November 25th, 2010 by Edwin Leap, M.D. in Better Health Network, Health Tips, True Stories
Tags: Appreciation, Being Thankful, Comfort Food, Dr. Edwin Leap, Emotional Well-Being, Enjoying Others, Faith, Family and Friends, Family Medicine, Food and Drink, Fun Activities, General Medicine, Gifts Of Others, Gratefulness, Gratitude, Greenville News, Loved Ones, Personal Perspective, Personal Priorities, Sacrifices Of Others, Thankfulness, Thanksgiving, Time With Family
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Here is my column in [the November 21st] Greenville News:
This Thanksgiving we will have 32 guests at the table. Rather, at the tables we scatter about the dining room…and living room…and kitchen. At our house, food is practically a sacrament. And obviously Thanksgiving is the high holiday of American eating. So we will be honoring the tradition by feeding everyone as much as we can.
Because the guests are all beloved to us, we will also have a variety of foods, in a variety of presentations. For instance, there will be fresh cranberries for organic purists, as well as a maroon gelatinous mass of cranberries for those who feel that cranberries indeed spring from aluminum. The turkeys will be divided perfectly among dark and light meat lovers. And for the carb-loving, there will be sweet potatoes, mashed potatoes, and potatoes soft, but cut into chunks. (In deference to the texture-challenged.)
We will have assorted dressings, casseroles and vegetables. And more types of sweets than any of us really need. All of it because we love one another, friends, family, young and old. And we want everyone to have something that they love. The sheer pleasure of eating is one (but not the only) reason that we love the holiday so much.
I think we also love it for a few other reasons. For instance, we (and I mean all Americans) love it because it slows us down, just a bit, before the Christmas madness sets in. Yes, the day after Thanksgiving it’s “game on.” But on Turkey Thursday we stop, if only because we are too full to move. So much of our lives involve rushing, hurrying, competing. Thanksgiving is a food-stuffed, sleep-inducing speed bump in the frantic activity of the season.
We also love it because it is tangible. Today so much is virtual. So much of our lives are borne on the airwaves, across cell-towers or satellites. Our pleasures are so often intangible, insubstantial — distant sounds and images on movies, television shows, or the Internet. Even our work is often virtual. Thanksgiving is a time when we can touch and taste, listen and embrace. Read more »
*This blog post was originally published at edwinleap.com*
November 24th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Research, True Stories
Tags: Atlantic Magazine, Dr. Carl Elliott, Gary Schwitzer, HealthNewsReview.org, Medical Ghostwriter, Medical Ghostwriting, Medical Litigation, Medical Writers, Medication-Related Lawsuits, Moral Outrage, Pharmaceutical Research, Plagiarism, Playing Doctor, Science Writing
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Dr. Carl Elliott writes about ghostwriting in the December issue of The Atlantic magazine, “Playing Doctor: How to spin pharmaceutical research.” He profiles a young scientist (“David”) who became a ghostwriter about 10 years ago.
Excerpts:
“Ghostwritten articles surface again and again in litigation (in cases concerning Vioxx, Fen-Phen, Zyprexa, Premarin, Neurontin, and Zoloft, to mention just a few). Years before the Avandia scandal, GlaxoSmithKline paid $2.5 million to the State of New York to settle a lawsuit alleging that it had concealed studies suggesting an increased risk of suicidal behavior in children and teenagers taking Paxil, most notoriously in an article “authored” by Dr. Martin Keller of Brown University. One 2003 study in The British Journal of Psychiatry found that ghostwriters working for a single medical-communications agency had produced more than half of all medical-journal articles published on Zoloft over a three-year period.
To many critics, the moral outrage of ghostwriting is like that of plagiarism: academic physicians are getting credit for articles they didn’t actually write. To David, letting someone else take the credit for his work is a minor humiliation. The real problem, of course, is much worse: spinning data perverts science. It also downplays risks that can lead to serious injuries, and deaths. As David puts it, “The moral crime I was being asked to commit was to do with truthfulness.” Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
November 24th, 2010 by Shantanu Nundy, M.D. in Better Health Network, Health Policy, Opinion, True Stories
Tags: Academic Medical Center, BeyondApples.org, Canadian Healthcare, Chicago, Comparing Healthcare Systems, Dr. Shantanu Nundy, Free Clinic, Hospital Clinic, Internal Medicine, Medical Residents, Primary Care, Single-Payer Government-Run System
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This past September, a group of medical residents at my institution began seeing primary care patients at a free clinic down the street from our tertiary academic medical center (“hospital clinic”). Far from my expectations, the care we are able to provide at our free clinic is in many ways better than our hospital clinic. Somewhat paradoxically, the experience has given me a taste of what the practice of medicine is like in single-payer healthcare systems like Canada’s.
When I volunteered to start seeing patients at a nearby free clinic, I had little idea what I was signing up for. The term “free clinic” conjured up memories as a medical student in East Baltimore tending to patients at a local homeless shelter with severe frostbite or at a student-run clinic rummaging through the storage room for anti-hypertensive medications. I expected our patients to be terribly poor, the clinic to be little more than a warehouse, for supplies and medications to be few and far between, and for the care we provided to be more about putting out fires than delivering high-quality primary care.
But the place I have come to cherish working at is none of these things. A surprising number of our patients have stable lives and regular jobs — it’s just that their jobs don’t offer health insurance (including some who work in healthcare!) Patients call for appointments. When they arrive they are triaged by a nurse who takes their vitals and asks about their chief complaint before putting them in an exam room. We provide comprehensive primary care complete with routine lab tests for cholesterol and diabetes, age appropriate vaccinations, and referrals for mammograms and colon cancer screening. Read more »
*This blog post was originally published at BeyondApples.Org*
November 24th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, News, Opinion, True Stories
Tags: Barrier To Patient Care, Captain Chelsey Sullenberger, Chuck Yeager, Cookbook Medicine, Doctors As Cowboys, Dr. Atul Gawande, Dr. David Ring, Dr. Davis Liu, Dr. John Collins Warren, Dr. Peter Pronovost, Future Doctors, General Medicine, Infallable Doctors, Jeff Skiles, Massachusetts General Hospital, Medical Errors, Medical Schools, New England Journal of Medicine, Patient Safety, Performing the Wrong Operation, Primary Care, Procedures, Protocols, Quality Patient Care, Rescue Efforts, Saving Money and Surviving the Healthcare Crisis, The Practice of Medicine, US Airways
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A recent medical error of a wrong-site surgery that occurred in one of the country’s best hospitals, Massachusetts General, reminded me why doctors need to be less like Chuck Yeager and more like Captain Sullenberger.
Growing up, I always wanted to be a fighter pilot, years before the movie “Top Gun” became a part of the American lexicon. My hero was World War II pilot Chuck Yeager, who later became one of the country’s premier test pilots flying experimental jet and rocket propelled planes in a time when they were dangerous, unpredictable, and unreliable.
Much like the astronauts in the movie “The Right Stuff,” Yeager and his colleagues literally flew by the seat of their pants, made it up as they went along, and never really knew if their maiden flight in a new aircraft might be their last. They were cowboys in the sky wrangling and taming the heavens.
Fast forward to January 2009, when shortly after takeoff, a one-in-a-million chance, a double-bird strike completely disabled a US Airways jetliner. Captain Chesley Sullenberger, with the help of his co-pilot Jeff Skiles, ditches the aircraft in the Hudson River in under four minutes even as the nation surely expected a tragedy. But not on that day. Not with that pilot. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
November 24th, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
Tags: Ancillary Service Vendors, Cost of Healthcare, Doctors' Profits, Dr. Rob Lamberts, Family Medicine, General Medicine, Healthcare reform, Healthcare Revenue, Healthcare System, Internal Medicine, Less Time With Patients, Medical Justification, Medical Practice Dollars, Musings of a Distractible Mind, Number of X-rays, Primary Care, Private Medical Practice, Quality Patient Care, Seduction In Medicine, To Take Care Of People
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Hey there, big, smart, good-looking doctor…
Are you tired of being snubbed at all the parties? Are you tired of those mean old specialists having all of the fun?
I have something for you, something that will make you smile. Just come to me and see what I have for you. Embrace me and I will take away all of the bad things in your life. I am what you dream about. I am what you want. I am yours if you want me…
Seduce: verb [trans.] attract (someone) to a belief or into a course of action that is inadvisable or foolhardy : they should not be seduced into thinking that their success ruled out the possibility of a relapse. See note at “tempt.”
(From the dictionary on my Mac, which I don’t know how to cite.)
If you ever go to a professional meeting for doctors, make sure you spend time on the exhibition floor. What you see there will tell you a lot about our system and why it is in the shape it is. Besides physician recruiters, EMR vendors, and drug company booths, the biggest contingent of booths is that of the ancillary service vendors.
“You can code this as CPT-XYZ and get $200 per procedure!”
“This is billable to Medicare under ICD-ABC.DE and it reimburses $300. That’s a 90 percent margin for you!”
This is an especially strong temptation for primary care doctors, as our main source of income comes from the patient visit — something that is poorly reimbursed. Just draw a few lab tests, do a few scans, do this, do that, and your income goes up dramatically. The salespeople (usually attractive women, ironically) will give a passing nod to the medical rationale for these procedures, but the pitch is made on one thing: Revenue. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
