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Cutting Healthcare Costs In Spain: Evidence-Based Disinvestment

In an economic downturn, two classic cost-reducing solutions come to mind in the healthcare services industry: reduce offerings (give fewer services)  or control demand (limit access to healthcare or increase copayments). There are many more but these two are the most frequently used. Actually, budget cuts in the Spanish region of Catalonia fit in the first type: they will need fewer resources (both human and material) because their services offered will shrink.

It’s always controversial to cut healthcare services in Spain. Even talking about it leads to accusations of promoting total privatization, attacking the Welfare State and so on. But there is another way to cut services, drugs or technologies. It’s what Dr. Iñaki Gutierrez-Ibarluzea called ‘Evidenced-based disinvestment’ in an op-ed for Spain’s ‘Primary Care Journal’ (‘Revista de Atención Primaria’). It’s easy: just find out which services, technological means or drugs offer little or no benefit for patients’ health. In other words, stop financial support for anything inefficient. Read more »

*This blog post was originally published at Diario Medico*

Accidental Corneal Tear From Hugging A Baby

So on Sunday night, I finished singing BSparl her bedtime song and leaned in to tuck her into her crib.  But because she was giggling and reaching for me, I leaned in to give her an extra hug.

NEVER GO IN FOR THE EXTRA HUG.

Or at least that’s what someone should have whispered in my ear.

Because when I leaned it, she happened to reach up at the same time and her thumb met my eye with such force that it knocked me to my knees.  Apparently, her thumb nail scraped off a section of my cornea (or, as my eye doctor said, “You know when you eat string cheese and you pull a section of the cheese off?”  Thanks, Dr. S.  I will never, ever eat string cheese again.  Ever.) and severely damaged my eye. Read more »

*This blog post was originally published at Six Until Me.*

Physician Says It’s Legally Safer To Blog About Food Than Healthcare

A Rhode Island emergency room doc has been fired for posting about a trauma patient on her facebook page. While the post did not reveal patient name or personal identifiers, it had enough clinical info that a third party was able to  recognize the patient.

I say if you’re going to write online about a patient, you had better disguise them so well they don’t even recognize themselves, and never post anywhere near the time of the event’s occurrence. Some bloggers I know change age, sex and other details, and post events long after they’ve happened, so no one one could ever know for sure who they’re talking about. Some doc bloggers go so far as to disguise themselves – preferring to remain anonymous both to protect themselves and their patients.

Some medical blogsites are rich with teaching cases, including x-rays and clinical information that, if disguised, would alter the diagnostic possibilities. As online venues begin to replace the time honored medical journal or local grand rounds, how do we keep our ability to teach one another with clinical cases and still respect patient privacy?  In the past, the limited circulation of medical journals kept these cases amongst the medical community, but now with the internet (and the lay public’s interest in medicine), the audience for such case histories is limitless. Read more »

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

iPhone Surpasses Android In Breadth Of Healthcare Apps For Physicians

Last month on match day, fourth year medical students from around the country — myself included — found out where we’ll be doing our residencies.

I was extremely excited to find out I matched at my home institution, Wake Forest University School of Medicine, to do my Emergency Medicine residency, a program rich in EM culture and innovation.

Almost immediately after “The Match”, iMedicalApps received emails from fourth year medical students questioning what type of mobile device they should purchase for residency — almost all asking between an iPhone or Android.

We even found out some residency directors were already making suggestions for the incoming residents, choosing the iPhone. Below is an excerpt from one such e-mail:

If you are considering a change in mobile companies, please look carefully at an iphone. There are many apps that we will be using in the near future and it would be a significant benefit to have one.

After much debate between the editors at iMedicalApps, we have came to the conclusion that the choice of smartphone for not only a resident, but for physicians and others in healthcare has now become abundantly clear — the iPhone.

Here’s why. Read more »

*This blog post was originally published at iMedicalApps*

Should Pharmaceutical Companies Get Involved In Social Media?

Imagine you’re a pharmaceutical company product manager and your specific product helps people with a chronic illness, or a cancer that can be managed by taking a pill or an injectable medicine over many years. You want to be part of the dialogue patients have with each other. You want to be part of the community. Facebook users, and other social media participants, are increasingly forming groups around health conditions, big and small. You want to be there, because, after all, your company has invested hundreds of millions of dollars developing the approved drug and hopes this medicine, and perhaps a successor, will be on the market for a long time.

This is an exciting time on the Internet and pharmaceutical product managers want to be part of health discussions. But it is fraught with legal pitfalls and penalties that can range into the millions of dollars if the product manager, or associated marketing agencies, make even an innocent mistake. Read more »

*This blog post was originally published at Andrew's Blog*

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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