January 21st, 2010 by KevinMD in Better Health Network, Health Policy, Opinion
Tags: Administrative Burden, Disrespect, Family Medicine, Internal Medicine, Low Pay, Primary Care, Primary Care Shortage
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It’s no secret that without a stronger primary care foundation, the current reform efforts are unlikely to be successful. If anything, it will only delay the inevitable.
I wrote last month that one discussed solution, adding more residency slots, won’t help: it would simply perpetuate the disproportionate specialist:primary care ratio.
A recent op-ed in The New York Times expands on that theme. The authors suggest that not only does primary care need to be promoted, specialist slots should be limited. Simply building more medical schools, or adding more residency slots, without such restrictions will only add to the number of specialists.
Already, many primary care residency slots go unfilled – what’s the point of adding more?
You have to solve the root cause that shifts more students away from primary care: disproportionately low pay, disrespect that starts early in medical training, and poor working conditions where bureaucracy interferes with the doctor-patient relationship.
Until each of those issues are addressed, simply more spending money to produce more doctors simply isn’t going to work.
*This blog post was originally published at KevinMD.com*
January 21st, 2010 by Medgadget in Better Health Network, Research
Tags: Drop-Down Menus, Google, Men and Women, Psychology, Technology, The Way We Think, What We Think About
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A post on Dan Ariely’s Predictably Irrational draws our attention to Google as a source of data for all sorts of research into human emotions. Dan Ariely, the James B. Duke Professor of Behavioral Economics at Duke University, believes that by using drop down suggestions in Google, we can gain insights into “what people might care the most about concerning a given topic. Read more »
*This blog post was originally published at Medgadget*
January 21st, 2010 by Steve Novella, M.D. in Better Health Network, Research
Tags: Ban, Behavior, Hypertension, Low-Salt Diet, New York, Nutrition, Primary Care, Salt, Science, Sodium
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The problem with the Western diet is not one of deficiency, but one of excess. We get too much of a good thing – too many calories, too much of the wrong kind of fat, and too much salt. As a result obesity, diabetes, and hypertension are growing health problems.
There also does not appear to be an easy solution – voluntary diets founded primarily on will power are notoriously ineffective in the long term. Add to that is the marketplace of misinformation that makes it challenging for the average person to even know where to apply their (largely ineffective) will power.
It can be argued that this is partly a failure, or an unintended consequence, of market forces. Food products that provide cheap calories and are tasty (sweet, fatty, or salty) sell well and provide market incentives to sell such products. Consumers then get spoiled by the cheap abundance of tempting foods, even to the point that our perspective on appropriate portion sizes have been super-sized. Read more »
*This blog post was originally published at Science-Based Medicine*
January 20th, 2010 by JessicaBerthold in Better Health Network, News, Research
Tags: Emergency Medicine, Hospital, Mortality Rate, Neurology, Stroke, tPA, Weekend, Weekend Effect
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In early 2008, researchers at the International Stroke conference unveiled two studies showing a “weekend effect” in stroke– ie, mortality from stroke was higher on the weekends (and at night) than weekdays. We explored this topic in the June 2008 ACP Hospitalist.
Now, a new Archives of Neurology study has found no difference in stroke death rates based on weekend/weekday arrival. What’s more, stroke patients admitted on weekends were more likely to get tPA. This flies in the face of one of the main theories about the weekend effect–namely, that stroke rates may be higher on weekends because there is often a shortage of staff and resources, which leads to less aggressive treatment. Read more »
*This blog post was originally published at ACP Hospitalist*
January 20th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Health Policy
Tags: Communications, Doctor Patient Relationship, HIPAA, Merck, Mexico, Privacy, Social Media, Technology
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This picture from 3G Doctor is remarkable. It captures the flier of a Merck supported Mexican Medmobile initiative that apparently connects patients with their doctors via SMS (translation available on 3G Doctor Blog.)
But don’t expect fliers of this type in American offices anytime soon. Risk of privacy violation and difficulty in documentation stifle this level of
doctor-patient connectivity. The very laws created to protect patients may ultimately thwart the timely adoption of new communication channels.
And the slow march towards a single payer system will only make real connectivity a rare bird.
Look to the groundswell in mobile technology and social platforms will force change in our current privacy laws. Until then look for innovation to come from the second and third world.
*This blog post was originally published at 33 Charts*
