awards financial incentives to hospitals and physicians that demonstrate “meaningful use” of digitized records — “takes a top-down strategy and assumes that there is uniform and solid evidence for use of technology in all types of provider settings, a view that is inconsistent with current evidence.” Hussain cites an uncertain return on investment, a lack of data supporting &... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4841424 Tue, 17 May 2011 17:11:15 +0100 4841424 http://www.medworm.com/index.php?rid=4841953&cid=t_100730_147_f&fid=39273&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2FyzxWJHkRsnk%2Fdigital-presence-of-doctors-and-sales.html The Teledoc iPad and iPhone devices are on their way this summer reports Mobiledia.  These digital tools are apps that allow patients to request on demand video chats with registered physicians.  This is just one way doctors and Pharma are bridging the new gaps to connect with patients in light of budget cuts and the poor economy. The Pharma companies are diving in as well, Astra Zeneca has adopted AZ Touchpoints, Boehringer Ingelheim launched an educational marketing campaign for doctors with Pradaxa, and Novo Nordisk has launched the "Coags Uncomplicated" app to diagnose bleeding disorders.  The article, does mention at the end, these technical advances still don't replace face to face contact and the benefits that can provide for the doctor/patient relationship or even t... ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=4841953 Tue, 17 May 2011 14:20:00 +0100 4841953 http://www.medworm.com/index.php?rid=4820846&cid=t_100730_87_f&fid=38805&url=http%3A%2F%2Fwww.denisesilber.com%2Fehealth%2F2011%2F05%2Fddw11-socialmedia.html Let's congratulate DDW11 for a very pro-active social media strategy. YouTube channel : David Sack, a visiting gastro-enterologist at Digestive Disease Week 2011, did the above video interview, at the "win a Flipcam" contest at the conference.  The DDW organized the video recording of 32 poster presenters and of numerous physicians presenting highlights of the conference here. Facebook: here is the DDW page  The FB page is another vehicle to tell the story of DDW and be where the audience is.  Twitter:  1700 tweets approximately tell the story of Digestive Disease Week 2011. You can read the transcript here, gathered on FoxePractice Téléchargement  #ddw11 - Healthcare Twitter Transcript » So, if you didn't get to DDW11, y... Denise Silber's eHealth blogs http://www.medworm.com/rss/comments.php?id=4820846 Thu, 12 May 2011 23:00:00 +0100 4820846 http://www.medworm.com/index.php?rid=4813405&cid=t_100730_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F85sOFDSPdJM%2F I’m not sure where I came up with the following idea. I had stored it in my list of future posts and I didn’t have any reference for it. So, if I forgot to acknowledge who provided me the comment I’m sorry. This is the comment that I received from someone, “EMR provides benefits to the patient (better patient care) and payers (cost savings).” Of course, we could argue these two points until we’re blue in the face. In fact, feel free to argue either point in the comments below. That will be interesting. I’ll just say that there’s the potential for better patient care and the potential for cost savings to the payers. Whether the potential will become a reality will be a fun discussion in the comments. When I saw the above statement I started to... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4813405 Wed, 11 May 2011 22:45:06 +0100 4813405 http://www.medworm.com/index.php?rid=4813303&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1586   Ordinarily, I’m wary of all things dental.  I had too many cavities as a child.  As a young man, I had a root canal done on the wrong tooth, followed immediately be the correct one.  My dental memories are a bit tainted.  Not an indictment of the entire profession so much as a kind of PPSD…post procedure stress disorder. But when I moved to South Carolina, my wife and I found a wonderful general dentist in Dr. Ronald Moore, in Seneca, SC.  Rarely would I ascribe the words ‘painless dentistry’ to one of the practitioners of that esteemed profession.  But I have to give credit where credit is due.  His hygenists, and Dr. Moore, have all been the pinnacle of gentility.  Even my children aren’t afraid to go for cleanings.  And when I need anesthesia, w... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4813303 Wed, 11 May 2011 17:57:24 +0100 4813303 http://www.medworm.com/index.php?rid=4813634&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F05%2Fthat-lovely-place-to-wait.html I feel like I should run around quoting 'Candide', where the cast runs around wishing for the best of all possible worlds in the middle of the Spanish inquisition where its 'oh what a day for an auto-da-fe'. Basically incredible amounts of optimism in the midst of chaos and bad things.Yesterday I had a wonderful time at the hospital. I met with my back pain doctor and we discussed my back and how it actually feels better these days due to my new drugs and my actually making it to the gym regularly. He also gave me a greatly appreciated cortisone injection in my left hip which has been full of bursitis recently. My back feels okay - meaning it doesn't give me nearly constant pain, but it is not and will never be cured so don't jump up and down with optimism for me. I don't have to see him f... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4813634 Wed, 11 May 2011 10:03:00 +0100 4813634 http://www.medworm.com/index.php?rid=4813290&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fdrlindagalloway.files.wordpress.com%2F2011%2F05%2F350by403.jpg If a pregnant woman finds herself scratching and itching during the third trimester, these symptoms should not be ignored. Each year, approximately 0.1 to 15% of pregnant women are affected by a liver disorder called Intrahepatic Cholestasis of Pregnancy or (ICP). ICP patients tend to develop symptoms of itchiness of their hands and feet that becomes progressively worse and then spreads all over their body. The itchiness usually worsens at night and if untreated can cause jaundice and several life-threatening complications to the unborn fetus. When a pregnant woman complaints of itchiness (pruritus) all over her body, the first order of business is to determine whether a rash is present. If a rash is absent, ICP should be suspected. The liver is the largest gland in the body and in additio... Better Health blogs http://www.medworm.com/rss/comments.php?id=4813290 Tue, 10 May 2011 21:00:28 +0100 4813290 http://www.medworm.com/index.php?rid=4813279&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F05%2Fsome-hospital-infections-can-be-eliminated.html Hospitals that institute a simple checklist and other safety measures can eliminate infections in their intensive-care units for a year or more, according to a study published this week in the Archives of Internal Medicine. The study focused on bloodstream infections in 57 hospitals, mostly in Michigan, caused by central lines, catheters that deliver fluid, nutrition, and medication to patients. Most of the hospitals that participated in the study eliminated the infections for at least a year, and a quarter did so for two years. Overall, the program led to a statewide decline in the number of bloodstream infections that has lasted 36 months. Forty-four other states are now instituting a similar program. The authors of the study wrote that while the results are encouraging, similar effo... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4813279 Tue, 10 May 2011 19:55:00 +0100 4813279 http://www.medworm.com/index.php?rid=4803027&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F9CWiYYUTua4%2F Given the growing cost of malpractice suits from missed or delayed diagnoses in the emergency department, hospitals and their liability insurers are mining resolved claims for lessons on how to reduce such errors, today’s Informed Patient column reports. In one of the more ambitious efforts, Crico/RMF, which insures Harvard-affiliated hospitals, last year convened an emergency medicine leadership summit with insured hospitals and clients of its risk-management strategies business to identify the key factors contributing to missed or delayed diagnoses in the ER. Their main finding: physician-nurse communication breakdowns often happen at a critical juncture in care. The participating hospitals field-tested strategies to improve communication, and compiled a list of best practices that hosp... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4803027 Tue, 10 May 2011 13:50:01 +0100 4803027 http://www.medworm.com/index.php?rid=4803563&cid=t_100730_177_f&fid=38133&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTubalReversalBlog%2F%7E3%2F1GeYsSUMLGw%2Fadvice-on-picking-a-tubal-reversal-doctor.html Personal advice on how to pick the best tubal reversal doctor and the best tubal reversal center is provide by an experienced tubal reversal surgeon. Hard questions to ask potential reversal doctors are offered for readers so they can make the best decision possible about where and with whom to have tubal reversal surgery. (Source: Tubal Reversal Blog) Tubal Reversal Blog blogs http://www.medworm.com/rss/comments.php?id=4803563 Tue, 10 May 2011 12:55:14 +0100 4803563 http://www.medworm.com/index.php?rid=4803136&cid=t_100730_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsafe-injection-protocols-are-not-being-followed-by-clinicians%2F2011.05.10 Thanks to Laura Landro for shining light on unsafe injections in her WSJ blog, “Unsafe Injection Practices Persist Despite Education Efforts.” Landro writes: “A new push is underway to eliminate unsafe injection practices, which remain a persistent safety problem despite years of efforts to educate clinicians about the risks of re-using needles, syringes and drug vials. In the U.S., failure to follow safe practices in delivering intravenous medications and injections has resulted in more than 30 outbreaks of infectious disease including hepatitis C, and the notification of more than 125,000 patients about potential exposure just in the last decade, according to health-care purchasing alliance Premier Inc.” As a registered nurse this is unthinkable.  Learning to administer injectio... Better Health blogs http://www.medworm.com/rss/comments.php?id=4803136 Tue, 10 May 2011 11:00:38 +0100 4803136 http://www.medworm.com/index.php?rid=4803505&cid=t_100730_147_f&fid=39266&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCreationInteractive%2F%7E3%2F2-Mhrduf310%2F When it comes to targeting healthcare professionals, physician social networks provide a valuable resource for studying the behaviour of doctors, and engaging them in relevant and well-targeted ways. However, the sheer number of physician networks, and the range of capabilities, can make for complex strategy planning and implementation across international regions. Today, however, a brand new service has been announced that allows pharmaceutical companies and healthcare organizations to research and engage healthcare professionals in eight European countries, promising ‘integrated programme management and measurement’. Networks in Health is an alliance between Europe’s largest online physician communities: the UK’s Doctors.net.uk; France’s Egora and La Revue du Practicien; Medcen... Creation Interactive blogs http://www.medworm.com/rss/comments.php?id=4803505 Tue, 10 May 2011 08:13:38 +0100 4803505 http://www.medworm.com/index.php?rid=4795027&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F05%2Fshould-your-doctor-tell-you-truth-or.html So you go to see your doctor because you have been sick for a week and you want some antibiotics so you can finally get better. Or you have a cough and are concerned its more than just a cough and think the doctor should give you a chest x-ray to make sure its nothing more. You get the point - you go to the doctor with an expectation of care you should receive.But the doctor doesn't agree and says what you want is unneeded. Your cold is a cold and will get better, antibiotics will do nothing. Your cough is a cough and you don't need an x-ray. Should the doctor agree with you and give you the antibiotics or x-ray or should they just tell you the truth? I want the truth.I don't want a doctor to sugarcoat anything (especially when they say 'you may feel a pinch' - I want them to say 'it will ... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4795027 Sat, 07 May 2011 10:54:00 +0100 4795027 http://www.medworm.com/index.php?rid=4789592&cid=t_100730_147_f&fid=39273&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2FlqwLs1Flerg%2Fpfizer-tests-vaccine-education-via-sms.html VAXTEXT, the new SMS promotion by Pfizer, is looking to create awareness and inform the public about childhood vaccinations. This is currently being tested in the Las Vegas, Phoenix and Miami markets, three of the major metropolitan areas where childhood vaccinations are low. The goal of the promotion is to send personalized texts educating parents on their options for vaccines, what illnesses they can prevent and the optimal timelines for receiving them. Parents can sign up for alerts at vaxtext.com. The ePharma Summit series is your best chance to learn about using mobile as a piece of your digital media strategy. Join us for our “Art of Mobile” workshop or general sessions such as “Mobile: Putting the “Smart” in Smartphone Marketing Decision Making” and “Measuring Digital ... ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=4789592 Thu, 05 May 2011 17:47:00 +0100 4789592 http://www.medworm.com/index.php?rid=4789197&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fx9sVFi-kdc0%2F At a House subcommittee meeting today, medical societies weighed in on how to fix the much-maligned Medicare physician payment formula. The current formula, which absolutely no one thinks can continue in its present form, is (ironically) called the Sustainable Growth Rate, or SGR. It pegs the growth of Medicare reimbursement to the GDP — problematic, since GDP growth has famously been outpaced by the increase in health-care spending for years. Automatic, across-the-board reimbursement cuts kick in if spending reaches a certain level. But it’s so expensive to fix this problem — $298 billion just to wipe out accumulated debt — that nothing permanent has been done. Instead, we’ve seen a Chinese water torture of last-minute, short-term fixes. Scheduled to appear t... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4789197 Thu, 05 May 2011 17:16:47 +0100 4789197 http://www.medworm.com/index.php?rid=4789188&cid=t_100730_87_f&fid=35049&url=http%3A%2F%2Fwww.nakedmedicine.com%2Fwould-you-cancel-a-surgery-if-your-surgeon-is-getting-a-kick-back The specific question is about getting kickbacks as a surgeon using a medical device, and was originally asked on Quora. The explanation to the question (posted by the asker) said, “The department of justice has investigated conflicts of interest, and the Pittsburgh Post Gazette has published on the topic. To quote from the gazette: Payments [...] (Source: NAKEDMEDICINE.COM) NAKEDMEDICINE.COM blogs http://www.medworm.com/rss/comments.php?id=4789188 Wed, 04 May 2011 21:55:06 +0100 4789188 http://www.medworm.com/index.php?rid=4789263&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1576 Years ago I had a conversation with a surgeon at our facility.  He was unhappy that a seriously injured trauma patient came to our facility after an MVC.  ‘These patients shouldn’t come here Ed, they should go to a trauma center!’ Fair enough; we aren’t a trauma center.  Not a Level I, not a Level II or III; not even a level 0.5!  But we are the only hospital in a large rural county, and the closest, largest facility for portions of a few other counties nearby.  The nearest hospital with neurosurgery and thoracic surgery is at least 30 minutes further away. The problem is, torn blood vessels, crushed spleens,  collapsed lungs, swollen brains don’t look at the clock, and cars aren’t designed to wreck only near trauma centers, any  more than assaila... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4789263 Wed, 04 May 2011 14:43:20 +0100 4789263 http://www.medworm.com/index.php?rid=4789540&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F05%2Fi-am-not-just-another-medical-chart.html So yet another study came along but this is one I like and will incorporate into my doctor interactions.This new study says that patients who bond with their doctors are more likely to get better and doctors who show hope and optimism have patients who are more likely to get better. While the study focuses on mental health issues the article goes on to add that it is applicable across all medical ailments and diseases.What does this mean to me? That I will be more active in who my doctors are and treat the first interactions more of interviews - where I am interviewing them - than as blind acceptance of in who ever's office I ended up. A doctor is someone who you (or your insurance) pay for a service. There is no reason to stick with one you don't like or who doesn't listen to you. If you ... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4789540 Wed, 04 May 2011 10:13:00 +0100 4789540 http://www.medworm.com/index.php?rid=4780303&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F05%2Fnew-york-senators-to-doctors-lose-germ-infested-neckties.html A group of New York senators are pushing to make doctors ditch neckties and other accessories, including white coats, in an effort to curb the spread of bacteria. "What your doctor wears around his or her neck can literally make you sick," Democratic Senator Jeffrey Klein told the New York Post. The New York legislation would appoint a commission to come up with a dress code, and discourage doctors and health-care workers from wearing accessories that could harbor diseases. This is not a new issue for the medical community at large. In 2006, a British Medical Journal article warned doctors to ditch disease-ridden neckties during their hospital rounds because, according to the British Medical Association, the dangling neckties can spread disease. At that time, the MBA issued guideline... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4780303 Tue, 03 May 2011 18:16:00 +0100 4780303 http://www.medworm.com/index.php?rid=4771028&cid=t_100730_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1567 Paying hospitals for quality…and good patient satisfaction scores.  Are you kidding me? http://www.acep.org/Content.aspx?id=78862 So now, in addition to the many other bits of medical meddling we have from CMS, there’s this. Reimbursements to hospitals, from Medicare, will be partly tied to patient satisfaction scores. We’ve seen payments already being tied to ‘quality indicators,’ as dictated by the federal government; rewards for doing a better job on care for heart attacks, pneumonia, etc.. At least that’s quantifiable, whether scientifically correct or not. But patient satisfaction scores? These scores, part of the constant ‘customer satisfaction’ trend in medicine, are fraught with peril. And despite the validation and complex statistic... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4771028 Sat, 30 Apr 2011 20:58:08 +0100 4771028 http://www.medworm.com/index.php?rid=4768203&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F04%2Fcultural-competency.html What is cultural competency? Well I could google it or look it up in wikipedia but its too early in the morning (and I am slightly distracted because I really want to see Kate's wedding dress). Therefore I will define it as I understand it. In my opinion, cultural competency is being informed on other the socio-economic and culture issues of cultures other than the one in which you grew up. For example, is a big city person familiar with life on a farm? Or someone from suburban American familiar with life in a third world country? And its not just being comfortable with the other lives but aware of the differences in life style, social constraints, religious pressures, economic quality of life, etc. And to understand that these differences are theirs and you cannot force them on you. There... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4768203 Fri, 29 Apr 2011 09:53:00 +0100 4768203 http://www.medworm.com/index.php?rid=4759040&cid=t_100730_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F9a0xO_8AxcM%2F For the second time in less than a year, the Massachusetts House of Representatives has attempted to repeal a 2008 law that bans drug and device makers from giving gifts to docs. An effort last summer failed (read here). This time, however, a repeal is gaining traction. A bipartisan majority voted 128-to-22 yesterday to overturn the ban. The law, which you can read here and here, was seen as a way to limit undue industry influence over medical practice. But the ban has upset doctors, and pitted various consumer and patient groups against restauranteurs and the pharmaceutical and device industries ever since. Those in favor of repeal argue the ban stifled business seeking to expand in Massachusetts and robbed the state of revenue from two medical conventions that held their events elsewhere... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4759040 Wed, 27 Apr 2011 13:13:56 +0100 4759040 http://www.medworm.com/index.php?rid=4753627&cid=t_100730_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2011%2F04%2F27%2Fhow-a-valentines-editorial-about-chocolate-semen-lead-to-the-resignation-of-top-surgeon-greenfield%2F Dr. Lazar Greenfield, recently won the election as the new President of  ACS (American College of Surgeons). This position would crown his achievements. For Greenfield was a truly pre-eminent surgeon. He is best known for his development of an intracaval filter bearing his name. This device probably has saved many lives by preventing blood clots from going into the [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=4753627 Tue, 26 Apr 2011 23:51:44 +0100 4753627 http://www.medworm.com/index.php?rid=4753972&cid=t_100730_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fb_qg-ukLNv0%2F The ongoing refusal by Johnson & Johnson to partipicate in the Medicines Patent Pool, which is an initiative designed to streamline patent licensing for producing generics of patented HIV meds and offering lower prices in poor countries, has now generated a scolding from Doctors Without Borders, the international humanitarian organization. In a statement, the group accuses the health care giant of turning its corporate back on HIV patients by undermining access to key AIDS drugs. J&J holds patents on rilpivirine, which is being developed as a first-line HIV treatment, as well as darunavir and etravirine, two meds that treat HIV patients who have become resistent to other drugs. The missive appears carefully timed. Later this week, J&J will hold it annual shareholder meeting,... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4753972 Tue, 26 Apr 2011 12:28:30 +0100 4753972 http://www.medworm.com/index.php?rid=4753660&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FWZnBbnQF2f4%2F Despite some efforts to make primary care more appealing to med students and residents, there’s still a shortage of those doctors looming — particularly with more people gaining coverage under the health-care overhaul law. A study just published in the Archives of Internal Medicine compares med students’ attitudes about internal medicine careers in 1990 and 2007. And it finds that while about the same percentage of med students — 23% in the earlier survey of 1,244 students, and 24% in the later survey of 1,177 students — plan internal med careers, the proportion planning to go into primary care fell to 2% from 9%. And the appeal of primary care as a reason to go into internal medicine fell to 33% from 57%. Med students are “drawn more to what they see fr... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4753660 Mon, 25 Apr 2011 21:47:53 +0100 4753660 http://www.medworm.com/index.php?rid=4747596&cid=t_100730_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2FAJHv85RtyPs%2F Trimming Medicaid: Maine’s Paul LePage is among other governors trying to narrow eligibility requirements for Medicaid, the federal-state insurance program for the poor, amidst budget crunches, the WSJ reports. Some changes proposed in Maine — such as making ineligible for the program families of three earning more than $24,645 per year — are likely to be approved by the federal government, while others — such as cutting eligibility for a program for adults without kids — are not permitted by the new health-care overhaul law, the paper says. Prescription Data Case: Tomorrow the Supreme Court will hear arguments in a case over whether a law in Vermont that restricts the use of physicians’ prescription records for marketing purposes violates the Constituti... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4747596 Mon, 25 Apr 2011 12:30:02 +0100 4747596 http://www.medworm.com/index.php?rid=4747840&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F04%2Fdoctors-have-history.html Wait, that can't be. Doctors are supposed to be all knowing and medicine should be black and white. This symptom means this, that one means that, and it is curable by this. None of this nonsense of maybe this, maybe that, never mind that once before they saw this and the result was that. But no, that is not the way life is. Doctors have a history as well. Life is not fair. Doctors go through medical school and then get out in the real world as residents and start seeing patients who color everything in shades of gray. Women and men don't show cardiac symptoms the same way. Heck, every cancer is different - put ten patients in the same room with the exact same diagnosis and then start comparing their treatment protocols, how they reacted them, and their current medical health - nothing will... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4747840 Mon, 25 Apr 2011 10:19:00 +0100 4747840 http://www.medworm.com/index.php?rid=4747722&cid=t_100730_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F04%2F22%2Fim-a-plumber-despite-just-wanting-to-be-an-emr-blogger%2F About a month ago, the market finally fell enough for my wife and I to buy our first house. It’s pretty exciting to finally be able to do it since we pretty much tried to buy a house every year since we moved to Las Vegas 6 years ago. Thankfully, we never did until now (although that’s another story). After purchasing the home, I found myself spending a fair amount of time having to repair a number of things around the house. One day I pretty much spent all day being a plumber as I (and a nice friend) replaced the garbage disposal, fixed a leaking sink, replaced the mechanism (whatever it’s called) in the toilet. Turns out that none of these things are really all that difficult. Although, it definitely had the initial learning curve for me to realize that it’s prett... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4747722 Fri, 22 Apr 2011 18:57:58 +0100 4747722 http://www.medworm.com/index.php?rid=4742622&cid=t_100730_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F04%2Fmind-of-confused-patient.html I have decided that when doctors go through medical school, they take special classes designed to 'help' their patients. There must be a special class on how to confuse patients. Sometimes I leave the doctor's office and think, wait, what the heck am I supposed do? I am confused.Now I really know most doctors mean well and are highly trained and have the patient's best interest at heart but sometimes I think they are there to drive me crazy. My latest doctor interaction is leading me to question my doctor's thought process. I am on Savella for back pain. This was prescribed by my back pain doctor - Dr. G. Previously I was on Cymbalta and Lyrica for back pain and nerve pain but they also treated my depression. So I went back to my psychiatrist, Dr. S., for a new anti depressant and she put ... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=4742622 Fri, 22 Apr 2011 09:38:00 +0100 4742622 http://www.medworm.com/index.php?rid=4742380&cid=t_100730_87_f&fid=38113&url=http%3A%2F%2Fnews.consumerreports.org%2Fhealth%2F2011%2F04%2Fcd-medical-images-can-reduce-unnecessary-ct-scans.html Reducing radiation exposure can be as simple as shipping a CD, according to a new study published online April 19 in the journal Radiology. Researchers found that uploading X-rays and CT scans taken at other hospitals from a CD-ROM can reduce the need for additional imaging for the two million or so critically ill patients transferred between hospitals each year. The number of imaging scans in U.S. hospitals has been soaring in recent years, for a variety of reasons. One major one is that a new doctor that doesn’t have access to previous tests, will have another scan done. That can increase the radiation dose for the patient, and health care costs. The current push for national improvements in health care technology includes high-tech solutions like imaging networks and repositories... Consumer Reports Health Blog blogs http://www.medworm.com/rss/comments.php?id=4742380 Thu, 21 Apr 2011 18:28:49 +0100 4742380 http://www.medworm.com/index.php?rid=4734612&cid=t_100730_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Fdoctors-drinking-affects-next-days-surgery%2F Persistent Next-Day Effects of Excessive Alcohol Consumption on Laparoscopic Surgical PerformancePurpose; To examine the effect of previous-day excessive alcohol consumption on laparoscopic surgical performance.Study 1 was a randomized controlled trial. Study 2 was a cohort study. Sixteen science students (laparoscopic novices) participated in study 1. Eight laparoscopic experts participated in study 2. All participants were trained on the Minimally Invasive Surgical Trainer Virtual Reality (MIST-VR).The participants in study 1 were randomized to either abstain from alcohol or consume alcohol until intoxicated. All study 2 subjects freely consumed alcohol until intoxicated. Subjects were assessed the following day at 9 AM, 1 PM, and 4 PM on MIST-VR tasks.Assessment measures included time, ... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4734612 Wed, 20 Apr 2011 00:30:58 +0100 4734612