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Medical Economics: Highly experienced physicians lost to medicine over bad health IT
The title of the article is actually "Physicians leaving profession over EHRs" , but that title omits the real impact of the phenomenon: seasoned physicians, along with their medical expertise, judgment and experience, are lost to the pool of people entrusted to provide care thanks to poorly designed and badly implemented IT:http://cci.drexel.edu/faculty/ssilverstein/cases/Bad Health IT is IT that is ill-suited to purpose, hard to use, unreliable, loses data or provides incorrect data, is difficult and/or prohibitively expensive to customize to the needs of different medical specialists and subspecialists, causes cognitive...
Source: Health Care Renewal - January 28, 2018 Category: Health Management Tags: bad health IT data trafficking Ddulite Medical Economics Munzoor Shaikh physicians leaving medicine Ramin Javahery MD Tom Davis MD FAAFP Source Type: blogs

A 50-something with h/o coronary bypass has chest pain and a ventricular paced rhythm
Conclusions: ACO in VPR is an uncommon condition. The MSC showed good Sens for diagnosis of ACO in the presence of VPR, especially among patients with high peak cTn, and Spec was excellent. These methods and results are consistent with studies that have used the MSC to diagnose ACO in LBBB.
Source: Dr. Smith's ECG Blog - December 3, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs

“ Non academic ” Tips and tricks in CTO – PCI : Open sesame ! , Show me your treasures !
We know, The Mysterious Alibaba cave opens  with a voice password . . . legend  tell us it had unlimited hidden treasures. It would appear , CTOs mimic the cave in several ways. What is inside ? Should we open it ?  Can we come out safely ? Do we have any magical password in cath lab to get across the complex tissue boulders ?,   every cardiologist would love to have one ! Dear CTO,Open Sesame . . . I have come with all the wires you love !  Please let me in ! Indication “CTOs are never an emergency  . . .but please realise  we can very easily create one  while resuscitating a dead snake  !  Don’t...
Source: Dr.S.Venkatesan MD - November 27, 2017 Category: Cardiology Authors: dr s venkatesan Tags: cardiology -Therapeutics Cath lab Hardware cath lab tips and tricks cto chronic total occlusion absolute refractory period Best guideline on cto pci cart reverse cart chronic total occlsuion cross boss sting ray cto club CTO club euro Source Type: blogs

To Achieve Its Goals, Population Health Needs More Specialists
By VIKRAM REDDY, MD I attended a Population Health conference this summer where a number of representatives from large health systems and physician organizations convened to discuss common challenges. Many of my healthcare colleagues assume that anything that carries the label “Population Health” must relate to health disparities and food deserts. While we do address these topics, the vast majority of sessions and conversations had one underlying theme: lowering the total cost of care. In rebuttal to any charges that our group is far too corporate to be considered a fair example of Population Health advocates, even the...
Source: The Health Care Blog - October 28, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized ACO Medicare Population Health Source Type: blogs

Population Health & the Missing Specialist
By VIKRAM REDDY, MD I attended a Population Health conference this summer where a number of representatives from large health systems and physician organizations convened to discuss common challenges. Many of my healthcare colleagues assume that anything that carries the label “Population Health” must relate to health disparities and food deserts. While we do address these topics, the vast majority of sessions and conversations had one underlying theme: lowering the total cost of care. In rebuttal to any charges that our group is far too corporate to be considered a fair example of Population Health advocates, even the...
Source: The Health Care Blog - October 28, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized ACO Medicare Population Health Source Type: blogs

I Refuse to Tell You What to Eat
By MICHEL ACCAD, MD A recent tweet from JAMA, the journal of the American Medical Association, urged me andother doctors to “include nutrition counseling into the flow of [our] daily practice.” Along with the tweet came a link to an article that outlines “relatively small” dietary changes, based on the latest Dietary Guidelines for Americans, that can “significantly improve health.” My response to the tweet was swift and knee-jerk.  I will not do it.  I simply will not.  I refuse to follow dietary guidelines or recommend them to my patients. “What are you saying?!” “Are you the kind of self-in...
Source: The Health Care Blog - October 24, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Early thrombolysis knocks out pPCI yet again . . . this time from Shanghai !
Primary PCI (pPCI) is a  glorious revascularization strategy for STEMI practiced for over 2 decades  but still has not proved its perceived mettle convincingly as a large population based strategy. In the mean time, the utility value  of  thrombolysis  was systematically  (Intentionally too! )  downgraded in the minds of both academic and public mind. Truth can’t be buried for long. Series of revelations are coming up restoring the superiority of early thrombolysis over pPCI even in PCI capable centers. In 2013, the high Impact STREAM trial argued  for pharmacoinvasive approach within 3 hrs as it was at e...
Source: Dr.S.Venkatesan MD - October 18, 2017 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology -guidelines cardiology -Therapeutics cardiology journals EARLY MYO trial circulation ppci vs thrombolysis primary PCI vs thrombolysis stream trial Source Type: blogs

How Hurricane Harvey changed this medical student
When Hurricane Harvey swept through Texas, devastating millions of people, I was lucky to be in an area of Houston where the flooding did nothing more than confine me to my apartment for a few days. It hurt to see so many people suffering after reading the news and social media posts about people losing their homes, many of their belongings, and in some cases, their lives. As the flooding calmed down and the roads became safe to drive, I knew that I could not just go back into my daily routine. As a medical student, I responded to a call for help from physicians staffing a makeshift medical triage unit at the NRG Center, o...
Source: Kevin, M.D. - Medical Weblog - September 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/ryan-jacobs" rel="tag" > Ryan Jacobs < /a > Tags: Education Cardiology Diabetes Emergency Medicine Endocrinology Source Type: blogs

The Cost of Public Reporting
ANISH KOKA MD In an age where big data is king and doctors are urged to treat populations, the journey of one man still has much to tell us. This is a tale of a man named Joe. Joseph Carrigan was a bear of a man – though his wife would say he was more teddy than bear.  He loved guitar playing,  and camp horror movies.  Those who knew him well said he had a kind heart, a quick wit and loved cats. I knew none of these things when I met Joe in the Emergency Department on a Sunday afternoon.  I had been called because of an abnormal electrocardiogram – the ER team was worried he could be having a heart attack. ...
Source: The Health Care Blog - September 18, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs

The High Cost of Public Reporting
ANISH KOKA MD In an age where big data is king and doctors are urged to treat populations, the journey of one man still has much to tell us. This is a tale of a man named Joe. Joseph Carrigan was a bear of a man – though his wife would say he was more teddy than bear.  He loved guitar playing,  and camp horror movies.  Those who knew him well said he had a kind heart, a quick wit and loved cats. I knew none of these things when I met Joe in the Emergency Department on a Sunday afternoon.  I had been called because of an abnormal electrocardiogram – the ER team was worried he could be having a heart attack. ...
Source: The Health Care Blog - September 18, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Cardiac surgery High-risk Quality Reporting Source Type: blogs

“Going Palliative” is Not a Thing
by Staci MandrolaI love the segment onLast Week Tonight with John Oliver called “How is this still a thing?” His snarky Britishness targets everything from the Sports Illustrated Swimsuit issue to ‘Why do we dress up as other races?’ The skits start out funny but leave you questioning and unsettled.I hope “going palliative” ends before it shows up on “How is this still a thing?” How do I know " going palliative " is a thing? The phrase is popping up in the academic medical center where I practice palliative care. [And many other hospitals too - Ed.] PT/OT has signed off patients who have a palliative c...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 18, 2017 Category: Palliative Care Tags: culture hospice mandrola palliative Source Type: blogs

Deans Need Progressive Responsibility Too
Dr. Antman and her family at the 2016 American Heart Association Boston Heart & Stroke Gala Editor’s Note: This blog post complements the recently published study “The Decanal Divide: Women in Decanal Roles at U.S. Medical Schools.” Read the full study on academicmedicine.org. By: Karen Antman, MD Dr. Antman is dean, Boston University School of Medicine, provost, Boston University Medical Campus, and chair, AAMC Council of Deans Why aren’t more medical school deans women? Medical school faculty don’t normally wake up thinking, “I want to be dean.” How then does one end up there? I was asked to...
Source: Academic Medicine Blog - September 12, 2017 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective AAMC Council of Deans Boston University Medical Campus Boston University School of Medicine gender leadership research women Source Type: blogs

Beware Automated Interpretations of Atrial Fibrillation!
See this ECG:There is an irregularly irregular rhythm.The Automated interpretation was " Atrial Fibrillation. "What is it?Look at the lead II rhythm strip across the bottom. There are clearly sinus P-waves for the first 6 beats, although they speed up.This change of rate of the sinus node is called " sinus arrhythmia " and is related to vagal tone from inspiration (which increases vagal tone and slows down the rate, but this takes several seconds and this gets out of phase, which means that by the time it is slowing down, the patient is actually expiring).Then beats 7 and 8 appear and do not show P-waves in lead II.&n...
Source: Dr. Smith's ECG Blog - August 11, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs

How Much Is That CAT Scan in the Window?
ANISH KOKA, MD Who knew healthcare could be so complex? The GOP proposal for health care reform rests on health savings accounts and high deductible health plans.   The basic premise is that price opacity, and deep pocketed third party payers drive up the cost of health care.   Giving patients dollars in health savings accounts they control should make them price sensitive, and thus help reduce the cost of healthcare.  A recent analysis by Drs. Chandra and others provides an interesting perspective on the matter. The researchers took a large self insured firm that required all of its employees to switch from an insuran...
Source: The Health Care Blog - July 27, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Anish Koka Source Type: blogs

How Twitter is a vital tool in medicine
Recently, Twitter exploded with angry commentary directed at the American Diabetes Association (ADA) after the organization actively attempted to censor what was posted on Twitter during their annual sessions in San Diego. The fiasco began when an attendee posted a picture of slides on Twitter — in an attempt to “live Tweet” during a session on the recommended #ADA2017 hashtag. The @AmDiabetesAssn Twitter feed then began to post tweets instructing individual attendees to take down specific tweets that involved photography. In fact, the ADA Twitter feed at one point was dominated by their repeated requests for attende...
Source: Kevin, M.D. - Medical Weblog - July 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/kevin-r-campbell" rel="tag" > Kevin R. Campbell, MD < /a > Tags: Social media Twitter Source Type: blogs