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During a physician’s infertility journey, another doctor offers hope
While lying on a hard metal table with my legs spread open and a clamp on my cervix, I was instructed to “relax.” My audience included a nurse, two radiologists, and my OB/GYN’s partner, who I met minutes earlier when she rushed in apologizing that my OB/GYN was called away to a delivery.
A delivery: the culmination of those nine months of a pregnancy that I so eagerly desired. I got myself onto this metal radiology table after months of unsuccessful attempts to get pregnant and my OB/GYN, who suddenly became unavailable for the procedure she requested, suggested a hysterosalpingogram, or HSG, to make sure there ...
Source: Kevin, M.D. - Medical Weblog - January 15, 2016 Category: Journals (General) Authors: Katie Lockwood, MD Tags: Physician OB/GYN Source Type: blogs
What medicine is really like isn’t seen in some medical schools
Any Stanford student knows all too well that the immense campus, with its seemingly eternal sunshine and endless rows of palm trees, can make it difficult to want to get outside and experience the real world. When it comes to medical education, this creates a very real concern: Is it possible to experience the full diversity of our health care system when you are living in the so-called “Stanford bubble” — an idyllic college campus in one of the wealthiest counties in the United States?
I’ve certainly felt the effects of the Stanford bubble, but interestingly, working with a diverse population of patients has n...
Source: Kevin, M.D. - Medical Weblog - November 24, 2015 Category: Journals (General) Authors: Nathaniel Fleming Tags: Education Medical school Source Type: blogs
Health Information Technology: A Guide to Study Design For the Perplexed
This study, which was widely reported in the news media and influenced policy, found significant differences in the rate of flu-related deaths and hospitalizations among the vaccinated elderly compared with their unvaccinated peers. Although it controlled for certain easy-to-measure differences between the 2 groups, such as age, sex, and diabetes, it did not account for other more difficult-to-measure “healthy user” factors that affect the well-being of the elderly, such as their socioeconomic status, diet, exercise, and adherence to medical treatments and advice.
The cohort design has long been a staple in studies of...
Source: The Health Care Blog - September 13, 2015 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
The ‘Must Do’ List: Certain Patient Safety Rules Should Not Be Elective
The modern patient safety field was built on a foundation of “systems thinking,” namely, that we should avoid assigning individual blame for errors, instead focusing on identifying and fixing dysfunctional systems. While this approach is largely correct and is responsible for many of the field’s successes, it needs to be balanced with a need for accountability.
Today, while there is an increasing appreciation of the importance of achieving such balance, leaders of health care delivery systems are unsure about how and when to enforce certain safety standards and rules. We believe that the time has come to articulate c...
Source: Health Affairs Blog - August 20, 2015 Category: Health Management Authors: Robert Wachter Tags: Health Policy Lab Health Professionals Hospitals Organization and Delivery Population Health Public Health Quality Just Culture Lucian Leape Institute National Patient Safety Foundation National Quality Forum Robert Wachter Source Type: blogs
Research and Reviews in the Fastlane 075
This study further defends the pathway of early discharge from the ED without evocative testing in subsets of patients with low risk chest pain.Recommended by Anand SwaminathanNeurology Edwards C, et al. Residency Training: A failed lumbar puncture is more about obesity than lack of ability. Neurology 2015; 84(10):e69-72. PMID: 25754807This is an interesting article exploring the reasons for LP failure. The authors reviewed all elective LPs done by Neurology residents in a LP clinic. They recorded all the demographic of the patient and the characteristics of the proceduralist. The overall LP failure rate was 19% and it w...
Source: Life in the Fast Lane - March 19, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Emergency Medicine Infectious Disease Neurology R&R in the FASTLANE Respiratory Toxicology and Toxinology literature recommendations research and reviews Source Type: blogs
A "PR Pawn" Confounds the Public Relations Burnishing of Texas Health Resources and its CEO
The Ebola virus epidemic in Africa is hopefully winding down. The uproar, if not panic, over Ebola virus in the US has been eclipsed by the latest internet craze. However, we are still learning from the echoes of the brief, and thankfully very localized US experience with Ebola.In particular, the country's response to the virus should continue to inspire unease about how our supposedly market based, managerially focused health care non-system can handle real public health threats.Background - Ebola at Texas Health PresbyterianStarting on October 2, 2015, we discussed numerous concerns about whether proble...
Source: Health Care Renewal - March 5, 2015 Category: Health Management Tags: Ebola virus generic management generic managers public relations Texas Health Presbyterian Hospital Texas Health Resources Source Type: blogs
Dad Has the Flu and There’s a Baby at Home
By PHILIP LEDERER, MD At 6:30 AM, I kissed my 14-week-old son Joe on the forehead and headed off to work at the hospital. By 3 PM I was back in bed with a hacking cough and a fever. I had influenza. As a doctor training in infectious diseases, I knew that the flu can be […]
Source: The Health Care Blog - March 4, 2015 Category: Consumer Health News Tags: THCB CDC CDC Foundation infectious diseases Lenzer Pediatrics Philip Lederer Tamiflu Source Type: blogs
In Defense of the Hyperangulated Blade
Let me begin, as is my wont, with a story. Let's say, for the sake of discussion, that I was moonlighting at Janus General Hospital. I had a patient signed out to me by my partner: a young patient with COPD, influenza, and pneumonia. He was on BiPAP and supposedly stable waiting for an ICU bed. Murphy's law being what it is, immediately after my partner left, the patient deteriorated and clearly was going to require intubation. He had all the predictors of being a tough tube, so I made sure to have my back-up plans articulated and ready to go.My go-to technique for quite a few years is video laryngoscopy (VL) with the hype...
Source: Movin' Meat - February 4, 2015 Category: Emergency Medicine Source Type: blogs
Beyond Law Enforcement: The FTC’s Role In Promoting Health Care Competition And Innovation
By now, the Federal Trade Commission’s (FTC) law enforcement efforts in the health care area are well known. We have successfully challenged several hospital and physician practice mergers in the last few years. We also continue to pursue anticompetitive pharmaceutical patent settlements, following a victory at the Supreme Court in the Actavis case. Speaking of the Court, it is currently reviewing a case we brought against the North Carolina Board of Dental Examiners, alleging that its members conspired to exclude non-dentists from providing teeth whitening services in North Carolina.
Perhaps less publicized are the FTC...
Source: Health Affairs Blog - January 26, 2015 Category: Health Management Authors: Maureen Ohlhausen Tags: All Categories Competition Connected Health Consumers Health Care Costs Health Law Innovation Policy States Technology Workforce Source Type: blogs
You Won’t Believe Which Big-Name Groups are Opposed to Flu Vaccine Mandates
Conclusion
Millions of people are refusing vaccines, in record numbers, as they realize that vaccines are dangerous and ineffective. Now, unions and professional organizations are joining the ranks of anti-vaxers, at least with regard to mandatory vaccination. Those organizations value their members and know that they deserve choices about their bodies and their health care.
In return, those groups will be rewarded with a collectively healthier, more innovative work force, because their employees will not be forced to receive injections laced with toxic chemicals. Their employees will also know their ideas and opinions are...
Source: vactruth.com - January 17, 2015 Category: Allergy & Immunology Authors: Missy Fluegge Tags: Missy Fluegge Top Stories American Medical Association (AMA) Mandatory Vaccination National Childhood Vaccine Injury Act truth about vaccines Vaccine Adverse Events Reporting System (VAERS) Source Type: blogs
A scary new medical intervention…
This is a story about a new medical intervention. It’s an important one because it affects all doctors—and therefore all patients.
1. It’s expensive. Of course.
2. There is no credible evidence that it works. But its marketing is aggressive.
3. The overwhelming majority of physicians disapprove of it.
4. Cheaper alternatives exist.
5. The company that makes the treatment is rich and influential.
It’s hard to believe something like this could be approved in the United States. But not only is this new intervention approved; it is being forced on physicians—and patients—by eminence-based fiat.
The treatment is the...
Source: Dr John M - January 8, 2015 Category: Cardiology Authors: Dr John Source Type: blogs
Product Review: The Nice Voice Surgical Mask
Boston, MA -- Healthcare professionals have reason to rejoice with TLC Industry's new language transformation filter - The Nice Voice - that promises to allow medical professionals to speak their minds without fear of losing their jobs.Never let honesty get you in trouble again.The Nice Voice was created by Robin Hruska, a hospital floor nurse reprimanded last year for telling an attention seeking 20 year-old female admitted through the ER with generalized weakness - after she refused to go home and take care of herself - to put down her phone, stop being a whiny little brat and get her ass out of bed.Tho...
Source: The Happy Hospitalist - December 15, 2014 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Does Public Health Have A Future?
Ebola’s arrival in the U.S. hit Americans with a jolt. Regardless of how you feel about the response to date, it should remind everyone of the importance of public health.
Fortunately, public health in the U.S. has built an extraordinary track record of success. Smallpox, one of the most dreaded diseases in history, was eradicated worldwide. New vaccines have sharply cut the toll of deaths and disabilities from H flu meningitis, tetanus, pneumococcal sepsis and other deadly diseases.
Adding folate to foods dramatically reduced neural tube defects in newborns. Safer cars and better roadway designs cut fatal crashes per m...
Source: Health Affairs Blog - December 10, 2014 Category: Health Management Authors: Arthur Kellermann and Mark Kortepeter Tags: All Categories Environmental Health Prevention Public Health Source Type: blogs
Lessons from Ebola: The Infectious Disease Era, And The Need To Prepare, Will Never Be Over
With the wall-to-wall news coverage of Ebola recently, it’s hard for many to distinguish fact from fiction and to really understand the risk the disease poses and how prepared we are to fight it.
Fighting infectious diseases requires constant vigilance. Along with Ebola, health officials around the globe are closely watching other emerging threats: MERS-CoV, pandemic flu strains, Marburg, Chikungunya and Enterovirus D68. The best defense to all of these threats is a good offense — detecting, treating and containing as quickly and effectively as possible.
And yet, we have consistently degraded our ability to respond...
Source: Health Affairs Blog - October 28, 2014 Category: Health Management Authors: Jeffrey Levi Tags: All Categories Global Health Hospitals Pharma Policy Prevention Public Health Research Workforce Source Type: blogs
Promoting Health, Science, and Public Trust through Laboratory Safety
As you may know from recent news reports, there have been lapses in safety practices at federal laboratories involving potentially lethal microbes such as avian flu (H5N1) and anthrax, including an incident involving discovery of 60-year old smallpox vials in an FDA laboratory building located on the National Institutes of Health (NIH) campus in Bethesda, MD. Such lapses, which undermine public confidence in biomedical research and could put people’s health at risk, remind us of the need for constant attention to biosafety standards.
Scientists can never become complacent in routine safety practices—one mistake could h...
Source: NIH Extramural Nexus: Rock Talk Blog - August 27, 2014 Category: Research Authors: Sally Rockey, Francis Collins, Lawrence Tabak, and Amy Patterson Tags: Rock Talk biosecurity General Source Type: blogs
