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Secretary-General On World Mental Health Day: We Must Invest In Mental Health

U N I T E D   N A T I O N S

THE SECRETARY-GENERALMESSAGE ON WORLD MENTAL HEALTH DAY: 10 October 2011
There is no health without mental health.  Mental disorders are major contributors to illness and premature death, and are responsible for 13 percent of the global disease burden.  With the global economic downturn – and associated austerity measures – the risks for mental ill-health are rising around the globe.

Poverty, unemployment, conflict and war all adversely affect mental health.  In addition, the chronic, disabling nature of mental disorders often places a debilitating financial burden on individuals and households.  Furthermore, individuals with mental health problems – and their families – endure stigma, discrimination and victimization, depriving them of their political and civil rights and constraining their ability to participate in the public life of their societies.

Resources allocated for mental health by governments and civil society are Read more »

*This blog post was originally published at Shrink Rap*

Physicians’ Donations To Political Parties: You Get What You Give

Why don’t docs get more of what they want in DC?  There’s a quite instructive graph in a blog post from NRO last week (talking about Union campaign donations), but I found this one to be very instructive, and have added labels so the point cannot be missed:

In politics, generally what you give is what you get. I’ve taken to giving more to the PACs that represent me.

As an aside, it’s political malpractice to give only to one party (Teachers). Eventually that one party will be on the outs, and then where are you?

*This blog post was originally published at GruntDoc*

Medicare Only Covers Some Medications During A Hospital Stay

One of the worst parts of my job over the years has been to tell patients I was going to bring them into the hospital as an observation status because they did not have any criteria for full inpatient status.  There is a huge difference in how CMS pays for hospital care (excluding critical access hospitals) between inpatient versus observation.

Observation is considered outpatient.  Medicare will pay for observation hospital services for up to 48 hours to allow physicians a chance to observe the patient and determine if they need to have an inpatient hospital admission.  Observation was never intended to be used as a holding pit  to help social workers arrange for a nursing home transfer during normal business working hours because it can’t be arranged, on either end, at 10 pm on a Friday night.
What used to be a moral family obligation to care for loved ones too weak to care for themselves has now been relinquished to the role of hospitals and hospitalists.  And we all pay for it.  Families have abandoned their loved ones for good.  It’s really quite sad.  Bringing patients into the hospital for the purpose of arranging a nursing home transfer is, in my opinion, a form of Medicare fraud, since these patients have no intention of being fully admitted.

But it’s paid for and will always be paid for, except when Read more »

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

Physician Questions The Need For Demographic Data With The EMR

Race is a medically meaningless concept.

Spare me the few tired cliches about prostate cancer, diabetes, and sarcoidosis being more common in blacks than whites, or even the slightly increased risk of ACEI cough in patients of Asian descent. We screen Jews of Ashkenazi descent for Tay Sachs without any racial labeling. All that information is readily accessible under the Family History section of the medical history. It is no more than custom which dictates the standard introductory format including age, race, and gender. It turns out I’ve blogged about this before at some length (pretty good post, actually). What is new is the advent of electronic medical records.

Much hullabaloo has been made about federal stimulus funds allocated to doctors as payments for adopting EMRs; “up to $44,000!” Here’s the problem with that figure, though, including how it breaks down (source here): Read more »

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

Do Physicians Have A Role In Controlling Healthcare Costs?

The Role of Physicians in Controlling Medical Care Costs and Reducing Waste by the RAND Corporation and David Geffen, University of California Los Angeles School of Medicine, Santa Monica was just published in the Journal of the American Medical Association (JAMA).  I do not think the JAMA should have published this article.

1.Why would the JAMA publish such an article?

2. Why are physicians blamed for all the waste in the system?

3. Why is it the physicians’ responsibility to eliminate waste when they are not the cause of the greatest percentage of the waste?

“The amount of money spent on medical care is increasing faster than the gross domestic product (GDP), and the federal deficit is increasing.”

The initial statement assumes that the government deficit is increasing because physicians control government spending for healthcare.

This is only partly correct. Read more »

*This blog post was originally published at Repairing the Healthcare System*

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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