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Who’s More Pessimistic About Healthcare Reform, Physicians Or Patients?

While public opposition to healthcare reform has diminished since its passage, physician opinions are still negative, especially among specialists who see their value to the healthcare system decreasing as reform emphasizes primary care.

A survey reports that 65 percent of nearly 3,000 physicians in all specialties said the quality of healthcare in the country will deteriorate in the next five years. Seventeen percent of respondents believe the quality of healthcare will stay the same and 18 percent believe it will improve. Meanwhile, 30 percent of healthcare consumers believe that the quality of healthcare will improve.

Physicians cited as reasons for their pessimism personal political beliefs, anger at insurance companies and a lack of accurate planning in the reform act. Other reasons include that primary care physicians won’t have the time to keep up with the extra workload, forcing more patients to depend upon nurse practitioners for primary care. When asked who will likely handle the 32 million Americans expected to receive healthcare following passage of the reform, 44 percent said primary care physicians will handle the load and 44 percent said that nurse practitioners will see them. (Physicians could vote for more than one category; options include physicians assistants and specialists, for example.) Read more »

*This blog post was originally published at ACP Internist*

The Slippery Slope Of Anti-Vaccine Complacency

I got a package in the mail today: My very own (complimentary) copy of Paul Offit’s new book, “Deadly Choices; How the Anti-Vaccine Movement Threatens Us All.” Needless to say, I can’t wait to read it. Not coincidentally, Dr. Offit has been making the rounds of interviews in the wake of the book’s release. Although I haven’t heard any of them directly, I did see a reference to this NPR interview on the FaceBook page of an old friend, who quoted from it thusly:

IRA FLATOW:  You write that some pediatricians will not see kids who are not vaccinated. Is that a good solution to the problem?

DR. PAUL OFFIT: I don’t know what’s a good solution to that problem. And I feel tremendous sympathy for the clinician who’s in private practice. On the one hand, and my wife sort of expressed this, she’s a general practitioner, a pediatrician, you know, she’ll say, you know, parents will come into her office and say I don’t want to get vaccines, including, for example, the Haemophilus influenzae vaccine, which is vaccine that prevents what was, at one point, a very common cause of bacterial meningitis.

And, you know, we’ve had three cases or three deaths, actually, from this particular bacterial form of meningitis in the Philadelphia area just in the last couple years.

And, you know, to her, it’s like, you know, let me love your child. Please don’t put me in a position where I have to practice substandard care, which can result in harm, which can hurt your child. Please don’t ask me to do that.

And I certainly understand the sentiment. On the other hand, if you don’t see that child, you know, where does that child go? Do they go to a chiropractor who doesn’t vaccinate?

I think it’s hard because then you lose any chance to really immunize the child.

My friend then offers his take, that of a pediatrician in private practice. Read more »

*This blog post was originally published at Musings of a Dinosaur*

Consider Medical Conditions Before Jumping On The New Year’s Resolution Diet-And-Exercise Bandwagon

The first week of January was full of news reports of giving advice on your new diet and exercise program to help you lose the weight you’ve always wanted to. In a previous post and video I talk about some do’s and don’ts when planning for your weight loss New Year’s resolution.

In the video below, I talk about some medical issues to keep in mind before starting your program. For example, do you have a family history of medical problems like high blood pressure or diabetes? If so, you may want to schedule an appointment with your personal physician before jumping on the diet and exercise bandwagon.

If you find this video helpful, I invite you to check out other TV interviews at MikeSevilla.TV. Enjoy!

*This blog post was originally published at Doctor Anonymous*

Getting Kids To Eat Low-Sugar Cereals

fiberonecancer0 300x264 Getting Kids to Eat Low Sugar CerealsJust about everybody agrees that kids should eat breakfast every day. Breakfast improves their overall nutrition and their performance in school, among other things. But how helpful can breakfast really be if it consists of cereal deluged in sugar?

“Not very” is the answer.

Thankfully, a new study by Jennifer Harris and colleagues at Yale suggests that kids are perfectly willing to consume low-sugar cereals instead, particularly if they can add a pinch of table sugar or fresh fruit to the mix.

To evaluate kids’ willingness to eat low-sugar cereals, Harris’ team randomized 91 kids between the ages of five and 12 to two groups. Kids in the first group were offered low-sugar cereals like Cheerios, Corn Flakes, and Rice Krispies, which contain one to four grams of sugar per serving. Kids in the other group chose between Cocoa Pebbles, Frosted Flakes and Fruit Loops, which contain about 12 grams of sugar per serving.

Kids in both groups were also offered orange juice, 1 percent milk, pre-cut sections of bananas and strawberries, and sugar packets. The kids served themselves and then completed a questionnaire about their breakfast. Read more »

*This blog post was originally published at Pizaazz*

Physician Visibility In Public: I See Patients, And They See Me

In the movie “The Sixth Sense,” there was that kid who saw dead people. I’m like that. But I see patients and their parents instead. They’re all around me.

They’re watching at the grocery store when my kids act up. We meet during anniversary dinners, at Christmas Eve service, and on the treadmill at the Y. I bump into parents when buying personal effects and even during the early morning coffee run in my oldest sweats. I see patients.

The follow-up dialog between the parents might go something like this:

Dad: “Marge, don’t you think Billy’s colitis might be better managed by a doctor capable of pulling himself together?”

Mom: “Don’t be ridiculous, Frank. DrV’s bedhead has nothing to do with his ability to care for Billy. And besides, I’ve heard that he can intubate the terminal ileum in under 10 minutes.”

It’s not that I necessarily mind being seen in the wild. I’m pretty comfortable in my own skin, even when it’s glistening after a workout. I’m bothered more by the fact that patients may be repulsed by my occasional bedraggled appearance. If I knew they were good with it, I might be less caught up with the whole matter. Read more »

*This blog post was originally published at 33 Charts*

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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