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FDA Agency Update December 2015
As 2015 comes to a close for the FDA, it remains an agency in transition. The agency should soon see a new commissioner and may be the subject of legislative overhauls. We have recently reported on the FDA's new patient engagement advisory committee, anticipated biosimilars naming guidance, PDUFA reauthorization, and continued issuance of warning letters. FDA funding, drug approvals: key concerns RAPS reported FDA Acting Commissioner Ostroff's recent comments, describing the importance of biomarkers in drug development, inspection policies, and patient-centric approaches. With so much talk of FDA reform, his comments on ...
Source: Policy and Medicine - December 3, 2015 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Nominee for New FDA Commissioner Derived Salary from Six Pharmaceutical Companies LAST YEAR
In President Obama's first inauguration speech, he promised to restore science to its proper place in government by shielding the regulatory process from corporate influence. One of his specific proposals to carry out this promise was to prevent anyone with a severe corporate conflict of interest from serving in the executive branch until at least one full year had gone by without the conflict in place. Thus, if you received salary from a pharmaceutical company in 2014, you would not be permitted to serve as the FDA Commissioner at least until 2016.Unfortunately, as we have repeatedly seen campaign promises wither, this on...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - November 19, 2015 Category: Addiction Source Type: blogs

How Doctors Became Subcontractors
By MICHEL ACCAD, MD In our healthcare system, the “middleman” is not who you think During my recent podcast interview with Jeff Deist, president of the Ludwig von Mises Institute, I remarked that third-party payers are not, in fact, intermediaries between doctors and patients. In reality, it is the physician who has become a “middleman” in the healthcare transaction or, as I argued, a subcontractor to the insurer. Important as it is, this reality is not well recognized—not even by physicians—because when doctors took on this “role” in the late 1980’s, the process by which healthcare busine...
Source: The Health Care Blog - October 30, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB MICHEL ACCAD Source Type: blogs

The Corporate Physicians' Dilemma - Three Hospital Systems Settle Cases Alleging Pressure on Employed Physicians to Refer Patients Within the System
Physicians are sworn to provide the best possible care to each individual patient.  Yet in the US, physicians increasingly practice as employees of large organizations, sometime for-profit corporations.  Physicians may be in a bind when their bosses pressure them to make patient level decisions so as to increase revenue, regardless of their effects on the patients.In particular, physicians' oaths may suggest that patients who require referrals for consultation, diagnosis or treatment should go to the professionals and facilities best suited to their particular problems.  However, physicians bosses may want p...
Source: Health Care Renewal - October 27, 2015 Category: Health Management Tags: Adventist Health System Broward Health corporate physician crime Stark Law Tuomey Healthcare System Source Type: blogs

Anatomical encounters of Aortic valve with bundle of His : An Illustration
Car tyres warrant  replacement  every  20,000 km or so .Its batteries do require periodic attention. Human heart , which runs non stop from womb to tomb . . . deserves how much ? Unfortunately no one (What about your cardiologist?) can  provide  a flawless lifetime maintenance contract to this restless bio-mechanical pump ! Fortunately still, God has  created this wonder organ ,that can with stand the stress of life for nearly 10 decades . . . if we live a proper life ! However ,there are many areas in heart that are prone for mechanical stress even if it’s structurally normal .These are  the zones where the r...
Source: Dr.S.Venkatesan MD - October 17, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Anatomy of heart Complete heart block anatomy of complete heart bock aortic root valve stress aortic valve calcification aortic valve sclerosis calcific aortic stenosis mechanism of complete heart block tavr stress on his bundle Source Type: blogs

Turn That Door Around - A Physician Substantially Tied to the Pharmaceutical Industry Nominated to Run the FDA
It seems to be the season of the revolving door in health care.  The latest version got some media attention, because it involves one of the most important health care leadership positions in the US government, the Director of the Food and Drug Administration (FDA).  However, the case actually seems much more serious than what the media has recently reported.The BasicsFor an introduction, we turn to the Wall Street Journal from September 15, 2015:President Barack Obama plans to nominate the prominent cardiologist and medical researcher Robert Califf as the next commissioner of the Food and Drug Administration, th...
Source: Health Care Renewal - September 24, 2015 Category: Health Management Tags: boards of directors CME conflicts of interest FDA key opinion leaders logical fallacies revolving doors Source Type: blogs

Reducing Practice Variation At Crystal Run Healthcare
Research has shown wide variation in per capita spending among different states and among different counties within the same state. Some of this variation can be explained by the health status of the population, local pricing, patient cultural and demographic factors, and the local liability environment. However, the vast majority of variation in spending is unexplained and likely due to a failure of health care providers to follow established best practice guidelines. This type of variation is associated with unnecessary over-utilization, while reducing variation leads to reductions in utilization and improvements in qua...
Source: Health Affairs Blog - July 23, 2015 Category: Health Management Authors: Scott Hines, Jonathan Nasser and Linda Green Tags: Costs and Spending Equity and Disparities Health Professionals Innovations in Care Delivery Medicaid and CHIP Medicare Organization and Delivery Population Health Quality ACOs chronic conditions Crystal Run Healthcare NCQA Physic Source Type: blogs

The Core Quality Measures Collaborative: A Rationale And Framework For Public-Private Quality Measure Alignment
Editor’s note: The full list of authors for the Core Quality Measures Collaborative Workgroup is included at the end of the blog post. In today’s health care system, physicians are faced with an unprecedented number of quality measures required by different entities. Payment is pivoting away from traditional reimbursement models toward value-based health care, where value is a function of both quality and cost. Patients are making an about-face from traditionally passive receivers of health care to informed consumers with expectations of transparency. Payers and employer groups are demanding accountability for how thei...
Source: Health Affairs Blog - June 23, 2015 Category: Health Management Authors: Patrick H. Conway and the Core Quality Measures Collaborative Workgroup Tags: Featured Hospitals Organization and Delivery Payment Policy Population Health Quality 3Rs AHIP AHRQ CMS health outcomes National Quality Forum Source Type: blogs

Co-management agreements have risks. Beware.
Co-management agreements are growing in popularity as health care shifts to outcomes-based reimbursement models.  Physicians and hospitals contract with one another in quality-oriented pay-for-performance arrangements, in which physicians oversee and manage service lines (most commonly orthopedics, oncology, and cardiology). The overarching goal of these agreements is quality improvement, which benefits all parties involved — especially the patient.  The hospital benefits financially in part from reducing costs and physicians receive a base fee and/or incentive bonuses for accomplishing quality measures and benchma...
Source: Kevin, M.D. - Medical Weblog - June 10, 2015 Category: Journals (General) Authors: Tags: Policy Health reform Hospital Source Type: blogs

Endomyocardial Fibrosis (EMF)
is a type of restrictive cardiomyopathy. It is characterised by fibrosis and obliteration of the ventricular cavity, predominantly involving the right ventricle. Isolated involvement of left ventricular inflow region may cause left ventricular inflow and mimic mitral stenosis. But that variety is extremely rare. The common variety involves the right ventricular inflow and body, often obliterating the right ventricular apex. Right ventricular outflow is usually spared. This is the only region of the right ventricle which contracts well in EMF and is clinically evident as right ventricular outflow tract pulsations in the th...
Source: Cardiophile MD - May 9, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

Physiological Interventricular de-synchrony : Right ventricle contracts like an Intestine !
Right ventricle,being a venous chamber has distinct anatomical and physiological features to carry out this function.RV has a complex shape, its triangular in long axis and  crescent like in short axis , thin (<5mm)  more distendable  .Contraction of RV begins slightly early but ends later than LV  (30ms ) https://www.youtube.com/watch?v=GH5trHYjozI RV receives blood from RA and ejects in to PA in a sequential manner .The inflow, body and outflow contract somewhat like  intestinal peristalsis. This is facilitated  by the incremental  delay in the electrical depolarization of right ventricle.In physiological condi...
Source: Dr.S.Venkatesan MD - May 5, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Anatomy of heart Right ventricle best articles on right ventricle cardiac peristalsis physiological inter ventricualr desynchrony Right ventricle anatomy and physiology right ventricular sequential peristaltic contraction Source Type: blogs

People are not units — US healthcare policy obstructs good doctoring
There is a lot of talk about rewarding value in US healthcare. Don’t believe any of it. It’s not happening. Not even close. This is a post about the real world–where I practice medicine. In a comment on yesterday’s post, Lisa wondered how I connected the current model of employing doctors and paying them on productivity to the three trends I wrote about on Medscape Cardiology–fear-mongering, lack of communication, and treating diseases not people. I started to explain in the comments section but then realized the topic was big enough to warrant a new post. To be blunt again: the current model ...
Source: Dr John M - November 2, 2014 Category: Cardiology Authors: Dr John Source Type: blogs

Cardiology MCQ 319: de Vega’s annuloplasty
de Vega’s annuloplasty is commonly used for: a) Mitral valve b) Tricuspid valve c) Aortic valve d) Pulmonary valve ["Click here for the answer with explanation", "Correct Answer:"] b) Tricuspid valve In this procedure, de Vega’s annuloplasty ring is sewn at the tricuspid annulus to reduce its dimensions and thereby reducing the leak which occurs mostly because the valve leaflets do not touch each other when the enlarged right ventricle contracts. The post Cardiology MCQ 319: de Vega’s annuloplasty appeared first on Cardiophile MD.
Source: Cardiophile MD - September 21, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiac Surgery Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Key Takeaways From The Medicare Trustees’ Report
TweetNote: In addition to Keith Fontenot, Kavita Patel also coauthored this post.  Depending on which article you read, either the Medicare Trustees think the program is coming to an end, or the news is great and we don’t need to do anything. The reality is that the recent Trustees’ report contains both positive and sobering news: while costs have been flat for the last two years and growth is expected to moderate for some years to come, Medicare’s financing is still not in good shape over the long run. Current law benefits exceed financing to pay for them, and the Hospital Insurance Trust Fund will be unable to pa...
Source: Health Affairs Blog - August 14, 2014 Category: Health Management Authors: Keith Fontenot, and Kavita Patel Tags: All Categories Health Care Costs Health Care Delivery Health Reform Medicare Payment Physicians Spending Source Type: blogs

Cardiology EHR Selection Checklist for Small Practices
Software developers have been working hard the past couple of years to be ready for the heightened interest in EMR/EHR systems. The initial focus was on "generic" systems that could work in various practices. Basic functionality isn't always enough to impress medical offices – especially medical specialists such as cardiologists. The Certification Commission for Health Information Technology, a nonprofit group that vets EHR systems for compliance with performance standards, has also noted that a one-size-fits-all approach to electronic health records does medical practices a disservice. Knowing what features you need and...
Source: EMR EHR Blog for Physicians - June 6, 2014 Category: Technology Consultants Authors: Alok Prasad Source Type: blogs