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Deductibles and donuts change the flavor of health care
A guest column by the American College of Physicians, exclusive to KevinMD.com.
In the annual cycle of a medical practice, there are seasons. For example, we have “flu season,” “poison ivy season,” “camp or school physical season,” “snowbirds back from Florida season,” and in my part of the world, “Lyme disease season.” There are other seasons that physicians must endure that have little to do with medicine and everything to do with our payment system.
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Your patients are rating you online: How to respond. Manage your online reputation: A social medi...
Source: Kevin, M.D. - Medical Weblog - March 14, 2014 Category: Family Physicians Tags: Policy Primary care Source Type: blogs
Top stories in health and medicine, December 31, 2013
From MedPage Today:
Antibiotic Use in Animals Under Fire. Every day, Americans use some 51 tons of antibiotics. But only about a fifth of that is to treat human illness.
Testosterone Level Affects Flu Shot Response. Men with high testosterone and a certain gene cluster may not experience an antibody response after a flu shot, researchers suggested — a finding that could affect men taking prescription testosterone.
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - December 31, 2013 Category: Family Physicians Tags: News Infectious disease Source Type: blogs
Treat your child’s fever before the doctor’s appointment
It’s the beginning of cold and flu season. That means a lot of kiddos, big and small, are coming to the office with fever.
As docs, we know that fevers can freak moms and dads out. Kids look pretty awful when their temperature climbs, and it is understandable that parents want to bring them to the office for an evaluation.
In the exam room, I often hear worried parents say something like this: “Dr. Natasha, we gave her some ibuprofen for her fever last night, but we did not give her anything this morning. I wanted you to see what she looks like with no medicine.”
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Your patients are rating you ...
Source: Kevin, M.D. - Medical Weblog - December 25, 2013 Category: Family Physicians Tags: Conditions Pediatrics Source Type: blogs
Patients who refuse their physicians’ advice
In the North American hemisphere flu season is here. Influenza, as most people know, is a serious respiratory infection that can be life-threatening in the very young and the very old. Some strains, as we’ve all heard about in the press in the past, are more deadly than others and may threaten even the strong. Luckily, however, we’ve developed a vaccine. It doesn’t guarantee you won’t get the flu: the influenza virus mutates rapidly and authorities must make their best guess about how to prepare a new vaccine every year, and sometimes they miss. Even when they get it right, you can still get the flu; you’ll jus...
Source: Kevin, M.D. - Medical Weblog - December 18, 2013 Category: Family Physicians Tags: Physician Primary care Source Type: blogs
ACP: Making the most of opportunities to get people immunized
A guest column by the American College of Physicians, exclusive to KevinMD.com.
It seems to begin earlier and earlier each year — displays are up in stores in late July, newspaper and radio ads start appearing in August, and the media reports on it before the kids even go back to school. Yes, flu vaccine season is in full motion. Last year I shared with you a few pointers to increase your practice’s immunization rate. This year I would like to add some more helpful tips and discuss some common barriers to vaccinating your patients.
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Your patients are rating you online: How to respond. Manage ...
Source: Kevin, M.D. - Medical Weblog - October 16, 2013 Category: Family Physicians Tags: Conditions Infectious disease Primary care Source Type: blogs
Top stories in health and medicine, October 7, 2013
From MedPage Today:
Biomarkers Predict Second MS Attack. In patients who experienced a first attack of multiple sclerosis (MS) symptoms, risk of a second attack was associated with a variety of baseline factors.
Flu Shot Cuts Risk of Pneumonia. Flu vaccination sharply reduced the risk of community-acquired pneumonia, one of the most serious complications of influenza.
Daytime Snoozing May Tell Risk of Hypoglycemia. Older patients with diabetes who are overly tired during the day may be at a higher risk for hypoglycemia.
Gait, Cognition Predict Falls in Early Parkinson’s. Factors that helped predict which patients w...
Source: Kevin, M.D. - Medical Weblog - October 7, 2013 Category: Family Physicians Tags: News Endocrinology Neurology Source Type: blogs
Top stories in health and medicine, September 27, 2013
From MedPage Today:
Sulfonylureas May Raise Death Risk. When taken as first-line therapy, sulfonylureas may increase the risk of death in patients with type 2 diabetes.
Parkinson’s Makes for Distrust, Risk-Taking. Compared with healthy controls, patients with Parkinson’s disease were markedly less trusting of strangers in a psychosocial experiment, even while showing greater willingness to take risks.
Cholesterol Meds May Hold Glycemic Benefit. Cholesterol-lowering drugs that work by binding to bile acids in the gut modestly improve glycemic control and pose little risk of hypoglycemia.
Kids Beat Adults at Ge...
Source: Kevin, M.D. - Medical Weblog - September 27, 2013 Category: Family Physicians Tags: News Diabetes Endocrinology Heart Pediatrics Source Type: blogs
The time to get flu shots is now
Please don’t tune me out on this one. Don’t let this post resemble Gary Larson’s The Far Side cartoon where you only hear, “Blah, blah, blah, Flu shot, blah, blah, blah, Flu shot, blah, blah, blah”
I write about flu every year because it’s one infectious disease that is not only more aggressive and dangerous for babies and young children, it’s vaccine preventable. The flu causes high fever, terrible cough, body aches, and significant discomfort. It can also potentially cause more serious infections like pneumonia. Unlike viruses that cause the common cold (rhinovirus or RSV), we have a vaccine for influen...
Source: Kevin, M.D. - Medical Weblog - September 25, 2013 Category: Family Physicians Tags: Conditions Infectious disease Source Type: blogs
A gameplan against this year’s flu
Did your team win this weekend?
I hope so. It is so exciting when your team gets to throw up a “W” after their first contest. It gives all the fans hope for a successful and exciting season.
Fall also is a time to cheer for our annual opportunity to protect our families against a predictably unpredictable opponent: influenza.
That’s right. It’s time to defend against the flu by getting an annual flu vaccine.
This season, your defensive coordinator (aka, your pediatrician) has a few “players” to choose from for your family’s best success.
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Your patients are rating you online: How to respo...
Source: Kevin, M.D. - Medical Weblog - September 17, 2013 Category: Family Physicians Tags: Meds Medications Pediatrics Source Type: blogs
Top stories in health and medicine, August 8, 2013
Brought to you by MedPage Today.
1. Higher Blood Sugar Tied to Dementia Risk. Higher glucose levels had a significant association with an increased risk of dementia in older, nondiabetic individuals.
2. Scientists Urge Controversial H7N9 Studies. A star-studded group of influenza researchers is calling for genetic experiments on the H7N9 avian flu strain that could lead to so-called “gain-of-function” mutations.
3. Cocoa May Boost Brain Function in Seniors. Older people with impaired neurovascular coupling at baselinewho drank two cups of cocoa a day for a month had significant improvement in cognitive functio...
Source: Kevin, M.D. - Medical Weblog - August 8, 2013 Category: Family Physicians Tags: News Infectious disease Neurology Source Type: blogs
Top stories in health and medicine, May 29, 2013
Brought to you by MedPage Today.
1. Don’t Stop Warfarin for Dental Visits. Patients taking aspirin or warfarin (Coumadin) for prevention after a stroke don’t need to stop the drug for dental procedures and probably can stay on it for most other minor medical procedures.
2. Silent Afib Linked to Stroke in Diabetics. Asymptomatic atrial fibrillation might lie behind stroke of unknown origin in patients with type 2 diabetes.
3. Tamiflu Resistance Confirmed in H7N9 Flu Cases. Chinese researchers reported, for the first time, clinical evidence of oseltamivir (Tamiflu) resistance in patients infected with the novel a...
Source: Kevin, M.D. - Medical Weblog - May 29, 2013 Category: Family Physicians Tags: News Heart Infectious disease Neurology Source Type: blogs
Top stories in health and medicine, May 14, 2013
Brought to you by MedPage Today.
1. Adult-Observed ADHD Reflects True Rate in Kids. Parent- and teacher-reported rates of attention-deficit/hyperactivity disorder do not appear to overestimate the true prevalence of the condition.
2. H7N9 Pandemic? Not Yet but Still Worrisome. The H7N9 avian influenza now circulating in China has two of the three characteristics of a pandemic virus.
3. If Job Stress Mounts, Healthy Living May Be Lifesaver. A handful of studies have suggested that high stress work environments are bad for the heart, but some of the job-related risk may be reduced by avoiding a quartet of known lifestyle ris...
Source: Kevin, M.D. - Medical Weblog - May 14, 2013 Category: Family Physicians Tags: News Infectious disease Psychiatry Source Type: blogs
Nurse practitioners should be released from their arbitrary bondage
As of early April, you can walk into Walgreens in 18 states (plus D.C.), and along with a gallon of skim milk, a pair of photo mugs, a six-pack of toilet paper, and a flu shot, you can meet your new primary care provider, get your cholesterol checked, pick up your statin, and schedule a return visit. That primary care provider will not be a physician but a nurse practitioner (or a physician assistant, but that’s for another article). Those states, and now Walgreens, have recognized that nurse practitioners can handle a lot more than antibiotics for urinary tract infections: They can practice primary care just fine withou...
Source: Kevin, M.D. - Medical Weblog - May 8, 2013 Category: Family Physicians Tags: Physician Primary care Source Type: blogs
4 ways to beat time constraints and guide patients to better health
As doctors, we’re typically compensated for the work we do, not the hours we spend. Our jobs are structured so that we’re taxed for time, making even the most routine office visit feel like a race against the clock. Trying to develop a long-term strategy with a patient in this context is not time-efficient. It is, in fact, incredibly frustrating.
Yet medicine is a team effort, and we understand that we’re treating people, not algorithms. We know that when patients are more informed they tend to make better choices at home (eating healthful foods), and in our offices (scheduling things like flu shots). Here, four ways...
Source: Kevin, M.D. - Medical Weblog - May 2, 2013 Category: Family Physicians Tags: Patient Primary care Source Type: blogs
The young and healthy can die from influenza complications
Nothing was helping. Everything had been tried for a week of the most intensive critical care possible. A twenty year old man, completely healthy only two weeks previously, was holding on to life by a mere thread and nothing and no one could stop his dying.His battle had been lost against MRSA pneumonia precipitated by a brief influenza-like illness. Despite aggressive hemodynamic, antibiotic and ventilator management, he was becoming more hypoxic, his lungs collapsing and his renal function deteriorating. He had remained unresponsive during his ICU ordeal due to intentional sedation.Continue reading ... Manage...
Source: Kevin, M.D. - Medical Weblog - February 20, 2013 Category: Family Physicians Tags: Conditions Infectious disease Source Type: blogs
