Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Are Patients Charging Their Doctors For Time In The Waiting Room?

Patients are starting to bill doctors for making them wait, reports CNN.

“When he keeps patients waiting more than 15 minutes, Dr. Timothy Malia, a primary care physician in Fairport, New York, hands them a $5 bill. If patients in Eugene, Oregon, wait more than 10 minutes to see Dr. Pamela Wible, they receive a handmade soap or a bottle of lotion. When Dr. Cyrus Peikari, an internist in Dallas, recently had to miss a day of work because of a family emergency, he gave the patients whose appointments he canceled $50 at their next appointment.”

I’ve been kept waiting at doctors’ offices. I’ve been kept waiting as pharma reps walked past a full waiting room bearing plates of food. But I’ve also been kept waiting as doctors have handled other patients, undoubtedly more complex cases than mine.

Practice administrator and blogger Brandon Betancourt sums up the point nicely, and further extends the idea to every delay faced in life, such as toll booths on turpikes tied up with traffic.

I’ve also been squeezed into the schedule for emergency appointments, undoubtedly making someone else wait. And I’ve also been treated by phone on nights, weekends and holidays, and I’m not so sure that my primary care physician gets reimbursed for that.

So, kudos to those few physicians who respect their patients’ busy schedules enough to reward them. But I’m Read more »

*This blog post was originally published at ACP Internist*

E-prescribing Has Similar Error Rate To Hand-Written Prescriptions

About 10% of computer-generated prescriptions included at least one error, of which a third had potential for harm, researchers reported in the Journal of the American Medical Informatics Association.

This errors rate matched that of handwritten prescriptions, deflating at least one reason for the federal government’s incentives to switch providers to e-prescribing. The government had provided incentives for switching to e-prescribing; those turned to penalties for not doing so on July 30.

Researchers conducted a retrospective cohort study of 3,850 e-prescriptions received by a commercial outpatient pharmacy chain across three states over four weeks in 2008. A panel reviewed them for medication errors, potential adverse drug events, and rate of prescribing errors by type and by prescribing system. Read more »

*This blog post was originally published at ACP Internist*

Are The Benefits Of Smoking Cessation Eclipsed By Obesity?

Epidemic by Tobyotter via Flickr and a Creative Commons license

Obesity is filling in for smoking as a cause of death in working class women, concluded researchers after reviewing mortality rates from a nearly 30-year study in Scotland.

In Europe, wealthier people either aren’t starting to smoke or are finding it easier to quit, which accounts for up to 85% of the observed differences in mortality between population groups, researchers noted.

Their analysis showed higher rates of being overweight or obese among those who’d never smoked in all occupational classes, with the highest rates in women from lower occupational classes. Almost 70% of the women in the lower occupational classes who had never smoked were overweight or obese, and severe obesity was seven times more prevalent than among smokers in higher social positions. Among women who had never smoked, lower social position was associated with higher mortality rates from cardiovascular disease but not cancer.

To investigate the relations between causes of death, social position and obesity in women who had never smoked, Scottish researchers conducted a prospective cohort study. They drew from the Renfrew and Paisley Study, a long term prospective community based cohort named for two neighboring towns in west central Scotland from which all residents then aged between 45 and 64 were invited to participate from 1972 to 1976.

Researchers reported their results online Read more »

*This blog post was originally published at ACP Internist*

Prescription Opiate Abuse On The Rise

Prescription opiates rose to one-third of all treatment admissions in 2009, from 8% in 1999, reflecting the rising trends in prescription opiate abuse. There were nearly 2 million substance abuse treatment admissions in 2009 among people ages 12 and older were reported to the Treatment Episode Data Set, a reporting system involving treatment facilities from across the country.

Five substance groups accounted for 96% of admissions: alcohol (42%), opiates (21%), marijuana (18%), cocaine (9%), and methamphetamine/amphetamines (6%), reported the Substance Abuse and Mental Health Services Administration. The data came from 49 states and Puerto Rico. Georgia and the District of Columbia did not report admissions for 2009. One person can be reported as multiple admissions in a year.

Read more »

*This blog post was originally published at ACP Internist*

Loss Of Consciousness From Vigorous Laughter: A Case Series

Laughter is the best medicine, and now, here’s the best medicine to treat laughter. Fainting from laughter happens, albeit rarely, and is probably a vasovagal response, reports a case series in the medical literature.

Dubbed “Sitcom Syncope,” the series of three patients and a literature review of other cases evaluated patients who reported loss of consciousness during vigorous laughter. The series was reported by Prashan H. Thiagarajah, MD, an ACP Associate Member at the Allegheny General Hospital in Pittsburgh, Pa., and colleagues in Postgraduate Medicine.

The three patients reported seven fainting spells induced by vigorous laughter that were witnessed friends or family.

All patients were hospitalized and underwent a complete history and physical, 12-lead echocardiogram, chest radiograph, routine blood analysis, transthoracic echocardiography, Holter monitoring, carotid duplex study, stress testing, polysomnography, and head-up tilt table testing. In each cases, structural heart disease and cerebrovascular disease were ruled out. Read more »

*This blog post was originally published at ACP Internist*

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…

Read more »

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…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

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…

Read more »

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…

Read more »

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…

Read more »

See all book reviews »

Commented - Most Popular Articles