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“Social Mission”: A Primary Care Score For Medical Schools

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Medical schools are traditionally ranked on criteria like research funding and technological innovation. These rankings are highly significant. A place on the U.S. News‘ annual “Best Medical School” list  is a coveted spot indeed.

So that’s why there was some media attention paid to a recent study from the Annals of Internal Medicine, which ranked medical schools according to their “social mission” — a phrase that defines a school’s commitment to primary care, underserved populations and workforce diversity. Using this new criterion, some of the traditionally high ranking schools fell significantly. Read more »

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

The Male Menopause Story: Journalists All Over The Map

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An article on the Knight Science Journalism Tracker comments on German media coverage of the “Is there male menopause?” question. An excerpt:

One study, but very different types of headlines: “‘Male Menopause’ discovered” and “Men have no Menopause.” Both types of headlines are based on one study published in the New England Journal of Medicine, which analyzed 3219 European males between 40 and 79. Blood samples provided testosterone levels and questionnaires (!) asked about the “general, sexual, physical, and psychological health.”

What the scientists found was nothing more and nothing less than a correlation between a low testosterone level and three clinical symptoms (“decreased frequency of morning erection, decreased frequency of sexual thoughts, and erectile dysfunction”). So, one could call it an age-related testosterone deficiency, affecting only a minority (about 2%) of elderly men.

But one shouldn’t name it “andropause” or “male menopause” — and the scientists themselves did NOT use the term in the whole article — because this term immediately suggests a relation to menopause, which is a completely different and natural developmental phenomenon for every woman above the age of 50. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

University Hospitals And The “3-For-1” Doctor Swap

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As doctors increasingly become physician-employees, there’s no longer a need to share resources with university specialists:

Three University of Virginia cardiologists have been told by the Augusta Health board they will lose their hospital privileges next week, impacting the 2,500 patients the doctors serve.

Augusta Health officials [Crow] told the doctors in a letter that they won’t be able to treat their patients in emergencies or otherwise at the hospital in Fishersville. Crow’s statement said the board is limiting cardiology department participation to doctors “under contract to Augusta Health.”

Augusta Health has four cardiologists on staff, and will soon have a fifth, he said. Limiting cardiology participation to the hospital’s own doctors will allow Augusta Health “to build a strong and financially viable community-based cardiology program,” Crow said.

Universities have a long history of exporting their clinical expertise in the hopes of capturing more complicated surgical cases from their imbedded specialists. With more and more health systems consolidating (note the 3-for-1 swap above), the days of collaboration and shared resources between health systems are ending and patients are finding access to doctors more challenging.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Medicaid In A Squeeze

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New reports peg Medicaid’s future as dismal and unsustainable, as states struggle for ways to pay for the rising costs of caring for their poorest residents. The Deloitte Center for Health Solutions study, “Medicaid Long-Term Care: The Ticking Time Bomb,” estimates Medicaid costs will nearly double as a percentage of state budgets by 2030, or perhaps nearly triple.

Meanwhile, the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured estimates Medicaid expansion will cost $464.7 billion by 2019. The federal government will cover $443.5 billion (95.4 percent) and the states will cover the remaining $21.2 billion. Minnesota won’t expand its Medicaid program until 2014 because of budget fears. Connecticut will. (The Fiscal Times, MedPage Today, Reuters, U.S. House Rep. John B. Larson)

U.S. Senators, meanwhile, are looking to phase out federal subsidies Medicaid as a way of pushing through stalled legislation — the same package that had included the “doc fix.” Speaking of that, Sen. Majority Leader Harry Reid said the Senate may soon turn its attention away from that toward other issues. (Wall Street Journal, The Hill, ABC News)

*This blog post was originally published at ACP Internist*

How Much Are Your Organs Worth?

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I don’t plan to sell my organs on eBay, but as organ transplantation, lack of donors, and illegal organ trafficking gets more and more serious, this infographic comes just in time. It provides some interesting answers to questions like, “How much does a liver cost in South Korea?” and “How many patients are waiting for transplants?” Click on the image for the original larger version:

*This blog post was originally published at ScienceRoll*

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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…

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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…

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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…

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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…

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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…

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