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Physicians As Conversation Agents In New Media

I frequently talk about the visibility of doctors in the online space. How can doctors make content, contribute to the broader dialog, and be more visible? Maybe I need to spend less time pushing the idea that every doctor needs to create. Most doctors, after all, just want to listen and watch. Maybe we need to be cultivating dedicated communicators.

There’s a role evolving where physicians are formally involved in the creation of content and the maintenance of dialog. Wendy Swanson at Seattle Children’s Hospital and Claire McCarthy at Boston Children’s Hospital come to mind as good examples. Both serve as models for how institutions can leverage the voice of an individual for a branded online identity while contributing to the common good. Both are evolving as conversation agents on social platforms and IRL. Call them medical conversation agents of new media. Read more »

*This blog post was originally published at 33 Charts*

WebMD Worries That Possible Misinformation On Their Website Will Result In Legal Action

More and more patients these days are seeing their physician pull out an iPhone or iPad to look up drug dosing information, review lab and radiology data, or help teach them more about their medical condition. And as developers, and the increasing number of physician-developers, continue to find more creative ways to bring medical resources to the point of care, we can certainly expect smartphone platforms and medical apps to become pervasive at the bedside. However, just as healthcare providers and patients are noticing this trend, there are number of others who are paying attention as well – for WebMD, one of the largest companies in this industry, it is the lawyers who may be watching that are worrisome.

As they put it in their annual statement to the SEC,

If our content, or content we obtain from third parties, contains inaccuracies, it is possible that consumers, employees, health plan members or others may sue us for various causes of action.

We’ve talked in the past about potential liability issues for healthcare providers using medical apps and the developers who produce them, as well as similar issues related to electronic health records. The fact that WebMD found the issue significant enough to report it to the SEC and their investors clearly indicates the issue is still unresolved and the remainder of their statement adds some further interesting perspective. Read more »

*This blog post was originally published at iMedicalApps*

Collaborative Care Can Decrease Mental Health Costs


I briefly scanned the Robert Wood Johnson synthesis report on mental and medical co-morbidity so I thought I’d summarize the highlights for the blog. If you’d rather watch the recorded web seminar you can hear it here.

The report relied on systemic literature review to look at the relative risk and mortality associated with co-morbid medical and mental health conditions. The looked at studies using structure clinical interviews, self-report, screening instruments and health care utilization data (diagnostic codes reported to Medicaid).

This is what they found:

  • 68 percent of adults with a mental disorder had at least one general medical condition, and 29 percent of those with a medical disorder had a comorbid mental health condition
  • These findings support the conclusion that there should be strong integration of medical and mental health care Read more »

*This blog post was originally published at Shrink Rap*

Should Home Allergy Shots Be Permitted?

DISCLAIMER: This post is not meant to condone or promote allergy shots to be given at home. It is meant to promote discussion and make patients aware of the issues involved.
Allergy shots, unlike medications like claritin and flonase, offer patients with significant allergies a way to potentially be cured of their misery without the need for daily medication use. However, there is a small, but substantial risk for anaphylaxis and even death with allergy shot administration. After all, a patient is being injected with the very substances that cause their allergies. As such, many allergists will allow allergy shots to be administered ONLY within a medical setting. Also, the American Academy of Allergy Asthma and Immunology (AAAAI) specifically forbids allergy shots to be administered at home.

Furthermore, the allergen extracts used to make the allergy vial serum used for allergy shots carry a black box warning on the medication package insert: Read more »

*This blog post was originally published at Fauquier ENT Blog*

New Drug Warnings For Breastfeeding Mothers

Periodically, the FDA publishes drug warnings that should be shared with the public, especially if it affects pregnant women. Each year, over 4 million babies are born in the US and 43% will continue to be breast fed at 6 months. All of these moms will invariably use meds at some point after birth, so which meds are helpful and which are potentially harmful? These questions may now be answered by the Infant Risk Center, at the Texas Tech University Health Center, in Amarillo, Texas. This center provides up-to-date information regarding the safety of medications that are taken both during pregnancy and after birth.

Most drugs enter breast milk immediately after birth and during the first 4 to 10 days of life at a fairly fast rate based on the physiology of breast cells. New moms must therefore be careful of pain medications that are prescribed during the post partum period. Hydrocodone aka Vicodin is a potentially addictive opiate that is given for pain management. When it is processed by the body, it breaks down into a component called hydromorphone that is even more potent. The University of California at San Diego Medical Center performed a small study to determine how much of the drug is secreted into breast milk and what percentage is absorbed by newborns. 3 to 4% of hydromorphone was found in breast milk which is considered safe. As a rule of thumb, nonopioid medication should be prescribed first during the post partum period for pain relief. If the pain persists, no more than 6 Vicodin (hydrocodone) tablets or 30 mg should be prescribed in one day. Dosages greater than 40 mg should be avoided and the newborn should be monitored carefully for depressed behavior or inadequate breastfeeding.

Recently the FDA sent a drug warning to healthcare providers regarding the risks associated with the entire class of antipsychotic medications such as Haldol, Risperdal®, Risperdal® Consta®, Invega® and Invega®Sustenna, Clozaril, Zyprexa, Seroquel, Abilify, and Geodon. These medications are used to treat schizophrenia and bipolar disorders but are associated with abnormal muscle movements and withdrawal symptoms of newborns whose mothers took these medications during the third trimester. However it is recommended that patients should not abruptly stop taking these medications without speaking with their healthcare professional first. For further information, readers may go to the FDA website http://www.fda.gov/Drugs/Drug Safety/ucm243903.htm.

Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.

*This blog post was originally published at Dr. Linda Burke-Galloway*

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