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Total 287 results found since Jan 2013.

The danger of grading doctors…
It goes without saying that caregivers are not interchangeable. Quality matters. What else is there other than our health? From the day I began as a doctor, the absence of a legitimate meritocracy has been a source of inflammation. In 1996, when I started private practice, referrals depended too much on old-boy networks. In 2014, the situation is worse. Now, referrals depend almost exclusively on who employs whom. I could be a wizard of catheter ablation, but referring doctors who are employed by competing systems will not send me patients. They might sneak their mother in, but their patients go to the electrophysiologist ...
Source: Dr John M - January 24, 2014 Category: Cardiology Authors: Dr John Source Type: blogs

31 Year Old Male with RUQ Pain and a History of Pericarditis. Submitted by a Med Student, with Great Commentary on Bias!
This was submitted by a fantastic medical student who wished to remain anonymous: A 31 year old male with a history of viral pericarditis one year ago presented with right upper quadrant pain. Here is his initial ED ECG:The R-wave in V4 extends to 33 mm, the computerized QTc is 372 msThe only available previous ECG is from one year ago, during the admission when he was diagnosed with pericarditis:1 year ago ECG, with clinician and computer interpretatioin of pericarditis What do you think? What do these EKGs show? What is your plan for this patient?Here was the story from my perspective, prospectively:I was shown this ECG ...
Source: Dr. Smith's ECG Blog - December 20, 2013 Category: Cardiology Authors: Steve Smith Source Type: blogs

The biggest mistake is not learning from one…
A friend recently asked me why I am so hard on doctors. “You write a lot of negative stuff about us,”  he said. That worries me. I am not a nihilist. I believe in what we do. I put doctoring decidedly in the noble category, right alongside teachers. In fact, my attachment to doctoring is the reason I write about it. Here’s my thinking about confronting negative stuff: One of the major problems with healthcare at this moment is an erosion of trust in doctors. We have a credibility problem. The information age has changed the landscape of medicine in two major ways: First, access to health information is n...
Source: Dr John M - December 15, 2013 Category: Cardiology Authors: Dr John Source Type: blogs

Are doctors being duped through medical education? Could social media help?
I made a discovery this week about the novel anticoagulant medications, dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Lixiana). I was looking into the often-asked question of how these new drugs compare to the old standard, warfarin. The discovery felt like a Eureka moment. I ran it by my stats guy–my son–and a couple of colleagues, and they confirmed, that my discovery was truth. I’m working on a post now that discusses the details of how the medical world has been misled about these drugs. Stay tuned. Medical Education: For now, though, this revelation got me thinking abo...
Source: Dr John M - December 14, 2013 Category: Cardiology Authors: Dr John Source Type: blogs

Clear Guide Brings Easy Needle Guidance to Any Ultrasound System (w/video)
Ultrasound guided needle placement has allowed clinicians to perfect regional anesthesia procedures, needle biopsies, central line placement, and other procedures. Though a variety of techniques are used to track the path of the needle, from mechan...
Source: Medgadget - December 11, 2013 Category: Technology Consultants Authors: Editors Tags: Anesthesiology Cardiac Surgery Cardiology Critical Care Emergency Medicine Ob/Gyn Radiology Urology Source Type: blogs

With vaccines…Is there no middle ground, no room for questions?
“We should be as demanding of ourselves as we are of those who challenge us.” Dr. Jerome Groopman, writing in the New Rupublic Writing about the medical decision-making surrounding vaccines proved to be sketchy. Yesterday’s post brought stinging criticism from both sides of the debate. A pediatrician felt the structure of the post was patronizing. Just an hour later, a skeptic sent me the same message–patronizing. This was educational. Criticism is taken seriously here, especially when it comes from both sides of an argument. The reflex: Perhaps its useful to write more on the matter? (It’s f...
Source: Dr John M - December 6, 2013 Category: Cardiology Authors: Dr John Source Type: blogs

Global Database on CME Meetings and Providers
MedMeme LLC, a global leader in providing comprehensive integrated medical and scientific information database platforms to the top pharmaceutical and biotechnology companies recently launched its new MEPmemeTM (MEP) database that offers the latest information on medical education providers, according to a press release from the company. "This robust product will help pharmaceutical and healthcare professionals such as medical affairs, personnel managers, researchers and pharmaceutical executives to easily filter through the massive amount of data on medical education providers and make the best possible decision on thei...
Source: Policy and Medicine - November 27, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs

Congress Writes CMS To Change Sunshine Rule For Textbooks
A bi-partisan group of more than two dozen members of Congress has written the US Centers for Medicare & Medicaid Services to demand the agency modify the reporting requirements of the Sunshine Act, so that medical textbooks and peer-reviewed journal reprints are excluded from the data that must be collected by drug and device makers. The move comes one month after dozens of national and medical societies - including the American Medical Association, the American Academy of Family Physicians, the American College of Cardiology and the American Society of Clinical Oncology - made the same request and threatened to file ...
Source: Pharmalot - November 26, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs

The future of simulation is to be found in Tel Hashomer
Simulation centers have been popping up in hospitals across the world.  These are useful, but for the most part their function is to provide technical training in surgical and other interventional techniques, as well as to practice resucitation and the like. Sometimes, too, they are used to study teams in stressful situations to provide lessons in team dynamics.Amitai Ziv has a broader view of the purpose of simulation. His goal is nothing less than to use this tool to help in the transformation towards a safe, humane, ethical, and patient-centered medical culture.  As the director of MSR, the Israel Center for M...
Source: Running a hospital - November 25, 2013 Category: Health Managers Source Type: blogs

Simulations from the Future of Cardiology
Cardiology is a key area that could use some refreshments regarding the tools and devices used to teach its anatomy and physiology in the medical curriculum. Based on a patient’s CT scan and using a mix of stereo lithography and other prototyping techniques, xCardio creates a copy of a human heart that is anatomically correct both inside and out. While the main purpose of a new game, Relive, is to increase the awareness about CPR and push people, especially teenagers and young adults, to take a CPR class and be prepared to intervene in case of need.   See 6 Reasons Why I Wish I Was a Medical Student Now and ...
Source: ScienceRoll - November 21, 2013 Category: Geneticists and Genetics Commentators Authors: Dr. Bertalan Meskó Tags: Education Invention Medical education Medicine Medicine 2.0 Video cardiology Source Type: blogs

Statin Insanity
The medical student was confused. "Well, that's not good."He was seeing, in black and white, the benefits and harms of statin medicines. After years of systematic inculcation about the power of cholesterol reduction, this was the first time he had seen the numbers."I don't get it. I thought cholesterol was the big player in heart attacks."Not really. Three-quarters of people having a first heart attack, for instance, have normal cholesterol levels."Seriously?"Indeed. In fact, 50 years ago during the Framingham Heart Study, researchers first suggested that cholesterol may be a weak risk factor for heart disea...
Source: PharmaGossip - November 16, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs

Film recommendation — Amour teaches important lessons about humanity
It goes without saying that having an appreciation for humanity is critical for doctoring. One of the areas of medicine that is most tragic is how we treat the elderly. If I could change one thing about medical care, I would make the care of the elderly more gentle. Dr Dan Matlock (@Dan_Matlock) is a friend and academic physician interested in improving decision quality. He wrote this in a comment on my recent Medscape/Cardiology post. Somewhere in the last 100 years, we have replaced humanity with technology.  I actually think we have huge gains to make in bringing the humanity back to medicine.  A field of medicine wit...
Source: Dr John M - November 3, 2013 Category: Cardiology Authors: Dr John Source Type: blogs

Making sense of the healthcare debate
by Kent Bottles "Men govern nothing with more difficulty than their tongues, and can moderate their desires more than their words." - Baruch Spinoza. The most depressing aspect of the debate about the transformation of the American healthcare system is how liberals and conservatives talk past each other. It is hard not to get frustrated when zealots on both sides of the aisle refuse to listen to each other and refuse to learn from each other. The "ObamaCare 2016: Happy Yet?" op-ed in the Wall Street Journal last week serves as a prime example of an unbalanced and unfair attack on the Affordable Care Act. Bradley Alle...
Source: hospital impact - November 1, 2013 Category: Health Managers Authors: Wendy Johnson Source Type: blogs

Doctors To HHS: Exclude Textbooks And Reprints From Sunshine Act, Or Else
As drug and device makers begin collecting data to comply with the Sunshine Act, dozens of national and medical societies are asking the US Department of Health & Human Services to modify the reporting requirements so that medical textbooks and peer-reviewed journal reprints are excluded. And if HHS refuses to comply, the groups are considering seeking help from Congress and, possibly, filing a lawsuit. The Sunshine Act, you may recall, establishes procedures for gathering and publishing data containing financial ties between physicians, teaching hospitals and drug and device makers, as well as group purchasing organiz...
Source: Pharmalot - October 29, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs

Study shows FaceTime with iPhone is successful in teaching Cardiac Ultrasound remotely
Pocket sized ultrasound devices (PUDs) have  potential to  improve global health care delivery due  to their potential role in areas with limited resources.   Although theoretically  they have much promise, their use has been limited due to a lack of imaging protocol and trained users. This particular study, titled — “Feasibility of remote real-time guidance of a cardiac examination performed by novices using a pocket-sized ultrasound device” looked at the cardiac limited ultrasound exam (CLUE)  to screen for  left ventricular (LV) […]
Source: The Palmdoc Chronicles - October 21, 2013 Category: Technology Consultants Authors: Farah Moustafa Tags: cardiac Emergency Medicine FaceTime facetime doctor facetime medicine Medical/PDA Physicians (DO) Physicians (MD) pocket ultrasound pocket ultrasound device Research Cardiology iPad iPhone News Radiology Source Type: blogs