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Do Physicians Prefer Ventilated And Sedated Patients?

You ever wonder what doctors really think but are afraid to say out loud?  Here’s one example:

“I wish all my patients were on a ventilator”

There’s a reason vented and sedated patients are considered desirable.  In addition to the obvious economic benefits of

There are the less talked about, but equally pleasant side effects most hospitalists, ER doctors, cardiologists, gastroenterologists, pulmonologists,  surgeons, infectious disease doctors, endocrinologists, psychiatrists, rheumatologists, dermatologists, nurses, respiratory therapists and physical therapists wouldn’t admit, but would agree, without hesitation.  As a general rule:

  • Patients on ventilators are just faster, easier and more pleasant to take care of. Read more »

*This blog post was originally published at The Happy Hospitalist*

Why Should You Get An HIV Test? National HIV Testing Day

Note: Yesterday President Obama issued a statement on National HIV Testing Day

Thirty years ago, at the beginning of the HIV/AIDS epidemic, there was no test for HIV, the virus that causes AIDS. For many, there was only the long and worrisome wait for the signs of infection. Once those signs appeared, no treatment for the virus was available. I personally cared for many, many patients in this era, and I am thankful that those days are over. Today, HIV testing is accurate, widely available, and often free—and treatment can help people living with HIV enjoy long, healthy lives, especially when they get diagnosed early.

The good news is that more people are being tested for HIV than ever before. It is estimated that almost 83 million American adults between 18 and 64 have been tested for HIV, as of 2009. That’s an increase of more than 11 million from 2006 when the Centers for Disease Control and Prevention (CDC) recommended that HIV testing become a routine part of medical care for adults and adolescents.

However, more than half of American adults still have never taken an HIV test. That’s why we need to spread that message that HIV testing saves lives and why Read more »

*This blog post was originally published at Centers for Disease Control and Prevention (CDC)*

A Rare MRI Finding In Multiple Sclerosis

Gray matter (GM) damage, in terms of focal lesions,1 “diffuse” tissue injury, and atrophy is a well-known feature of multiple sclerosis (MS). Recently, T1-hyperintensity on unenhanced T1-weighted sequences has been found in the dentate nuclei of patients with MS with severe disability and high T2 lesion load.2 Such an abnormality has been interpreted as an additional sign of the neurodegenerative processes known to occur in the course of MS. This report describes a patient who, despite being mildly disabled and having a low T2 lesion load and no evident brain atrophy, showed a bilateral dentate nucleus T1 hyperintensity.

The patient was a 44-year-old man who had a diagnosis of relapsing-remitting MS (RRMS) in September 1997, after 3 relapses that occurred in June 1995, March 1997, and September 1997. Brain and cord MR imaging and CSF examination were suggestive of MS. After the diagnosis, he started treatment with interferonβ-1α, with clinical stability until January 2009, when he complained of vertigo, which gradually resolved after 5 days of steroidtreatment (methylprednisolone, 1 g daily intravenously). In September 2010, he entered a research protocol and underwent neurologic and neuropsychologic (Rao Brief Repeatable Neuropsychological Battery) evaluations and brain MR imaging on a 3T scanner. The neurologic examination showed Read more »

*This blog post was originally published at AJNR Blog*

More Employers Are Dropping Healthcare Insurance Coverage

McKinsey Quarterly has reported its survey concluding there will be a radical restructuring of employer-sponsored health benefits (ESI) as a result of President Obama’s following the 2010 passage of the Affordable Care Act.

Healthcare insurance rates have already skyrocketed as a result of anticipating the conditions of Obama care. President Obama has been powerless to do anything about the increases.

Thirty percent (30%) of companies providing ESI to their employees will drop healthcare insurance coverage once Obama care takes effect in 2014.

The survey included 1300 employers providing ESI across industries, geographies, and employer sizes. Other surveys have found that as we get closer to 2014, President Obama’s Healthcare Reform Act will provoke a much greater number of employers to drop employer sponsored healthcare insurance.

The penalty for not providing healthcare insurance coverage is much cheaper than providing healthcare coverage.

McKinsey’s survey suggests that when more employers become aware of the new economic and social incentives embedded in Obamacare the percentage of employers dropping ESI will Read more »

*This blog post was originally published at Repairing the Healthcare System*

Is Your Cell Phone Carrying Bacteria?

Alright doctors, time to give up the cell phones. (Never mind that there has not been a study linking cell phones and hospital acquired infections).

From the American Journal of Infection Control:

A cross-sectional study was conducted to determine bacterial colonization on the mobile phones (MPs) used by patients, patients’ companions, visitors, and health care workers (HCWs). Significantly higher rates of pathogens (39.6% vs 20.6%, respectively; P = .02) were found in MPs of patients’ (n = 48) versus the HCWs’ (n = 12). There were also more multidrug pathogens in the patents’ MPs including methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Escherichia coli, and Klebsiella spp, high-level aminoglycoside-resistant Enterococcus spp, and carabepenem-resistant Acinetobacter baumanii. Our findings suggest that mobile phones of patients, patients’ companions, and visitors represent higher risk for nosocomial pathogen colonization than those of HCWs. Specific infection control measures may be required for this threat.

What specific measures might they consider?

They better be careful what they wish for or they might also have to take away all those dirty EMR computer keyboards, too.

*This blog post was originally published at Dr. Wes*

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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