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The BVS Disappearing Stent: Promise, Hype and the Tension Between Progress and Safety
Medicine does not stand still. You want innovation; you want progress. But you also want safety. Millions of patients have coronary stents placed in the arteries supplying blood to the heart. It’s big business. Metal cages placed in the setting of a heart attack can be life saving. In other settings, however, the strongest quality evidence says metal cages perform no better than medicines. One of the two* main reasons stents don’t improve long-term outcomes for patients with stable coronary disease are that they trade improved blood flow (good) for the presence of a metal cage in the artery (bad). The metal cag...
Source: Dr John M - July 22, 2016 Category: Cardiology Authors: Dr John Source Type: blogs

CMS Proposed Physician Fee Schedule 2017 – Includes Open Payments Questions
CMS released its proposed Physician Fee Schedule on July 7, including a section on Open Payments. CMS notes it does not intend to finalize any requirements related to Open Payments directly as a result of this proposed rule. However, CMS does indicate it may undertake future rulemaking that will impact Open Payments. The proposed rule can be found here, along with its page on the Federal Register website on July 15th. The CMS Proposed Physician Fee Schedule 2017 - Open Payments Section can be downloaded. Comments are due to CMS by 5 p.m. on September 6, 2016. When commenting, refer to file code CMS-1654-P. Comments...
Source: Policy and Medicine - July 7, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

My dear physician , don ’ t feel ashamed to prescribe Digoxin for Atrial fibrillation !
  It was delicate few minutes  in one of  my recent  visits to a corporate hospital , when I noticed an emergency physician  hesitated to follow my advice to  prescribe IV Digoxin for a patient with  Atrial fibrillation and fast ventricular rate.His fear was, his consultant, a modern day cardiologist wouldn’t like it as Amiodarone has become a default drug for atrial fibrillation in that Institution. I could sense. . .he felt so out of place to take on my suggestion. I reminded the young physician , the uniqueness  of  Digoxin and its  un-diminished value for this particular indication ,still he was rel...
Source: Dr.S.Venkatesan MD - July 1, 2016 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized bio ethics digoxin drugs for atrial fibrillation how to practice medicine Source Type: blogs

My dear physician , don’t feel ashamed to prescribe Digoxin for Atrial fibrillation !
  It was delicate few minutes  in one of  my recent  visits to a corporate hospital , when I noticed an emergency physician  hesitated to follow my advice to  prescribe IV Digoxin for a patient with  Atrial fibrillation and fast ventricular rate.His fear was, his consultant, a modern day cardiologist wouldn’t like it as Amiodarone has become a default drug for atrial fibrillation in that Institution. I could sense. . .he felt so out of place to take on my suggestion. I reminded the young physician , the uniqueness  of  Digoxin and its  un-diminished value for this particular indication ,still he was rel...
Source: Dr.S.Venkatesan MD - July 1, 2016 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized bio ethics digoxin drugs for atrial fibrillation how to practice medicine Source Type: blogs

Can Apple Teach Silicon Valley to Think Different About Healthcare?
By DAVID SHAYWITZ, MD I was thrilled to learn that Stephen Friend, co-founder and CEO of the nonprofit open data platform Sage Bionetworks, has accepted a role at Apple and is stepping away from day-to-day operations at Sage (he will continue to serve as chair of the board). I’ve known Friend for over decade, starting when I was at Merck (he led cancer research), and continuing through his cofounding of Sage with Eric Schadt (I was at the Boston Consulting Group by then and served as a founding advisor). (Disclosure/reminder: I am chief medical officer of DNAnexus, a cloud-based health data management platform based in S...
Source: The Health Care Blog - June 29, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Dialog: Doubling Down on Dropping Out
Dr. Wible and her young colleague have responded to my previous post: [Cross posting with her comment section, to share the clicky love as we continue the dialogue] A few corrections to your blog Lucy: 1) I do NOT have a subscription practice. I see all-comers and I take insurance. 2) I have never turned anyone away for lack of money. I don’t believe in a two-tiered health care model. 3) Diet and nutrition is not woo (and is certainly not taught in med school). There are HUGE problems with allopathic medicine which does not prepare us to care for patients in an outpatient setting when it comes to prevention, lifestyle, a...
Source: Musings of a Dinosaur - June 10, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs

How do you explain these inferior hyperacute T-waves?
Alberto Pinsino, a cardiology fellow from Milan, Italy, sent this case:Dr. Smith,I would be interested in knowing your opinion about this case..The CaseA 59-year-old Asian woman with hypertension and hypercholesterolemia and no past history of CAD came to the ED of a major teaching hospital with waxing and waning chest pain worsened by minimal efforts which had been ongoing for 5 days.  She had visited the same ED two days before for the same reason.  The EKG is not available but described by the on-call cardiologist as “non specific repolarization abnormalities.”  The troponin was negative and she was d...
Source: Dr. Smith's ECG Blog - June 9, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs

Top 10 Most Prestigious Medical Centers in the World (2016)
The world is full of excellent medical centers all competing to make the newest medical discovery, perform the latest procedure and be a top-performing hospital with the best reputation. These renowned medical centers model excellent clinical practice and dedicated patient care that you just can’t find anywhere. Out of all the prestigious medical centers in the world, these 10 lead the way: Texas Medical Center: The Texas Medical Center in Houston, Texas, is the largest of its kind. Not only does the TMC have one of the highest volumes of clinical facilities for patient care, basic science and research, but it also has ...
Source: Unbounded Medicine - May 24, 2016 Category: Surgery Authors: Jon Mikel Iñarritu Tags: News Source Type: blogs

ProPublica: Tying Open Payments Physician Data to Medicare Part D Data
ProPublica is once again trying to make a "correlation equals causation" argument between payments made to physicians and their prescribing patterns. ProPublica is arguing that an analysis they performed showed that "doctors who receive payments from the medical industry do indeed tend to prescribe drugs differently than their colleagues who don't." They are arguing that doctors who received more than $5,000 from companies in 2014 had the highest brand-name prescribing percentages, giving an example that among internists who received no payments, the average brand-name prescribing rate was 20%, compared to about 30% for ...
Source: Policy and Medicine - March 21, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

The 5 Stages of EMR Acceptance (With Apologies to Kubler-Ross)
By FRANK MEISSNER                                                    DENIAL                    I can’t believe they are making me use this system!                                                  ANGER                 I CAN’T BELIEVE THEY ARE MAKING ME USE WHAT                       THEY LAUGHINGLY CALL A SYSTEM!                                                 BARGAINING  ‘Look if I agree too willingly and cheerfully use this system, can you ask for and fund these change orders, add these features, re...
Source: The Health Care Blog - March 15, 2016 Category: Consumer Health News Authors: John Irvine Tags: Featured THCB Uncategorized Source Type: blogs

The Paradox of Evidence-based Medicine
By MICHEL ACCAD, MD Anish Koka recently wrote a great piece entitled “In Defense of Small Data” that was published on The Health Care Blog. While many doctors remain enamored with the promise of Big Data or hold their breath in anticipation of the next mega clinical trial, Koka skillfully puts the vagaries of medical progress in their right perspective. More often than not, Koka notes, big changes come from astute observations by little guys with small data sets. In times past, an alert clinician would make advances using her powers of observation, her five senses (as well as the common one) and, most importan...
Source: The Health Care Blog - March 15, 2016 Category: Consumer Health News Authors: Simon Nath Tags: Featured Physicians THCB MICHEL ACCAD Source Type: blogs

Can I Trust You With This? How Pistis Left My Toolbox One Day
Editor’s Note: Be sure to check out the collection of articles in the March issue and our new blog content for more on the patient voice in medicine. By: Martina Rosenberg, PhD, assistant professor, Department of Biochemistry and Molecular Biology, University of New Mexico Health Sciences Center. Dr. Rosenberg teaches mostly undergraduate biochemistry majors and non-majors, including students in the combined BA/MD degree program. She is interested in barriers of learning in the STEM disciplines. The view from the stretcher in an ambulance racing towards the ER is not particularly intriguing or interesting. Yet, it was wh...
Source: Academic Medicine Blog - March 15, 2016 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective medical education patient centered care patient voice physician-patient relationship Source Type: blogs

New Health Care Symposium: Dubious Health Care Merger Justifications—The Sumo Wrestler And ‘Government Made Me Do It’ Defenses
Editor’s note: This post is part of a Health Affairs Blog symposium stemming from “The New Health Care Industry: Integration, Consolidation, Competition in the Wake of the Affordable Care Act,” a conference held recently at Yale Law School’s Solomon Center for Health Law and Policy. Links to all posts in the symposium will be added to Abbe Gluck’s introductory post as they appear, and you can access a full list of symposium pieces here or by clicking on the “Yale Health Care Industry Symposium” tag at the bottom of any symposium post. Market power is pervasive in the health care sector. Most hosp...
Source: Health Affairs Blog - February 24, 2016 Category: Health Management Authors: Thomas Greaney Tags: Costs and Spending Health Professionals Hospitals Insurance and Coverage Medicare Payment Policy Population Health Quality insurance mergers market consolidation Supreme Court Yale Health Care Industry Symposium Source Type: blogs

Short-selling Private Practice
By KAREN SIBERT, MD Today is a remarkable day for me. I’m officially leaving private practice after almost 18 years, to return to academic medicine with a faculty position in a highly regarded California department of anesthesiology. Why would I do that? There are many positive reasons. I believe in the teaching mission of academic medicine:  to train the anesthesiologists of the future, and the scientists who will advance medical care. I enjoy teaching. The years I’ve spent at the head of the operating room table, anesthetizing patients every day, have given me a great deal of hands-on experience (and at least some ...
Source: The Health Care Blog - February 3, 2016 Category: Consumer Health News Authors: Simon Nath Tags: THCB Karen Sibert Source Type: blogs