January 18th, 2011 by Michael Kirsch, M.D. in Better Health Network, Opinion
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Whistleblower readers know of my criticisms of the electronic medical record (EMR) juggernaut that is oozing over the medical landscape. Ultimately, this technology will make medical care better and easier to practice. All systems will be integrated, so that a physician will have instant access to his patients’ medical data from other physicians’ offices, emergency rooms and hospitals.
In addition, data input in the physician’s office will use reliable voice activated technology, so that some antiquated physician behaviors, such as eye contact, can still occur. Clearly, EMR is in transition. I place it on the 40 yard line, a long way from a touch down or field goal position.
A colleague related a distressing meeting he had at the community hospital he works at. This hospital, like nearly every hospital in Cleveland, is owned by one of the two towering medical behemoths. I’m not a businessman, but I have learned that when something owns you, it’s generally better for the owner than the ownee. This meeting was about the hospital’s upcoming EMR policy. Sometimes, these hospital meetings are ostensibly to seek physician input, but the true purpose is to inform the medical staff about decisions that have already been made.
In the coming months, this hospital will adopt a computerized ordering system for all patients. In theory, this would be a welcome advance. It would create a digital and permanent record of all physician orders that could be accessed by all medical personnel involved in the patients’ care. It would solve the perennial problem of inscrutable physician handwriting, including mine. Read more »
*This blog post was originally published at MD Whistleblower*
January 18th, 2011 by PJSkerrett in Better Health Network, Health Tips
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After shoveling the heavy, 18-inch layer of snow that fell overnight on my sidewalk and driveway, my back hurt, my left shoulder ached, and I was tired. Was my body warning me I was having a heart attack, or were these just the aftermath of a morning spent toiling with a shovel? Now that I’m of an AARP age, it’s a question I shouldn’t ignore.
Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases when enough of the white stuff has fallen to force folks out of their homes armed with shovels or snow blowers.
What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. Pushing a heavy snowblower can do the same thing. Cold weather is another contributor because it can boost blood pressure, interrupt blood flow to part of the heart, and make blood more likely to form clots.
When a clot forms inside a coronary artery (a vessel that nourishes the heart), it can completely block blood flow to part of the heart. Cut off from their supply of life-sustaining oxygen and nutrients, heart muscle cells begin to shut down, and then die. This is what doctors call a myocardial infarction or acute coronary syndrome. The rest of us call it a heart attack.
The so-called classic signs of a heart attack are a squeezing pain in the chest, shortness of breath, pain that radiates up to the left shoulder and down the left arm, or a cold sweat. Other signs that are equally common include jaw pain, lower back pain, unexplained fatigue or nausea, and anxiety. Read more »
*This blog post was originally published at Harvard Health Blog*
January 18th, 2011 by KevinMD in Opinion, Research
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I wrote last year in USA Today about the impact of physician burnout. Not only do doctors suffer, but so do their patients.
Burnout starts early in residency, with entering interns having a depression rate of 4 percent, similar to the general public. But after the first year of residency, that number balloons to 25 percent.
Now another study adds fuel to this disturbing trend. A paper published in the Archives of General Surgery looks at the prevalence of physician burnout in surgeons:
In a national survey, one in 16 surgeons reported contemplating suicide, researchers reported.
An increased risk of suicidal ideation was linked to three factors: depression, burnout, and the perception of having made a recent major medical error …
… But only about one in four of those who reported thinking about taking their own lives sought psychiatric or psychologic help.
The rate of suicidal ideation in surgeons, at 6.3 percent, was almost double of that in the general population (3.3 percent).
Physician burnout is a phenomenon that’s often ignored. The practice environment is deteriorating, with increasing time pressures and worsening bureaucratic burdens. Little of this is addressed in the national health conversation, or in the recently passed health reform law. Read more »
*This blog post was originally published at KevinMD.com*
January 18th, 2011 by Peggy Polaneczky, M.D. in Better Health Network, Opinion
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Google is an amazing thing — it occasionally tosses you a link that lands you in an alternate universe of folks you’d never encounter in real life.
Like cattle ranchers. I’ve just spent the good part of an hour wandering their world — reading about their concerns (water, wolves, the economy), seeing how cattle breeding has changed (you pick a sire at Bullsemen.com, then do genomic profiling on your stock — did you know that cows bred for docility have more tender meat ?), and learning that ranchers are not immune to marketing from the world of scientific woo.
Check this out — it’s called SOP Life Vibration or “Serio Bio-Hygienization.” They’re selling it to farmers and ranchers in Europe and the U.S. as the latest and greatest answer to bacterial growth and odors in farm feed and bedding:
SOP products are formulated with the innovative Sirio Operating Process technology to improve the environment of the farm in a more effective and longer lasting way than current available means.
SOP® products are natural and scientifically tested. They are not enzymes, bacteria nor disinfectants. Using a process of “frequential bio-conditioning” they selectively favor the activity of the “beneficial” micro-organisms and create unfavorable conditions to inhibit the development of the “pathogenic” ones.
A 100% natural product. Through a bio-frequency method, SOP® is created with strategic wavelength and harmony. This same technology is comparable to the electronic systems used for radio broadcasting.
“100% natural,” “Bio-hygeinization,” ”Frequential bio-conditioning”…
I smell a woo. And that makes me nervous.
After all, I’m a meat eater. If someone’s putting something wacky into and around my food source, I want to know about it. So I decided it was worth my while to find out what the heck was in this SOP® stuff. Read more »
*This blog post was originally published at tbtam*
January 17th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Tips, Research
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Cancer of the ovary is a particularly nasty disease. It often remains asymptomatic until it has reached an advanced, incurable stage, and scientists have been unable to develop an effective screening test for the disease like the ones in widespread use for cancers of the breast and cervix.
The dismal status of ovarian cancer screening was underscored a year ago when an NIH-sponsored study showed that over 70 percent of cancers detected by transvaginal ultrasound and CA 125 biomarker testing — the two best ovarian screening tests we’ve got — had reached stage III or IV at the time the patients screened positive. That’s about what happens when women aren’t screened at all.
That wasn’t the worst of it, however. In just the first year of that screening program, positive test results obligated 566 surgical procedures which uncovered only 18 cancers. That’s an awful lot of unnecessary surgery and associated morbidity right there. Things were no better on the false-negative side of things. Overall, 89 cases of ovarian cancer were diagnosed during the NIH study, and a third of them had been missed by both screening modalities.
What’s new?
The NIH study didn’t evaluate the impact of screening on ovarian cancer mortality, but a recent study by Laura Havrilesky and colleagues at Duke did indeed address the point. Sadly, the results were abysmal. Read more »
*This blog post was originally published at Pizaazz*
