February 16th, 2011 by DrWes in Better Health Network, Opinion
Tags: Becker's Hospital Review, Dr. Wes Fisher, Employment Contracts, Healthcare Economics, Hospital Business, Independent Cardiology Groups, Medicine and Money, Opt-Out, Outpatient Cardiology Services, Physician Productivity
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It’s no surprise that hospitals are acquiring cardiology and primary care groups groups in droves lately. It seems there’s a signficant financial incentive to do so for now, but doctors (and especially cardiologists) should read the tea leaves ahead. From Becker’s Hospital Review:
While hospitals are limited to paying fair market value for practices, they can gain an edge over competing hospitals by offering longer employment contract terms or better electronic medical record systems and management services. If hospitals move forward with a transaction, Ms. Kaplan suggests they limit employment contracts to no more than two years if possible and rebase compensation annually based on productivity.
“In healthcare you shouldn’t assume anything is permanent,” says Ms. Kaplan. She cautions that the revenue increases that are currently available to hospitals through expanding outpatient cardiology services may not last forever, which is why she urges hospitals to limit employment contracts and other agreements to only a few years. Doing so will afford an “out” for the hospital if the service line goes from a money-maker to a money pit.
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
February 16th, 2011 by Elaine Schattner, M.D. in Better Health Network, Opinion
Tags: Cigarettes, Difficulty With Speech, Doctor Patient Relationship, Doctor-Patient Communication, Doctor-Patient Trust, Epilepsy, King George VI, King of England, Medical Credentials, Medicine and History, Medicine and Movies, Prince Albert, smoking, Speech Impediment, Speech Therapy, Stuttering, The King's Speech, Tobacco Use
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Over the weekend I went to see “The King’s Speech.” So far the film, featuring Colin Firth as a soon-to-be-king-of-England with a speech impediment, and Geoffrey Rush as his ill-credentialed but trusted speech therapist, has earned top critics’ awards and 12 Oscar nominations. This is a movie that’s hard not to like for one reason or another, at least most of the way through. It uplifts, it draws on history, it depends on solid acting.
What I liked best, though, is the work’s rare depiction of a complex relationship between two imperfect, brave, and dedicated men. At some level, this is a movie about guys who communicate without fixating on cars, football (either kind), or women’s physical features. Great! (Dear Hollywood moguls: Can we have more like this, please?)
The film’s medical aspects are four, at least: The stuttering, the attitude of physicians toward smoking, a closeted sibling who had epilepsy and died at an early age (just mentioned in passing), and the king’s trusted practitioner’s lack of credentials.
At the start, Prince Albert (young King George VI) has a severe speech impediment. It’s said that he stutters, and on film Firth does so in an embarrassingly, seemingly extreme and compromising degree. He’s the second of George V’s sons, and might or might not succeed to the throne depending on events in history, his older brother’s behavior, and his capacity to serve the Empire at the brink of war. Being effective as the king of England in 1936, and especially at the start of war in 1939, entails speaking confidently.
Prince Albert’s been through the mill with doctors who’ve tried to help him talk. Some recommend he smoke cigarettes — these, they advise, would help him to relax because they’re good for the nerves, they say. One asks him to speak with a mouthful of marbles, on which this doctor watching the film worried he might choke. Eventually Albert’s wife, Elizabeth (Queen Mother to be), finds a speech therapist in London, Lionel Logue, who uses unorthodox approaches with, by rumor, exceptional results. Eventually Prince Albert — or “Bertie” as the therapist insists on calling him — trusts and accepts help from this peculiar Australian who, it turns out, developed his methods of assisting stutterers through his work with shell-shocked soldiers in WWI. Read more »
*This blog post was originally published at Medical Lessons*
February 16th, 2011 by Glenn Laffel, M.D., Ph.D. in Better Health Network, Research
Tags: Behavioral Change, Biological Substances, Body Language, Chemical Composition Of Tears, Chemical Signaling, Dr. Glenn Laffel, Drop In Testosterone Levels, Emotional Response, Emotional Tears, Gender Studies, Heart Rate, Male Libido, Men's Response To Women's Tears, Noam Sobel, Pheromones, Physiological Response, Physiology, Pizaazz, Psychological Response, Psychology, Respiratory Rate, Salivary Testosterone, Science Journal, Sexual Arousal, Sexual Health, Skin Temperature, Tears From Eye Irritation, Washington Post, Weizmann Institute, When Women Cry
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Humans are the only living things that cry when they are overcome with emotion. Why do we do this?
A study by Noam Sobel and colleagues at the Weizmann Institute provide part of the answer, at least as it relates to women. The scientists showed that when men get a whiff of women’s tears, they experience a temporary, generalized loss of libido and a dip in testosterone. Really. (And you thought that red, runny nose was the turn off, didn’t you?)
Scientists have known for decades that the chemical composition of “emotional tears” differs from tears shed due to simple irritation. But now, it appears that some of the chemicals contained in the former are actually pheromones; biological substances that create behavioral changes in others who are exposed to them. Such chemicals were known to exist in urine in anogenital gland secretions (dont ask), but not in tears.
Sobel’s team began its study by posting ads on Israeli college campus bulletin boards in which they sought volunteers who cried easily. Seventy-one people responded. All but one were women. From that group, the scientists identified six who were profuse criers and who could return to their labs every other day.
The scientists then asked each one to select a movie that was guaranteed to make them break down, to watch it in private, and to collect their tears in a vial. For the controls, Sobel’s group trickled a saline solution down the same women’s cheeks and collected that. Sobel’s group subsequently asked male volunteers to sniff the contents of the two vials and ran a battery of psychological and physiological tests to measure their responses. Read more »
*This blog post was originally published at Pizaazz*
February 15th, 2011 by Medgadget in Better Health Network, Research
Tags: Artificial Gut, Biotechnology, Combating Obesity, Creating New Foods, Dietetics, Digestion, Digestion Lab, Feel Full With Less Food, Feelings of Satiation, Food and Nutrition, Food Research and Development, Foods That Satisfy, Foods That Trick The Body, Gastrointestinal Phenomenon, Gastrointestional Medicine, Gastrointestional Tract, GI Tract, Human Food Consumption, Hunger Control, Ileal Break, Lausanne, Medgadget, Nestle, Peptidal Feedback System, Reduces Food Intake, Satiety-Inducing Foods, Science and Medicine, Slows Food Transit, Stomach Studies, Switzerland
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What do you do when you’re one of the world’s biggest food companies and you’re looking to explore what happens after your products get chewed and swallowed? Apparently you build a large refrigerator-sized, million dollar model of a human gut, complete with valves, injection ports for enzymes, and a transparent window for visibility, of course.
Nestle, in their quest to create foods that trick your body into feeling even more satisfied after eating than you otherwise would be, has a research and development center that holds this artificial gut, tucked next to the mountains in Lausanne, Switzerland. Here they’re busy studying and trying to commercialize gastrointestinal phenomenon such as the “ileal break,” a peptidal feedback mechanism that both slows transit through the GI system and reduces food intake by triggering feelings of satiation. They hope to release products based on this science within five years.
From the Wall Street Journal:
Tracking the movement of food in a person’s gastrointestinal tract isn’t easy. So at a “digestion lab”—part of Nestle’s sprawling research and development center here—scientists use a million-dollar model of the human gut.
The machine is about the size of a large refrigerator. It has several compartments linked by valves, and it is carefully calibrated to the body’s temperature. The entire setup is controlled by a computer. The front is glass, allowing observers to watch as food travels through the system.
On a recent day, the “stomach” section at the top slowly squeezed and churned a salt solution, just like the real thing. The liquefied result then wended its way down the other tubes, representing other sections of the digestive tract. At each stage, tiny valves released the appropriate salt, bile and enzymes, which helped to digest the food.
The question still stands: What comes out the other end?
The Wall Street Journal article: Hungry? Your Stomach Really Does Have a Mind of Its Own…
*This blog post was originally published at Medgadget*
February 15th, 2011 by RyanDuBosar in Better Health Network, Research
Tags: ACP, Agency for Healthcare Research and Quality, Ambulatory Care, Ambulatory Visits, American College Of Physicians, Cost of Medical Care, Government Statistics, Inpatient Visits, Kidney Disease, Medicare Payments, National Healthcare Costs, Renal Disease, Ryan DuBosar
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Medical spending to treat kidney disease totaled on average $25.3 billion annually from 2003 to 2007 (in 2007 dollars). Almost half of the expenditures ($12.7 billion) were spent on ambulatory visits.
On average, 3.7 million adults (1.7 percent of the population) annually reported getting treatment for kidney disease, reports a statistical brief from the Agency for Healthcare Research and Quality. During 2003-2007, for those ages 18 to 64, more than half of the total kidney disease expenditures were from ambulatory visits (53.1 percent) compared with about one third (30.3 percent) from inpatient visits. Among those age 65 and older, ambulatory visits accounted for 46 percent of the total kidney disease expenditures and hospital stays were 43 percent.
Similar amounts were spent on prescription medicines ($1.4 billion) and emergency room visits ($1.5 billion). Hospital stays amounted to $9.1 billion. Medicare paid 40 percent of the total expenditures to treat kidney disease.
*This blog post was originally published at ACP Internist*
