October 19th, 2010 by RyanDuBosar in Better Health Network, News, Research
Tags: ACP Internist, American College Of Physicians, Anesthesiologists, CNN/Money, Healthcare Administrators, How Meaningful Is Medical Practice, Medical Careers, Medical Education, PayScale.com, Physician Assistants, Physician Careers, Practicing Medicine, Ryan DuBosar, Social Workers
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Doctors are the top six best-paid careers (based on median and top pay), with anesthesiologists being the best-paid, primary care being the sixth-best and nurse anesthetists the seventh best-paid, according to a survey by CNN/Money magazine and PayScale.com. But not one of the physician careers landed on the top lists for job growth or quality of life. The title of best job went to software architect and the second-best job went to physician assistant.
Take heart, though. When asked about having the most meaningful work (based on the percentage who think their job makes the world a better place), the top spot went again to anesthesiologists, and second through ninth went to some kind of medical provider or healthcare administrator. Social workers rounded out the tenth spot. (CNN/Money)
*This blog post was originally published at ACP Internist*
October 18th, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion, Research
Tags: ACP Advocate, American College Of Physicians, Bob Doherty, comparative effectiveness research, Health Affairs, Healthcare Policy, Healthcare reform, Less-Effective Care, Less-Effective Treatments, Medicare, Medicare Payment Fix, Medicare Reimbursement, Medicare's Agnosticism, Patient Protection and Affordable Care Act, PPACA, Rationed Care, Wall Street Journal Health Blog
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From its inception, Medicare has been agnostic about the effectiveness of different treatments when it sets payment rates. Once a treatment is found to be “reasonable and necessary,” Medicare establishes a payment rate that takes into account complexity and other “inputs” that go into delivering the service. But it is prohibited by law from varying payments based on how well an intervention works.
This would change under a “dynamic pricing” approach proposed by two experts in this month’s issue of Health Affairs. The article itself is available only to Health Affairs subscribers, but the Wall Street Journal health blog has a good summary.
The researchers propose that Medicare pay more for therapies with “superior” results and the same for two therapies with comparable effectiveness. A new service without any evidence on its relative effectiveness would be reimbursed in the usual way for the first three years, during which research would be conducted on its comparative effectiveness. If such research found that the service was less effective than other interventions, Medicare would have the authority to reduce payments. If it was found to be more effective, Medicare could pay more than for other available interventions. The WSJ blog gives an example of how this would work. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
October 17th, 2010 by Peter Lipson, M.D. in Better Health Network, Health Tips, Opinion, Quackery Exposed, Research
Tags: Age-Related Testosterone Deficiency, CAM, Complementary And Alternative Medicine, Direct-To-Consumer Drug Advertising, Dr. Peter Lipson, Endocrine Society, Endocrinology, Evidence-Based Healthcare Decisions, Hormone Replacement Therapy, HRT For Men, Low Sex Drive, Low T, Low Testosterone, Male Sexuality, Men's Health, Pharma Advertising, Pharmaceutical Companies, Reproductive Health, SBM, Science Based Medicine, Science-Based Treatments, Sexual Health, Snake Oil, Solvay, Testosterone Deprivation, Testosterone Replacement Therapy
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If you google “low testosterone” you’ll see lots of ads for testosterone replacement. Some are from pharmaceutical companies that sell testosterone, others from obvious snake-oil salesmen.
Both types of ads list vague sets of symptoms, encourage you to believe that they are pathologic, and want to sell you something to make you better. For example, the pharmaceutical company Solvay gives you a handy guide for speaking to your doctor, and a quiz to see if you have “low T.” The quiz asks some questions that may be useful, but also asks very general questions about your sense of well being. Read more »
*This blog post was originally published at Science-Based Medicine*
October 14th, 2010 by RyanDuBosar in Better Health Network, News, Research
Tags: ACP Internist, American College Of Physicians, Center for Studying Health System Change, Communicating With Colleagues, Communicating With Other Doctors, Communicating With Patients, Doctor-Patient Communication, Doctor-to-Doctor Communication, Doctor-to-Patient Communication, Doctors Who Email, Emailing With Patients, General Medicine, Health Information Technology, Office-Based Physicians, Ryan DuBosar, Who Doctors Email
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Only 6.7 percent of office-based physicians routinely e-mailed patients about clinical information in 2008, according to an issue brief from the Center for Studying Health System Change.
Only 34.5 percent of office-based, ambulatory care physicians reported that information technology for communicating with patients about clinical issues via e-mail was available in their practice in 2008. Of that third, 19.5 percent routinely e-mailed patients, or 6.7 percent overall, while the rest were split between occasional use or non-use. The study sample was restricted to 4,258 office-based physicians and the response rate was 62 percent.
In contrast, twice as many physicians spent at least some time each work day e-mailing physicians and other clinicians. Read more »
*This blog post was originally published at ACP Internist*
October 14th, 2010 by RamonaBatesMD in Better Health Network, News, Opinion, Quackery Exposed, Research, Uncategorized
Tags: Aesthetic Society, American Society of Aesthetic Plastic Surgery, ASAPS, Chris Woolston, Cosmetic Surgery, Dr. Ramona Bates, Fat Injections, Health Scams, Health Skepticism, LA Times, Stem Cell Face-Lifts, Suture For A Living
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It’s been almost a month since the LA Times ran the article by Chris Woolston entitled The Healthy Skeptic: Stem cell face-lifts on unproven ground. It’s well written and presents a fairly balanced view. While I am a fan of stem cell research, I think the “claims” are often put ahead of the science. This is one of those times. I can’t find any decent articles to support the claims of the plastic surgeons doing “stem cell face-lifts.”
My view is echoed in the article (bold emphasis is mine):
Rubin says he’s excited about the potential of stem cells in the cosmetic field and beyond. Still, he adds, there are many unanswered questions about the cosmetic use of stem cells, and anyone who claims to have already mastered the technique is jumping the gun. As Rubin puts it, “Claims are being made that are not supported by the evidence.”
While researchers in Asia, Italy, Israel and elsewhere are reporting decent cosmetic results with injections of stem cell-enriched fat, Rubin says that nobody really knows how the stem cells themselves are behaving. He points out that fat injections alone can improve a person’s appearance, no stem cells needed.
Rubin believes it’s possible that injected stem cells could create new collagen and blood vessels — as they have been shown to do in animals studies — but such results have never been proved in humans. And, he adds, the long-term effects of the procedures are an open question.
Stem cell face-lifts could someday offer real advances, says Dr. Michael McGuire, president of the American Society of Plastic Surgeons and a clinical associate professor of surgery at UCLA. But he believes that scientists are still at least 10 years away from reliably harnessing stem cells to create new collagen and younger-looking skin. Until then, promises of a quick stem cell face-lift are a “scam,” he says.
The American Society for Aesthetic Plastic Surgery (ASAPS) issued a statement two weeks after the article first appeared. Read more »
*This blog post was originally published at Suture for a Living*
