July 5th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
Tags: ACEP, American College of Emergency Physicians, American Medical Association, Angela Gardner, Associated Press, Battery Of Tests, Cardiology, Chest Pain, Doctor Sued, Doctor-Patient Communication, Dr. Robert Bitterman, Emergency Department, Emergency Medicine, Emergency Room Doctors, ER, Evidence-Based, Health Reformers, Malpractice Insurance, Malpractice Protection, Medical Lawsuits, Medical Malpractice, Overtesting, Pros And Cons Of Testing, Shared Decision, Standardized Guidelines, Suspected Heart Attacks, Unhappy Patients, Unnecessary Medical Tests, X-ray
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Emergency physicians are in a dilemma. Risk missing a diagnosis and be sued, or be criticized for overtesting.
Regular readers of this blog, along with many other physicians’ blogs, are familiar with the difficult choices facing doctors in the emergency department.
The Associated Press, continuing its excellent series on overtesting, discusses how lawsuit fears is a leading driver of unnecessary tests. Consider chest pain, one of the most common presenting symptoms in the ER:
Patients with suspected heart attacks often get the range of what the ER offers, from multiple blood tests that can quickly add up in cost, to X-rays and EKGs, to costly CT scans, which are becoming routine in some hospital ERs for diagnosing heart attacks …
… and the battery of testing may be paying off: A few decades ago insurance statistics showed that about 5 percent of heart attacks were missed in the emergency room. Now it’s well under 1 percent, said Dr. Robert Bitterman, head of the American College of Emergency Physicians’ medical-legal committee.
“But you still get sued if you miss them,” Bitterman added.
The American Medical Association’s idea of providing malpractice protection if doctors follow standardized, evidence-based guidelines makes sense in these cases. Furthermore, it can also help reduce the significant practice variation that health reformers continually focus on. Read more »
*This blog post was originally published at KevinMD.com*
July 5th, 2010 by Berci in Better Health Network, Health Policy, News, Opinion, Research
Tags: Cost Of Healthcare Reform, Healthcare Economics, Healthcare reform, New U.S. Healthcare Bill, Who's Paying For It
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Ever wondered who’s paying for the U.S. healthcare bill? My new favorite blog just published an infographic describing this issue in detail (click on the image for the original larger version):
*This blog post was originally published at ScienceRoll*
July 5th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News, Opinion, Research
Tags: Care Management, Course Of Treatment, Doctor-Patient Communication, Doctors In A Hurry, Evidence Based Medicine, Family Medicine, General Medicine, Health Affairs, Highly-Desired Treatments, Internal Medicine, Medical Evidence, Medical Language Lesson, Medical Research, Medical Specialists, Medical Terminology, More Expensive Treatments, Patient Education, Patient Understanding, Primary Care, Quality Guidelines, Quality Standards, Rushed Office Visit
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Doctors trying to help patients understand a course of treatment must teach them new terms such as “medical evidence,” “quality guidelines” and “quality standards.” Patients might not be willing to accept that language lesson.
A study in Health Affairs concluded that 41 percent of patients didn’t ask questions or tell doctors about problems. The main barriers were that patients didn’t know how to talk to doctors, or their physicians seemed rushed. Only 34 percent of patients recalled physicians discussing medical research in relation to care management.
But, physicians say, that’s only half the problem. Sometimes, patients demand to see specialists when they don’t really need to. Or, they don’t accept it when evidence shows that highly-desired treatments aren’t the best ones for care. One reason may be that one in three patients believe that more expensive treatments work better than less expensive ones, according to the study in Health Affairs. Once the evidence is laid out, it can be a delicate negotiation to get patients to accept that. (American Medical News, Health Affairs, RangelMD, KevinMD)
*This blog post was originally published at ACP Internist*
July 3rd, 2010 by David Kroll, Ph.D. in Better Health Network, Health Policy, Opinion, Research
Tags: AA, Alcohol Addiction, Alcoholics Anonymous, Bill Wilson, Brendan Koerner, Clinical Research, David Brooks, Drug Dependency, DrugMonkey, Higher Power, Medical Mysteries, Medical Writing, Project MATCH, Psychology, Science Writing, Substance Abuse, The New York Times, Unorganized Organization, Wired Magazine
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To further emphasize my admiration for superb sci/med/health writing, I wish to add another writer to my growing blog category of “Journalists, Awesome.”
Via my drug abuse research colleague, DrugMonkey, my attention was drawn to a new Wired magazine article by Brendan I. Koerner entitled, Secret of AA: After 75 Years, We Don’t Know How It Works. I strongly recommend this long-form article for anyone in the field of substance abuse and dependence research, psychology and general clinical research, students of excellent science writing, alcoholics and their family members, and anyone who thinks that good science writing no longer exists.
I don’t want to influence your views any further, other than to say that since I poured my first whiskey and water for my grandmother when I was around 7, I’ve had a longstanding interest in why Alcoholics Anonymous helps so many alcohol-dependent folks kick the disease for decades while others trying the approach continue to crash and burn or otherwise abhor its very tenets, especially the “Higher Power” focus. The reader comments there also reflect this bipolar view of the unorganized organization. Read more »
*This blog post was originally published at Terra Sigillata*
July 2nd, 2010 by DrRob in Better Health Network, Humor, Opinion, True Stories
Tags: Ask Dr. Rob, EHR, Electronic Health Record, Electronic Medical Record, EMR, General Medicine, health care, healthcare, Medical Humor, Medical Terminology, Musings of a Distractible Mind, Oprah, Politically Correct
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It’s been a very long time since I did an “Ask Dr. Rob” post. It’s also been a long time since I shot a spitball out of a straw and hit someone behind the ear during social studies class. I realize that just because it’s been a long time since I’ve done something, it doesn’t mean the world is better off with me doing it again.
Still, there have been some interesting questions that have come up and I think it’s time they should be answered. They’re both along the same line:
Question 1: What’s the difference between health care and healthcare? I see that you contribute to the Health Care Blog, but you write about healthcare all of the time. What’s the deal?
Question 2: What’s the difference between EMR and EHR? It seems that some people feel that it’s vile and uncouth to call it “EMR,” only accepting people who call it “EHR” into their secret societies of people who are smarter than everyone else. What’s the deal? Read more »
*This blog post was originally published at Musings of a Distractible Mind*
