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Mr. Roger’s “Medical Home” Neighborhood

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My image of Pittsburgh has been one of a blue-collar, rough-and-tumble town: Perogies, Heinz ketchup, steelworkers, football, and Roberto Clemente. But an exhibit in Pittsburgh’s airport the other day informed me that Pittsburgh also is the home of the iconic “Mr. Roger’s Neighborhood” — the gentle PBS show that entertained toddlers for generations. Mr. Rogers always started the show off with the following verse:

It’s a beautiful day in this neighborhood,
A beautiful day for a neighbor,
Would you be mine?
Could you be mine?

It’s a neighborly day in this beautywood,
A neighborly day for a beauty,
Would you be mine?
Could you be mine?

I have always wanted to have a neighbor just like you,
I’ve always wanted to live in a neighborhood with you.

So let’s make the most of this beautiful day,
Since we’re together, we might as well say,
Would you be mine?
Could you be mine?
Won’t you be my neighbor?

Won’t you please,
Won’t you please,
Please won’t you be my neighbor?

Fittingly, the same week that I was reminded of “Mr. Roger’s Neighborhood,” the American College of Physicians (ACP) released its “medical home neighborhood” position paper. The paper was developed by a workgroup of ACP’s Council of Subspecialty Societies (CSS), which is comprised of representatives of internal medicine subspecialty societies and related organizations.

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*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Medical Devices, Daylight Savings Time, And Y2K Nostalgia

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Remember that cold December in 1999 when we all thought that planes would soon be dropping out of the sky, nuclear power plants were to be melting down, and the world was going to end? This weekend Health Canada is giving clinicians across the country (and really all of North America) an opportunity to feel the anxiety, fear, and excitement all over again.

In 2007, the dates for switching between Standard and Daylight Saving time were changed, and the authorities, three years into the new schedule, have issued a warning for this weekend’s one hour rollback:

Medical equipment manufactured prior to 2007 may not function optimally if the equipment has not been updated by manufacturers to compensate for the new dates.

To date, Health Canada has not received any reports of device malfunctions because of the revised time change that began in 2007. However, examples of medical devices that could be affected by the change include (but are not limited to): implanted pacemakers/defibrillators with sleep modes that can only be adjusted by physicians; Holter monitors, used to continuously record heartbeat; and glucose monitors that store data on glucose levels.

If a medical device displays the incorrect time after 2:00 a.m. on Sunday, November 7, 2010, users should contact the manufacturer to bring the problem to their attention and consult a health care professional.

Press release: Health Canada Reminds Canadians to Check Medical Device Clocks After the Switch to Standard Time …

Image credit: Dan Woods…

*This blog post was originally published at Medgadget*

Healthcare Reform, Texas-Style

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Via the Texas Tribune:

Some Republican lawmakers — still reveling in Tuesday’s statewide election sweep — are proposing an unprecedented solution to the state’s estimated $25 billion budget shortfall: dropping out of the federal Medicaid program.

Hmmm. Welcome to entitlement reality, Texas-style. Currently 20 billion a year and going to go up with expanded eligibility, the article does say the Feds pay 60 percent, but doesn’t say: 1) It’s temporary, then the Federal contribution goes down or away, and 2) The Federal component doesn’t come from magical money fairies — it’s money taken from taxpayers then funneled back into a particular program.

Medicaid is not loved or respected in medicine. Decreasing reimbursements coupled to increasing requirements mean it’s at a minimum inefficient for both patients and providers.

I’m not against kicking Medicaid to the curb, PROVIDED the state has some kind of replacement program — which I’m not sanguine about.

*This blog post was originally published at GruntDoc*

Do The Elderly Benefit From The “Fury Of American Medicine?”

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I don’t consider myself a right-wing healthcare fear monger, but if I were this study would be worthy of amplification. As reported concisely in the New York Times, from the journal Demography (not previously known to me), population researchers reported that even though elderly Americans have more medical problems than their peers in Britain, older Americans live longer once they make it to 70. Why would this be?

Is it because Americans who reach 70 are “heartier” than Britons, as Columbia University PhD (but now on leave and working at HHS) Sherry Giled says. Or is better survival of the American elderly one of the benefits of the “fury of American medicine?” Read more »

*This blog post was originally published at Dr John M*

5 Tips For Diagnosing Yourself Online

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“What’s the highest peak in North America, Mt. McKinley or Denali?” This is a great question the Web can answer for you. “What’s that lump on my neck?”  This is another great question — but not one you should rely on the Web to solve.

Best Doctors recently conducted a Twitter-based poll to find out what channels of information people use to get healthcare advice.  It turns out, 54 percent of respondents use the Web as their primary source of information. Is this kind of do-it-yourself medicine a good idea?

I’m a firm believer that you should do everything you can to make sure you’re getting the right care when you’re sick. But before you start your do-it-yourself journey, here are five things to keep in mind:

1. To get the right answer, you need to ask  the right questions. If you decide that that lump on your neck is a sign of lymphoma, you’re going to get very worried and start researching everything you can on lymphoma. You may see your doctor and when he tells you it’s actually a benign cyst, you’re going to have a hard time believing him. Now, your skepticism is a good thing, but before you start driving yourself crazy with serious conclusions, make sure you have your facts straight. Read more »

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

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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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