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 'healthcare policy'. Sat, 03 Sep 2011 02:08:25 +0100 http://www.medworm.com/index.php?rid=5169545&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-physicians-have-a-role-in-controlling-healthcare-costs%2F2011.08.27 The Role of Physicians in Controlling Medical Care Costs and Reducing Waste by the RAND Corporation and David Geffen, University of California Los Angeles School of Medicine, Santa Monica was just published in the Journal of the American Medical Association (JAMA).  I do not think the JAMA should have published this article. 1.Why would the JAMA publish such an article? 2. Why are physicians blamed for all the waste in the system? 3. Why is it the physicians’ responsibility to eliminate waste when they are not the cause of the greatest percentage of the waste? “The amount of money spent on medical care is increasing faster than the gross domestic product (GDP), and the federal deficit is increasing.” The initial statement assumes that the government deficit is increasing because phy... Better Health blogs http://www.medworm.com/rss/comments.php?id=5169545 Sat, 27 Aug 2011 21:05:19 +0100 5169545 http://www.medworm.com/index.php?rid=5158988&cid=t_100870_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Frebuilding%2Fmay-god-save-us-from-the-public-health-experts The “expert class” – the knowledgeable elites who are appointed by the Central Authority to establish the rules under which all of us in the great unwashed masses are to live our lives – will always (as a general proposition) tend to do great harm. Nowhere is this result more evident than in the policies promulgated in recent decades by the public health experts. In each of the following three articles, DrRich deconstructs one of the major initiatives with which public health experts have assaulted the general public in recent years.  Each of these three initiatives was launched with great fanfare, displaying all the arrogant certainty exuded by any religious zealot, but sadly, was based on what to any objective observer was clearly insufficient data.  So the rece... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=5158988 Tue, 23 Aug 2011 11:45:05 +0100 5158988 http://www.medworm.com/index.php?rid=5158989&cid=t_100870_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1739%2F0%2Fright-to-healthcare.mp3 Podcast: If we are ever to gain control of our healthcare spending, which is a necessity if we are going to avoid an economic catastrophe during the next couple of decades, we have to come to some agreement, as a society, on a few essential questions.  Chief among these questions is whether healthcare is something we must consider to be a right for all Americans. The question of whether healthcare is a right has become a very contentious one. One side passionately declares that of course it is a right, as healthcare is so critically important that how could it be otherwise? And the other side, with equal conviction, asserts that nothing can be a right that creates an involuntary burden on another. That is, advocates on either side of the argument maintain their respective positions as be... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=5158989 Mon, 22 Aug 2011 11:09:50 +0100 5158989 http://www.medworm.com/index.php?rid=5130743&cid=t_100870_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1714%2F0%2Fduty-to-wellness.mp3 Podcast: DrRich considers it his responsibility to point out to his readers certain truths related to modern American healthcare which may not be obvious to everyone, and which the fine people in the mainstream press choose not to mention. Be honest. If it weren’t for DrRich, would you be aware that the only reason Obamacare became the law of the land is that the private insurance companies needed it in order to have any hope of long term survival?  Would you understand that the Progressive healthcare system to which we are now legally committed inherently requires all of the following things (while loudly proclaiming the opposite): ending the classic doctor-patient relationship; preventing individuals from spending their own money on their own healthcare; killing off the practice ... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=5130743 Mon, 15 Aug 2011 11:26:01 +0100 5130743 http://www.medworm.com/index.php?rid=4872424&cid=t_100870_147_f&fid=39266&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCreationInteractive%2F%7E3%2FXWpkY8wTwPQ%2F Yesterday, I met the Shadow Secretary of State for Health, John Healey MP, at the Royal Society of Medicine in London where he gave a speech as Labour launched a paper entitled “After the ‘pause’ – Labour’s alternative on the Health and Social Care Bill”. Healey raised three primary concerns over the Bill, namely the breaking up of the NHS; ensuring patient and democratic accountability; and turning the NHS into a free market. As independent advisors on healthcare engagement, it has been interesting for the team at Creation Healthcare to review and discuss the UK Government’s proposals and to answer questions from our clients worldwide about how the proposed changes will affect their own engagement with stakeholders in the UK including healthcare professionals, payers, policy... Creation Interactive blogs http://www.medworm.com/rss/comments.php?id=4872424 Fri, 27 May 2011 13:01:32 +0100 4872424 http://www.medworm.com/index.php?rid=4622290&cid=t_100870_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F03%2F21%2Fpsychologists-still-seek-prescription-privileges-no-new-news%2F This story caught my eye only because of its headline, Psychologists seek authority to prescribe psychotropic medications. Really? I thought… I never heard that before. Oh, wait a minute, I have. Because the last time I checked, psychologists have been seeking prescription privileges for something like 16 or 17 years, maybe longer. In all of that time, they’ve only gained them in two states. Was another state joining New Mexico and Louisiana? Was there a renewed push for this service because of a sudden demand for prescriptions from those who have a mental illness? In other words, for this new article that appeared in the Washington Post (but was actually written by the Kaiser Family Foundation, a healthcare policy organization) — what’s newsworthy about this story?... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4622290 Mon, 21 Mar 2011 21:39:31 +0100 4622290 http://www.medworm.com/index.php?rid=4560276&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedical-ethics-and-the-r-word%2F2011.03.07 [Recently] a short article in the New York Times, New Kidney Transplant Policy Would Favor Younger Patients, [drew] my attention to a very basic problem in medical ethics: Rationing. According to the Washington Post coverage, the proposal comes from the United Network for Organ Sharing, a Richmond-based private non-profit group the federal government contracts for allocation of donated organs. From the Times piece: Under the proposal, patients and kidneys would each be graded, and the healthiest and youngest 20 percent of patients and kidneys would be segregated into a separate pool so that the best kidneys would be given to patients with the longest life expectancies. This all follows [the recent] front-page business story on the monetary value of life. I have to admit, I’m glad to s... Better Health blogs http://www.medworm.com/rss/comments.php?id=4560276 Mon, 07 Mar 2011 19:00:35 +0100 4560276 http://www.medworm.com/index.php?rid=4552057&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffirst-monetary-hipaa-fine-issued%2F2011.03.05 Via the Threatpost article “HIPAA Bares Its Teeth: $4.3m Fine For Privacy Violation“: The health care industry’s toothless tiger finally bared its teeth, as the U.S. Department of Health and Human Services (HHS) issued a $4.3 m fine to a Maryland health care provider for violations of the HIPAA Privacy Rule. The action is the first monetary fine issued since the Act was passed in 1996. … A copy of a penalty notice against Cignet depicts a two-year effort in which HHS struggled with what appears to be a dysfunctional Maryland provider unaware of the potential impact of HIPAA non-compliance, and unwilling or unable to cooperate with HHS in any way. When first reading the title I was willing to rail against HIPAA, as I’m tired of it. Then I read the post. Wow. It’s like ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4552057 Sat, 05 Mar 2011 18:00:37 +0100 4552057 http://www.medworm.com/index.php?rid=4549754&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedicaid-will-the-cost-of-expanding-eligibility-be-overwhelming%2F2011.03.04 Medicaid has been front and center this week as President Obama addressed the National Governors Association, and several governors testified before the House Energy and Commerce Committee. Obama told the governors that he supports the Wyden-Brown bill, which would accelerate the availability of waivers under the Affordable Care Act (ACA), so that states would not have to first create health insurance exchanges under the law, and then have the right to dismantle them and replace them with other mechanisms to achieve coverage goals of the law without additional cost to the federales. (See Wyden-Brown fact sheet.) The sponsors’ home states, Oregon and Massachusetts would otherwise have to dismantle parts of their own health reform efforts in order to align with the federal mandates... Better Health blogs http://www.medworm.com/rss/comments.php?id=4549754 Fri, 04 Mar 2011 14:00:45 +0100 4549754 http://www.medworm.com/index.php?rid=4532212&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-headlines-bash-doctors%2F2011.02.28 While I know it grabs the eye, it really didn’t matter what the article was about. The headline says it all: Doctors are the problem, not the system, right? -WesMusings of a cardiologist and cardiac electrophysiologist. *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4532212 Mon, 28 Feb 2011 16:00:00 +0100 4532212 http://www.medworm.com/index.php?rid=4512392&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-first-emergency-physician-elected-to-congress%2F2011.02.23 I was unaware that Dr. Joe Heck of Nevada is the first emergency physician to be elected to Congress. Good for him! From the American College of Emergency Physicians (ACEP): In one of the closest congressional races of 2010, Republican challenger and ACEP member Dr. Joe Heck upset Rep. Dina Titus in Nevada’s third Congressional District.  Dr. Heck is the first ACEP member and emergency physician to be elected to Congress. I suppose that leaves me to be the first for the Senate… *This blog post was originally published at GruntDoc* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4512392 Wed, 23 Feb 2011 20:00:39 +0100 4512392 http://www.medworm.com/index.php?rid=4495202&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-negative-medical-studies-are-good%2F2011.02.18 This is a guest column by Ivan Oransky, M.D., who is executive editor of Reuters Health and blogs at Embargo Watch and Retraction Watch. One of the things that makes evaluating medical evidence difficult is knowing whether what’s being published actually reflects reality. Are the studies we read a good representation of scientific truth, or are they full of cherry-picked data that help sell drugs or skew policy decisions? That question may sound like that of a paranoiac, but rest assured, it’s not. Researchers have worried about a “positive publication bias” for decades. The idea is that studies showing an effect of a particular drug or procedure are more likely to be published. In 2008, for example, a group of researchers published a New England Journal of Medicin... Better Health blogs http://www.medworm.com/rss/comments.php?id=4495202 Fri, 18 Feb 2011 22:20:24 +0100 4495202 http://www.medworm.com/index.php?rid=4455262&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fintegrating-major-health-systems-could-make-things-worse%2F2011.02.09 Health reformers propose the proliferation of integrated health systems, like the Mayo Clinic or Kaiser Permanente, which, according to the Dartmouth Atlas, lead to better patient care and improved cost control. To that end, accountable care organizations (ACOs) have been a major part of health reform, changing the way healthcare is delivered. Never mind that patients may not be receptive to the new model, but the creation of these large, integrated physician-hospital entities that progressive policy experts espouse comes with repercussions. Monopoly power. To prepare for the new model of healthcare delivery, physician practices have been consolidating. In many cases, they’re being bought by hospitals. Last year, I wrote how this is leading to the death of the private practice physician... Better Health blogs http://www.medworm.com/rss/comments.php?id=4455262 Wed, 09 Feb 2011 22:00:58 +0100 4455262 http://www.medworm.com/index.php?rid=4419139&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpossible-5-million-fine-or-prison-for-doctors-who-ask-about-guns-in-the-home%2F2011.01.31 No photo for this post. You can imagine why. I’m a little stunned by the news that a politician in Florida is trying to stifle pediatricians from asking questions about guns in the home. My reaction is utterly predictable. Should I YELL IT or write it down or leave it up to your genius (and imagination)? (silence) The skinny on the Florida proposal: Florida Rep. Jason Brodeur said “he has heard about a number of cases in which doctors asked about guns. He thinks the topic should be off-limits.” Brodeur says he’s concerned about doctors asking patients about guns in the home. He’s concerned that information could get into the hands of the government or insurance companies. Under the proposed legislation, a doctor could face a fine of up to $5 million or be sent to prison for up t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4419139 Mon, 31 Jan 2011 16:00:08 +0100 4419139 http://www.medworm.com/index.php?rid=4405776&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstate-of-healthcare-in-the-union%2F2011.01.27 Short and sweet. That’s how President Obama addressed healthcare reform in his State of the Union address [Tuesday] night. In less than 700 words, he outlined how he’d improve but not retreat on what’s been enacted into law. He’s willing to work on changes, he said, naming malpractice reform and reducing onerous paperwork burdens for small businesses. But, he cautioned, “What I’m not willing to do is go back to the days when insurance companies could deny someone coverage because of a pre-existing condition.” President Obama had invited two real people to his address to highlight the law’s successes. One is a brain cancer survivor who can access health insurance through high-risk pools created by the law. The other is a small business owner w... Better Health blogs http://www.medworm.com/rss/comments.php?id=4405776 Thu, 27 Jan 2011 16:00:00 +0100 4405776 http://www.medworm.com/index.php?rid=4394442&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fclinical-guidelines-who-writes-them-anyway%2F2011.01.25 While DrRich is a conservative American, and has made plain the difficulties he has with the Progressive program in general and with Progressive healthcare reform in particular, at times he is forced to admit that, on occasion, the Progressive way of looking at the world has certain merits. And as DrRich contemplates a question that has been bothering him lately, a question that no doubt plagues many American physicians who (unlike DrRich) are still toiling away in the trenches, he finds that this is one such occasion. That question is: Just who are the people writing all those clinical guidelines — the  “guidelines” physicians are now expected to follow in every particular in every case, on pain of massive fines, loss of career, and/or incarceration? DrRich is quick to say that... Better Health blogs http://www.medworm.com/rss/comments.php?id=4394442 Tue, 25 Jan 2011 14:00:26 +0100 4394442 http://www.medworm.com/index.php?rid=4372047&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-doctors-be-allowed-to-self-refer%2F2011.01.19 Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue — a practice called “self-referral” — unless the facility is located in their own practice. This exemption exists to allow patients with access to a laboratory test, X-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less inconvenience and speeder diagnosis and treatment — what could be wrong with that? Much, say the critics, if it leads to overutilization and higher costs and doesn’t really represent a convenience to patients. This is the gist of two studies by staff employed by the American College of Radiology, published in the December issue of Health Affa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4372047 Wed, 19 Jan 2011 16:00:00 +0100 4372047 http://www.medworm.com/index.php?rid=4331012&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-patients-and-remote-third-parties%2F2011.01.10 From the ominously-titled book “New Rules” by Donald Berwick, M.D., and Troyen Brennan M.D.: “Today, this isolated relationship [between doctor and patient] is no longer tenable or possible. . . Traditional medical ethics, based on the doctor-patient dyad, must be reformulated to fit the new mold of the delivery of health care. . . The primary function of regulation in health care…is to constrain decentralized individualized decision making.” Unfortunately, Dr. Berwick’s straightforward formulation of the appropriate role of the individual physician in our reformed healthcare system is not isolated to thinkers of the Progressive persuasion. The notion that most clinical decisions can be usefully made by a centralized authority is attractive even to some conservatives. For examp... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331012 Mon, 10 Jan 2011 22:00:27 +0100 4331012 http://www.medworm.com/index.php?rid=4331014&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fbuzcooper.files.wordpress.com%2F2011%2F01%2Fmedpac-fig-2c.png MedPAC has released another report in which they have tried to explain variation in healthcare utilization among metropolitan statistical areas (MSAs), of which there are approximately 400. MSAs more-or-less correspond to Dartmouth’s 306 hospital referral regions (HRRs), and the conclusions reached by the Dartmouth folks and MedPAC tend to correspond. In commenting about MedPAC’s last report, issued in December 2009, I noted that the major variation was caused by high Medicare expenditures in seven southern states, where patients are poorer and sicker and use much more care.    In their new report, MedPAC went a step beyond measuring expenditures, which they adjusted for prices and other factors in their last report, to measuring the actual units of service, a far better way to ass... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331014 Mon, 10 Jan 2011 18:00:23 +0100 4331014 http://www.medworm.com/index.php?rid=4331016&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffirst-report-from-the-society-of-participatory-medicines-newly-appointed-public-policy-committee-chair-david-harlow%2F2011.01.10 In December, the Society for Participatory Medicine’s executive committee appointed health law attorney David Harlow to represent the Society in public policy matters. Regular readers of HealthBlawg::David Harlow’s Health Care Law Blog know what a patient-centered, participatory thinker David is. This is his first report. I am delighted to offer my first report as Public Policy Committee Chair for the Society of Participatory Medicine. I encourage all of you who are not yet Society members to join, and I encourage new and old members to consider volunteering to help with the wide range of public policy issues facing us today. Over the past couple of months, the Public Policy Committee has gotten its sea legs. We are beginning to add the Society’s voice to the national discourse on p... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331016 Mon, 10 Jan 2011 14:00:15 +0100 4331016 http://www.medworm.com/index.php?rid=4287416&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-twelve-days-of-healthcare-reform%2F2010.12.24 Today’s blog will be my last for 2010, as I will be taking a break to spend the Christmas and New Year’s holidays with family and friends. In keeping with a tradition I started two years ago, I again have taken the liberty of mangling a beloved holiday song, story, or rhyme to give a humorous (I hope!) perspective on current politics. In December, 2008, I adapted “Twas the Night Before Christmas” to convey President-elect Obama as being a not-so-jolly old elf besieged by lobbyists demanding stimulus gifts. Last year, I depicted the GOP as the Grinch trying to stop “ObamaCare” from coming. Today, I’ve re-written the “Twelve Days of Christmas” carol so that it is the government bestowing “gifts” (based on actual provisions of the Affordable Care Act) that the new Co... Better Health blogs http://www.medworm.com/rss/comments.php?id=4287416 Fri, 24 Dec 2010 14:00:00 +0100 4287416 http://www.medworm.com/index.php?rid=4253139&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwomens-health-in-the-u-s-gets-an-f%2F2010.12.12 The Oregon Health and Science University has published its fifth report card since 2000. It grades and ranks the United States on 26 health-status indicators for women. In 2010, not one state received an overall “satisfactory” grade for women’s health, and just two states — Vermont and Massachusetts — received a “satisfactory-minus” grade. Overall, the nation is so far from meeting the goals set by the U.S. Department of Health and Human Services that it receives an overall grade of “unsatisfactory.” The national report card uses status indicators to assess women’s health: Women’s access to healthcare services (medically under-served area, no abortion provider, no health insurance and first trimester prenatal care) Wellness... Better Health blogs http://www.medworm.com/rss/comments.php?id=4253139 Sun, 12 Dec 2010 18:00:00 +0100 4253139 http://www.medworm.com/index.php?rid=4214112&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwikileaks-what-it-means-for-healthcare-privacy%2F2010.11.29 From the official White House statement yesterday regarding WikiLeaks disclosure of diplomatic cables: “By releasing stolen and classified documents, WikiLeaks has put at risk not only the cause of human rights, but also the lives and work of the individuals. We condemn in strongest terms, the unauthorized disclosure of classified documents and sensitive national security information.” No matter what people think of WikiLeaks disclosure of approximately 250,000 classified diplomatic cables to the Internet yesterday with the help of the New York Times, The Guardian, Der Spiegel, and Le Monde, the implications to electronic healthcare information security are significant. Day in and day out, I type huge volumes of information on my patients on a computer and my fellow physicians ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4214112 Mon, 29 Nov 2010 19:00:00 +0100 4214112 http://www.medworm.com/index.php?rid=4214114&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-reform-law-is-gaining-public-support%2F2010.11.29 GOP hardliners soon to be in control of the House have made repeal of the detested healthcare reform law a cornerstone of their agenda, despite the impossibility of actually being able to repeal it, politically, at least until an election or two has passed, and despite the fact that their ascent to power had more to do with the terrible economy and high unemployment than any mandate to repeal the law. It seems that, finally, there may be movement towards increased public support for the law. A new McClatchy poll shows a majority of Americans now in favor of the law: A majority of Americans want the Congress to keep the new health care law or actually expand it, despite Republican claims that they have a mandate from the people to kill it, according to a new McClatchy-Marist poll. The post... Better Health blogs http://www.medworm.com/rss/comments.php?id=4214114 Mon, 29 Nov 2010 15:00:00 +0100 4214114 http://www.medworm.com/index.php?rid=4190151&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwheres-my-government-provided-healthcare%2F2010.11.22 Freshman Republican Congressman Andy Harris, who was elected on a promise to repeal the Patient Protection and Affordable Care Act (PPACA), is outraged that he’s going to go a whole month before his government-provided health insurance kicks in. From Politico: A conservative Maryland physician elected to Congress on an anti-Obamacare platform surprised fellow freshmen at a Monday orientation session by demanding to know why his government-subsidized health care plan takes a month to kick in. Republican Andy Harris, an anesthesiologist who defeated freshman Democrat Frank Kratovil on Maryland’s Eastern Shore, reacted incredulously when informed that federal law mandated that his government-subsidized health care policy would take effect on Feb. 1st –- 28 days after his Jan. 3rd sw... Better Health blogs http://www.medworm.com/rss/comments.php?id=4190151 Mon, 22 Nov 2010 19:00:00 +0100 4190151 http://www.medworm.com/index.php?rid=4167956&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-decision-making-and-don-berwicks-leaders-with-plans%2F2010.11.15 From a recent post of the Retired Doc’s Thoughts blog entitled “What Are the Plans Of Don Berwick’s ‘Leaders With Plans?’“: “I wonder which is worse: A medical leader recommending price controls out of ignorance of basic economics or being aware of the likely outcomes and mak[ing] that recommendation anyway?” Wow. I’m speechless. Thanks to Retired Doc for getting this out in a cogent summary. *This blog post was originally published at GruntDoc* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4167956 Mon, 15 Nov 2010 23:00:55 +0100 4167956 http://www.medworm.com/index.php?rid=4142748&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-reform-texas-style%2F2010.11.07 Via the Texas Tribune: Some Republican lawmakers — still reveling in Tuesday’s statewide election sweep — are proposing an unprecedented solution to the state’s estimated $25 billion budget shortfall: dropping out of the federal Medicaid program. Hmmm. Welcome to entitlement reality, Texas-style. Currently 20 billion a year and going to go up with expanded eligibility, the article does say the Feds pay 60 percent, but doesn’t say: 1) It’s temporary, then the Federal contribution goes down or away, and 2) The Federal component doesn’t come from magical money fairies — it’s money taken from taxpayers then funneled back into a particular program. Medicaid is not loved or respected in medicine. Decreasing reimbursements coupled to increasing requirements mean it’s at a... Better Health blogs http://www.medworm.com/rss/comments.php?id=4142748 Sun, 07 Nov 2010 20:00:29 +0100 4142748 http://www.medworm.com/index.php?rid=4139237&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-reform-and-a-divided-congress%2F2010.11.05 Republicans who had opposed healthcare reform before the election are now elected officials with a say in how the programs are funded. At federal and state levels, the program’s opponents either have a larger voice or are now in charge of implementing elements of reform. Sen. Majority Leader Harry Reid said he’d consider adjustments to healthcare reform. Frightened seniors flipped toward opposition to healthcare reform, while flipping on the issue may have saved a few Democrats. Exit polling showed 48 percent would repeal healthcare reform, 16 percent would leave it as is, and 31 percent would expand it. Now that Republicans have a larger say in the matter, take a look at their plan for healthcare in A Pledge to America, starting on page 25, and decide for yourself. (New Yor... Better Health blogs http://www.medworm.com/rss/comments.php?id=4139237 Fri, 05 Nov 2010 14:00:00 +0100 4139237 http://www.medworm.com/index.php?rid=4105669&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-new-healthcare-law-so-sad-its-funny%2F2010.10.25 Thanks to Scott Hensley over at Shots, NPR’s Health Blog, for highlighting this sad but funny video on where we’re going with healthcare. Scary what happens when theory meets reality: -WesMusings of a cardiologist and cardiac electrophysiologist. *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4105669 Mon, 25 Oct 2010 13:00:00 +0100 4105669 http://www.medworm.com/index.php?rid=4097936&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-hospitals-and-the-yankees%2F2010.10.23 Joe Boyd hated the Yankees. “Those damn Yankees. Why can’t we beat ‘em?” Then he got the opportunity to save his beloved Washington Senators by making a deal with the devil — giving up his soul in exchange for being transformed into “Shoeless Joe” to propel his team to win the World Series. Interesting. I think a lot of doctors are making their deal with the devil. They are looking for a small gain in comparison to a long-term of misery. True — Joe Boyd made out in the end, but that will only happen if someone from Hollywood writes our script. Here’s the problem: At the core of our problems with healthcare is the total lack of cohesive communication. Doctors have no idea what other doctors have done with a patient. Tests get ordered, medications get changed, proc... Better Health blogs http://www.medworm.com/rss/comments.php?id=4097936 Sat, 23 Oct 2010 16:00:04 +0100 4097936 http://www.medworm.com/index.php?rid=4082092&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-customer-service-is-good-care%2F2010.10.18 Gosh, a whole lot of huffing over a little word! “Customer.” Okay, now grab a paper bag and breathe slowly and steadily into it. I know it’s hard to hear that word. I am sorry to have caused such trouble. Some folks misunderstood my last post, thinking that I thought patients should only be considered customers, or that they should be referred to as customers. I never said that, nor did I imply it. I simply said that patients are customers. They are. Medical care is not free, and it is being paid for by the patient (directly or indirectly). Medicine is a business that has been so mismanaged that we are now in a crisis over its financial side. The trouble is the cost of care. Cost implies money is used, and trading money for services or goods is what business is about. We�... Better Health blogs http://www.medworm.com/rss/comments.php?id=4082092 Mon, 18 Oct 2010 22:00:20 +0100 4082092 http://www.medworm.com/index.php?rid=4082093&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Facos-the-gathering-storm%2F2010.10.18 Those of you who’ve read this blog for any length of time know that I have been a pretty strong advocate for healthcare reform. This has been primarily motivated by my passion for universal coverage, but also with my frustration with the cost of the current healthcare system, the generally crummy outcomes, and the overall level of fragmentation in the whole affair. Even today, I had to repeat blood tests on a cancer patient who came to the ER. He had had blood tests at the cancer center ACROSS THE STREET before presenting, but, so sorry, our computers don’t talk to theirs and it’s after 5pm now, so forget about getting those results.  So it’s with a mixture of enthusiasm and dread that I consider the coming onslaught of accountable care organizations (ACOs). What ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4082093 Mon, 18 Oct 2010 19:00:00 +0100 4082093 http://www.medworm.com/index.php?rid=4077245&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedicare-should-it-pay-less-for-less-effective-care%2F2010.10.18 From its inception, Medicare has been agnostic about the effectiveness of different treatments when it sets payment rates. Once a treatment is found to be “reasonable and necessary,” Medicare establishes a payment rate that takes into account complexity and other “inputs” that go into delivering the service. But it is prohibited by law from varying payments based on how well an intervention works. This would change under a “dynamic pricing” approach proposed by two experts in this month’s issue of Health Affairs. The article itself is available only to Health Affairs subscribers, but the Wall Street Journal health blog has a good summary. The researchers propose that Medicare pay more for therapies with “superior” results and the same f... Better Health blogs http://www.medworm.com/rss/comments.php?id=4077245 Mon, 18 Oct 2010 13:00:00 +0100 4077245 http://www.medworm.com/index.php?rid=4055713&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-patient-engagement-be-regulated%2F2010.10.11 Last month in Cambridge I met Twitter friend Bryan Vartabedian, M.D. (Twitter @Doctor_V) at a meeting at Vertex Pharmaceuticals. We’ll cross paths this fall on the conference speaking circuit. [Recently] on his blog he raised a rowdy, rough, but valid point: As e-patients (obviously including me) get into the business, should they/we be regulated? He said: Will industry be required to publicly list monies used for sponsorship, travel and swag support of high profile patients in the social sphere? Should high visibility patients who serve as stewards and advocates disavow themselves of contact with pharma just as many academic medical centers have begun? As is often the case, I don’t have an answer. I’m just raising the questions. Smart questions. My short answer: Fine with me if ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4055713 Mon, 11 Oct 2010 18:00:46 +0100 4055713 http://www.medworm.com/index.php?rid=4036650&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-doctors-work-weekends%2F2010.10.05 Peter Orszag wants doctors to work weekends. The former director of the White House Office of Management and Budget wrote as much in this past weekend’s New York Times: Doctors, like most people, don’t love to work weekends, and they probably don’t enjoy being evaluated against their peers. But their industry can no longer afford to protect them from the inevitable. Imagine a drugstore open only five days a week, or a television network that didn’t measure its ratings. Improving the quality of health care and reducing its cost will require that doctors make many changes — but working weekends and consenting to quality management are two clear ones. And he’s right, to a point. I’ve pointed to studies showing that mortality rises on the weekends, in part due to skeleton staffs ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4036650 Tue, 05 Oct 2010 18:00:02 +0100 4036650 http://www.medworm.com/index.php?rid=4031244&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Faccountable-care-organizations-global-payments-to-replace-fee-for-service%2F2010.10.04 Federal health reform and Massachusetts health reform may find a point of convergence in the development of ACOs (accountable care organizations) and the payment mechanisms that will make them tick (or hum, or do whatever it is that we want them to do).  The Federales will be holding a listening session next week on the issues raised by ACOs across the HHS and FTC landscapes.  Meanwhile, back in Boston, the inner circle of health care regulators and the regulated community are busy hashing out an approach to global payments that could be ready for prime time by January 1. The need for payment reform in Massachusetts has been well-documented — see the health care market report from the AG’s office, as well as an earlier report on the imperative to keep insurance risk on insure... Better Health blogs http://www.medworm.com/rss/comments.php?id=4031244 Mon, 04 Oct 2010 16:00:22 +0100 4031244 http://www.medworm.com/index.php?rid=4027159&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedicare-reimbursement-a-23-percent-cut-soon-to-come%2F2010.10.03   “It will never happen.” “They know better than to do it.” “They realize the disaster it would be if they let it pass.” That’s what I hear. I hear that the upcoming SGR adjustment, the one that will cut Medicare reimbursement by 23 percent, won’t go through. In case you missed it, the SGR is a formula coming from the Balanced Budget Act of 1997 that does automatic cuts to Medicare reimbursement. This year we witnessed a legislative game of chicken in congress, with both sides agreeing that it was a bad idea to screw physicians in a time that they are trying to fix healthcare. (more…) *This blog post was originally published at Musings of a Distractible Mind* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4027159 Sun, 03 Oct 2010 16:00:13 +0100 4027159 http://www.medworm.com/index.php?rid=3987087&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fy61rB5Z-J1g%2Fwill-my-opt-out-status-affect-you.html I opted out of Medicare several years ago.  This means I don’t see Medicare patients other than in the emergency room when I’m on unassigned call.   I don’t submit bills to Medicare or to those patients.  I just let it slide. Last Wednesday, I received the following letter from a large radiology group in my home town: September 2010 RE:  PECOS Enrollment To our referring physicians and their office managers: At __________we have begun a project to identify ordering physicians who are not enrolled in Medicare’s Provider Enrollment, Chain and Ownership System (PECOS).  Our purpose is to remind physicians of the importance of enrollment to them and to us. Beginning in January, 2011 those providers filing Medicare claims listing an NPI number on the ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3987087 Mon, 20 Sep 2010 11:18:00 +0100 3987087 http://www.medworm.com/index.php?rid=3858153&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffixing-up-primary-care-is-anyone-home%2F2010.08.11 By John Henning Schumann, M.D. The Patient Protection and Affordable Care Act (aka “Health Care Reform”) signed by President Obama in March will revolutionize primary care in the United States. By 2014 tens of millions of uninsured people will “enter” the system by being granted insurance, either through expansion of the Medicaid program or through mandated purchasing of insurance via state pools or the private market. This alone will have a profound impact, straining the capacity of our already frayed system. Therefore, embedded in the law are funds to encourage growth and improvement in primary care: Incentives to encourage graduates to enter primary care fields (family medicine, internal medicine, and pediatrics) and practice in underserved areas (through scholar... Better Health blogs http://www.medworm.com/rss/comments.php?id=3858153 Thu, 12 Aug 2010 01:00:00 +0100 3858153 http://www.medworm.com/index.php?rid=3848869&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F809%2F0%2Fsaveobamacareimplications.mp3 Why Big Health Insurance Supported Obamacare, Part IV In the past few posts (in particular, here and here), DrRich has shown why the health insurance industry embraced Obamacare, and indeed, took extraordinary steps to assure that Obamacare became the law of the land. This, of course, is especially interesting in light of the common perception that Obamacare constitutes a major defeat for the greedy health insurance industry. But the fact that big health insurance gave critical support to Obamacare is far more than merely interesting. It has major implications both to supporters of Obamacare, especially the ones who hope for an eventual single-payer outcome, and to opponents of Obamacare, many of whom hope to repeal it after the 2010 mid-term elections. For the health insurance industry to... Better Health blogs http://www.medworm.com/rss/comments.php?id=3848869 Mon, 09 Aug 2010 20:00:46 +0100 3848869 http://www.medworm.com/index.php?rid=3808666&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Flife-insurance-companies-and-cancer-survivors%2F2010.08.01 I have always heard that Northwestern Mutual Life (“The Quiet Company”) was a grade-A company. And for years I have been happy to have a disability insurance policy and a term life one with them. I got those policies back in the early 1990s, and it was a good thing I did. In 1996 my health changed. I was diagnosed with leukemia. I knew I was very lucky to have insurance in place because, as many told me: “You’ll never get insurance now.” Now fast-forward 14 years, and 10 years after receiving treatment in a phase II clinical trial. I have no evidence of disease and have not had any evidence for nine years. The drug therapy I received in a trial has now been approved by the FDA and in Europe as the standard of care. People are living well with this leukemia and it is extending li... Better Health blogs http://www.medworm.com/rss/comments.php?id=3808666 Sun, 01 Aug 2010 16:00:44 +0100 3808666 http://www.medworm.com/index.php?rid=3726599&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-road-rage%2F2010.07.05 Road and construction projects have stopped all over town, thanks to concerns about future healthcare benefits. From ChicagoBreakingNews.com: Construction companies and labor unions are divided over healthcare packages. The unions seek a 15 percent annual benefits increase over three years, while contractors have countered with a 1 percent annual increase. -WesMusings of a cardiologist and cardiac electrophysiologist. *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3726599 Mon, 05 Jul 2010 12:00:00 +0100 3726599 http://www.medworm.com/index.php?rid=3706674&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhoop-de-do-to-the-medicare-physician-pay-cut-problem%2F2010.06.28 After months of dithering, delaying, denying, and defaulting on a decision, Congress ended up…doing as little as possible to address the Medicare physician pay cut problem. Thursday night the House of Representatives acceded to the Senate’s bill to provide physicians with a 2.2 percent update retroactive to June 1. This respite, though, lasts only through the end of November, when physicians and patients will again face another double-digit cut. And if the past is prologue, a lame-duck Congress then will wait until the very last minute to enact another short-term patch, or worse yet, allow the cut to go into effect on December 1 and then pass some kind of retroactive adjustment. You know that the situation has gotten ridiculously bad when the President says this about the bill he ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3706674 Mon, 28 Jun 2010 18:00:00 +0100 3706674 http://www.medworm.com/index.php?rid=3706675&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsgr-tired-of-congress-hitting-the-6-month-snooze-button%2F2010.06.28 I have not a single thing I want to write about today. I am weary of the obvious topic: the “passage” of the 6-month extension on the SGR, but do feel I need to comment. I am tired of this. I am tired of being jerked around by congress. I am tired of congress hitting the 6-month snooze button and somehow feeling that they are doing something good. This is procrastination, not a solution. Reassurances that something will be done are starting to be irrelevant. The problem is becoming the frustration, anger, and exhaustion that congress is thrusting upon doctors and patients, not the pay cut itself. The idea of no longer having to deal with the passive-aggressive tactics of congress is becoming increasingly appealing –- and if it’s this way for me, I’m sure it’s the s... Better Health blogs http://www.medworm.com/rss/comments.php?id=3706675 Mon, 28 Jun 2010 16:00:17 +0100 3706675 http://www.medworm.com/index.php?rid=3706676&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedicaid-in-a-squeeze%2F2010.06.28 New reports peg Medicaid’s future as dismal and unsustainable, as states struggle for ways to pay for the rising costs of caring for their poorest residents. The Deloitte Center for Health Solutions study, “Medicaid Long-Term Care: The Ticking Time Bomb,” estimates Medicaid costs will nearly double as a percentage of state budgets by 2030, or perhaps nearly triple. Meanwhile, the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured estimates Medicaid expansion will cost $464.7 billion by 2019. The federal government will cover $443.5 billion (95.4 percent) and the states will cover the remaining $21.2 billion. Minnesota won’t expand its Medicaid program until 2014 because of budget fears. Connecticut will. (The Fiscal Times, MedPage Today, Reuters... Better Health blogs http://www.medworm.com/rss/comments.php?id=3706676 Mon, 28 Jun 2010 15:00:00 +0100 3706676 http://www.medworm.com/index.php?rid=3662672&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fless-is-more-in-medicine-why-patients-arent-buying-it%2F2010.06.14 In a recent article, the editors of the Archives of Internal Medicine make the case that too much unneeded care is being delivered in physician’s offices these days. According to the authors, “patient expectations” are a leading cause of this costly problem. Their solution? Get physicians to share with patients the “evidence” for why their requests are crazy, wrong, ill-informed or just plain stupid. But getting patients to buy into the “less is more” argument is a daunting task as most physicians already know. The problem is complicated by the fact that patients have a lot good reasons for not buying it. (more…) *This blog post was originally published at Mind The Gap* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3662672 Mon, 14 Jun 2010 20:00:18 +0100 3662672 http://www.medworm.com/index.php?rid=3658953&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoc-fix-vote-awaits-reimbursement-cut-to-take-effect%2F2010.06.14 Senators visited their districts Friday and again today, so the earliest they could vote on the doc fix is tomorrow (6/15) — the day the 21.3 percent reimbursement cut takes effect. Slowing down the process are the numerous amendments. For example, the duration of the fix is still being negotiated. And there are amendments such as redefining what makes up a rural health district. In California, some rural areas are seeing urban levels of patient demand, but giving more money to these counties is being seen as a kickback akin to others that were proposed during healthcare reform. (Part B News, The Hill) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3658953 Mon, 14 Jun 2010 12:00:00 +0100 3658953 http://www.medworm.com/index.php?rid=3644763&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-medical-home-in-ontario-the-poor-left-behind-again%2F2010.06.09 In a recent blog posting, I described Group Health’s medical home for 8,000 patients. It proved to be a boon for primary care physicians, who were able to reduce the size of their patient panels, see fewer patients per day, refer more patients to specialists, and maintain or increase their incomes. Patients liked it, too. And Group Health was happy because expenditures per patient were 2 percent lower. But poor patients had trouble getting through the front door of the medical home, so based on demographic differences alone, expenditures should have been lower by 10 percent or more. Nonetheless, they declared victory. Now news filters south from Ontario’s eight-year experiment with medical homes for 8,000,000 patients, and the news is similar. Participation is skewed to healthier an... Better Health blogs http://www.medworm.com/rss/comments.php?id=3644763 Wed, 09 Jun 2010 14:00:52 +0100 3644763 http://www.medworm.com/index.php?rid=3621684&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedicare-cut-effective-today-who-should-doctors-be-angry-at%2F2010.06.01 Instead of blogging (again) about Congress’s failure to stop the 21% Medicare SGR cut, which went into effect today, I could just re-run my April 16 post. I wrote then: “It is the failure of both political parties, over many years, to honestly deal with the SGR, including the cost of getting rid of it, which has resulted in the current ongoing SGR farce. And yet members of Congress wonder why the public holds them in such low regard.” Blogging in DB’s Medicare Rants, Dr. Bob Centor captures the outrage felt by most physicians: “I am mad. Every physician I know is mad. Patients should join us in expressing anger. Physicians cannot trust Congress if they cannot repair this absurdity.” (Bob references ACP’s statement, released on Friday; click here to... Better Health blogs http://www.medworm.com/rss/comments.php?id=3621684 Tue, 01 Jun 2010 20:00:00 +0100 3621684 http://www.medworm.com/index.php?rid=3603598&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealth-insurance-and-medical-loss-ratio-foolishness%2F2010.05.25 Like Ezra Klein, smart people keep saying foolish things about the health insurance business. This time it’s a pair of bloggers talking about the largest expense that health insurers face — their “medical loss ratio.” According to Richard Dale at the Venture Cyclist: [W]hy do they call it Medical Loss Ratio? Why is looking after me (or you) called “Medical Loss,” when the whole point of a healthcare system is to look after me (or you)? (Sigh.) Alan Katz, one of the leading health insurance bloggers, surprisingly links to this with approval, saying “words matter.” The problem? The word “loss” is probably one of the four oldest words in the insurance industry. I’d say the others are probably “premium,” “commission,” and “profit.” Should we start outlawi... Better Health blogs http://www.medworm.com/rss/comments.php?id=3603598 Wed, 26 May 2010 01:00:39 +0100 3603598 http://www.medworm.com/index.php?rid=3573689&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcutting-healthcare-costs-means-saying-no-to-patients%2F2010.05.17 Let’s face it, the best way to cut healthcare costs is to say “no.” That means denying unnecessary tests that most patients in the United States are accustomed to having. The New York Times‘ David Leonhardt has the best take on this issue that I’ve read. He acknowledges the difficulty of telling the American public “no,” and cites examples ranging from the breast cancer screening controversy to the managed care backlash in the 1990s: This try-anything-and-everything instinct is ingrained in our culture, and it has some big benefits. But it also has big downsides, including the side effects and risks that come with unnecessary treatment. Consider that a recent study found that 15,000 people were projected to die eventually from the radiation they received from CT scans given i... Better Health blogs http://www.medworm.com/rss/comments.php?id=3573689 Mon, 17 May 2010 18:00:58 +0100 3573689 http://www.medworm.com/index.php?rid=3526743&cid=t_100870_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmost-people-arent-angry-about-healthcare-reform%2F2010.05.03 I just got back from a wonderful week in Toronto, Canada. No, I wasn’t up there to take tips on how to impose socialized medicine on an unsuspecting public, notwithstanding what some of you may incorrectly-surmise about my political leanings. Rather, I was there to attend ACP’s annual scientific meeting, during which I had the opportunity to serve as faculty for three separate scientific sessions that discussed the impact of the new Patient Protection and Affordable Care Act (PPACPA) of 2010 on internists and their patients. Several hundred ACP members attended these sessions. And guess what? Rather than encountering doctors who were angry at the new law and ACP’s support for it, I instead found an engaged and curious group of internists who are looking at health reform i... Better Health blogs http://www.medworm.com/rss/comments.php?id=3526743 Mon, 03 May 2010 12:00:00 +0100 3526743 http://www.medworm.com/index.php?rid=3443730&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FaGpaw7F_x50%2Finsurance-premium-increase.html Physicians aren’t exempt from the struggles with personal health insurance coverage, affordability, denied coverage, etc.   When I finished my training and opened my practice 20 years ago I had to buy individual coverage.   All options included a rider that excluded coverage on my uterus and ovaries due to fibroid surgery during training.  So when I had my TAH & BSO a few years later, the entire cost came out of my pocket.  Fortunately, I knew how to ask for cost reductions, but still… My husband and I are both small business individuals.   I have always carried our health insurance under my name (office).  Over the years we have gone to a health savings account with a high deductible to keep the cost reasonable.  Fortunately, we ha... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3443730 Wed, 07 Apr 2010 11:01:00 +0100 3443730 http://www.medworm.com/index.php?rid=3432953&cid=t_100870_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2010%2F04%2Fhate-and-healthcare.html With physical intimidation, racial epithets and other threats being aimed at lawmakers who voted for health care reform, a newly appalling era of American politics seems to have dawned.As members of The Tea Party call Representative Barney Frank a "faggot" and scream the "N-word" at Representative John Lewis, a true Civil Rights-era hero, the level of debate in the country has certainly taken a decidedly downward turn.The controversial vote on health care reform has indeed made many enemies, and it is widely agreed that there is no way that this legislation will please everyone. While some on the left feel that the "reform" is nothing but a capitalist grab at health care dollars, many on the right opine equally strongly that "socialism" is now simply lapping at the shores of the country ag... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=3432953 Thu, 01 Apr 2010 19:14:00 +0100 3432953 http://www.medworm.com/index.php?rid=3395166&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FYXQUeVYCUmM%2F250000-for-loss-of-consortium.html Why should the husband of  a woman who was disfigured by her facelift get $250,000 for pain and suffering?  Actually, his is for “loss of consortium.” President Barak Obama is scheduled to sign the new healthcare bill into law today.  No tort reform was included. According to the Georgia Supreme Court ruling In January 2006, Harvey P. Cole, M.D., of Atlanta Oculoplastic Surgery, d/b/a Oculus, performed CO2 laser resurfacing and a full facelift on appellee Betty Nestlehutt.  In the weeks after the surgery, complications arose, resulting in Nestlehutt’s permanent disfigurement. Nestlehutt, along with her husband, sued Oculus for medical malpractice. The case proceeded to trial, ending in a mistrial. On retrial, the jury returned a verdict of $1,265,000, comprised ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3395166 Tue, 23 Mar 2010 17:10:00 +0100 3395166 http://www.medworm.com/index.php?rid=3314682&cid=t_100870_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2010%2F02%2Fnational-health-service.html As Congress argues about whether national health care can ever be a reality here in the United States (with fears of socialism abounding), the British National Health Service (NHS) is often brought up as an example of socialized medicine gone awry.Just a few days ago, I received an email from a contact who wanted me to share with my readers some real facts about the NHS in order to counter many of the falsehoods bandied about. The NHS was established in 1948 for the benefit of the residents of England, Wales, Scotland and Northern Ireland, and contrary to popular opinion here in the US, residents of those countries can indeed purchase private health insurance, go to private hospitals and otherwise pursue high-quality care.An article on Health Express extolls many of the positive aspects of... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=3314682 Fri, 26 Feb 2010 17:47:00 +0100 3314682 http://www.medworm.com/index.php?rid=3706914&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2FWelfare_for_health_insurance_companies.php%23unique-entry-id-83 Up until last night, I supported the healthcare reform plans of President Obama. I did so, despite the evisceration of important parts of the proposed law, including the public option, stricter controls on insurance companies, and broader coverage for more people. What we are going to have is a law that is no more than a transfer of wealth from the taxpayers to rich health insurance companies. Sure, those companies have to accept customers with pre-existing conditions, but they get to charge more. Sure, they have to accept older individuals, but they get to charge them more. Moreover, this bill will charge people who do not have insurance so that they might be covered. If they don’t have the money, the government will give it to you, and it will go to the insurance companies.... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706914 Wed, 16 Dec 2009 00:00:00 +0100 3706914 http://www.medworm.com/index.php?rid=3071194&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FVUjrc80es3s%2Fhelp-fight-botax-send-your-senator.html I am against the Cosmetic Surgery Tax (or BoTax).  I feel it is an unfair tax which will heavily affect women more so than men.  It will also affect many more in the middle class than in the wealthy class.  I’d like to join the Aesthetic Society and all of organized Plastic Surgery in fighting this unfair tax. For more on how the tax is a bad idea, check out this article Breast-Enlargement Tax That Failed in Jersey Taints U.S. Plan by Nicole Gaouette over at Bloomberg.com (H/T to Jeff Frentzen, PSP Blog) ”It was a real education,” said Cryan, a Democrat who now wants the levy repealed, in a telephone  interview. “We essentially discouraged the business from happening at all.” Susan Hughes, a Cherry Hill, New Jersey, facial surgeon, said her business droppe... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3071194 Wed, 09 Dec 2009 12:01:00 +0100 3071194 http://www.medworm.com/index.php?rid=3048144&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FW7uluojjTNU%2Fare-bpa-products-safe.html I love the convenience of my microwave. It is especially good for reheating leftovers like the chili I made recently. I took the chili to the office in a plastic container for lunch the next day. The question is: are the BPAs in the plastic container a health risk? Should I put my chili in a Pyrex or ceramic bowl before microwaving? Yesterday afternoon, I participated in Better Health's very first blogger briefing. The subject was Bisphenol-A (BPA) plastic safety. The briefing included an interview with Steve Hentges, PhD., Executive Director of the Polycarbonate/BPA Global Group of the American Chemistry Council (ACC), and was moderated by Dr. Steven Novella, founder of the blog Science-Based Medicine and the new policy non-profit, The Institute For Science In Medicine. Bisphenol-A (BPA)... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3048144 Wed, 02 Dec 2009 12:01:00 +0100 3048144 http://www.medworm.com/index.php?rid=3015305&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FeVSB5YO9Xbo%2Fbotax-on-elective-surgery.html I agree with all who feel there needs to be healthcare reform (or more honestly health insurance reform), but I don’t agree with Senator Harry Reid who feels one way to pay for it is by taxing elective surgery.  This proposed tax has been dubbed the Bo-Tax and was first mentioned back in the summer.  Then it was proposed as a 10% tax on elective and cosmetic procedures.  Now it is proposed as a 5% tax on those procedures. As defined by the Internal Revenue Code of 1986, "Any procedure which is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease."  These procedures would be the target of the proposed tax. The price tag for the proposed bill (here in pdf ) is ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=3015305 Fri, 20 Nov 2009 18:01:00 +0100 3015305 http://www.medworm.com/index.php?rid=3706920&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2FFlu_vaccination_locations.php%23unique-entry-id-76 Google maps has an interesting application that shows locations and availability of seasonal flu and H1N1 vaccinations. I'm not sure how accurate it is, but you should give it a try. By Michael W Simpson (Source: Medical Products Insight RSS Feed) Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706920 Tue, 17 Nov 2009 00:00:00 +0100 3706920 http://www.medworm.com/index.php?rid=2995758&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Ftr_y1N_2_LU%2Fus-healthcare-reform-photoshop-contest.html Dr Wes and his wife, Diane, are holding a contest: US Healthcare Reform Photoshop Contest. Bring us your snark, your wit, your creativity about the health care reform efforts encapsulated in a single photograph. Photographs in support or against the current efforts will be equally considered, and you, dear internet devotees, will be the final judge. The winner receives an iPod Touch. Full details on the rules can be found at Dr Wes’ blog here.  You must send in your entry no later than 11:59 PM on 30 November 2009.   Dr Wes and Diane will then chose 5 or 6 finalists. On 2 December 2009 or so, the chosen finalists will be displayed and the polls will open for you to choose the winner. The photograph with the most votes tallied will receive an 8Meg iPod Touch. Voting on... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2995758 Sun, 15 Nov 2009 20:03:51 +0100 2995758 http://www.medworm.com/index.php?rid=2943835&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F8alTQ7gVAmo%2Fjohn-stossel-speaks-at-healthcare-town.html I am not as well educated in healthcare policy or politics as Dr Wes, Dr Val, KevinMD, Movin’ Meat, or Dr Sid Schwab.  I keep reading and listening, trying to understand and decide where I stand.  I seem to be more of a centrist (I think). I was not able to attend any of the previous town hall meetings held in Little Rock on healthcare, but was able to attend the one today.  It was sponsored by the Americans for Prosperity.   The headline speaker was John Stossel.  I am happy to note it was a civil discourse though that may be due to most of them leaning the same way. I didn’t come away any clearer than before.  I do tend to agree with Stossel that “when insurance is paying” (and not the individual) “it changes behavior.”  We aren’t as... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2943835 Thu, 29 Oct 2009 21:36:53 +0100 2943835 http://www.medworm.com/index.php?rid=2931009&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FPrnxmCTk-0U%2Fshout-outs_27.html Codeblog  is this week's host of Grand Rounds.  You can read this week’s “Trick or Treating” edition here. Welcome to Grand Rounds!  This is volume 6, number 6…. and the 6th time I am hosting… during the week of Halloween.  Does anyone else find that creepy coincidentally satanic fascinating?! For this edition, I thought we could go out Trick or Treating on Medblogger Lane.  I’m sure we will find some colorful stories along the way… …………………………. Better Health highlights’ Evan Falchuk JD  post:  If I Could Fix One Thing About US Healthcare. ………….In response, a friend of mine challenged me:  if the system is too complicated, how should we simplify it? I wish more policy-makers were asking this ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2931009 Tue, 27 Oct 2009 11:40:44 +0100 2931009 http://www.medworm.com/index.php?rid=2851860&cid=t_100870_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2009%2F09%2Ffacing-unknown.html The health care debate seems to be full of unknowns these days. As the arguments over health care reform heat up to the boiling point, the notion of a government-run program raises the hackles of so many people across the spectrum, and cries of socialism are heard across the land. Will our care be rationed? Will grandma be left to die when a bureaucrat decides that she has reached her life expectancy and her surgery is not cost effective based on her age? Misrepresentation and misinformation abounds.Meanwhile, H1N1 challenges the public health infrastructure, and the availability and distribution of the vaccine poses questions that still cannot be fully answered. And as the manufacturing of that new vaccine is ramped up, seasonal flu vaccine distribution has been slowed to a veritable tric... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=2851860 Thu, 01 Oct 2009 02:19:00 +0100 2851860 http://www.medworm.com/index.php?rid=2737762&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F6_TAEwrw6xI%2Fabortion-coverage-and-health-insurance_27.html I’m going to wade right in here.  I am not a fan of abortions, but neither am I of amputations.  Both are sometimes necessary.  To me, too often abortion opponents forget the mother.  She is a life present before us.  Her care should not be forgotten. I have been listening and reading the discussions over how the abortion coverage may sink health care reform.  I think it would be a shame if this one issue does sink reform. If my understanding of the Hyde Amendment (and it’s amendments over the years) is correct the Federal Government covers the cost of abortions in cases of rape or incest or when the life of the mother is at risk.  It does not cover the cost when the health of the mother is at risk: With these bans, the federal government turns its ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2737762 Thu, 27 Aug 2009 11:01:00 +0100 2737762 http://www.medworm.com/index.php?rid=3706931&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fcivilized_medicine_part_iii_my_proposal.php%23unique-entry-id-65 Originally, I was going to make my proposals for healthcare reform as the last item. But now there is so much debating, amending, backtracking, and all around lying, I can’t figure out what’s being proposed. Well, I do know there are no death panels, even if Sarah Palin makes stuff up. Since I’ve installed myself as health care czar (in my own mind), let me make my proposals. 1 There should be a single payer system. Frankly, health insurance companies cannot be trusted to treat anyone fairly and ethically. I’ve been observing healthcare insurance companies for too long in my career, and I am convinced. However, they can stick around to provide high priced supplemental insurance to those who want and can afford it. Because they will have to compete for this... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706931 Mon, 17 Aug 2009 23:00:00 +0100 3706931 http://www.medworm.com/index.php?rid=3706932&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fcivilized_medicine_part_iia_myths.php%23unique-entry-id-64 Although so many others have debunked this myth, I want to make sure that I add to the roar (of laughter, derision and anger) about the latest right-wing attempt to demonize healthcare reform. Stephen Hawking, the world’s preeminent theoretical physicist, has a form of ALS (amyotrophic lateral sclerosis, also known as Lou Gehrig’s Disease in the United States), a progressive neuromuscular disease, which has left him paralyzed and unable to communicate except through an advanced communication device. Despite his disease, he has published numerous books and starred in an episode of Star Trek:The Next Generation. On August 3, an Investor’s Business Daily editorial stated, “People such as scientist Stephen Hawking wouldn't have a chance in the U.K. where the Nationa... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706932 Fri, 14 Aug 2009 23:00:00 +0100 3706932 http://www.medworm.com/index.php?rid=3706934&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fhealthcare_reform_equals_nazis.php%23unique-entry-id-62 I have been vaguely uncomfortable with the comparison of Obama’s healthcare plan with Nazis or Hitler. Use of that analogy in a discussion or debate is often referred to as Godwin’s Law, which states that “As a discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches 1.” What has begun to trouble me is that either those opposed to healthcare reform are clueless about recent history, or they are representing a form of Holocaust denial, which is a belief that the murder of six million Jews during World War II did not happen. I know that certain individuals in the healthcare debate are prone to rhetorical flourish, but there is no way that healthcare reform is equivalent to Nazi’s. Unless you believe that Hitler was engage... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706934 Wed, 12 Aug 2009 23:00:00 +0100 3706934 http://www.medworm.com/index.php?rid=2688702&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2Fgpn-M3MgAAs%2Fshout-outs_11.html DrRich, The Covert Rationing Blog, is this week's host of Grand Rounds. You can read it here (photo credit).  It’s the “cost containment in healthcare” edition. Critics of the Obama health (insurance) reform plan have been formally served notice that they are under observation, ……….. So, as he embarks on this week’s edition of Grand Rounds, DrRich would like to welcome any visitors who are here on behalf of such important surveillance efforts, and hasten to tell you that DrRich is on your side. Indeed, this version of Grand Rounds is dedicated to exploring the many ways in which the proposed health (insurance) reforms will succeed in all its goals, and most especially in achieving cost containment…….     The latest edition of Change of Shift (Vol 4,... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2688702 Tue, 11 Aug 2009 11:49:51 +0100 2688702 http://www.medworm.com/index.php?rid=3706936&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fcivilized_medicine_part_ii_myths.php%23unique-entry-id-60 I have found the commentary against the proposed healthcare reform to be both disturbing (Limbaugh’s comments dishonors the memory of the Holocaust) and silly (and kind of disturbing too). But almost all of the comments are based on myths or half-truths, and as those of you who read this blog know, I can’t stand myths. The disinformation about Obama’s healthcare plan is poisoning the debate, because rational people tend to dismiss an opposing viewpoint if it has no sound foundation in logic. I think that there should be a reasoned debate on how to fix the healthcare system of the US. It’s not happening, because one side is channeling its hatred of the other side, and reason goes flying out the door. ...Let me state upfront that there were so many to choose, a... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706936 Sat, 08 Aug 2009 23:00:00 +0100 3706936 http://www.medworm.com/index.php?rid=3706938&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fcivilized_medicine_part_i_why.php%23unique-entry-id-58 Unless you live in a world that does not include the media or internet, you must be aware of the level and tone of debate about healthcare reform. Before we can discuss healthcare reform, we need to establish why we need healthcare reform. Cutting through the rhetoric as to what needs to be done, we still need to know the reasons that have lead the US to the point where we need to seriously consider some level of reform of the system. Setting aside some of the rhetoric and arguments, let’s look at the key issues regarding healthcare in the US. ...From a national perspective, the US (government and private) spends over $2.5 trillion on healthcare. Put another way, the US spends 16.9% of its Gross Domestic Product on healthcare, more than any other developed country in the world.... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706938 Tue, 04 Aug 2009 23:00:00 +0100 3706938 http://www.medworm.com/index.php?rid=3706939&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fcivilized_medicine.php%23unique-entry-id-57 I’m titling this post “Civilized Medicine” as opposed to “socialized medicine.” What I’m really going to discuss is Obama’s healthcare plan, but I wanted to start out by demolishing that old strawman argument that attempts to dismiss new ideas by calling them “socialist.” A civilized society owes its citizens the right to a healthy life. But that’s just semantics, and a thorough review the Obama’s proposal is warranted. When I first started to write this entry, I thought I could do it one article, albeit a long one. Instead, to make it easier to read, I’ve decided to do it over four parts over the next few days. I Why. I want to get some facts out there about why the country needs a healthcare reform. II M... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706939 Mon, 03 Aug 2009 23:00:00 +0100 3706939 http://www.medworm.com/index.php?rid=2645327&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FBAQ03fwpb7g%2Fshout-outs_28.html Captain Atopic is this week's host of Grand Rounds. You can read it here.  He calls it the “Grand Rounds 5:45 - Le Tour de France Edition!” Where Grand Rounds is the Grand Tour of Medical Blogging, the Grand tour of Cycling is undoubtedly Le Tour de France, which concluded on Sunday in Paris. After three weeks of cycling, nearly 3,500km at an average speed above 40km/h, the peleton will ride up Paris' Champs Elysee's to the finish. Throughout the race, certain riders and teams will have reached their goals, revealed their future potential and achieved great triumphs. This week's Grand Rounds features some sterling examples of writing, all capable of Stage Victories, and some, much more. Welcome to the Tour...  (photo credit)   The latest edition of Change of Shift (... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2645327 Tue, 28 Jul 2009 11:45:20 +0100 2645327 http://www.medworm.com/index.php?rid=2580239&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FKqYn0C3m22o%2Fdont-forget-hiipa-privacy-rules.html As we move towards EMR’s, the ability to know who has looked at the medical record may get more and more in trouble. While we are all curious about our friends, neighbors, and celebrities (local or global), it is important to respect each others privacy. This local Arkansas story shows the importance of this respect. Hospital emergency room coordinator Candida Griffin, patient account representative Sarah Elizabeth Miller and Dr. Jay Holland, a family doctor who worked part time at the hospital, each face up to a year in prison and $50,000 fine if convicted of the misdemeanor charge. I would hope that all three of the people listed above would have “known better.” When this story broke earlier this week, the staff in the OR and I had a nice discussion on who gets HIPAA training ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2580239 Tue, 07 Jul 2009 15:32:22 +0100 2580239 http://www.medworm.com/index.php?rid=2570534&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FKqYn0C3m22o%2Fdont-forget-hiipa-privacy-rules.html As we move towards EMR’s, the ability to know who has looked at the medical record may get more and more in trouble.   While we are all curious about our friends, neighbors, and celebrities (local or global), it is important to respect each others privacy.  This local Arkansas story shows the importance of this respect. Hospital emergency room coordinator Candida Griffin, patient account representative Sarah Elizabeth Miller and Dr. Jay Holland, a family doctor who worked part time at the hospital, each face up to a year in prison and $50,000 fine if convicted of the misdemeanor charge.   I would hope that all three of the people listed above would have “known better.”  When this story broke earlier this week, the staff in the OR and I had a nice discussio... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2570534 Thu, 02 Jul 2009 12:14:24 +0100 2570534 http://www.medworm.com/index.php?rid=2523071&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F5Vw_siRW4bI%2Fhealthcare-discussion.html I was in the “audience” of the phone conference today organized by Dr. Bob Goldberg, President, Center for Medicine in the Public Interest Advance (CMPIA).  In addition to him, Dr. Val Jones (Founder and CEO Better Health Network) and Dr Gary Puckrein (President, National Minority Quality Forum) were on the panel of speakers.  The focus was to be on the risks of government-run healthcare. It seemed to me that many good points were made, but the main one was that the focus of the healthcare discussion needs to be refocused on the patient and the care given rather than simply on the high cost of care/insurance and any cost savings to be gained short-term.  As Dr Wes pointed out in his recent post (The $400 Billion Dollar Question), patients aren’t at the “table” of m... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2523071 Wed, 24 Jun 2009 18:57:34 +0100 2523071 http://www.medworm.com/index.php?rid=2523069&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FkpQwqXIl03A%2Fshout-outs_23.html Barbara Olsen, Florence Dot Com,  is this week's host of Grand Rounds. You can read it here (photo credit).  Great edition! Welcome to Grand Rounds! It's officially summertime, and Flo & Bo are taking you out to the ballgame! At Florence dot com, Bo, a seasoned nurse with an engineer's mind, channels Florence Nightingale, a systems thinker whose interest in public health and service gave rise to modern nursing. (Flo favors cricket, but this is Bo's gig.) From Better Health comes “A Medical Transgender Primer”  written by DrJonLaPook.   Very nice article. Step one in reaching the public is defining terms. The terminology surrounding gender issues can be confusing. “Transgender man,”, “transmale,” and “affirmed male” have all been used to re... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2523069 Tue, 23 Jun 2009 12:20:40 +0100 2523069 http://www.medworm.com/index.php?rid=2523064&cid=t_100870_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2FraEedM93ocE%2Fbundling-what-will-it-mean.html In a lot of the healthcare policy talk I feel like an outlier.  Most of the healthcare policy talk is directed more towards the primary care specialties.  As a “potential” patient and as a medical specialist, I watch and read with interest.   Often I am unsure as to the definitions being thrown around in the discussion.  Take bundling for example.  Currently, many of the surgical payments are already “bundled” in that the surgery and the first 90 days postop are linked or “bundled” together.  When I do a breast reduction on a patient, the fee I receive covers the surgery itself and any visits during the first 90 days postoperative.   I see each of these patients the morning of surgery to do the preop marking and answer any new quest... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=2523064 Wed, 17 Jun 2009 18:13:05 +0100 2523064 http://www.medworm.com/index.php?rid=3706945&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fhealthcare_IT_perfect_product.php%23unique-entry-id-50 As discussed previously, I am convinced that the healthcare IT market is poised for explosive growth. I think there are going to be a few challenges to entrepreneurs and larger companies to participate in this growth, including FDA oversight, privacy and security, hardware/software incompatibility, and linking to medical devices. Finally, marketing to the customer base, whether it is the alternate site (physicians, surgery centers, long-term facilities) or hospitals, is going to take individuals who are skilled in the medical products marketing instead of IT marketing. So, what would be the perfect product in healthcare IT? It depends on the target market, but I would like to focus on the primary care physician (and other alternate site generalists and specialists), who may be the la... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706945 Sun, 07 Jun 2009 23:00:00 +0100 3706945 http://www.medworm.com/index.php?rid=3706947&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fhealthcare_IT_growth_drivers.php%23unique-entry-id-47 As I have discussed several times before, there seems to be a significant amount of activity in health information technology. President Obama’s stimulus package includes $19 billion to fund hospitals and individual physicians to upgrade their IT systems, specifically to migrate from paper-based patient records to electronic health records. In the near future, it would be possible for a patient record to be shared between all parts of the healthcare system. For example, patient with a severe trauma can be treated more quickly and effectively, if the emergency room had access to the patients record knowing what health issues may be critical to decisions about treating the patient. Having that information available within minutes can be crucial to saving the patient’s life. ... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706947 Tue, 02 Jun 2009 23:00:00 +0100 3706947 http://www.medworm.com/index.php?rid=3706950&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fvalue_of_blood_glucose_monitoring.php%23unique-entry-id-44 One of the paradigms of managing patients with Type II diabetes includes regular home testing of blood glucose levels using one of the widely available blood glucose monitors. The American Diabetes Association, one of the leading organizations that advocate for and provide information about diabetes, recommends home glucose monitoring for patients who have diabetes and are: • taking insulin or diabetes pills • on intensive insulin therapy ... • having a hard time controlling your blood glucose levels • having severe low blood glucose levels or ketones from high blood glucose levels • having low blood glucose levels without the usual warning signs These are probably good recommendations, based on good evidence. Controlling blood glucose in those ... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706950 Tue, 12 May 2009 23:00:00 +0100 3706950 http://www.medworm.com/index.php?rid=3706953&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fpoint_of_care_diagnostics_flu.php%23unique-entry-id-40 I am enamored of the point-of-care (POC) diagnostics market. It is clear that these tests bring benefits to patients, physicians and managed care. Influenza A H1N1 (apparently, the pork industry does is not fond of the swine flu label) may open a huge opportunity for rapid testing for flu. Quidel Corporation (NASDAQ GS: QDEL) manufactures and markets a rapid (less than 10 minutes from swab to results) diagnostic kit for Influenza A and B (and differentiates between the two). As Quidel states, they are not sure if it detects the swine flu strain. The test should be used for any patients that present with influenza symptoms, because a positive result may rule out other types of infections (and should involve contacting a local health department), although a negative result (if the test... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706953 Sun, 03 May 2009 23:00:00 +0100 3706953 http://www.medworm.com/index.php?rid=3706954&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fswine_flu_dont_panic.php%23unique-entry-id-39 With respect to the swine flu, I want to repeat myself, once again–Don’t Panic. Yes, the World Health Organization revised the pandemic alert for swine flu from 4 to 5. They did this to urge vaccine manufacturers to prepare a new vaccine, to warn governments to prepare in advance, and to request that government surveillance be heightened. This does not mean that we will be returning to the Spanish Flu epidemic of 1918, where more than 20 million people died worldwide. We are healthier, there are no major wars such as World War I, we have a better healthcare system, we have more focus from governments, and we have better treatments. One child in Texas has apparently died from swine flu. Although it is no small comfort to the family, who probably is grief-stricken by t... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706954 Wed, 29 Apr 2009 23:00:00 +0100 3706954 http://www.medworm.com/index.php?rid=3706955&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fswine_flu.php%23unique-entry-id-38 Well, actually I’m not going to say too much about swine flu, except that my initial impression is that it’s not that much different from other types of flu in terms of severity. For example, during the 2007-2008 flu season, there were 83 pediatric mortalities in the US that resulted from influenza infections. In other words, like a lot of diseases that we think are minor, there are serious health consequences that often fly “under the radar.” There is a certain fascination with this disease because of where it started (Mexico), conspiracy theories, and for other reasons that are beyond my ability to understand. I am personally not concerned, because, as I mentioned above, the morbidity of the infection probably is similar to other types of influenza. There ar... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706955 Tue, 28 Apr 2009 23:00:00 +0100 3706955 http://www.medworm.com/index.php?rid=3706958&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fdenialism_and_pseudoscience.php%23unique-entry-id-35 Today, I commented to a blog entry at Beyond the Short Coat, which is one of my daily stops on the medical blogosphere. The author, like a lot of bloggers in the medical arena, has been taking on the world of medical woo, that is, those ideas in medicine that completely lack verifiability and scientific credibility. I have a similar disdain for woo, for essentially the same reasons as the physicians who write in those various blogs. Mostly, they are troubled that patients turn to these useless therapies because they may not be getting adequate medical care, or even that those fake therapies may have terrible consequences for the patient. I take it a step further in that I believe that this woo has a substantial economic consequence with increased costs for patients, providers, and thir... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706958 Mon, 20 Apr 2009 23:00:00 +0100 3706958 http://www.medworm.com/index.php?rid=3706962&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fhealthcare_IT_growth_potential.php%23unique-entry-id-30 Today, Kim Hart at the Washington Post wrote an interesting column about one of the positive effects of the recently passed American Recovery and Reinvestment Act of 2009 (stimulus package) for the health care industry. Approximately $19 billion of the package is specifically targeted for health information technology (HIT) upgrades for providers such as hospitals, clinics, and individual physician practices. As discussed previously, improved HIT is a cornerstone of a long-term plan to improve the quality and decrease the costs of health care in the US. Investment in HIT should have some positive consequences to the healthcare industry: • Improve health care quality ... • Reduce health care costs ... • Expand access to affordable care Much of the investment will... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706962 Sun, 12 Apr 2009 23:00:00 +0100 3706962 http://www.medworm.com/index.php?rid=3706963&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fscientific_medicine_and_big_pharma.php%23unique-entry-id-29 I keep reading across the blogosphere that Big Pharma (for the sake of this discussion, defined as all medical products companies, including ones that don’t manufacture or market pharmaceuticals) somehow blocks either positive or negative results to further their profits. The accusations come from a wide variety of sources, some of the more vocal being the anti-science proponents, such as the anti-vaccination movement. Utilizing an ad hominem argument of personalizing the issues and then attacking the motives or character of others, usually those who dispute the claims made by pseudoscience. Even during the recent Larry King interview, Jenny McCarthy and her fellow Google University graduate, Jim Carrey, make wild accusations about the ethics of the pharmaceutical industry: KIN... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706963 Tue, 07 Apr 2009 23:00:00 +0100 3706963 http://www.medworm.com/index.php?rid=3706968&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fthe_anti_vaccination_tragedy.php%23unique-entry-id-23 I have written about the anti-vaccination movement several times recently, yet every day, I read another article or another comment somewhere that reminds me of this situation. Today, I came across a recently published article in The Lancet, one of the most respected peer-reviewed medical journals, which reinforced one of the consequences of the anti-vaccination movement. The article, Measles in Europe: an epidemiological assessment, states that there were 12,232 cases of measles in Europe during 2006 and 2007. Most cases were unvaccinated or improperly vaccinated children. Since we appear to have lost the collective memory of the consequences of measles, let’s review the complications of this disease: 1 Otitis media (ear infection) occurs in 7–9% of cases 2 Otoscle... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706968 Mon, 30 Mar 2009 23:00:00 +0100 3706968 http://www.medworm.com/index.php?rid=3706969&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fvaccines_once_again_and_irreverent.php%23unique-entry-id-22 As I’ve discussed previously, I find the anti-vaccine movement, linking cases of autism to pediatric vaccinations, to be based on pseudoscientific principles. There are several individuals that have pushed this quackery, but one of the more visible is Jenny McCarthy, ex-Playboy Playmate of the Year (no, I’m not going to link to it), bad actress, and failed game-show host. I am flabbergasted that anyone would listen to this woman, a scientific illiterate, about anything outside of how to model and possibly how to choose bad movies. That parents are making decisions about vaccinating their children based on her bogus beliefs is beyond my simple understanding of the world. There are always consequences to every action, and there are many by delaying or refusing vaccinations. ... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706969 Sun, 29 Mar 2009 23:00:00 +0100 3706969 http://www.medworm.com/index.php?rid=3706971&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fpolitics_and_the_FDA.php%23unique-entry-id-20 With the election of Barack Obama, many believe that there would be a change in healthcare policy, reversing some of the policies of his predecessor. I had discussed some of the predicted changes several times recently. Additionally, with the appointment of a new FDA Commissioner, Margaret A. Hamburg, I was becoming confident that the FDA would become an advocate for consumers and industry, and that many of the more egregious political decisions that harmed the medical products industry would be overturned or modified. It is clear that the change would be take time because of the many priorities in the new Obama administration, but decisions such as the executive order clearing the way for research using embryonic stem cells are moving medicine and science in a healthy direction. I p... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706971 Thu, 26 Mar 2009 00:00:00 +0100 3706971 http://www.medworm.com/index.php?rid=3706972&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fdesigning_better_medical_devices.php%23unique-entry-id-19 I am an early adopter of any new technology, not only because I like new gadgets, but because I always expect the newer technology will have improved quality, power, and ease-of-use. Sometimes, I am quite pleased with the results, my iPhone from Apple being one of the better examples. ...Without intending to be an uncritical fan of Apple (you can find those discussions in several other locations on the web), there are real reasons that the iPhone is simply the best cell phone on the market. First, it holds a good sampling of my music collection, eliminating one other device to carry with me. And that music is transferred to my iPhone by simply the most elegant piece of software I’ve ever used: iTunes. I hear people tell me that they can get music on their phones, but it takes w... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706972 Sun, 22 Mar 2009 00:00:00 +0100 3706972 http://www.medworm.com/index.php?rid=3706973&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fwikipedia_and_bad_medicine.php%23unique-entry-id-17 I admit I go to the website many times a day to get more information on a topic of interest to me, sometimes just for entertainment, and occasionally to laugh at the quality of articles. ... Sometimes it appears that the project is more of an anarchy, but there are “police”, called administrators or admins, and several levels of bureaucracy above the police, to control the situation. ... They can block editors (kind of a punishment), and as best as I can tell, every single action by anyone is subject to a lot of yelling, screaming, whining, and complaining. ...A Wikipedia article is almost always the #1 hit when a google search is done on a subject. This might be useful if you are interested in episodes of 24 or need to know all about the Boston Red Sox. In most cases, the ... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706973 Mon, 16 Mar 2009 00:00:00 +0100 3706973 http://www.medworm.com/index.php?rid=3706976&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fsuccessful_marketing_management.php%23unique-entry-id-14 I haven’t done an entry in about a week, because I have been focused on a consulting assignment on pricing strategies in a couple of medical device segments. Interestingly, it was for a large investment banking firm. In this down-market, research into medical companies, because they are spending more time analyzing the fundamentals of these corporations. Part of my assignment was to give a one day training session on how manufactured products get to the market. Trying to condense 20 years of knowledge in this industry down to a six hour Powerpoint presentation (yes, too long, but they didn’t have 20 years to get up to speed) is challenging, but it was critical to their understanding of the medical products market. I often relate a story about the medical products market... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706976 Thu, 12 Mar 2009 00:00:00 +0100 3706976 http://www.medworm.com/index.php?rid=3706979&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fvaccines_part_2.php%23unique-entry-id-11 If you read what I have written so far, I am firmly against pseudoscience influencing healthcare policy. Anti-vaccinationists, who have harmed human beings with their pseudoscientific assertion that MMR vaccines cause autism, are now on the run as I’ve stated earlier. David H. Gorski, MD, PhD, says it better than I ever will. His conclusion bears repeating: That is a religious, cultish attitude. A little thing like a news report revealing the hero of the antivaccine movement to be a scientific fraud or a court ruling that, even under the most favorable standards of evidence imaginable, vaccines do not cause autism will not change the mind of someone like this, nor will it make the antivaccine movement have second thoughts about its cultish beliefs. The only hope that we who ... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706979 Wed, 25 Feb 2009 00:00:00 +0100 3706979 http://www.medworm.com/index.php?rid=2205004&cid=t_100870_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2009%2F02%2Fobama-administration-invests-in-nurses.html Several major American nursing organizations are applauding the support demonstrated by Congress and the Obama administration for the nursing profession, with newly allocated funding that should have a profound impact on every aspect of nursing, including the central focuses of education, practice, retention and recruitment.As part of the American Recovery and Reinvestment Act (H.R. 1), $300 million were awarded to the National Health Service Corps and $200 million will be divided between the Nursing Workforce Development Programs (Title VIII of the Public Health Service Act) and the Health Professions Training Programs (Title VII). $10 billion will also be allocated for the National Institutes of Health, with $7.4 billion distributed to various Institutes, including the National Institute... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=2205004 Fri, 20 Feb 2009 17:34:00 +0100 2205004 http://www.medworm.com/index.php?rid=3706982&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fvaccines_who_are_you_going_to_believe.php%23unique-entry-id-6 In one corner, we have Jenny McCarthy, former Playboy Playmate of the Year, Dr. Andrew Wakefield, and pseudoscience with an extra dose of quackery. In the other corner, we have the Centers for Disease Control, the Institute of Medicine for the National Academy of Sciences, UK’s National Health Service, and the National Vaccine Injury Compensation Program (what is commonly called the Vaccine Court). The battle is over MMR vaccine, a mixture of three live attenuated viruses administered by injection for immunization against measles, mumps and rubella (formerly known as German measles). Let’s take a close look at the participants. First, Jenny McCarthy, whose extensive medical and science education includes....not much. In 2005, she announced that her child was diagnosed wi... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706982 Thu, 19 Feb 2009 00:00:00 +0100 3706982 http://www.medworm.com/index.php?rid=3706983&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fobama_and_healthcare_2.php%23unique-entry-id-5 According to a report from The Center for Public Integrity, which produces original investigative journalism on public issues, there are over 45 million Americans who lack health insurance. Politicians of all political outlooks have constantly promised Americans a plan for health insurance. Nothing has happened. President-elect Barack Obama made health care a critical part of his election platform and is now a central facet of his presidential agenda. I can assume that with the current economy, there will be opposing forces of “we can’t afford it” and “we need it for the unemployed”, so it still will not be easy. Obama’s plan has several goals in mind, some of which have substantial effect on medical products industry. The plan claims that it wil... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706983 Sun, 25 Jan 2009 00:00:00 +0100 3706983 http://www.medworm.com/index.php?rid=2067392&cid=t_100870_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F12%2Fcost-of-chronic-disease.html A recent press conference sponsored by the Partnership to Fight Chronic Disease (PFCD) revealed a startling statistic: chronic disease costs the American taxpayer more than two Wall Street bailouts per year. (To listen to the press conference or download a transcript, click here.)According to PFCD, 45% of Americans live with a chronic illness; poorly controlled asthma sends 5,000 people to the ER every day; and obesity rates of American teenagers has tripled in the last 20 years.Perusing the PFCD website, it's obvious that there is a great deal of optimism being verbalized vis-a-vis the opportunity that Barack Obama and his administration have in terms of addressing chronic illness and health care reform. Improvement in the management of chronic illness is seen as a clearly bipartisan issu... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=2067392 Sat, 27 Dec 2008 18:28:00 +0100 2067392 http://www.medworm.com/index.php?rid=2065242&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Fwww.frommedskool.com%2F2008%2F12%2F25%2Fright-of-conscience%2F For at least a month new expansive rules issued by the Bush administration will protect health care providers right of consicence. The right to not deliver care when they have a moral objection. (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=2065242 Thu, 25 Dec 2008 16:08:56 +0100 2065242 http://www.medworm.com/index.php?rid=2017549&cid=t_100870_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F12%2Fobama-biden-health-care-agenda.html The Obama-Biden Transition Team is requesting that all interested citizens pay a visit to the transition's website, Change.gov, and voice ideas and concerns regarding American health care and health care reform. By clicking here, you can go directly to the web page dedicated to the health care agenda and submit your opinions and views.The Obama-Biden web page discusses health care in this manner:"On health care reform, the American people are too often offered two extremes -- government-run health care with higher taxes or letting the insurance companies operate without rules. Barack Obama and Joe Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of ... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=2017549 Sat, 06 Dec 2008 23:32:00 +0100 2017549 http://www.medworm.com/index.php?rid=1975021&cid=t_100870_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F11%2Foffice-of-national-nurse-and-obama.html Now that Barack Obama has been elected and some changes in the trajectory of American healthcare are on the way, those of us who support the creation of an Office of the National Nurse are asking that citizens supportive of our cause please communicate that support to the Obama team. For a review of the importance of such an office, please see my previous blog post on the subject. To communicate your opinion to the Obama-Biden team, please click here.While the current Chief Nurse Officer (CNO) of the United States serves as Assistant Surgeon General, many of us feel strongly that it is time for nurses to be taken seriously as key players in the development of far-reaching preventive measures to improve the health and well-being of the American people. Rather than have the CNO remain in a s... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=1975021 Thu, 20 Nov 2008 16:03:00 +0100 1975021 http://www.medworm.com/index.php?rid=1975022&cid=t_100870_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F11%2Fobama-daschle-and-healthcare.html It is now confirmed that Barack Obama has asked former South Dakota Senator Tom Daschle to serve as the administration's Secretary of Health and Human Services. While the nominee has already undergone a rigorous vetting process by the Obama transition team, he will of course face a Senate confirmation hearing after the President-Elect is inaugurated on January 20th. I will venture a guess that Daschle will be handily confirmed by the Senate, and I imagine that he is already setting his sights on a broad plan of action. Whether that plan leads to successful change in the healthcare trenches remains to be seen.Meanwhile, a powerful bipartisan group of senators met in the offices of Edward Kennedy (D-MA) today, at the behest of Senator Max Baucus (D-MT), to begin shaping potential Democratic ... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=1975022 Wed, 19 Nov 2008 22:35:00 +0100 1975022 http://www.medworm.com/index.php?rid=3706984&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fobama_and_science.php%23unique-entry-id-4 It was an issue that did not drive polls or voter behavior. It was an issue that did not bring a lot of interest from policy wonks or political pundits. But science is one issue that has significant impact on individual, cultural, and national growth and security. If one takes a long-term strategic view of America, investment, education and training in science will profit America financially. The Bush administration led a war on science, especially in the areas of stem-cell research and global warming. Even in areas such as the teaching of creationism in schools, the Endangered Species Act, and NASA, there is a profound anti-science attitude exhibited by the current administration. Economic security, as well as national security, result from innovative and competitive scientific an... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706984 Mon, 10 Nov 2008 00:00:00 +0100 3706984 http://www.medworm.com/index.php?rid=3706986&cid=t_100870_147_f&fid=39211&url=http%3A%2F%2Fblog.insighthealthcaresolutions.com%2Ffiles%2Fobama_and_healthcare.php%23unique-entry-id-2 What politicians say during their campaign is usually not what they do when they are in office. We are all cynical about their statements, but there are reasons why we should think that his policies might be implemented. First, and most importantly, he will have a presidential honeymoon, where he will have the goodwill of the country, including other politicians. For three to four months, he will have the ability to push through legislation that otherwise might founder in the legislative process. Second, he has a solidly Democratic congress, many of whom have an interest in healthcare policy. Of course, the huge elephant (not referring to metaphorical Republicans) in the room is that the economy and the cost of saving the country’s financial institutions may only leave a few do... Medical Products Insight RSS Feed blogs http://www.medworm.com/rss/comments.php?id=3706986 Thu, 06 Nov 2008 00:00:00 +0100 3706986 http://www.medworm.com/index.php?rid=1940334&cid=t_100870_118_f&fid=36984&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FHealthManagementRx%2F%7E3%2F442900575%2Fyes-we-can.html President Obama - congratulations.If you need an international healthcare team focused on innovation, we're already assembling one on Twitter.I donated to the campaign. I was at your speech at Manassas. I'll be here commenting on your policy. I'll be here - fired up. Ready to go. So will many others on Twitter.  (Source: Health Management Rx) Health Management Rx blogs http://www.medworm.com/rss/comments.php?id=1940334 Wed, 05 Nov 2008 05:56:00 +0100 1940334 http://www.medworm.com/index.php?rid=1692710&cid=t_100870_118_f&fid=36984&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FHealthManagementRx%2F%7E3%2F359591141%2Fback-of-napkin-healthcare-reform-hmrx.html This is a blog post I've been meaning to write for a few months. You know what they say about the best laid plans...Impetus to finally write it arrived while watching a replay of healthcare-related testimony before the Democratic National Committee on CSPAN2.Unfortunately it's another sad rehash of problems with very few suggested solutions (although the next President's camp needs to hire farmer Ray McCormick from Vincennes, Indiana, as a policy advisor - his suggestions for improving access to care delivery and info include nifty, 'rogue' ideas like universal broadband availability).When I think about where our healthcare system IS and IS GOING my stomach gets all swirly and twitchy. I'm certainly not alone.82 percent of the American public believes US healthcare needs an overhaul.From t... Health Management Rx blogs http://www.medworm.com/rss/comments.php?id=1692710 Fri, 08 Aug 2008 15:27:00 +0100 1692710 http://www.medworm.com/index.php?rid=1682935&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F08%2F05%2Fno-more-patient-dumping-hopefully%2F Los Angeles Skid Row A Los Angeles city ordinance is going to prohibit patient dumping on skid row. That practice by some Los Angeles hospitals (many of them affluent) got wide media coverage after several high profile cases. I’ve made some non-normative comments on this problem of patient dumping in the past. I’ve helped play social [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1682935 Tue, 05 Aug 2008 11:53:58 +0100 1682935 http://www.medworm.com/index.php?rid=1655425&cid=t_100870_111_f&fid=34712&url=http%3A%2F%2Fdigitaldoorway.blogspot.com%2F2008%2F07%2Fobama-healthcare-and-trio-of-mythic.html (Note: This is my second post under the auspices of the nurse blogger scholarship which I recently received from Value Care, Value Nurses.)Barack Obama, the presumed Democratic nominee for President, faces a tough crowd when talking about healthcare in America. As a nurse, I myself am a tough crowd, and my cynicism towards politicians of any stripe runs relatively deep. In my (potentially naive) hopes for a universal, single-payer health plan for all Americans, I see potential for such a future in some of Senator Obama's positions, but when it comes to his chances (and true motivation) to deliver the goods, my jury is still definitively out.When perusing the Senator's website, we begin with a quote by Mr. Obama from a speech in Iowa City on May 29, 2007:“We now face an opportunity — an... Digital Doorway blogs http://www.medworm.com/rss/comments.php?id=1655425 Fri, 25 Jul 2008 20:18:00 +0100 1655425 http://www.medworm.com/index.php?rid=1645880&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F07%2F22%2Fwhy-local-news-sucks%2F So this story is seemingly tragic. In it a young Florida woman with Chiari Type I is having debilitating headaches and is about to get a p fossa decompression to cure her when her insurance company cancels her family’s health insurance plan and she doesn’t get the operation. Here is how the story describes it, A [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1645880 Wed, 23 Jul 2008 01:21:53 +0100 1645880 http://www.medworm.com/index.php?rid=1630981&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F07%2F16%2Fanother-year-without-the-sgr-mandated-reimbursement-cuts%2F There has been some drama going down on The Hill in case you haven’t been paying attention. This year was arguably the closest physicians have ever come to having the Sustained Growth Rate formula automatically reduce their reimbursement under Medicare. Medicare is supposedly a fixed budget system when it comes to paying providers like physicians. [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1630981 Wed, 16 Jul 2008 17:27:23 +0100 1630981 http://www.medworm.com/index.php?rid=1537878&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F06%2F22%2Fwhy-i-support-barack-obama-for-president%2F Seriously, John McCain Has Never Even Heard of A Health Savings Account Everyone likes feeling like they ‘know‘ their leaders. No matter how cynical they are about politics in general. I’m not different; I’m star struck of Barack. I’ll say with a smile (despite it’s true inconsequence) that I met the future President once. I attended [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1537878 Sun, 22 Jun 2008 23:23:20 +0100 1537878 http://www.medworm.com/index.php?rid=1531137&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F06%2F19%2Four-prayers-are-with-you-dr-davis%2F The immediate past president of the American Medical Association has pancreatic cancer. At the annual meeting I just rolled back from his address at the opening session of the House of Delegates was…very touching. The second hand accounts online don’t really do it justice but here is the WSJ Health Blog on it and the [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1531137 Thu, 19 Jun 2008 11:11:22 +0100 1531137 http://www.medworm.com/index.php?rid=1526051&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F06%2F17%2Fthe-ama-on-industry-funding-of-education%2F I just got back from Chicago and part of the American Medical Association’s Annual Meeting. I’ve been very involved with organized medicine over my medical school career.I think I fairly readily admit the faults of organized medicine (and forgive them) and I also realize that my involvement has been mostly, nearly fatuous. Many of my [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1526051 Wed, 18 Jun 2008 00:44:05 +0100 1526051 http://www.medworm.com/index.php?rid=1508220&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F06%2F10%2Fpresidential-candidates-health-care-plans%2F Health care, something I was sure would be the primary domestic issue this election is slowly fading away as it usually does. Not into oblivion obviously but taking a decidedly back seat to the more pressing economic issues facing the country. But it is important and people should take the time to distinguish Obama’s and [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1508220 Tue, 10 Jun 2008 23:04:31 +0100 1508220 http://www.medworm.com/index.php?rid=1484839&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F06%2F01%2Fphysicians-saying-im-sorry%2F Their is a (perhaps) growing trend of physicians being very candid when they make mistakes when caring for patients and saying I’m sorry. For decades, malpractice lawyers and insurers have counseled doctors and hospitals to “deny and defend.” Many still warn clients that any admission of fault, or even expression of regret, is likely to invite [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1484839 Mon, 02 Jun 2008 02:43:36 +0100 1484839 http://www.medworm.com/index.php?rid=1475115&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F05%2F28%2Fpathologicizing-obesity%2F “Weight bias”? Really? The political correctness is going to smother me. Reported discrimination based on weight has increased 66% in the past decade, up from about 7% to 12% of U.S. adults, says one study, in the journal Obesity. Lynn McAfee, director of medical advocacy at the non-profit Council on Size and Weight Discrimination in Mt. Marion, [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1475115 Thu, 29 May 2008 02:24:13 +0100 1475115 http://www.medworm.com/index.php?rid=1460914&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F05%2F21%2Fdb-elected-to-the-acp-board-of-regents%2F My favorite medical blogs were obviously one of my biggest motivations for starting my own. One of the first blogs I started reading after I had been admitted to medical school was DB’s Medical Rants. True, I’ve become increasingly critical of some of the arguments put forth by the primary care blogosphere concerning the ‘outpatient [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1460914 Wed, 21 May 2008 23:43:48 +0100 1460914 http://www.medworm.com/index.php?rid=1451756&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F05%2F18%2Fpbs-takes-a-look-at-dtc%2F Bill Moyer takes a look at direct to consumer advertising and the video is on the PBS website. Just an opportunity to reaffirm my opinion: restricting pharma advertising is wrong as long as what they’re saying about their drugs is factually correct (even if sometimes incomplete). Even if I didn’t believe that DTC served any [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1451756 Mon, 19 May 2008 01:47:13 +0100 1451756 http://www.medworm.com/index.php?rid=1442753&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F05%2F14%2Fsorry-milton-two-wrongs-make-a-right%2F Come Down To My Basement…I’ve Got Candy Down There… Organized medicine is certainly facing a little bit of a faith crisis. From those they’re supposed to represent come cries that the AMA, specialty and state societies do not do enough for [put individual specialty here]. From the interested public and other interest groups comes cries that [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1442753 Thu, 15 May 2008 04:51:20 +0100 1442753 http://www.medworm.com/index.php?rid=1439502&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Fwebstorage3.mcpa.virginia.edu%2Fdebates%2Faudio%2Fdeb_2008_0409_healthcare.mp3 Is health care a right? That is the question the thoughtful should be asking; not whether guaranteed access for all can work. Let us be honest, if you goal is improving utilitarian public health measures - life expectancy, infant mortality, time to treatment for diseases, access to care - then a single payer system could work [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1439502 Tue, 13 May 2008 22:27:44 +0100 1439502 http://www.medworm.com/index.php?rid=1428952&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F05%2F07%2Fshould-raw-medicare-provider-data-stay-private%2F The move towards cost transparency is generally something I support. But there is an argument I will buy that such should be prospective. That’s the line I’m buying with the current lawsuit over Medicare provider data that some consumer groups are waging. In an unusual statement, the Health and Human Services Department endorsed the objectives of [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1428952 Thu, 08 May 2008 00:26:48 +0100 1428952 http://www.medworm.com/index.php?rid=1423118&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F05%2F05%2Fthose-specialists-arent-paid-enough%2F Several in the medical blogosphere (here and here) have picked up on a front page WSJ story concerning specialist income and shortages. Probably an overblown story. But a look at specialist income got me thinking. Is it just me or is diagnostic radiology the specialty most likely to be disappointed over the next couple of decades? When [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1423118 Mon, 05 May 2008 21:46:58 +0100 1423118 http://www.medworm.com/index.php?rid=1397613&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F04%2F24%2Fpatient-privacy-only-half-applies-to-physicians%2F Brittney Spears underwent a very publicly reported invasion of her privacy during two stays at UCLA affiliated hospitals. As happens with celebrities many hospital employees took a look at her records without a need to. The trouble is that physicians who did so apparently got off lighter than other employees. [A]t least 53 UCLA staffers — including [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1397613 Thu, 24 Apr 2008 21:22:04 +0100 1397613 http://www.medworm.com/index.php?rid=1386797&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F04%2F20%2Ffour-myths-of-the-primary-care-crisis%2F If there’s a bigger single topic discussed in the medical blogosphere than the primary care crisis I’m not sure what it is. It permeates blogs (here and here and here) and the media (here and here and here). I do believe that the distribution of primary care physicians to specialists in this country is askew [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1386797 Mon, 21 Apr 2008 01:25:11 +0100 1386797 http://www.medworm.com/index.php?rid=1373401&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F04%2F15%2Fthe-nhs-doesnt-know-how-to-allocate-organs%2F This is my second post on the ethics of organ transplantation today but in this one I actually discuss something which disgusts me. The story from the BBC goes like this: a dying 21 year old is an organ donor and the daughter of a mother who needs a kidney transplant. This young woman tries [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1373401 Tue, 15 Apr 2008 16:06:02 +0100 1373401 http://www.medworm.com/index.php?rid=1373402&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F04%2F15%2Fimmigrant-transplants%2F Get This In Mexico, Get A Liver Transplant Here Should illegal immigrants get transplants in the United States and should taxpayers pay for them? Discuss amongst yourselves. Ana Puente was an infant with a liver disorder when her aunt brought her illegally to the U.S. to seek medical care. She underwent two liver transplants at UCLA Medical [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1373402 Tue, 15 Apr 2008 15:59:37 +0100 1373402 http://www.medworm.com/index.php?rid=1353926&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F04%2F06%2Fpre-emption-for-big-pharma%2F But We Can Still Sue Them Right? I’m naive about the cases facing Johnson & Johnson over Ortho Evra. But that’s not important because what I am interested in is the potential that pre-emption may be upheld as a legitimate defense in drug liability suits. This legal argument is called pre-emption. After decades of being dismissed by [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1353926 Mon, 07 Apr 2008 00:26:09 +0100 1353926 http://www.medworm.com/index.php?rid=1353927&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F04%2F06%2Fcan-market-forces-solve-any-of-our-health-care-woes%2F It’s no surprise that I’m not a fan of Paul Krugman. His dismissal of the potential for market forces to help reform health care is chief amongst my disagreements with his positions. In his most recent column, “Voodoo Health Economics,” he’s up to it again. His starting point is this claim, Elizabeth Edwards has cancer. John [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1353927 Sun, 06 Apr 2008 21:33:50 +0100 1353927 http://www.medworm.com/index.php?rid=1340517&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F03%2F31%2Fwhy-physicians-should-be-able-to-seek-confidential-alcohol-drug-treatment%2F As I type, front page on CNN is a profile piece on a plastic surgeon and several of his patients who are upset he continued to operate while in an alcohol treatment program. [Dr.] West is an alcoholic, according to a Medical Board of California decision, and a member of the state’s Physician Diversion Program. The program [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1340517 Mon, 31 Mar 2008 23:43:14 +0100 1340517 http://www.medworm.com/index.php?rid=1337916&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F03%2F31%2Fbritish-doctors-say-dont-treat-the-old-and-unhealthy%2F Lying In A Beach Chair Does A Number On Your Hips This survey of British physicians was published in a British magazine a while back and I only now picked it up. In it a majority of respondants say that some care, apparently especially some operations, should be limited by patients’ age and lifestyles. Smokers, heavy drinkers, [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1337916 Mon, 31 Mar 2008 11:37:20 +0100 1337916 http://www.medworm.com/index.php?rid=1327456&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F03%2F25%2Fa-science-fiction-writer-says-something-stupid%2F A science fiction writer says we should solve the rising costs of health care by scaring illegal immigrants into not coming into the hospital…sounds like a gre-…wait, what?! [Larry] Niven said a good way to help hospitals stem financial losses is to spread rumors in Spanish within the Latino community that emergency rooms are killing patients [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1327456 Wed, 26 Mar 2008 01:18:34 +0100 1327456 http://www.medworm.com/index.php?rid=1315345&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F03%2F19%2Femployers-foot-more-of-the-health-care-bill-around-the-world%2F The cost of health care has been and continues to rise dramatically in the United States. But only in the magnitude is the United States alone in the world with such a problem. A New York Times blush points out that, The United States has long been an unusual study in medical care, with employers assuming [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1315345 Thu, 20 Mar 2008 02:17:43 +0100 1315345 http://www.medworm.com/index.php?rid=1309024&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F03%2F17%2Fso-much-of-the-world-has-a-market-for-organs%2F Punished…Or Sold I’ve linked to stories concerning black markets for organs in the past. Now we get a story in the Los Angeles Times concerning such a market in Egypt. And it focuses around a terribly tragic story. Hamed’s 4-year-old son, Mohamed, was dying of cancer and needed an artery transplant that cost $5,000. The only savings [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1309024 Tue, 18 Mar 2008 03:56:23 +0100 1309024 http://www.medworm.com/index.php?rid=1296032&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F03%2F11%2Froll-the-dice-for-healthcare%2F I’m not getting all bleeding heart, but this is kind’ve a weird situation as thousands apply for a drawing for cheap access to health care. Tens of thousands of Oregonians queued up quickly for a chance at the state’s latest lottery, but this one is no game. Officials began drawing names last week for a chance at [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1296032 Tue, 11 Mar 2008 23:40:09 +0100 1296032 http://www.medworm.com/index.php?rid=1269554&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F02%2F29%2Ftalk-about-backtracking%2F Remember all the hoopla about doctor’s in direct to consumer pharmaceutical ads that has arisen lately? Well, Pfizer is getting the hell out of the way of the controversy by killing the Dr. Jarvik-Lipitor ads Pfizer has spent more than $258 million advertising Lipitor since January 2006, most of it on the Jarvik campaign, as the [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1269554 Sat, 01 Mar 2008 00:52:58 +0100 1269554 http://www.medworm.com/index.php?rid=1253206&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F02%2F24%2Fwalk-off-the-job-and-youre-prosecuted%2F I have definite mixed feelings about this. 10 nurses conspired hurt their employer by walking off the job without notice. Now they’re facing criminal charges for endangering the lives of their patients with their sudden resignations. Prosecutors say the nurses’ resignations — without notice — on April 7, 2006, jeopardized the lives of children at Avalon [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1253206 Sun, 24 Feb 2008 22:37:06 +0100 1253206 http://www.medworm.com/index.php?rid=1240165&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F02%2F18%2Fgeneral-surgery-be-done%2F It was fun, especially on trauma call. But beyond trauma call it was a pretty repetitive service. My home surgical residency program, admittedly merely through faculty report, has the single highest average number of lap choles performed per graduate. I’m not sure that’s really a selling point (although the laparoscopic cholecystectomy is one of the [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1240165 Mon, 18 Feb 2008 23:29:47 +0100 1240165 http://www.medworm.com/index.php?rid=1236924&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F02%2F16%2Fi-need-it-so-i-should-get-it%2F Edwin Leap looks at how much physicians should be paid (h/t Kevin MD) in light of some grumpiness over physician earnings. Here’s the comment I’m interested in and which I couldn’t agree more with, On to medicine. Doctors just make too much money, right? I don’t know. Maybe, because medicine is something people [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1236924 Sat, 16 Feb 2008 17:10:34 +0100 1236924 http://www.medworm.com/index.php?rid=1236926&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F02%2F16%2Fshould-doctors-participate-in-dtc%2F Doctor Jarvik, What Are You Doing Inside My Television? There’s no doubt that the Democratic Congress is coming after big pharma after all the money the pharmacuticals pumped into Republican coffers over the decade prior, especially as Part D came into existence. Once Democrats seized the committee chairmanships on Capitol Hill, the big drug companies sharply aligned [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1236926 Sat, 16 Feb 2008 15:31:55 +0100 1236926 http://www.medworm.com/index.php?rid=1204627&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F02%2F04%2Fdown-goes-the-california-plan%2F I’ll have to post “analysis” later but the story is (albeit a little late getting to it) that the California ‘universal’ health care plan has died. At least for now. In handing Gov. Arnold Schwarzenegger his biggest legislative setback, members of a Senate panel expressed concerns Monday that his plan to cover most Californians without health [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1204627 Mon, 04 Feb 2008 23:16:51 +0100 1204627 http://www.medworm.com/index.php?rid=1179075&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F01%2F25%2Fengland-to-pay-people-to-lose-weight%2F I guess as long as the government is going to be making health care expenditures, that this is as good a use of tax money as anything else. Obese and overweight adults in England could be paid to lose weight under plans being considered by the Government. The new strategy to tackle poor eating habits and [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1179075 Fri, 25 Jan 2008 22:47:26 +0100 1179075 http://www.medworm.com/index.php?rid=1167172&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F01%2F21%2Fthe-ends-justify-the-means%2F The old arguments for government guaranteed access to health care. Here’s my favorite point: Also, the people who are so adamantly against throwing a couple bucks of their tax money into the pot to help out their fellow countrymen are really sad excuses for human beings. Really. Subhuman at best. Certainly, but it ignores the entire point [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1167172 Tue, 22 Jan 2008 02:19:56 +0100 1167172 http://www.medworm.com/index.php?rid=1165298&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F01%2F20%2Fopt-out-opt-in%2F This is alarming. Everyone should be an organ donor, but to force such is shameful. And the ability to opt out is an inadequate solution to protect people’s right to themselves which I would argue extends past their death. Gordon Brown has thrown his weight behind a move to allow hospitals to take organs from dead [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1165298 Mon, 21 Jan 2008 02:58:21 +0100 1165298 http://www.medworm.com/index.php?rid=1132682&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F01%2F06%2Fhealthcare-is-a-big-deal%2F Listen To The Candidates On Healthcare I always say that the plural of anecdote is not data but of the hundreds of Iowans I talked to last week not a single one told me health care was the issue driving their Caucus vote. So despite all the coverage it is difficult for me to imagine healthcare [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1132682 Mon, 07 Jan 2008 04:18:25 +0100 1132682 http://www.medworm.com/index.php?rid=1132133&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2008%2F01%2F06%2Fthe-social-justice-debate-continued%2F Panda Bear and Graham have conflicting posts on the merits of ‘Social Justice’ and just what Social Justice entails. Social Justice is certainly an amorphous term which in part makes the debate difficult to keep within a set of boundaries but essentially Social Justice is the idea that to each, as he deserves, goes the [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1132133 Sun, 06 Jan 2008 23:47:30 +0100 1132133 http://www.medworm.com/index.php?rid=1113883&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2007%2F12%2F23%2Fwould-single-payer-have-saved-a-patient-requiring-liver-transplant%2F This is one of the worst stories I’ve ever heard. A girl goes into liver failure, is sent by her insurer to get evaluated for a transplant. Then develops complications and the insurer denies the transplant despite the organ sharing network having found a match for her. Then just hours after her family has taken [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1113883 Sun, 23 Dec 2007 18:57:49 +0100 1113883 http://www.medworm.com/index.php?rid=1113884&cid=t_100870_93_f&fid=34826&url=http%3A%2F%2Ffrommedskool.com%2F2007%2F12%2F23%2Fthe-crystal-ball-claifornia-taxes-will-pass%2F A new Fields Poll finds that the majority of Californians support the new health care proposal to increase access which recently passed the Assembly. The Field Poll found 64 percent of California voters inclined to support the universal health insurance plan outlined in the bill, compared with 23 percent opposed. The Field Poll also found 63 percent [...] (Source: From Medskool) From Medskool blogs http://www.medworm.com/rss/comments.php?id=1113884 Sun, 23 Dec 2007 16:36:58 +0100 1113884