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Conflict of Interest in Medicine--Why should we care?
This weeks issue if the JAMA (Journal of the American Medical Association) reads like an expose. At least 3 of the research articles do. So exciting. I don't want medicine, my field, to be ethically...
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The Affordable Care Act (aka Obamacare) on the chopping block
The Patient Protection and Affordable Care Act (ACA for short, or Obamacare as it has come to be known) was passed on March 23, 2010 after intense wrangling and many compromises. It is a huge and...
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Health insurance as a contributor to high medical costs
After writing about the coming demise of the Affordable Care Act, I began to think, again, about why it costs so much to deliver healthcare in this country. If it was cheaper, legislation to make...
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Universal healthcare and a single payer--definitely not the same thing.
I hear many of my progressive friends say that "obviously what we need is a single payer." That could work, but it is definitely not a sure thing. Overall what we want most is universal access to...
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Bedside (Point of Care) Ultrasound of the Lung--So Good
Last week was a big week. Many patients. Lots of bedside ultrasound.I've blogged on and on about my undying love for ultrasound at the bedside as a part of my physical exam. It keeps being powerful. It...
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Medicaid and the national debt--why should we shell out so much money for...
Medicaid, the program that provides funding for adults, seniors (along with Medicare), children and people who are blind or disabled who can't pay for their own healthcare, is expensive. It is...
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How reduced regulation by the FDA will save money--except not
There is enthusiasm in politics about reducing regulation to stimulate creativity and economic growth. Maybe. But reduction in oversight of medication and medical devices by the Food and Drug...
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Don't look hard for thyroid cancer--you will probably find it
Gilbert Welch has written an excellent commentary on the fresh-out-of-the-printer recommendations of the US Preventive Services Task Force (USPSTF) regarding screening for thyroid cancer. Dr. Welch, a...
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Bystander CPR--some interesting statistics
"Annie, Annie, are you OK?"Many of us learned to resuscitate a person who has collapsed using Annie, the manikin based on a death mask of a young woman who had drowned in the Seine in Paris in the 19th...
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Reducing my cardiovascular risks--the ongoing saga
About 5 months ago I embarked on an adventure in healthcare. My healthcare. I decided to take medicine to reduce my cardiovascular risk. I recognize that my cardiovascular risk is pretty low, and when...
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Should a type 2 diabetic monitor blood sugars? Maybe not!
Today in the JAMA (Journal of the American Medical Association) I read that a group out of the University of North Carolina had actually done a randomized study of whether non-insulin treated type 2...
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Agreement and division--the American Health Care Act and what we all want
It's been hard to be a concerned American citizen lately. We are facing huge problems which will become larger in our lifetimes, including the need to take care of our increasing global population and...
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The demise of the lecture--the rise of real education?
Today in the New England Journal of Medicine I read an editorial that discussed how lectures are being phased out in medical school education. I was, at first, a little bit appalled. Why would they...
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How a pocket sized ultrasound pays for itself--every week
I bought a pocket ultrasound in 2011, determined to learn how to perform and interpret ultrasound at the bedside and thus transform my internal medicine practice. I bought it new and it cost over...
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Physician Burnout and Suicide
Physician burnout and physician suicide has been getting more attention in the last several years. Suicide among physicians is horribly tragic, and maybe moreso because of several factors. Suicide is...
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How much do we love guns?
A letter written to JAMA (Journal of the American Medical Assn.) by Robert Tessler MD and colleagues at the Harborview Injury Prevention and Research Center in Seattle presented evidence that the...
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Technology is unkind to the elderly
In about 1990 we got our first computer. I say "we" because my husband and I shared a desktop which I used infrequently. I mostly used it for word processing, and the internet was very young. At the...
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Charitable Giving (Plus musings on the 2017 tax reform plan)
'Tis the seasonEvery year at about this time piles of mail comes to my box asking for money. I look through the pretty envelopes, some with calendars and return address stickers, some with wrapping...
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Menopausal Estrogen Replacement: can we start using this again safely?
Estrogen is a miracle drug for many women who experience the drenching sweats, sexual dysfunction and frustrating brain betrayals associated with entering menopause. It comes in expensive patches, less...
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Vitamin C and Sepsis: cheap and effective?
Sepsis is one of the most common diagnoses in our hospital that leads to admission to the intensive care unit. Sepsis is the syndrome that comes from uncontrolled, usually bacterial, infection and is...
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