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When Less Is More: How To Improve The Quality Of Primary Care

On the NPR Shots blog, Scott Hensley writes, “Quality Prescription For Primary Care Doctors: Do Less,” about an article in the Archives of Internal Medicine. Excerpt:

“A group of docs who want to improve the quality and cost-effectiveness of primary care tinkered with some Top 5 lists for of dos and don’ts for pediatricians, family doctors and internists.

After testing them a bit, they published online by the Archives of Internal Medicine. Most of the advice falls in the category of less is more.

So what should family doctors not be doing? The Top 5 list for them goes like this:

1. No MRI or other imaging tests for low back pain, unless it has persisted longer than six weeks or there are red flags, such as neurological problems.
2. No antibiotics for mild to moderate sinusitis, unless it has lasted a week or longer. Or the condition worsens after first getting better.
3. No annual electrocardiograms for low-risk patients without cardiac symptoms.
4. No Pap tests in patients under 21, or women who’ve had hysterectomies for non-malignant disease.
5. No bone scans for women under 65 or men under 70, unless they have specific risk factors.”

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Brain Imaging Shows Overlap Between Emotional Pain And Physical Pain

Heart-ache can be a literal thing, as well as a metaphor for all those weepy, jilted-lover torch songs.

Consensus thinking in the peer-review literature is that the parts of one’s brain responsible for physical pain, the dorsal anterior cingulate and anterior insula, also underlie emotional pain.

Researchers at Columbia University in New York recruited 40 people who’d recently ended a romantic relationship, put them in a functional magnetic resonance imaging machine, and recorded their reactions to physical and then emotional pain.

Physical pain was created by heating the person’s left forearm, compared to having the arm merely warmed. Emotional pain was created by looking at pictures of the former partner and remembering the breakup, compared to when looking at a photo of a friend.

The fMRI scans showed physical and emotional pain overlapped in the dorsal anterior cingulate and anterior insula, with overlapping increases in thalamus and right parietal opercular/insular cortex in the right side of the brain (opposite to the left arm).

The theory is that Read more »

*This blog post was originally published at ACP Internist*

Top Health Quotes of the Week

The combined profits of the Fortune 500 increased by 81% this year, the third largest gain in history. Compare that to the unemployment rate, which fell by just 8% over the past 12 months.” Ezra Klein, while analyzing last week’s jobs report by the Federal Government.

erictopol Top Quotes of the WeekWhy would I listen to ‘lub dub’ when I can see everything?” Eric Topol, a cardiologist in San Diego who carries a portable ultrasound device with him in lieu of a stethoscope. The device lets him and his patient see the heart muscle and valves, and blood flow into and out of the organ.

There probably is not a whole lot that we can do at the pipeline level to dramatically improve the number of students choosing primary care. Where the money is, is where the money is.” Mark Schwartz, an associate professor at the NYU School of Medicine, discussing a study showing that high medical school debt and low compensation are driving people away from General Internal Medicine.

It sounds like a new Apple product.” Bara Vada, describing IPAB, the Independent Payment Advisory Board, a controversial panel tasked by the Affordable Care Act to make binding recommendations to reduce Medicare spending. Read more »

*This blog post was originally published at Pizaazz*

Three Good Reasons For Healthcare Professionals To Use Social Networks

Social networking allows doctors, nurses and other health professionals to deeply connect and engage with the community and their colleagues.

“We are standing at the precipice of a new online revolution in health care. As more and more health experts embrace the Internet and increase their social media activity, health information seekers will undoubtedly benefit in profound ways.” [Source: Mashable]

Dynamic health and medical professionals engaged in social networking, using Twitter, Facebook, Blogs and YouTube are on the front-line of new modern medicine.

Today’s modern medicine is all about the patientParticipating, partnering and developing a professional relationship is paramount.

While many health consumers are searching the web for support, reassurance and specific health news and information; doctors and nurses continue to question the value of the internet for patients.

Social networking sites such as Twitter, Facebook, and Blogs are not a waste of time for health professionals because it offers value.

Social networking sites and blogs are a powerful and phenomenal platform to educate patients, raise awareness of health issues and it offers a forum to collaborate and connect.  It gives a voice to patients and it allows for the conversation to get started with their doctors and other health care professionals.

Doctors, nurses and other health professionals can help validate what is important for patients.

3 reasons why social networking is not a waste of time Read more »

*This blog post was originally published at Health in 30*

iPhone App Can Substitute For Expensive Pulse Oximeter

The Electrical and Computer Engineering in Medicine (ECEM) research group in collaboration with the Pediatric Anesthesia Research Team (PART) at the University of British Columbia have developed a mobile solution to measuring key vital signs — called the “Phone Oximeter”.

The Phone Oximeter uses a traditional FDA approved pulse oximetry sensor, but researchers have modified it to interface with a phone, in this case, your iPhone. Currently the setup is being interfaced with an iPhone for trial studies, but is compatible with Android, and other mobile operating systems.

What makes the Phone Oximeter special is its ability to capture SpO2 (blood oxygen saturation), heart rate, and respiratory rate — then dynamically comprehend the variables using the decision support software, giving medical staff or even laymen individuals key help in making decisions on medical care.

So how would a device like this be useful in the medical setting? Read more »

*This blog post was originally published at iMedicalApps*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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