December 20th, 2011 by Linda Burke-Galloway, M.D. in News, Opinion
Tags: 19 and Counting, Advanced Maternal Age, Celebrities, Children, Doctors, Dr. Linda Burke-Galloway, Duggar Family, High Risk Pregnancy, Midwife, Miscarriage, Nurses, OB-GYN, Obstetrician, Pregnancy, Pregnant Women
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Sometimes Fate has to shout in order to be heard, especially when the voice of reason is ignored. Michelle Duggar was pregnant with her 20th child to the aghast of many including this author. We squirmed in our seats. We moaned. We groaned. We blogged. The combination of Duggar’s 19 children and her advanced maternal age of 45 is enough to make any obstetrician or midwife cry, especially when she becomes pregnant, yet again. Not surprisingly, Duggar experienced a miscarriage with pregnancy number 20. According to media reports, when the Duggars presented for their ultrasound, a fetal heart beat could not be obtained. What occurred in obstetrical vernacular was a missed abortion or an early fetal demise. Based on the Duggars’ press release, his wife probably had no symptoms prior to receiving the ultrasound. The cramping, spotting, abdominal and back pain was probably absent. An early fetal demise without symptoms or missed abortion means the baby stopped growing because there was a condition present that was incompatible with life. Did Duggar’s age increase her chances of having a miscarriage? Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
December 19th, 2011 by PreparedPatient in Opinion, Research
Tags: ACA, Annual Wellness visit, Cost, Coverage, Entitled, Medicare, Medicare Advantage, Medigap, Payment, Physical Exam, Preventive Health Care, Seniors, social security, Vaccines
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Who doesn’t think preventive health care is important? Probably nobody if you ask this question abstractly. But when it comes to getting it–well that’s a different matter. Medicare stats show that too few people are getting preventive services even when they are free. It’s darn difficult, it seems, to get people to take good care of themselves.
By mid-November, of the four million or so new beneficiaries who signed up for Medicare this year, only 3.6 percent had had their “Welcome to Medicare” exam. Only 1.7 million of the more than 40 million seniors, most of whom were already on Medicare, had had their “Annual Wellness Visit.” A poor showing indeed given all the hoopla and hype surrounding the preventive benefits that health reform was supposed to bring to seniors.
To review: All new Medicare beneficiaries are entitled to a free physical exam within the first twelve months that their medical, or Part B, coverage becomes effective. It’s a one-time benefit, and Medicare says that seniors are told about the benefit when they sign up. A Medicare spokesperson added that Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
December 19th, 2011 by Michael Kirsch, M.D. in News, Opinion
Tags: Cleveland Browns, Collision, Colt McCoy, Concussion, Conflicts of Interest, Football, Head Injury, medical evaluation, NFL, Procedure, process, Professional Sports, SCAT2, Second Opinion, Standard, Standard Concussion Assessment Tool, Time
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The Cleveland Browns have been in the news this week, and not because of newfound success on the gridiron. While sports is not among my highest priorities, I have developed increasing interest over the years since professional sports is religion to so many here in Cleveland and in Ohio. Cleveland sports teams all enjoy great success, provided that success is not defined by victories. It’s not if you win or lose but how…
I watched the Cleveland Browns compete against the Pittsburgh Steelers two Thursdays ago. I cringed as I witnessed our young quarterback, Colt McCoy, take a blow to the head that could have landed the perpetrator a 10 year prison sentence had this act occurred on the street. I wasn’t worried that McCoy would have to miss the rest of the game. I feared that he might have to miss the rest of his life. Violence sells tickets.
If an activity requires a participant to don a helmet and a coat of armor, then clearly it is an unwise activity for a human to engage in.
McCoy was taken off the field and reentered the arena 2 plays later, after an exhaustive evaluation that was completed in about 100 seconds. Since everything in sports and medicine is now measured, we know that McCoy was sidelined for a total of Read more »
*This blog post was originally published at MD Whistleblower*
December 19th, 2011 by Bryan Vartabedian, M.D. in Opinion
Tags: Approval, Brilliance, Collaboration, Communication, Doctors, Filter, Ideas, Intelligence, Medical Journal, Opinion, Permission, Physician, Poke The Box, Publishing, Seth Godin, Sharing, Speak Up, Wisdom
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Let’s say you’re a doctor and you have an idea, opinion, or a new way of doing things. What do you do with it?
It used to be that the only place we could share ideas was in a medical journal or from the podium of a national meeting. Both require that your idea pass through someone’s filter. As physicians we’ve been raised to seek approval before approaching the microphone.
This is unfortunate. When I think about the doctors around me, I think about the remarkable mindshare that exists. Each is unique in the way they think. Each sees disease and the human condition differently. But for many their brilliance and wisdom is stored away deep inside. They are human silos of unique experience and perspective. They are of a generation when someone else decided if their ideas were worthy of discussion. They are of a generation when it was understood that few ideas are worthy of discussion. They are the medical generation of information isolation.
I spoke with a couple of students recently about Read more »
*This blog post was originally published at 33 Charts*
December 18th, 2011 by Dinah Miller, M.D. in Opinion, Research
Tags: Attitudes, Communication, EHR, Electronic Health Records, EMR, Health, Information, Medications, Mental Illness, Psychiatric Illness, Psychiatry, Psychology, Psychotropic, Research, Shrink, Stigma, Survey, Therapy
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For a while now we’ve been talking about issues related to psychiatry and electronic medical records. Roy is very interested in the evolution of EHR’s.
I don’t like them. I think they have too many problems still, both in terms of issues of efficiency and time, and how they divert the physician’s attention away from the patient, and they focus medical appointments on the collection of data– data that is used in a checkbox form: patient is not suicidal and I asked, whether it was clinically relevant or not– and will therefore serve as protection in a lawsuit, or demographic information used by insurers, the government, who knows.
From a privacy standpoint, I think they are appalling. If you are a patient in the hospital where I work, you get Read more »
*This blog post was originally published at Shrink Rap*
Sometimes Fate has to shout in order to be heard, especially when the voice of reason is ignored. Michelle Duggar was pregnant with her 20th child to the aghast of many including this author. We squirmed in our seats. We moaned. We groaned. We blogged. The combination of Duggar’s 19 children and her advanced maternal age of 45 is enough to make any obstetrician or midwife cry, especially when she becomes pregnant, yet again. Not surprisingly, Duggar experienced a miscarriage with pregnancy number 20. According to media reports, when the Duggars presented for their ultrasound, a fetal heart beat could not be obtained. What occurred in obstetrical vernacular was a missed abortion or an early fetal demise. Based on the Duggars’ press release, his wife probably had no symptoms prior to receiving the ultrasound. The cramping, spotting, abdominal and back pain was probably absent. An early fetal demise without symptoms or missed abortion means the baby stopped growing because there was a condition present that was incompatible with life. Did Duggar’s age increase her chances of having a miscarriage? Read more »
