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The hidden work of primary care
It was nearing the end of my day at the mobile health clinic where I work as a nurse practitioner, providing free, comprehensive primary care to uninsured patients in central Florida. Clinic was officially over, and we were no longer taking patients; I was signing notes and finishing up some teaching points with a PA student when a woman walked up and asked me if she could “talk to me for a minute, just to ask a quick question.” After many years working in community health, I know these types of requests are rarely “quick,” but, understanding our patients’ limited opportunities access to care, I obliged.
As soon ...
Source: Kevin, M.D. - Medical Weblog - December 11, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/michelle-nall" rel="tag" > Michelle Nall, MPH, ANP-BC < /a > Tags: Policy Primary Care Source Type: blogs
Racial inequalities in cancer survival
Three studies published in a supplemental issue of the journal Cancer this month come to disturbing conclusions: in the United States, the survival rates for colon, breast, and ovarian cancer are lower for black people than for white people. The news isn’t all bad: overall cancer survival rates are going up. The three studies mentioned here draw from two larger studies of worldwide cancer survival, the CONCORD... // Read More »
Source: blog.bioethics.net - December 10, 2017 Category: Medical Ethics Authors: Joe Gibes Tags: Health Care Justice Allocation / Access / Public Health allocation/access/public health; health care practice bioethics Culture / Ethnicity / Gender / Disability human dignity medicine racism syndicated Source Type: blogs
Why PCO patients should induce a period every month
Polycystic ovarian disease ( PCOD) is a common cause of infertility. Typically, most of these patients have irregular cycles because they don't ovulate regularly. Now, because they don't ovulate, they don't get pregnant , and they don't get regular periods either . This is because they produce a lot of estrogen, but there's no progesterone production at all, because of the lack of ovulation.Now, this means that every time they miss a period, they're very hopeful that this time they could be pregnant. They wait and they wait, and after two months or three months they don't get a period, they finally go to a doctor who does ...
Source: Dr.Malpani's Blog - December 5, 2017 Category: Reproduction Medicine Source Type: blogs
The Couric-Jolie effect: The impact of celebrities ’ medical advice
Follow me on Twitter @RobShmerling
Some called it the Katie Couric effect. Soon after her husband died of colon cancer in 1998, the journalist and television personality had a televised colonoscopy to promote the test. Rates of screening colonoscopies soared for at least a year. Or, call it the Angelina Jolie effect. In 2013, the actress wrote an editorial in the New York Times about the tests she had for genes (called BRCA) linked with breast and ovarian cancer, and how the positive result led her to have a double mastectomy. Soon after, rates of BRCA testing jumped.
Whatever you call it, the effect is real. When it comes...
Source: Harvard Health Blog - December 1, 2017 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Health Health care Managing your health care Source Type: blogs
The Couric-Jolie effect: When celebrities share their medical experiences
Follow me on Twitter @RobShmerling
Some called it the Katie Couric effect. Soon after her husband died of colon cancer in 1998, the journalist and television personality had a televised colonoscopy to promote the test. Rates of screening colonoscopies soared for at least a year. Or, call it the Angelina Jolie effect. In 2013, the actress wrote an editorial in the New York Times about the tests she had for genes (called BRCA) linked with breast and ovarian cancer, and how the positive result led her to have a double mastectomy. Soon after, rates of BRCA testing jumped.
Whatever you call it, the effect is real. When it comes...
Source: Harvard Health Blog - December 1, 2017 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Health Health care Managing your health care Source Type: blogs
Weekly Overseas Health IT Links – 11th November, 2017.
Here are a few I came across last week. Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.-----https://www.healthdatamanagement.com/news/artificial-intelligence-helps-detect-ovarian-cancer-early-and-accuratelyArtificial intelligence helps detect ovarian cancer early and accurately By Greg SlabodkinPublished November 03 2017, 7:47am EDTOvarian cancer is difficult to diagnose, particularly in its early stages, when survival rates are much higher. Because th...
Source: Australian Health Information Technology - November 11, 2017 Category: Information Technology Authors: Dr David More MB PhD FACHI Source Type: blogs
CMS Releases Final Rule for Second Year of QPP - Includes PI-QI CME Improvement Activity
Last week, the Centers for Medicare & Medicaid Services (CMS) released a final rule that makes changes in the second year of the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), including the Merit-based Incentive Program (MIPS) and Advanced Payment Models (APMs). The second year of the QPP continues to build on transitional year 1 policies, noting that a “second year to ramp-up the program will continue to help build upon the iterative learning and development of year 1 in preparation for a robust program in year 3.”
In addition to the final rule, CMS als...
Source: Policy and Medicine - November 6, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
CMS Releases Final Rule for Second Year of QPP
Last week, the Centers for Medicare & Medicaid Services (CMS) released a final rule that makes changes in the second year of the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), including the Merit-based Incentive Program (MIPS) and Advanced Payment Models (APMs). The second year of the QPP continues to build on transitional year 1 policies, noting that a “second year to ramp-up the program will continue to help build upon the iterative learning and development of year 1 in preparation for a robust program in year 3.”
In addition to the final rule, CMS als...
Source: Policy and Medicine - November 6, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Ovarian Cancer Does Not Exist; Effect on Gynecologic Cancer Surgery
When I was both a medical student and a pathology resident, I was intrigued by the fact that many ovarian cancers I looked at under the microscope consisted of columnar cells and often seemed to grow on the surface of the ovary. Various teachers told me that the neoplasms were mimicking peritoneal and tubal epithelium. Experts now assert that there is no such thing as"ovarian cancer" -- all such neoplasms are now thought to originate in the uterine tubes, thus explaining their histologic appearance (see:Tackling Cancer Myths: It ’s time to accept that ovarian cancer doesn’t exist). Here is an excerpt from thi...
Source: Lab Soft News - November 3, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Medical Consumerism Medical Education Medical Research Preventive Medicine Quality of Care Surgical Pathology Source Type: blogs
Birth Control is Essential
Listen, birth control was never "free". This is a f.ing lie. Since Obamacare became law, no one with standard employer-based health insurance got their monthly oral contraceptive prescription for free. If you have health insurance, that means you pay a premium every month. You pay money. Actual real live currency. In fact, you don't even get a chance to decide; it just comes directly out of your paycheck before the federal government can tax it. That's employer-sponsored health insurance. It has been that way since WWII.What changed with Obamacare was the creation of the concept of...
Source: Buckeye Surgeon - October 8, 2017 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs
Excess Visceral Fat Tissue Raises Cancer Risk
One of the many detrimental consequences of carrying excess fat tissue is an increased risk of cancer. Visceral fat generates chronic inflammation in addition to other forms of metabolic disruption, and that inflammation speeds the development and progression of all of the common age-related conditions, cancer included. The epidemiological research noted here is one way of looking at the numbers behind this relationship. When considering the number of people who are harming their health by being overweight, it is interesting to note the fact that progress in medical technology is still keeping pace to reduce mortality in l...
Source: Fight Aging! - October 6, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Saying goodbye shows how strong doctor-patient bonds can be
Starting a new job is always stressful — the move from one institution to another, getting hospital credentials, obtaining provider credentialing for various insurances, meeting new staff, and adjusting to a new work “culture”. Having done my share of moves, these are nearly universal experiences. However, as I find myself walking around the hallowed halls of Rhode Island Hospital like the proverbial chicken without a head, I also find my thoughts drawn back to the patients I’ve left in Boston.
There is Jane*, a young 42-year-old with ovarian cancer, who had come to her first appointment with her children and...
Source: Kevin, M.D. - Medical Weblog - October 2, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/don-s-dizon" rel="tag" > Don S. Dizon, MD < /a > Tags: Physician Hospital-Based Medicine Oncology/Hematology Source Type: blogs
It ’s not gonna’ kill you to take hormone replacement
It’s not going to kill you to take hormone replacement therapy.
That’s the take home message from the latest analysis of the Women’s Health Initiative, the largest and longest randomized trial of hormone replacement therapy (HRT) in menopausal women.
After almost 18 years of follow up in the WHI, there was no increase in overall mortality, including death rates from cancer, in women taking HRT for up to 5.6 years (estrogen plus progestin) or 7.2 years (estrogen alone). There was a non-significant reduction in mortality among those who started HRT between ages 50 and 59, the group most likely to be presc...
Source: The Blog That Ate Manhattan - September 22, 2017 Category: Primary Care Authors: Margaret Polaneczky, MD Tags: Hormone Replacement Menopause WHI breast cancer estrogen HRT Prempro Source Type: blogs
We Can Improve Care Management
As a physician and CIO, I ’m quick to spot inefficiencies in healthcare workflow. More importantly, as the care navigator for my family, I have extensive firsthand experience with patient facing processes.My wife ’s cancer treatment, my father’s end of life care, and my own recent primary hypertension diagnosis taught me how we can do better.Last week, when my wife received a rejection in coverage letter from Harvard Pilgrim/Caremark, it highlighted the imperative we have to improve care management workflow in the US.Since completing her estrogen positive, progesterone positive, HER2 negative breast cancer treat...
Source: Life as a Healthcare CIO - September 12, 2017 Category: Information Technology Source Type: blogs
After a $417 million judgment: What should corporations do?
I have written about talcum powder previously. Indeed, I have not only opined on the slippery substance, but I am also a regular consumer of the product. Talcum powder has become magic legal dust that brings forth zillions of dollars to those who have been attacked by the poisonous toxin.
Just last year, I informed readers of $55 million and $72 million judgments to cancer victims who used powder against the manufacturer Johnson & Johnson. Earlier this year a Missouri woman was awarded $110 million in damages.
Recently, a jury in California, where the cost of everything is stratospheric, ordered J&J to pay ...
Source: Kevin, M.D. - Medical Weblog - September 3, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/michael-kirsch" rel="tag" > Michael Kirsch, MD < /a > Tags: Physician Medications OB/GYN Oncology/Hematology Source Type: blogs
