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Grand Rounds: Edition 6.34

Grand Rounds logoAs the newly-appointed director of content for Better Health and personal editorial advisor to the infamous Dr. Val, I’ve been given the honor of hosting this edition of Grand Rounds — a weekly summary of the best health blog posts on the Internet.

This week’s submissions cover a nice mix of issues important to health and medicine, which I’m presenting in super-organized, far-from-creative alphabetical order. (Excuse my conservativeness as I’m originally a product of the Mayo Clinic, and even after jumping ship nearly five years ago, I’m still affected due to my unchanged physical location — I’ll find my more liberal social-media sea legs soon, promise!)

From geriatrics to Viagra, PET scans to personality disorders, dentists to American Idol, you’ll find it in this ever-so-tidy session of Grand Rounds.

Best of health,
Maria

GRAND ROUNDS: EDITION 6.34

A Healthy Piece Of Mind puts cancer in the context of the Serenity Prayer: The Audacity Of Trope: Cancer Stories.

ACP Hospitalist reports that the FDA has launched a campaign to help healthcare providers report misleading drug advertising and promotion: Join The Ad Police!

ACP Internist writes that telemedicine is changing the playing field in primary care as internists sign up to diagnose patients over the Internet: Doctors Delivering Diagnoses Online.

Behaviorism And Mental Health shares the idea that it’s wrong to consider certain lifestyles and mindsets as pathological: Personality Disorders Are Not Illnesses.

Colorado Health Insurance Insider blogs about how hospitals that don’t treat Medicaid patients will end up losing money under the new healthcare reform law: Colorado Expanding Access To Medicaid And CHP+.

Diabetes Mine writes about American Idol contestant Crystal Bowersox and how the media has reacted to her having diabetes: Doin’ Her Thing With The ‘Betes.

EverythingHealth offers tips on how to keep kids safe when communicating with others on the Internet: Keeping Kids Safe On Social Networking Sites.

Health AGEnda discusses a recent article calling for improved training in geriatrics for primary care physicians: Report From The Brain Trust.

HealthBlawg tells how electronic health records will soon be required as a condition of licensure for doctors and healthcare centers in Massachusetts: HIT Incentives In Massachusetts: Less Carrot, More Stick.

HealthNewsReview comments on Senator David Vitter’s recent request to have the U.S. Department of Health and Human Services remove breast cancer screening recommendations from its website: Senator Strikes Out By Politicizing Mammography Recommendations.

How To Cope With Pain explains that change is hard and offers the helpful advice of trying “half a habit” at first: Change A Habit Slooowly.

In Sickness And In Health (U.K.) summarizes new research that suggests that Viagra may improve the delivery of chemotherapy drugs in women with breast cancer that has spread to the brain: Viagra Could Help Women Too, But Not How You Think.

In Sickness And In Health (U.S.) writes about couples and illness, describing how other relationships in your life can affect your health or your partner’s health: My Mother, My Partner?

Jill Of All Trades, MD provides a public health doctor’s tips for patients who don’t have health insurance: My Top-15 Resource List For The Uninsured.

Laika’s MedLibBlog highlights research on how lack of sleep can affect your risk for obesity, diabetes and heart disease: What One Short Night’s Sleep Does To Your Glucose Metabolism.

Lockup Doc talks about when non-psychiatric illnesses in people with mental health histories are minimized or dismissed by healthcare providers: Psychiatric Patients With Medical Illness May Not Be Taken Seriously.

MD Whistleblower warns that dentists’ habit of overprescribing penicillin has “serious consequences” for patients: Why Do Dentists Prescribe Antibiotics So Often?

MedInnovationBlog talks about the obsession Americans have with medical technology and how it affects healthcare: Americans And Their Medical Machines.

Mental Notes debunks myths about depression after childbirth and reports on a recent study that used PET scanning to identify new moms at higher risk: What Causes Postpartum Depression?

Novel Patient shares thoughts on facing life’s difficulties and how to keep a positive attitude: Seeing Double.

Nutrition Wonderland presents new research on obesity that helps explain why dieting doesn’t always work as expected: When Cutting Calories Doesn’t Cut It.

Nuts For Healthcare says that “big pharma” should pay attention to significant advances in vaccine development: Vaccines, Vaccines…And How We Got To Provenge.

Supporting Safer Healthcare highlights confidentiality concerns about using portable data devices to store sensitive healthcare information and patients’ medical records: Lost Data Causing “10-Out-Of-10” Pain For Healthcare.

Suture For A Living tells the story of a recent brush with domestic abuse and provides resources to get help if you need it: Domestic Violence.

The Covert Rationing Blog conducts an “intervention” on behalf of two fellow medical bloggers in regards to American obesity, discrimination, and “demonizing” the obese: Defending The Anti-Obesity Movement, Again.

The Examining Room Of Dr. Charles tells the story of how a patient triggered memories of a doctor’s first experience with human anatomy: White Silken Ribbons.

The Happy Hospitalist says one group of physicians at his hospital wants to be compensated for their time on call: Should Hospitals Pay Doctors To Be On Call?

Who Pays For Healthcare? When Doctors And Patients Don’t Care

The essence of the moral hazard experience through a nice neighborly conversation:

Neighbor: These allergies are killing me.
Happy:  That’s terrible. I hope you feel better.
Neighbor:  I tried Zyrtec but it wasn’t doing anything for me, so my doctor prescribed ‘x.’ (inaudible drug name )
Happy:  Does it start with an ‘x?’ (The drugs name is Xyzal.)
Neighbor:  Yes, it does.
Happy: Oh, that drug (Xyzal) is nothing more than Zyrtec, which the company slightly changed the formula of and now they get to sell it as a patented medication at 10 times the price for the next 10 years.
Neighbor: Oh, I didn’t know that. But you’re right. It was  $110. 
Happy:  Did it help you with your allergies?
Neighbor: Nope.
Happy: I guess you just wasted $100.
Neighbor.  I didn’t waste anything. My insurance company paid for it.
Happy:  Actually, we all paid for it with higher premiums.
Neighbor: (Walks away.)

The doctor doesn’t care — he’s not paying for it. The patient doesn’t care — she’s not paying for it. But everyone complains that their insurance rates are out of control. It’s not insurance company profits that are making healthcare too expensive, it’s patients and doctors who don’t care. 

Bundled care solves this problem because the doctor won’t prescribe a $110 medication and offer therapies with no proven benefit over less-expensive options.

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

Is “Minimally Disruptive Medicine” An Emerging Field?

I recently stumbled onto the “Minimally Disruptive Medicine” blog maintained by Dr. Victor Montori from the Mayo Clinic. I have to admit that the name caught my attention so I scoped it out.

According to Dr. Montori, “minimally disruptive medicine refers to the practice of medicine that seeks to design effective treatment programs for patients while minimizing the burden of treatment.”  He describes this as an emerging field.

I have to admit that I was simultaneously puzzled and intrigued. After all, how is this different from the way good medicine is practiced? I, for one, like to think that I create individually-tailored programs that meet my patients’ needs while minimizing their treatment burden. Read more »

*This blog post was originally published at 33 Charts*

Cutting Healthcare Costs Means Saying “No” To Patients

Let’s face it, the best way to cut healthcare costs is to say “no.” That means denying unnecessary tests that most patients in the United States are accustomed to having.

The New York Times‘ David Leonhardt has the best take on this issue that I’ve read. He acknowledges the difficulty of telling the American public “no,” and cites examples ranging from the breast cancer screening controversy to the managed care backlash in the 1990s:

This try-anything-and-everything instinct is ingrained in our culture, and it has some big benefits. But it also has big downsides, including the side effects and risks that come with unnecessary treatment. Consider that a recent study found that 15,000 people were projected to die eventually from the radiation they received from CT scans given in just a single year — and that there was “significant overuse” of such scans. Read more »

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

I’m Your Doctor, And I’m Worth It

Rx Vending MachineI saw the note on the patient’s chart before I opened the door: “Patient is upset that he had to come in.”

I opened the door and was greeted by a gentleman with his arms crossed tightly across his chest and a stern expression. I barely recognized him, having only seen him a handful of times over the past few years. Scrawled on the patient history sheet in the space for the reason for his visit were the words, “Because I was forced to come in.”

My stomach churned. I opened his chart and looked at his problem list, which included high blood pressure and high cholesterol –- both treated with medications. He was last in my office in November — of 2008. I blinked, looked up at his scowling face, and frowned back. ”You haven’t been in the office for over 18 months. It was really time for you to come in,” I said, trying to remain calm as I spoke.

He sat for a moment, then responded with very little emotion. “I’m doing fine. You could’ve just ordered my labs and called in my prescriptions. I don’t know why I had to be seen.” Read more »

*This blog post was originally published at Musings of a Distractible Mind*

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