August 26th, 2011 by Edwin Leap, M.D. in Opinion
Tags: Culture, Cuts and Scrapes, Drug-Seeking, Emergency Department, Family, Hurt, Injury, Lortab, Merthiolate, Neosporin, Pain, Percocet, Sleep Medicine
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This might sting a little…
When I was a child, I was often painted orange with Merthiolate. My grandmother, like every good grandmother, kept a bottle handy at all times. Merthiolate was an antiseptic, containing Mercury, that was marketed for cuts and scrapes.
A fall on the gravel, a slide on the pavement, a run through the briar patch and you’d be sitting on the kitchen table while grandma colored you orange with the magical elixir, which incidentally burned like fire!
On a recent emergency department shift, we were colluding about the general state of drug-seeking in America, which has been enabled by our ‘nothing should hurt’ ideology. One of my dear friends, Nurse Nancy, had a realization; an epiphany, really. Read more »
*This blog post was originally published at edwinleap.com*
August 26th, 2011 by Davis Liu, M.D. in News, Opinion
Tags: Bedside Manner, Clinical Care, Compassion, Danielle Ofri, Diabetes, Doctor-Patient Communication, Dr. Brent James, Electronic Medical Records, Empathy, Goal, Humanistic, Intermountain Healthcare, Interpersonal Skills, Kaiser, New England Journal of Medicine, New York Times, NYU, Primary Care, Report Cards, Virginia Mason Hospital
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The New York Times recently published an article titled, Finding a Quality Doctor, Dr. Danielle Ofri an internist at NYU, laments how she was unable to perform as well as expected in the areas of patient care as it related to diabetes. From the August 2010 New England Journal of Medicine article, Dr. Ofri notes that her report card showed the following – 33% of patients with diabetes have glycated hemoglobin levels at goal, 44% have cholesterol levels at goal, and a measly 26% have blood pressure at goal. She correctly notes that these measurements alone aren’t what makes a doctor a good quality one, but rather the areas of interpersonal skills, compassion, and empathy, which most of us would agree constitute a doctor’s bedside manner, should count as well.
Her article was simply to illustrate that “most doctors are genuinely doing their best to help their patients and that these report cards might not be accurate reflections of their care” yet when she offered this perspective, a contrary point of view, many viewed it as “evidence of arrogance.”
She comforted herself by noting that those who criticized her were “mostly [from] doctors who were not involved in direct patient care (medical administrators, pathologists, radiologists). None were in the trenches of primary care.”
From the original NEJM article, Dr. Ofri concluded Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
August 25th, 2011 by Bryan Vartabedian, M.D. in Opinion
Tags: Blogs, Doctors, Facebook, Google, Information Overload, News sites, Physicians, Social Cast Network, Twitter, Unlimited Information
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Perhaps the biggest challenges facing the next generation of physicians is information overload. The problem: Unlimited information on limited human bandwidth. There’s simply too much to read and see. For physicians the problem is compounded by a perceived responsibility to keep up.
But the idea that we actually can have our hands around everything is reflective of a time when doctors actually could know all there was to know. Many of today’s physicians were raised at a time when a paper inbox and a pile of journals represented their only information inputs. But things are very different now.
Here are a few ideas on controlling your inputs: Read more »
*This blog post was originally published at 33 Charts*
August 25th, 2011 by DrWes in Opinion, Research
Tags: Cardiac Devices, cardiac implantable electronic devices, CIED, Comorbidities, Defibrillator, Diabetes, Heart, ICD, ICD Implants, Infection, medicaid, Medicare, Pacemaker, Renal Failure, Research, Respiratory Failure
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A new report published online in the Journal of the American College of Cardiology and reported in theHeart.org and elsewhere, suggests the infection rate of cardiac implantable electronic devices (CEID’s) between 1993 and 2008 has greatly increased from 1.53% in 2004 to 2.41% in 2008 (p < 0.001) with a dramatic rise in 2005:
Click image to enlarge
The authors explain this sudden increase on the basis of comorbities: Read more »
*This blog post was originally published at Dr. Wes*
August 24th, 2011 by admin in Health Policy, Opinion
Tags: Cost, Diario Medico, Europe, Germany, Health Care Costs, Health Care Providers, Health Insurance, Insurance Company, Medical Tourism, Patient Traffic, Spain, Wealthy Patients
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I must confess that I have a weakness for medical tourism. Patients have always been ready to go on a pilgrimage to find the world’s leading expert (we call it ‘key opinon leader’ now) hoping to find a cure. As long as traditional leaders in the field of Medicine have been the Germans, the French and the English -with some occasional Austrian and Spanish name in the mix- traffic of wealthy patients across Europe is nothing new.
Since we entered the antibiotics era, these leaders started to be located mainly in the United States, the cradle of modern, technology-driven Medicine. Thus hi-tech centers got ready to welcome foreign patients, building strong International Customer Support departments. A random example -by no means the only one- would be the Mayo Clinic. On their website you can see that their wealthy patients speak Arabic or come from Latin America. These healthcare services have a long tradition of client-oriented work because they work for private clients that pay for their treatment (sometimes the client is not the patient himself but his family). The important thing was never the price, but the patient. Read more »
*This blog post was originally published at Diario Medico*
