March 31st, 2010 by Happy Hospitalist in Better Health Network, Humor, News, Opinion, Primary Care Wednesdays
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“Am I having a heart attack?” From the files of the strange and unusual comes this self-test kit for myocardial infarction, otherwise known as a heart attack.
For the lay people out there, a heart attack occurs when bloodflow to the heart muscle stops, usually because of a blockage in the arteries around the heart (coronary arteries). (It’s what happened to Bill Clinton, although his heart muscle didn’t die, as it likely had collateral bloodflow from other arteries.) When bloodflow stops, the heart muscle dies. When the heart muscle cells die, they release compounds into the bloodstream which can then be detected on blood draws.
That is the basis for detecting a heart attack by drawing blood. There are some compounds that are specific to the heart, such as troponins that will only go up when the heart muscle is dying. Other enzymes, such as the CK go up with any muscle damage, including the heart.
That is the basis of this new self-test kit for heart attack testing from China Sky One Medical that tries to answer the “Am I having a heart attack?” question at home. It was approved in China in 2007 and recently received European Union clearance as well. Read more »
*This blog post was originally published at The Happy Hospitalist*
March 31st, 2010 by Edwin Leap, M.D. in Better Health Network, Health Policy, Health Tips, Opinion, Primary Care Wednesdays
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In the practice of medicine, as in any human endeavor, we encounter a wide variety of human beings. While thinking about this recently, in light of the passage of the healthcare reform act, I realized something startling that supporters of the bill may not realize: There are some patients that nobody wants to see.
This uncomfortable truth exists irrespective of the presence or absence of insurance. Sometimes physicians are accused of dismissing or avoiding certain patients on the basis of their finances alone. While that problem exists (and I have seen it), a great many of the patients who can’t find (or keep) a doctor simply aren’t much fun to be around, much less to treat. Read more »
*This blog post was originally published at edwinleap.com*
March 29th, 2010 by Shadowfax in Better Health Network, Health Policy, News, Opinion
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Last year when I interviewed then-American College of Emergency Physicians (ACEP) President Nick Jouriles I was disappointed that the ACEP had not staked out a clear position on healthcare reform. However, it wasn’t terrible that they didn’t have a position at that time, because the House bill was still being finished up and the Senate was still mired deeply in the fruitless “Gang of Six” negotiations. If ACEP wasn’t going to endorse reforms sight unseen, that was pretty reasonable, I thought. President Jouriles suggested that, in time, ACEP would weigh in with a position, one way or the other.
But we never heard ACEP take a position in the intervening months. So when I saw this post appear over at The Central Line, linking to this letter on the ACEP web site from ACEP’s current president, Angela Gardner, I was not surprised to see that ACEP has taken the weasel’s path and abstained from taking a position on the more or less final healthcare reform package. It’s pathetic, and brings into question whether ACEP can fulfill one of its most crucial functions: advocating for emergency room patients and advocating for emergency medicine physicians. The excuses offered by Dr Gardner for ACEP’s reticence to take a stand are fairly lame. Read more »
*This blog post was originally published at Movin' Meat*
March 27th, 2010 by Paul Auerbach, M.D. in Better Health Network, News, Opinion
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In a recent issue of Wilderness and Environmental Medicine (Volume 20, Number 2, 2009), Thomas Welch and colleagues have written an article entitled “Wilderness First Aid: Is There an Industry Standard?” The purpose of their inquiry was to determine if an “industry standard” exists for wilderness first aid training and certification of outdoor adventure and education leaders. To attempt to answer the question, they queried regulatory authorities, national organizations, and school/college groups with regard to their requirements for first aid training of their wilderness trek leaders.
They discovered that 10 or the 22 states with guide licensure programs required any first aid training as a condition of licensure, and none specified a specific course. Of the programs requiring such training, the requirements ranged from a 6-hour standard first aid course to more structured “wilderness first responder” (WFR or “woofer”) certification. Read more »
This post, “Backcountry” Injuries and Wilderness First Aid, was originally published on
Healthine.com by Paul Auerbach, M.D..
March 26th, 2010 by GruntDoc in Better Health Network, Health Policy, Opinion
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Much of the ongoing healthcare reform debate has focused on unnecessary healthcare expenses—specifically, medical bills that rack up without demonstrably improving people’s health. According to Peter Orszag, the director of the Federal Office of Management and Budget, about $700 billion, or 5 percent of the U.S. gross domestic product, is wasted on unnecessary care, such as extra costs related to medical errors, defensive medicine, and just plain fraud.
At the center of this discussion are “unnecessary” ER visits for minor conditions—colds, headaches, and feverish babies—that could be handled more cheaply in doctors’ offices. If we could only convince patients to take their stubbed toes to urgent care clinics or primary care offices instead of ERs, the thinking goes we could save a load and help fix this whole healthcare fiasco. But there are a few problems with this logic. See:
Are most emergency room visits really unnecessary? – By Zachary F. Meisel and Jesse M. Pines, Slate Magazine
It’s a short, well-written article. It makes some good points and being an EM doctor I happen to agree with most of them, specifically that a lot of money is spent in medicine on procedures of uncertain (at best) benefit. The fix is probably correct, too, though I don’t see Americans jumping on changing their sedentary, easy lifestyles (that includes me.)
*This blog post was originally published at GruntDoc*
