July 19th, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion
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One doesn’t usually look to the Federal Register to define meaning or purpose (philosophers, yes, but bureaucrats?), but the federal government has officially ruled on what constitutes “meaningful use” — for the purposes of distributing dollars to clinicians for electronic health records.
The Wall Street Journal’s health blog has an excellent synopsis of the rule and the reaction from different interest groups and experts, and the New England Journal of Medicine has a very clear explanation and summary of its key elements by David Blumenthal, M.D., F.A.C.P., the federal government’s coordinator of health information technology. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
July 18th, 2010 by Toni Brayer, M.D. in Better Health Network, Humor, Medical Art, Opinion, Quackery Exposed
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I really want to know what the treatment is that this “regular practicing physician” sent to the patient to reduce the surplus flesh. “Eat as much and as often as you please” and “no bandaging nor tightlacing.” Bring it on!
*This blog post was originally published at EverythingHealth*
July 15th, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research, True Stories
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There’s been a bit of buzz in the health blogs over President Obama’s decision last week to use the mechanism of a recess appointment to be the director of the Centers for Medicare and Medicaid Services (CMS).
Recess appointments, for those who may not be aware, allow a President to put a nominee in place when Congress is in recess in order to have him in place without the messy process of having him approved by the Senate. True, the Senate still has to approve a recess appointment by the end of its term, or the seat goes vacant again, but it’s an excellent way to avoid having nasty confirmation fights during election years. Of course, both parties do it, and the reaction of pundits, bloggers, and politicians tend to fall strictly along partisan lines.
If you support the President, then a recess appointment is a way to get around the obstructionism of the other party. If you don’t support the President, it’s a horrific abuse of Presidential power. And so it goes. Either way, I don’t really care much about the politics of how such officials are appointed so much as who is being appointed.
The man who was appointed last week to head CMS is Donald Berwick, M.D., CEO of the Institute for Healthcare Improvement. His being placed in charge of CMS will likely have profound consequences not just for how the recent health care/insurance reform law is implemented, but for how the government applies science-based medicine to the administration of the this massive bill. Read more »
*This blog post was originally published at Science-Based Medicine*
July 14th, 2010 by Toni Brayer, M.D. in Better Health Network, Health Tips, News, Research
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The medical journal Mayo Clinic Proceedings recently contained some clinical pearls that I wanted to pass on to my men readers who take medication for erectile dysfunction (ED). They reported on a healthy 67-year-old male who took two 25mg doses of Viagra (sildenafil) but still did not get erections. He was frustrated and inquired about other treatments for ED.
The article reported that patients often take Viagra and other phosphodiesterase type 5 inhibitors (Cialis, Levitra) incorrectly. To be effective, Viagra must be taken on an empty stomach at least one hour before intercourse. Research has shown that approximately half of patients who don’t respond to Viagra will have success when they take it properly. The dose can go up to 100mg, but there is no need to increase the medication until the patient learns how to take it.
So there you have it. Take it on an empty stomach at least one hour before sex.
*This blog post was originally published at EverythingHealth*
July 14th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion
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It happened. Guilty. I confess. Reading about Dr. Berwick’s recess appointment to lead the Centers for Medicare and Medicaid Services (CMS) induced me to watch a Fox news clip. Gosh, I feel bad about it. It felt good, though.
Patients — that’s you and me — should know that CMS controls doctors, nurses and especially hospital/practice managers. They are ten times more scary than the radar patrol car on the highway.
Dr. Berwick likes the British system of healthcare delivery. In Europe healthcare is free, and everyone likes free stuff. Free stuff happens all the time, doesn’t it?
In Cambridge, Mass — at Harvard — free stuff for all seems a plausible tenet. There must be a lot of coffee shops and free time in Cambridge. In the real world — on Main street, on the farm, in the factory, or really everywhere other than college — people know getting something for nothing is fantasy.
It hasn’t happened yet, so my Dad’s advice about not worrying too much about future events still holds true, but Dr Berwick’s recess appointment to lead the all-controlling CMS has the potential to make caring for patients even more challenging. Yes, more regulations, longer EMR notes with a really careful review of systems, and less pay to doctors will surely improve patient care. Scary indeed. Read more »
*This blog post was originally published at Dr John M*
