August 12th, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
Tags: Acupuncture, Center for Integrative Medicine, Clinical Therapeutics, Dr. Brian Berman, Evidence Based Medicine, Homeopathy, Integrated Medicine, Journal of Alternative and Complementary Medicine, National Center for Complementary and Alternative Medicine, Nature Journal, Naturopathy, NCCAM, NEJM, New England Journal of Medicine, Placebo Medicine, Pseudomedicine, Pseudoscience, Quackademic Medicine, Science Based Medicine
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One of the things that disturbs me the most about where medicine is going is the infiltration of quackery into academic medicine. So prevalent is this unfortunate phenomenon that Doctor RW even coined a truly apt term for it: Quackademic medicine.
In essence, pseudoscientific and even prescientific ideas are rapidly being “integrated” with science-based medicine, or, as I tend to view it, quackery is being “integrated” with scientific medicine, to the gradual erosion of scientific standards in medicine. No quackery is too quacky, it seems. Even homeopathy and naturopathy can seemingly find their way into academic medical centers. Read more »
*This blog post was originally published at Science-Based Medicine*
August 11th, 2010 by admin in Better Health Network, Health Policy, Opinion
Tags: ACP Internist, American College Of Physicians, Dr. John Henning Schumann, Family Medicine, GlassHospital, Healthcare Policy, Healthcare reform, Individualized Doctor-Patient Relationships, Internal Medicine, medicaid, New Primary Care Models, Patient Protection and Affordable Care Act, Patient-Centered Medical Home, Patient-Centered Medicine, PCMH, Pediatrics, Primary Care, University of Chicago
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By John Henning Schumann, M.D.
The Patient Protection and Affordable Care Act (aka “Health Care Reform”) signed by President Obama in March will revolutionize primary care in the United States. By 2014 tens of millions of uninsured people will “enter” the system by being granted insurance, either through expansion of the Medicaid program or through mandated purchasing of insurance via state pools or the private market.
This alone will have a profound impact, straining the capacity of our already frayed system. Therefore, embedded in the law are funds to encourage growth and improvement in primary care: Incentives to encourage graduates to enter primary care fields (family medicine, internal medicine, and pediatrics) and practice in underserved areas (through scholarships and loan forgiveness), and money to re-format the way that primary care is practiced and paid for. Read more »
*This blog post was originally published at ACP Internist*
August 11th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion
Tags: Bridging Care, Dr. Jesse Pines, Dr. Zachary Meisel, Emergency Medicine, Healthcare reform, Hospital Bouncebacks, Hospital Discharge, Hospital Re-Admissions, Improved Followup, Patient Noncompliance, Primary Care, Recently Discharged Hospitalized Patients, Shorter Hospital Stays, Slate, Transition Care Clinics
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In their most recent piece at Slate, emergency physicians Zachary F. Meisel and Jesse M. Pines tackle the issue of bouncebacks — that is, the re-admission of recently-discharged hospitalized patients. They bring up good some good points, and point out that until recently hospitals really didn’t have any incentive to reduce bouncebacks:
…hospitals have never had a compelling reason to try to prevent bouncebacks. Hospitals are typically paid a flat sum for each inpatient stay — shorter stays equal higher profits. When patients bounce back, hospitals can charge the insurance company twice for the same patient with the same problem. Many hospitals also view bouncebacks as out of their control: If a patient boomerangs back because she doesn’t follow doctor’s orders, it’s not the hospital’s fault.
With health reform, however, things are changing. In an effort to reduce bouncebacks, hospitals are paid less for re-admissions, and they must publish their bounceback rates. Read more »
*This blog post was originally published at KevinMD.com*
August 11th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, News, Opinion, Research
Tags: Academic Fraud, Annals Of Internal Medicine, Blogosphere, Brigham and Women's Hospital, Cut-And-Paste, Digital Reverberation, General Medicine, Harvard University, Medical Residency, Medical Students, New Generation of Doctors, Plagiarized Content, Residency Applicants, Technology and Medicine, Unethical Academic Conduct, When Young Doctors Lie
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This is something: A study published in the July 20, 2010 Annals of Internal Medicine finds that 5 percent of residency applications contain plagiarized content. The study from Boston’s Brigham & Woman’s Hospital is based on the personal statements of nearly 5,000 residency applicants that were matched against a database of published content.
The authors comment that the study is limited, among other things, by the fact that it was done in just one institution. It makes me wonder if the number is artificially high or potentially too low.
So why would medical students lie? Read more »
*This blog post was originally published at 33 Charts*
August 11th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Policy, Health Tips, Opinion
Tags: Dr. Rob Lamberts, Family Medicine, Family Practice, General Medicine, Housecalls, Internal Medicine, Internist, Med-Peds, Medical Residency, Medical School, Medical Training, Musings of a Distractible Mind, Obstetrics And Gynecology, Pediatrician, Pediatrics, Primary Care
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I like Dr. Rob, the one with the “distractible mind.” And although I thoroughly agree with the stance he takes in his recent post against cholesterol screening in kids, I must take issue with his opening statement:
I have a unique vantage point when it comes to the issue universal cholesterol screening in children, when compared to most pediatricians. My unique view stems from the fact that I am also an internist who deals with those children after they grow up on KFC Double Downs.
From Dictionary.com:
“Unique: existing as the only one or as the sole example; single; solitary in type or characteristics.”
Your med-peds training allows you to follow patients from birth to death (but no obstetrics or gynecology). You can care for all organ systems and all stages of disease (but without as much training in psychiatry). Congratulations! You’ve just (re)invented family practice (except for the above shortcomings). Oh, wait — that’s already a recognized specialty with its own residency programs, boards and everything like that, forty years now.
This misuse of the word “unique” is one of my pet peeves. “Unique?” I don’t think that word means what you think it means. After twenty years in practice, I agree that there probably isn’t much difference between what Dr. Rob does and what I do. After twenty years, I’m not even sure how much relevance remains from our “training.” Still, there remains a great deal of confusion about the very real differences between family practice and med-peds residencies. Read more »
*This blog post was originally published at Musings of a Dinosaur*
