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Should Doctors Work Weekends?

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Peter Orszag wants doctors to work weekends. The former director of the White House Office of Management and Budget wrote as much in this past weekend’s New York Times:

Doctors, like most people, don’t love to work weekends, and they probably don’t enjoy being evaluated against their peers. But their industry can no longer afford to protect them from the inevitable. Imagine a drugstore open only five days a week, or a television network that didn’t measure its ratings. Improving the quality of health care and reducing its cost will require that doctors make many changes — but working weekends and consenting to quality management are two clear ones.

And he’s right, to a point.

I’ve pointed to studies showing that mortality rises on the weekends, in part due to skeleton staffs that hospitals employ on Saturday and Sunday. And, since Mr. Orszag is an economist, the cost factor is noted. Tests that get pushed off until Monday cost the health system serious dollars. The problem I have is that Mr. Orszag, like most health reformers, offers doctors little incentive in return. Read more »

*This blog post was originally published at KevinMD.com*

The Quantified Self: Tools For Knowing Your Own Mind And Body

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I’ve been a fan of the Quantified Self project for a long time, and now a TED Talk describing their mission just became available:

*This blog post was originally published at ScienceRoll*

Medical App Improves Healthcare Access In Remote Areas

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A team of student and faculty researchers at MIT have developed an open source software system with the goal of improving healthcare access to patients in remote regions.

The software is called Sana and runs on the Android platform. The app allows healthcare workers in remote clinics to send pictures and videos to a database where they can be reviewed by a physician who is then able to provide a preliminary diagnosis via texting.

Sana is different than other collaborative electronic medical sharing efforts because it allows complex medical imaging, such as X-rays and ultrasound images to be uploaded and analyzed.

Since Sana is open source, it can be customized to a specific regions needs and tailored to specific pathologies that need to be studied. Program developers hope this gives healthcare workers a shared sense of responsibility and promotes a level of sustainability. Read more »

*This blog post was originally published at iMedicalApps*

The Simple Truth About Cholesterol

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The New York Times recently ran a piece that wondered if doctors were treating patients with cholesterol-lowering medication unnecessarily because a web-based calculator over estimated a person’s risk. The program was proudly sponsored by the pharmaceutical roundtable and was available at the American Heart Association.

The implication was obvious. Simple tool determines an individual’s risk for heart attack or death from heart attack. It over estimates risk. Patients treated unnecessarily. To be also clear, the program did underestimate risk as well.

Unfortunately, the article missed an important point. While the simplified calculator may not be as accurate as the more complex algorithm used by the National Cholesterol Education Program, the truth is doctors are likely to be overtreating patients not because the former program is presented by the pharmaceutical roundtable, but for another reason. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Hot Topic: Certification Of ER Doctors

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Texas is at the center of a heated national battle over the training emergency physicians need in order to advertise themselves as “board certified.” Via the Houston Chronicle:

At stake is the welfare of patients requiring immediate medical attention. Leaders of the traditional board say allowing physicians without proper training to advertise themselves as board-certified would mislead the public. Leaders of the alternative board say the proposed rule change will undermine the ability of Texas’ rural hospitals to staff their emergency departments with board-certified ER physicians.

A final verdict may only come, given one board’s already delivered threat, in a court of law.

At stake also are the careers of a lot of practicing Emergency Physicians, many of whom I’m proud to call friends and colleagues. (And it’s not just docs at rural hospitals, they’re in nearly every ED in Texas, and your lesser state).  They practice high quality Emergency Medicine, and I have no qualms about the practice of those who are alternately boarded. Read more »

*This blog post was originally published at GruntDoc*

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