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WebMD Worries That Possible Misinformation On Their Website Will Result In Legal Action

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More and more patients these days are seeing their physician pull out an iPhone or iPad to look up drug dosing information, review lab and radiology data, or help teach them more about their medical condition. And as developers, and the increasing number of physician-developers, continue to find more creative ways to bring medical resources to the point of care, we can certainly expect smartphone platforms and medical apps to become pervasive at the bedside. However, just as healthcare providers and patients are noticing this trend, there are number of others who are paying attention as well – for WebMD, one of the largest companies in this industry, it is the lawyers who may be watching that are worrisome.

As they put it in their annual statement to the SEC,

If our content, or content we obtain from third parties, contains inaccuracies, it is possible that consumers, employees, health plan members or others may sue us for various causes of action.

We’ve talked in the past about potential liability issues for healthcare providers using medical apps and the developers who produce them, as well as similar issues related to electronic health records. The fact that WebMD found the issue significant enough to report it to the SEC and their investors clearly indicates the issue is still unresolved and the remainder of their statement adds some further interesting perspective. Read more »

*This blog post was originally published at iMedicalApps*

Collaborative Care Can Decrease Mental Health Costs

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I briefly scanned the Robert Wood Johnson synthesis report on mental and medical co-morbidity so I thought I’d summarize the highlights for the blog. If you’d rather watch the recorded web seminar you can hear it here.

The report relied on systemic literature review to look at the relative risk and mortality associated with co-morbid medical and mental health conditions. The looked at studies using structure clinical interviews, self-report, screening instruments and health care utilization data (diagnostic codes reported to Medicaid).

This is what they found:

  • 68 percent of adults with a mental disorder had at least one general medical condition, and 29 percent of those with a medical disorder had a comorbid mental health condition
  • These findings support the conclusion that there should be strong integration of medical and mental health care Read more »

*This blog post was originally published at Shrink Rap*

CMS “Never Events” Incentivize Physicians To Avoid Caring For High Risk Patients

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In 2008, the Centers for Medicare and Medicaid Services (CMS) announced it would no longer pay for the treatment of “never events,” i.e., certain medical conditions in hospitalized patients which the Feds deem to be universally avoidable under all circumstances. These conditions included:

* Decubitus ulcers
* Two kinds of catheter-associated infections
* Air embolism
* Mediastinitis after coronary bypass surgery
* Transfusing patients with the wrong blood type
* Leaving objects inside surgery patients
* In-hospital falls

Then, having been delighted with the results of its original list (or dismayed that healthcare costs continued to skyrocket despite its original list) CMS subsequently proposed declaring several new conditions as “never events,” including: Read more »

*This blog post was originally published at The Covert Rationing Blog*

Does Medical Education’s High Price Tag Drive Some Healthcare Costs?

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My column in Sunday’s Greenville News.

‘Medical education shouldn’t cost an arm and a leg.’

I was talking to a young man who is starting medical school this fall. His tuition at one of South Carolina’s newer schools will be $40,000 per year. That’s admittedly on the high end. On the low end, it runs a paltry $33,000 per year. And this is all after college, of course. He and others like him are taking out loans to the tune of $240,000 to pay for their medical educations. Another young woman I recently met is in residency and her loan payments are around $2000 per month.

Thinking back on my own medical education, it seems my tuition was around $5000 per year. But then, what with all the Saber Toothed Tigers, Neanderthals and stone surgical tools, things were simpler.. These days, I don’t know how students will do it.

The thing is, American healthcare is expensive. But so is medical education. As we embark on this century, what are the odds that physicians with $240,000 loans for medical school will be able to offer inexpensive care? What are the odds they will enter low-paying specialties? They might be interested in charity care at first, but when the first loan payments come due all the good intentions in the world won’t change the fact that lenders want their money back. Likewise, it won’t change the hard reality that it will be extremely hard for these young physicians to pay for their student loans, buy a house, have a practice (pay malpractice) and raise a family; at least without making a large amount of money in their practices. And then there’s this striking (but seldom mentioned) fact: student loans are non-bankruptable. Student loans are friends for life, or until payed off. Whichever comes first. Read more »

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

The Devastating Emotional Impact Of Missed Diagnoses

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Bongi is an amazing writer, and if you haven’t, I strongly urge you to read his latest post, titled “The Graveyard.”

I imagine that a huge number of doctors know exactly what he means. I remember being told by a surgeon, while I was in medical school, that “you’re not a real doctor until you’ve killed someone.” I thought at the time (and still think) that there was a puerile bravado behind that admonition, but there is also a grain of truth. I have my own graveyard. Curiously, not all of its inhabitants are dead. They are the cases where I screwed up, or, charitably, cases that went bad where I feel that maybe I could’ve/should’ve done things differently.

The missed SAH

The missed DVT/PE

The missed AAA

The missed Aortic dissection

The missed MI

I remember them all, clearly and in detail. Read more »

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

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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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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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