October 1st, 2009 by Peter Lipson, M.D. in Better Health Network, Opinion, Quackery Exposed
Tags: Alternative Medicine, Bayes Theorem, Complementary And Alternative Medicine, Depression, Fibromyalgia, Placebo, Plausibility, Reproduceability, Research, Statistics
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One of the common themes regarding alternative medicine is the reversal of normal scientific thinking. In science, we must generally accept that we will fail to validate many of our hypotheses. Each of these failures moves us closer to the truth. In alternative medicine, hypotheses function more as fixed beliefs, and there is no study that can invalidate them. No matter how many times a hypothesis fails, the worst that happens is a call for more research.
Sometimes this is the sinister and cynical intent of an alternative practitioner—refuse to let go of a belief or risk having to learn real medicine. Often, though, there are flaws in our way of thinking about data that interfere with our ability to understand them.
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September 30th, 2009 by Happy Hospitalist in Better Health Network, Primary Care Wednesdays
Tags: Acid, Base, Blood Gas, Blood Gasses, Blood Test, Internal Medicine, Interpretation, Metabolic Alkalosis, Test
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To be a great internist you have to be great at blood gas interpretation. And you have to be able to do it quickly and efficiently. You have to understand what all the numbers mean and you have to get a good clinical sense of how to interpret them and how to change management based on their result. And you have to be able to do it without pulling out your formula books. In six years as a hospitalist I have never calculated what the compensatory responses should be. I just know.
Sometimes blood gases change your management or your medical opinion on what’s happening. Take for example my patient with advanced MS. She presented through the emergency department with “oropharyngeal bleeding of unclear etiology”. Her original BMP:
Na 137
K 4.0
CL 99
HCO3 36
BUN 35
CR 1.0
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*This blog post was originally published at A Happy Hospitalist*
September 30th, 2009 by Toni Brayer, M.D. in Better Health Network, Health Tips
Tags: Britain, Canada, France, Germany, Healthcare reform, Healthcare System, Japan, Models, Primary Care, Scandinavia
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I heard an interview with T.R.Reid and can’t wait to read his book The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. He traveled the world and compared how developed countries manage health care. He makes the point that all other developed countries have universal coverage. No-one is left out.
He found four basic systems (some named after their founders):
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*This blog post was originally published at EverythingHealth*
September 30th, 2009 by DrWes in Better Health Network, Health Policy, Opinion
Tags: Cardiology, CMS, Healthcare reform, Medicare, Payment Reform, Primary Care, Private Practice, Quality
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It’s the holy grail of physician payment reform: ending fee-for-service payments to doctors and, instead, pay doctors based on the quality of care they perform. Remarkably, Congress feels they’ve found the answer:
Thus, the new language in the Senate Finance bill would finally connect Medicare reimbursements to quality, as opposed to volume.
The measure gives the secretary of Health and Human Services, working with the Centers for Medicare and Medicaid Services, the power to develop quality measurements and a payment structure that would be based on quality of care relative to the cost of care. The secretary would have to account for variables that include geographic variations, demographic characteristics of a region, and the baseline health status of a given provider’s Medicare beneficiaries.
The secretary would also be required to account for special conditions of providers in rural and underserved communities.
Additionally, the quality assessments would be done on a group-practice level, as opposed to a statewide level. Thus, the amendment would reward physicians who deliver quality health care even if they are in a relatively low quality region.
The secretary of Health and Human Services would begin to implement the new payment structure in 2015. By 2017, all physician payments would need to be based on quality.
Wow. That sounds great! But there’s just one problem…
… how do we define “quality?”
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*This blog post was originally published at Dr. Wes*
September 29th, 2009 by David Kroll, Ph.D. in Better Health Network, News
Tags: Cash-Strapped Universities, Education, Retired Professors, Science, Teaching, Volunteerism
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As state university systems are making budget cuts and furloughing professors while have to expand course sections to meet burgeoning enrollment, one solution may be to tap the expertise of retired professors in the area.
The Research Triangle area of North Carolina, home to over a dozen colleges and universities, is also home to at least 600 retired professors.
This morning, Eric Ferreri of the Raleigh News & Observer, one of the best higher-ed reporters in the biz, reports on the offers from very accomplished profs who want to give back to their community and the relative lack of response from the big universities:
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