Help Medical Students

by Joe Flower

The rapidly ramifying crisis in health care may (we can pray) end all delusions. It may at least begin to weaken them by exposing them to the light, to the sobering effects of reality.

The reform act has not brought us to the Promised Land. By bringing us access without capacity, fierce restrictions coupled with vague language and loopholes, mandates coupled with fines low enough to become the cheap way out, strong new ideas that are only pilots, and tough commissions and task forces that have no teeth, the reform act delivers us into a period of maximum melee, in which the needs and desires of hospitals, doctors, citizens, politicians, insurers, drug companies, device manufacturers and hundreds to thousands of niche industries within the sector, get pitted nakedly against one another.

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Read the rest of Health care reform provides a chance that we can do the right thing

No comment | Tags: Health reform | Category: Health policy and politics

by Joe Flower

The rapidly ramifying crisis in health care may (we can pray) end all delusions. It may at least begin to weaken them by exposing them to the light, to the sobering effects of reality.

The reform act has not brought us to the Promised Land. By bringing us access without capacity, fierce restrictions coupled with vague language and loopholes, mandates coupled with fines low enough to become the cheap way out, strong new ideas that are only pilots, and tough commissions and task forces that have no teeth, the reform act delivers us into a period of maximum melee, in which the needs and desires of hospitals, doctors, citizens, politicians, insurers, drug companies, device manufacturers and hundreds to thousands of niche industries within the sector, get pitted nakedly against one another.

(…)
Read the rest of Health care reform provides a chance that we can do the right thing

No comment | Tags: Health reform | Category: Health policy and politics

by Joe Flower

The rapidly ramifying crisis in health care may (we can pray) end all delusions. It may at least begin to weaken them by exposing them to the light, to the sobering effects of reality.

The reform act has not brought us to the Promised Land. By bringing us access without capacity, fierce restrictions coupled with vague language and loopholes, mandates coupled with fines low enough to become the cheap way out, strong new ideas that are only pilots, and tough commissions and task forces that have no teeth, the reform act delivers us into a period of maximum melee, in which the needs and desires of hospitals, doctors, citizens, politicians, insurers, drug companies, device manufacturers and hundreds to thousands of niche industries within the sector, get pitted nakedly against one another.

(…)
Read the rest of Health care reform provides a chance that we can do the right thing

No comment | Tags: Health reform | Category: Health policy and politics

by Larry Husten, PhD

The authors call it “an in-office linguistic study” and write that it “was conducted to assess physician–patient discussions of mixed dyslipidemia.” But it’s really an Abbott marketing study for Niaspan, the company’s long-acting niacin product, and the question is: why is it published in the American Journal of Cardiology?

The study involves the recorded conversations of 12 cardiologists and 12 PCPs with 45 patients with low levels of HDL. The authors report that the physicians did a poor job in talking to their patients about dyslipidemia and patients did an even worse job in listening. After the conversations patients didn’t understand their lipid numbers and had only a fuzzy understanding of terms like HDL and triglycerides.

Overall, the visits did not contain discussions of specific health-related benefits associated with NER [niacin extended-release], such as a reduced risk of CVD or the regression of plaque in the arteries. Only 1 cardiologist stated in 1 visit that NER “… will improve your HDL and therefore protect you from having any heart blockages or development of plaque in the arteries.”

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Read the rest of Why a marketing study for Niaspan was published in a medical journal

No comment | Tags: Drugs, Heart | Category: Drugs and pharma

by Edward Pullen, MD

This evening I went to a meeting of many of the independent physicians in our community who came together to discuss ways we can help each other to remain viable as relatively small independent practices of medicine.  Two things about the meeting really hit home for me.

First is how seldom I get to meet socially with my fellow physicians in the community.  Now that many of us use hospitalists to take care of our patients when they need to be hospitalized, we seldom see each other face to face.

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Read the rest of We need a better way to share information to care for patients

1 comment | Tags: Health IT, Patient | Category: Health IT and EMR

by Colin Son, MD

The primary care-specialist pay gap is a popular target for those eager for reform. The gap is hailed independently as an example of and a cause of the lack of focus on primary care and prevention in the United States.

There is no doubt that the United States treats primary care, preventative care and triage much differently than most of the rest of the developed world. The distribution of primary care to specialists, especially procedure based specialists, favors the specialists much more here than in any other health care system, at least that I’m familiar with.

But I’ve expressed serious doubts about how payment reform might reshape the distribution of primary care versus specialists considering the per capita primary care population has grown just as fast that of the specialist, if for no other reason than the ever increasing influx of foreign medical graduates. FMGs who have picked up whatever slack was left by U.S. doctor’s perceived abandonment of primary care. We haven’t lost ground on primary care, in terms of the numbers, as the inequality between the earnings of the general practitioner and the specialist have grown.

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Read the rest of The primary care specialist pay gap shouldn’t be squeezed too hard

8 comments | Tags: Primary care, Specialist | Category: Specialist

by Melanie Lane, MD

I am a medical doctor.  I am also called an allopath, someone who practices “Western medicine.”

We allopaths like data, proof, science, randomized, double-blind, placebo-controlled trials.  We want to know the “mechanism of action.”  We want someone to prove that yoga or medication or some procedure actually helps your depression or blood pressure or back pain and that these treatments are safe before we prescribe them.  We feel more confident about our treatment plan that way, and let’s be honest, we’re less likely to lose a lawsuit if something goes awry.

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Read the rest of Most doctors don’t like prescribing pills

1 comment | Tags: Drugs, Patient, Primary care | Category: Physician practice

There are still about 4.7 million uninsured American children who are eligible for CHIP (Children’s Health Insurance Program) or Medicaid and are not enrolled, says a new report published in the journal Health Affairs. The report estimated about 7.3 million American children were uninsured on an average day in 2008 – of those, 65% of them (4.7 million) were eligible for Medical or CHIP but not enrolled. According to the report, ten states had participation rates either close to or above 90%. 39% of eligible uninsured children live in California, Florida or Texas, while 61% (2…

Many youths appear resistant to treatment from the onset of a severe asthmatic condition. Why? Simply put, many have been wrongly diagnosed or caretakers have not followed asthma treatment guidelines properly. There is no one cure-all for this condition that is a chronic, or long-term lung disease that inflames and narrows the airways…

The number of people in the USA who took one prescription medication in a one month period rose 10% during the decade up to the end of 2008. Americans spent US234.1 billion on prescription medications in 2008, more than double the figure in 1999, according to a report published by the CDC (Centers for Disease Control and Prevention). A prescription drug or medication is one that requires a doctor’s prescription, as opposed to an OTC (over-the-counter) drug, which can be purchased straight from the pharmacy without having to see the doctor first…