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Will Physician Education Be Valued In The Future?

The future of American healthcare will not value physician education. Perhaps it’s time to abandon the medical school model and train millions of nurses instead at a fraction of the cost. This comment was left on my blog over at NP=MD:

I don’t even compare NPs and MDs. Their models differ. One is not better than the other. The schooling — minus the residency — is nearly equivalent in terms of time spent. The problem is that NPs don’t get a long enough residency. If you take a NP and a MD, both with 20 years clinical experience, the MD does not know more than the NP. Sure, he had a few extra classes 20 years ago — which he doesn’t remember — but that’s about it.

NPs aren’t trying to steal MDs’ meal tickets, they’re attempting to better serve patients. Read more »

*This blog post was originally published at The Happy Hospitalist*

Herbal Remedy For UTI? If You’re A Lab Rat, Maybe

Lab ratA patient came into the office the other day carrying a small clipping from a reputable women’s health newsletter touting new research on an herbal remedy for urinary tract infection. Having recurrent bladder infections, my patient naturally was wondering if this was something she should try.

The article was entitled “Herbal Remedy Effective for Urinary Tract Infections” and began with this startling revelation:

The common herbal extract forskolin can greatly reduce urinary tract infections and could potentially help antibiotics kill the bacteria that cause most bladder infections. 

But the article advised that the “popular” remedy was not FDA approved for this indication, so you should “ask your doctor.” Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Pay Patients To Take Their Medicine?

The New York Times reported recently on efforts by providers and payers to increase patient medication adherence through the use financial incentives paid to patients. The article cited the use of small financial payments (<$100), awarded via lotteries, to patients that take Warfarin –- an anti-blood clotting medication.

There is certainly nothing wrong with financial incentives. Incentives have been proven successful in changing selected provider (quality and safety improvement) and patient behavior (stop smoking, weight loss and taking health risk surveys). But paying patients to take their medication is different. Actually, the evidence suggests that it is a just plain stupid idea for a whole lot of reasons. Read more »

*This blog post was originally published at Mind The Gap*

PSA Screening Not Recommended: NY Daily News Still Doesn’t Care

Headlines every day in the New York Daily News are luring men in as part of a mass prostate cancer screening campaign that the American Cancer Society not only does not endorse, but its chief medical officer recommends against. Yet the paper brags that it’s beginning its second decade of this non-evidence-based campaign. Sample headlines:

• Doctors urge New York men to take advantage of free, city-wide PSA testing

• What you don’t know can kill you. Get a FREE prostate cancer test. It can save your life

• Bring dad in for FREE prostate cancer test across the city on Father’s Day

and

• Don’t skip the PSA test! My prostate cancer is treatable because simple test caught it early (written by a Daily News staffer). Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Patient-Doctor Facebook “Friends” Could Be A HIPAA Violation

Should you friend your doctor on Facebook? It’s a question that’s gaining increasing relevance as Facebook increases its social networking dominance. I’ve touched upon the issue in the past. So has the New England Journal of Medicine.

Washington, DC, physician Katherine Chretian gives her take on the issue in a recent USA Today op-ed. She is an expert of the Facebook-medicine intersection, having authored a JAMA study on the issue.

She says, no, doctors should not be friending their patients:

Having a so-called dual relationship with a patient — that is, a financial, social or professional relationship in addition to the therapeutic relationship — can lead to serious ethical issues and potentially impair professional judgment. We need professional boundaries to do our job well.

Furthermore, there’s the little matter of patient privacy and HIPAA. I wasn’t aware of this, but simply becoming Facebook friends with patients can infringe upon uncertain ground. Read more »

*This blog post was originally published at KevinMD.com*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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