December 27th, 2010 by John Mandrola, M.D. in Better Health Network, News, Opinion, Research
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The end of the year marks a time for list-intensive posts. Recently Larry Husten from CardioExchange and CardioBrief asked for my opinion on the three most important cardiology-related news stories of 2010. Additionally, he wanted three predictions for 2011. Here goes:
Top Cardiology Stories Of 2010:
1. By far, the #1 heart story of 2010 was the release of the novel blood-thinning drug dabigatran (Pradaxa) for the prevention of stroke in atrial fibrillation. Until this October, the only way to reduce stroke risk in AF was warfarin, the active ingredient in rat poison. Assuming that there aren’t any post-market surprises, Pradaxa figures to be a true blockbuster. Doctors and patients have waited a long time to say goodbye to warfarin.
2. The Dr. Mark Midei stent story: Whether Dr. Midei is guilty or innocent of implanting hundreds of unnecessary stents isn’t really the big story. The real impact of this well-chronicled saga is the attention that it brings to the therapeutic misconceptions of coronary stenting. The problem with squishing and stenting is that although they improve the physics (of bloodflow), they do not change the biology of arterial disease — a hard concept to grasp when staring at a picture of a partial blockage. The vast press coverage of Dr. Midei’s alleged transgressions has served to educate many about heart disease, the nation’s #1 killer. Read more »
*This blog post was originally published at Dr John M*
November 17th, 2010 by John Mandrola, M.D. in Better Health Network, News, Opinion
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The best part of doctoring is its humanness. Machines can’t do it — not even Apple products.
But that’s the worst part, too. Since humans practice medicine, there will be “medical errors.” And when doctors err, people — not spreadsheets or profits — are hurt. That’s the rub. Like any endeavor, the greater the reward the greater the risk. Those cards were put on the table in medical school.
“Don’t want mistakes? Don’t do anything. Don’t make any decisions. Don’t do any procedures. Then, there will be no errors,” the grey-haired, Swiss-born cardiac surgeon counseled me many years ago after an imperfect ablation.
The headline was about a doctor’s error. It was a doozy. But for me, the story belies the headline. A Boston Globe reporter called a surgeon’s public admission of performing a wrong operation “an unusual display of openness.” I would call it something else: Breathtaking. Unprecedented. Courageous. Read more »
*This blog post was originally published at Dr John M*
November 17th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Policy, News, Opinion
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There’s an article in the New England Journal of Medicine entitled the “Unintended Consequences of Four-Dollar Generic Drugs.“ Ever one to hone in on unintended consequences of all stripes, I quickly clicked through. Oh, dear! What bad could possibly come of making drugs significantly more affordable?
Were more people demanding prescriptions for drugs they didn’t really need now that they were so cheap? (Dream on. I’m still twisting arms to get my high-risk cardiac patients to take their generic statins.) Were pharmacies going out of business, no longer to make ends meet without massive markups on brand name drugs, contributing to skyrocketing unemployment and otherwise adding to the country’s general economic malaise? Were cardiologists’ incomes plummeting because of sagging rates of coronary disease now that everyone could easily afford their beta blockers, ACE inhibitors, and statins?
Or maybe it was something good. I guess, technically, “unintended” doesn’t automatically equal “bad.” What could it be? So I read. And what did I discover? Read more »
*This blog post was originally published at Musings of a Dinosaur*
October 20th, 2010 by EvanFalchukJD in Better Health Network, Health Policy, News, Opinion, Research
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Who do you think is likely to be a better doctor: A board certified graduate of one of the top medical schools in America, or a non-certified doctor trained in a foreign country?
If your answer is “I have absolutely no idea,” then you’re probably spending a lot of time looking at the “report cards” that pass for measures of health care quality. And you’re probably confused.
Researchers in Pittsburgh studied 124 process-based quality measures in 30 clinical areas. These process measures are the state-of-the-art ways in which government and private insurers are checking up on the quality of medical care. They include things like making sure patients with heart problems are prescribed aspirin, and that women get Pap smears. The researchers compared these measures against other, simpler measures, like medical education, board certification, malpractice claim payments, and disciplinary actions.
The result? You couldn’t tell the differences among doctors. Read more »
*This blog post was originally published at See First Blog*
October 8th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Medblogger Shout Outs, News, Opinion, Research
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I [recently] received a press release from a friend in the Bay Area. Investigators at UCSF have published a study in the New England Journal of Medicine showing that less chemotherapy can be effective at treating some childhood cancers.
The paper was the result of an eight-year clinical study in children with neuroblastoma. In this particular population, researchers were able to reduce chemotherapy exposure by 40 percent while maintaining a 90 percent survival rate. You can read about it here.
The press release sparked a brief email exchange between me and my friend: Who might be interested in writing about this study and is there any way to get it to spread? What would make it sticky in the eyes of the public?
Here are a few ideas:
Figure out who cares. Sure it’s niche news, but there are people who would think this is pretty darn important. Think organizations centered on parents of children with cancer, adult survivors of childhood cancer, pediatric hematology-oncology physicians, pediatricians and allied professionals in pediatric medicine like nurse practitioners and hematology-oncology nurses. Networks form around these groups. Find them and seed them.
Make a video. Offer powerful, visual content beyond a press release. A four-minute clip with the principal investigator, Dr. Matthay, would be simple and offer dimension to what is now something restricted to print. The Mayo Clinic has done this really well. Read more »
*This blog post was originally published at 33 Charts*
