July 5th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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Emergency physicians are in a dilemma. Risk missing a diagnosis and be sued, or be criticized for overtesting.
Regular readers of this blog, along with many other physicians’ blogs, are familiar with the difficult choices facing doctors in the emergency department.
The Associated Press, continuing its excellent series on overtesting, discusses how lawsuit fears is a leading driver of unnecessary tests. Consider chest pain, one of the most common presenting symptoms in the ER:
Patients with suspected heart attacks often get the range of what the ER offers, from multiple blood tests that can quickly add up in cost, to X-rays and EKGs, to costly CT scans, which are becoming routine in some hospital ERs for diagnosing heart attacks …
… and the battery of testing may be paying off: A few decades ago insurance statistics showed that about 5 percent of heart attacks were missed in the emergency room. Now it’s well under 1 percent, said Dr. Robert Bitterman, head of the American College of Emergency Physicians’ medical-legal committee.
“But you still get sued if you miss them,” Bitterman added.
The American Medical Association’s idea of providing malpractice protection if doctors follow standardized, evidence-based guidelines makes sense in these cases. Furthermore, it can also help reduce the significant practice variation that health reformers continually focus on. Read more »
*This blog post was originally published at KevinMD.com*
June 30th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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Medical schools are traditionally ranked on criteria like research funding and technological innovation. These rankings are highly significant. A place on the U.S. News‘ annual “Best Medical School” list is a coveted spot indeed.
So that’s why there was some media attention paid to a recent study from the Annals of Internal Medicine, which ranked medical schools according to their “social mission” — a phrase that defines a school’s commitment to primary care, underserved populations and workforce diversity. Using this new criterion, some of the traditionally high ranking schools fell significantly. Read more »
*This blog post was originally published at KevinMD.com*
June 26th, 2010 by KevinMD in Better Health Network, Health Policy, Health Tips, Opinion, Research
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It’s time to ask patients whether they text and drive. An important perspective piece from the New England Journal of Medicine urges doctors to include that question during preventive health exams. The data surrounding texting and driving is grim:
Although there are many possible distractions for drivers, more than 275 million Americans own cell phones, and 81% of them talk on those phones while driving. The adverse consequences have reached epidemic proportions. Current data suggest that each year, at least 1.6 million traffic accidents (28% of all crashes) in the United States are caused by drivers talking on cell phones or texting. Talking on the phone causes many more accidents than texting, simply because millions more drivers talk than text; moreover, using a hands-free device does not make talking on the phone any safer.
The author of the piece, Amy Ship from Boston’s Beth Israel Deaconess Hospital, says that doctors should update traditional preventive questions to keep up with the times. The simple question, “Do you text while you drive?” is a way to start this important conversation. Read more »
*This blog post was originally published at KevinMD.com*
June 23rd, 2010 by KevinMD in Better Health Network, Health Tips, Opinion, Research
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Do doctors take care of themselves? Sometimes patients may better follow the advice of physicians who aren’t obese and don’t smoke. That was a question asked in a post last year, entitled “When fat doctors talk to obese patients.”
According to studies, as reported in the Wall Street Journal, it’s a mixed bag:
Physicians as a group are leaner, fitter and live longer than average Americans. Male physicians keep their cholesterol and blood pressure lower. Women doctors are more likely to use hormone-replacement therapy than their patients. Doctors are also less likely to have their own primary care physician—and more apt to abuse prescription drugs.
Clearly there’s room for improvement. Read more »
*This blog post was originally published at KevinMD.com*
June 21st, 2010 by KevinMD in Better Health Network, Health Policy, Health Tips, News, Opinion
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Should you friend your doctor on Facebook? It’s a question that’s gaining increasing relevance as Facebook increases its social networking dominance. I’ve touched upon the issue in the past. So has the New England Journal of Medicine.
Washington, DC, physician Katherine Chretian gives her take on the issue in a recent USA Today op-ed. She is an expert of the Facebook-medicine intersection, having authored a JAMA study on the issue.
She says, no, doctors should not be friending their patients:
Having a so-called dual relationship with a patient — that is, a financial, social or professional relationship in addition to the therapeutic relationship — can lead to serious ethical issues and potentially impair professional judgment. We need professional boundaries to do our job well.
Furthermore, there’s the little matter of patient privacy and HIPAA. I wasn’t aware of this, but simply becoming Facebook friends with patients can infringe upon uncertain ground. Read more »
*This blog post was originally published at KevinMD.com*
