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Heart Disease And Working Overtime

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The European Heart Journal studied 6,000 British civil servants and followed them for 11 years. They found that working an extra 3 to 4 hours a day is associated with increased coronary heart disease.

The researchers controlled and adjusted for lifestyle, cardiac risk factors, and other factors that would skew the results, and still found that people who worked 3 to 4 extra hours a day had a 60 percent increase in risk for heart disease. Read more »

*This blog post was originally published at EverythingHealth*

Recent Readings On Social Media In Medicine

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Here are a few papers and publications focusing on how social media can be used in medicine, healthcare and science. These represent the evidence-based approach in social media:

Google docs: a better method than a paper clinical schedule. Kippenbrock T, Holloway E, Moore DD. Comput Inform Nurs. 2010 May-Jun;28(3):138-40.

How to get the most from the medical literature: keeping up to date in nephrology. Cullis J, Webster AC. Nephrology (Carlton). 2010 Apr;15(3):269-76.

Twitter: consider the possibilities for continuing nursing education. Billings DM, Kowalski K, Bristol TJ. J Contin Educ Nurs. 2010 May;41(5):199-200.

Literature search on risk factors for sarcoma: PubMed and Google Scholar may be complementary sources. Mastrangelo G, Fadda E, Rossi CR, Zamprogno E, Buja A, Cegolon L. BMC Res Notes. 2010 May 10;3(1):131.

Effect of visual media use on school performance: a prospective study. Sharif I, Wills TA, Sargent JD. J Adolesc Health. 2010 Jan;46(1):52-61.

Patients’ Evaluations of Health Care Providers in the Era of Social Networking: An Analysis of Physician-Rating Websites. Lagu T, Hannon NS, Rothberg MB, Lindenauer PK. J Gen Intern Med. 2010 May 13.

Tweeting science and ethics: social media as a tool for constructive public engagement. Regenberg AC. Am J Bioeth. 2010 May;10(5):30-1.

*This blog post was originally published at ScienceRoll*

Emergency Care’s Ambiguity In The Affordable Care Act

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There’s just so much hidden and buried in the Affordable Care Act (ACA) that it’s like trying the find all the goodies in an Easter egg hunt. ACEP News pointed out one hidden goodie, nicely illustrated in this article from Kaiser Health News:

Under the new health law, insurance companies must extend several new protections to patients who receive emergency care. One of the biggest guarantees: Patients who need emergency treatment will have their costs covered at the same rate, regardless of whether they are treated at “in-network” or “out-of-network” hospitals.

The law also bars health plans from requiring prior authorization for emergency services. And it mandates that plans follow the “prudent layperson” rule. For example, if a person goes to the ER with chest pain, but ends up being diagnosed with indigestion, the claim has to be covered because going to the hospital under those circumstances made sense.

The provisions go into effect for every health plan issued after Sept. 23 – six months after the law was enacted — that offers emergency coverage.

This is potentially quite significant. As with so many things, the devil is in the details, and the implementation is not yet actualized. Read more »

*This blog post was originally published at Movin' Meat*

Patient Tests, EHRs, And Medical Homes: The Price Isn’t Right

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Healthcare reform is forcing medical students to learn about the financial costs of the tests they order, as well as their clinical importance. Once a taboo topic, it’s being openly taught to students to prepare them for practice.

At Harvard, one physician in training duplicated television’s “The Price is Right” to keep his peers guessing at the costs of tests on a patient’s bill. Molly Cooke, FACP, a Regent of the College, encourages doctors to consider the value of the tests they order as they deliver care. (Kaiser Health News, New England Journal of Medicine)

The price isn’t right for electronic medical records. Even $44,000 in stimulus money isn’t enough to make doctors jump into using computers. Read more »

*This blog post was originally published at ACP Internist*

Will Large Employers Dump Healthcare Coverage?

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Fortune magazine has made some news recently about the impact of healthcare reform on large employers:

Internal documents recently reviewed by Fortune, originally requested by Congress, show what the bill’s critics predicted, and what its champions dreaded: many large companies are examining a course that was heretofore unthinkable, dumping the healthcare coverage they provide to their workers in exchange for paying penalty fees to the government.

The only trouble? There’s no way these employers are seriously thinking about doing this.

I can understand why the employers would do the math. According to healthcare reform law, penalties for failing to provide health coverage are a small fraction of the cost of that coverage. But as with most everything else in healthcare, there’s much more to it than just a simple math equation. Here’s what I mean. Read more »

*This blog post was originally published at See First Blog*

Latest Interviews

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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