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Informed Consent: Must The Risk Of Death Be Discussed?

January 9, 2014 9:32 am | by Skeptical Scalpel | Comments

The mortality rates for a simple tonsillectomy range from about 1 in 10,000 to 1 in 35,000. For UPPP, the mortality rate for adults is generally quoted at 0.2 percent or 1 in 500. I was unable to find any information about the mortality rate for that operation in the pediatric age group. The issue then is—must a surgeon mention death as a possible outcome after this type of surgery?


How EHR Design Can Affect Patient Safety

January 8, 2014 9:42 am | by Michael Chen, M.D. | Comments

Besides the importance of physician happiness when using an EHR, using design principles that maximize user intuition and presentation of relevant information, there is one aspect of healthcare information systems that should never be overlooked: patient safety...


Are We Successfully Moderating Healthcare Spending?

January 7, 2014 9:26 am | by Janice Boughton, M.D. | Comments

The fact that healthcare spending is already going in the right direction is fascinating and almost entirely neglected in the press, probably because it doesn’t support the more popular story that everything to do with healthcare in America is going rapidly to hell in a handbasket...


Solving The High Rates Of Hospital Readmissions

January 7, 2014 9:16 am | by Suneel Dhand, M.D. | Comments

Healthcare systems everywhere are seeking solutions to keep their patients healthier and away from hospital. Any doctor practicing at the frontlines will be able to tell you what a big issue this is right now. We regularly see the same patients on something of a merry-go-round of frequent hospital admissions, often with the same illness. Why does this happen?


Why Medicaid Patients Use The Emergency Department For Primary Care

January 6, 2014 9:48 am | by Kevin Pho, M.D. | Comments

A study found that those on Medicaid in Oregon made 40 percent more visits to the emergency department. The Oregon Health Insurance Experiment included about 90,000 low-income people and assigned 30,000 of them to Medicaid by lottery. It’s essentially a naturally-occurring randomized controlled trial...


Medicine Should Welcome The Fact That It’s A Business

January 6, 2014 9:02 am | by Rich Bottner | Comments

Harnessing business values means thinking creatively to craft solutions for everyday problems. It is about delivering outstanding service while providing a scientific framework for doing so. It begs for efficiency and waste reduction. Perhaps, above all in our current healthcare climate, a good medical “business” is one that manages its costs — something we have profoundly failed at in healthcare...


Is Arthroscopic Surgery For A Partial Meniscal Tear Unnecessary?

January 3, 2014 9:00 am | by Jennifer Gunter, M.D. | Comments

Arthroscopic knee surgery is big business in the United States. Arthroscopic partial meniscectomies alone cost $4 billion per year. Yes, billion. But do they work? Given the poor performance of these other arthroscopic surgeries, answering the question of whether partial meniscectomies are effective is crucial...              


Is Obamacare Finally On Track And Moving Toward Success?

January 2, 2014 9:08 am | by Robert Laszewski | Comments

After the disastrous launch of Obamacare the enrollment of 1.1 million people in the 36 state exchanges run by the feds is a major accomplishment. It is likely that the enrollment in the 14 state-run exchanges will take total Obamacare’s private insurance enrollment to near 2 million for the year. Does this mean that Obamacare is finally on track and moving toward success?


Why Doctors Are The Worst Patients

December 31, 2013 9:07 am | by Natalie Azar, M.D. | Comments

It’s often said that doctors are the worst patients, and perhaps that’s precisely because we’re all too familiar with what it means to be sick and to have the vulnerabilities and fears of the ailing. It isn’t fun. For those same reasons, maybe we haven’t really proverbially grown out of our hypochondriasis...


Why A Physician Shortage Is Inevitable

December 30, 2013 5:49 am | by Kevin R. Campbell, M.D. | Comments

The Affordable Care Act has already demonstrated the ineptness of government to manage healthcare — the laughable website rollout, newly discovered “backend” issues with signups, inaccurate quotes and information and questionable security. Now, as the mandates loom, consumers are beginning to wonder where exactly they will be able to get care and who may be providing it. How can there not be a physician shortage?


Five Universal Problems Hospitals Need To Solve

December 27, 2013 1:55 pm | by Suneel Dhand, M.D. | Comments

As health reform sets in, hospitals are gearing up for many challenges. While some of these are new to the health industry, several are against the backdrop of old problems that have plagued us for decades. Speaking as a doctor who has worked in a number of different hospitals up and down the east coast, I would like to identify 5 of these that I believe are fairly universal...


Why Do Misconceptions About Brain Death Persist?

December 27, 2013 9:15 am | by Skeptical Scalpel | Comments

There are many issues surrounding this case. Was the tonsillectomy indicated? Some stories reported that it was done to improve her obstructive sleep apnea. Why wasn't she successfully rescued from her complication of bleeding? I can find no discussion about how she could have bled so much without intervention in any article about the case...


Three Questions Doctors Should Ask Themselves In 2014

December 26, 2013 9:28 am | by Natasha Deonarain, M.D., MBA | Comments

As we spin into the New Year, the question on many doctor’s mind is this: “What am I going to do next year? For 2014, as a fresh new start, I offer these as questions to be asked by each and every practicing physician in America...    


Why Graduate Medical Education Is Failing

December 23, 2013 9:04 am | by J. Russell Strader, M.D. | Comments

When a doctor finishes medical school, he or she has been exposed to a lot of data, and has learned a few basic facts about how to be a physician. But the haven’t learned really how to work independently in a field of medicine. That takes the 3-10 extra years of training collectively known as GME to acquire that skill.  It is a skill that encompasses a lot of “non-data” abilities...


OPINION -- The Affordable Care Act Perpetuates A Myth Of Health Insurance

December 23, 2013 9:02 am | by Luis Collar, M.D. | Comments

Unless we limit our reliance on insurance, costs will continue rising, physician reimbursement and therapeutic autonomy will continue declining, and patients’ understanding of, and control over, their own health will continue to wane...    



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