October 3rd, 2011 by DrWes in Health Policy, Opinion
No Comments »
I had a patient with non-valvular atrial flutter denied dabigatran (Pradaxa®) by their insurer recently. The patient had diabetes, hypertension and has had a heck of a time maintaining therapeutic blood thinning levels (prothrombin times).
But those are the rules, you see. Only patients with non-rheumatic atrial fibrillation can get dabigatran, I was told. Dabigatran was never approved for atrial flutter, only atrial fibrillation. Never mind the stroke risk in non-rheumatic atrial flutter, like atrial fibrillation, has been found to be significant.
For my patient, dabigatran would have been the perfect solution.
But increasingly I’m finding the patient is not mine, they’re Read more »
*This blog post was originally published at Dr. Wes*
September 28th, 2011 by Emergiblog in News, Opinion
No Comments »
You know me.
I’m all over anything that is from the BBC.
But this is different.
There is no TARDIS. And there are nurses along with the doctor. Lots of nurses.
And the only people flying through time and space are the trauma patients before they hit the bus or the ground.
24 Hours in the ER premiered last night on BBC America. I received a copy of the first two episodes from BBC America unedited for American television. Of course in Great Britian, this was called “24 Hours in A&E”.
On a personal level, I like it. It reminds me of the old “Trauma in the ER”.
On a professional level, Read more »
*This blog post was originally published at Emergiblog*
August 31st, 2011 by Bryan Vartabedian, M.D. in Opinion, True Stories
No Comments »
Sometime around 1998 in the Texas Medical Center:
DrV: (enters exam room) Hey, How are you? I’m Bryan Vartabedian (extends hand).
Father: (arms crossed, smiling, leaning against wall) Oh I know who you are, Doc. And I know where you went to school, where you’ve lived, if you’ve been sued and a few other things. And I’m fine, by the way.
DrV: Um, Okay. (Shakes hands with father. Looking to child, scruffing his hair). And this must be Caleb.
An odd moment, for sure. When it happened I didn’t know what it was about. After similar encounters I understood. It was about where patients found themselves in the early days of the information revolution. And there was the father who wheeled into the exam room two large boxes of printouts perched on a dolly. Inkjet validation of his role in the decision about his son’s surgery.
These situations illustrate Read more »
*This blog post was originally published at 33 Charts*
August 15th, 2011 by Berci in Opinion
No Comments »
Recently, I’ve had an interview with a national newspaper and the woman who performed the interview told me she was surprised that I seemed to be the first doctor in her life who was happy about patients using the internet. Well, she surprised me with this statement as I’ve never thought about that before. But she must be right. There are many doctors who get upset when they find out the patient tried to find information online. They are frustrated as they don’t even know how to use these online tools and have no idea how to help the patients in this perspective.
Myself, I’m pretty much happy about it. I love to hear patients Read more »
*This blog post was originally published at ScienceRoll*
July 26th, 2011 by Bryan Vartabedian, M.D. in Opinion
No Comments »
I can’t help but think that as time passes we’ll forget about how much medicine has changed with the introduction of the Internet. We’re witnessing a transition that hasn’t been seen in generations. We live with the end result but the memory of how we got here is fading quickly. Like any kind of cultural shift, once we’ve arrived it’s hard to remember what it was like along the way.
How did patients think before the information revolution? And how did it go down when patients began to search? How specifically did information clash with the old model of doctor and patient and how did we deal with it? There are stories here that need to be told. I think the real stories are in the small details of what went down between doctors and patients. But as early adopters, most of us spend our time looking forward, not back. Read more »
*This blog post was originally published at 33 Charts*
