January 2nd, 2012 by EvanFalchukJD in Health Policy, Opinion
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How Did My 2011 Predictions Turn Out?
Pretty well, actually.
As predicted last December, there was no big change to health care reform, doctors still didn’t have enough time with their patients, Microsoft (disclosure: Microsoft is a Best Doctors client) made moves to create a “Windows” for electronic health records, and “ACO” became the hot buzzword in health care. Some state governments started major redesigns of their benefits programs, saving money in the same ways private sector employers do. Meanwhile, more than ever, private sector employers are penalizing employees who don’t take care of themselves.
Misdiagnosis finally started to be recognized as a public health problem. At Best Doctors we got a great deal of press coverage in 2011 on this (for a few examples, go here, here, here, here and here). I will sneak in a 2012 prediction and tell you that you will hear a lot more about this this year, and not just from us.
What did I get wrong? Read more »
*This blog post was originally published at BestDoctors.com: See First Blog*
December 31st, 2011 by Toni Brayer, M.D. in News, Opinion
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| Kwashiorkor in Niger |
Is it plausible that one small hospital in rural Northern California treated 1,030 cases of Kwashiorkor within a two year period?
Before you answer that, let me explain what Kwashiorkor is. It is a severe form of protein malnutrition…starving to death actually. It is the type of starvation you see in African children. It is so severe that the patient needs special nutritional support including special re-feeding with vitamins and it occurs mainly in children ages 1-4. Adults can starve to death, but they do not develop classic Kwashiorkor.
Medicare pays hospitals a flat rate based on diagnosis codes for patients. Patients with more severe coded illnesses get paid at a much higher rate. Shasta Regional Medical Center, located in Redding, Shasta County, California is under the microscope for billing Medicare (our tax dollars at work) for 1,030 cases of Kwashiorkor to the tune of $11,463 for each diagnosis. This medical center is Read more »
*This blog post was originally published at EverythingHealth*
December 30th, 2011 by BruceCampbellMD in Opinion
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“Do any human beings ever realize life while they live it? —Every, every minute?”
-Thornton Wilder
His cancer was growing and his symptoms were progressing alarmingly. As holiday music played in the background, I searched the calendar to see how rapidly his surgery could be scheduled. The young man and his wife first looked relieved when we found a surgical opening in the coming week, but their faces fell as they realized that he would spend December 25th in the hospital. Family plans were to be put on hold that year. The future was uncertain.
It has always seemed to me that ”cancer” causes more life disruption during this time of year. The quickened pace of life and the family expectations, particularly when small children are involved, push people to their limits.
On the other hand, Read more »
December 23rd, 2011 by Steve Novella, M.D. in Quackery Exposed
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There are many medical pseudosciences that persist despite a utter lack of either plausibility or evidence for efficacy. Some practices emerged out of their culture of origin, or out of the prevailing ideas of a pre-scientific age, while others were manufactured out of the imagination of perhaps well-meaning but highly misguided individual practitioners. They were just made up – homeopathy, for example, or subluxation theory.
Iridology belongs to this latter category – a system of diagnosis that was invented entirely by Ignatz Peczely, a Hungarian physician who first published his ideas in 1893. The story goes that Peczely as a boy found an owl with a broken leg. At the time he noticed a prominent black stripe in the iris of one eye of the owl. He nursed the bird back to health and then noticed that the black line was gone, replaced by ragged white lines. From this single observation Peczely developed the notion of iridology.
Peczely’s idea was that the iris maps to the rest of the body in some way, and therefore the flecks of color in the iris reflect the state of health of the various body parts. This basic approach to diagnosis or treatment is called the homonculus approach – the idea that one part of the body maps to the rest of the body, including the organ systems. Reflexology, auricular acupuncture, and even straight chiropractic follow this approach.
This is what might have happened next: Read more »
*This blog post was originally published at Science-Based Medicine*
December 5th, 2011 by ChristopherChangMD in Opinion
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Would YOU as the patient see a doctor who is a well-known jerk, abuses drugs, gives the wrong diagnosis more often than not, and is known to like ordering very invasive tests??? Be honest…
The other week, a patient with a chronic cough exclaimed to me that she wished the fictional character Dr. House of TV fame actually existed in real life, because he was somebody who can diagnose anything.
I looked her straight in the eye and told her that somebody like Dr. House in the real world would be a physician nobody would want to see for many reasons:
- In the real world, patients expect doctors to have the correct diagnosis from the beginning (might forgive one wrong diagnosis). Dr. House seems to always get things wrong multiple times before he gets it right. I seriously doubt most patients would have stuck around as long as they do on the TV shows before going elsewhere. Read more »
*This blog post was originally published at Fauquier ENT Blog*