Medical Students, Small Towns, and the Power of Relationships
By: Scott Hippe, fourth-year medical student, University of Washington School of Medicine
Scott Hippe is currently traipsing about the Pacific Northwest on his clinical rotations. His interests include rural medicine, the outdoors, and listening to or telling a good story. He will be applying to a residency in family medicine this year.
Before ever setting foot in a medical school classroom, I spent a week observing competent, compassionate rural physicians care for the diverse health needs of their community. This was the first of my experiences participating in the WWAMI Targeted Rural Underserved Track (TRUST) Programâ€...
Source: Academic Medicine Blog - October 13, 2015 Category: Universities & Medical Training Authors: Guest Author Tags: Guest Perspective relationships rural health Targeted Rural Underserved Track Program underserved communities WWAMI Source Type: blogs
Physician Payments Sunshine Act: Comments For and Against CMS Including Open Payments Data on "Physician Compare" Profiles
On July 15, 2015, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule to update the Medicare physician fee schedule for 2016. Among the many proposals, CMS sought comment on whether to add Open Payments data to its “Physician Compare” website. The comment period closed last month; we have provided a list of comments listed by whether they were supportive or against the proposal.
Background
CMS launched the first phase of Physician Compare on December 30, 2010, and so far the website mainly contains physician identification information as well as whether they participate ...
Source: Policy and Medicine - October 8, 2015 Category: American Health Authors: Policy and Medicine Writing Staff Source Type: blogs
The ER doctor is only as good as her hospital allows, Nov 23, 2004
Continuing on with this lower GI bleed lady.She seemed okay after the questioning...and during rounds. But immediately after rounds she seemed to be sleeping. When the sheets were pulled back... ...she was laying in a mound of dark red clots of blood. Looked immediately up at the monitor, low and behold she was tachycardic and hypotensive. The juniors were all over it...and stabilized her with IVF, blood transfusions, and even got a tagged RBC scan to see where the blood was coming from...exactly.The RBC scan revealed a "sprinkler" in her descending colon. Surgery was called. They wanted an NGT lavage "the bleeding may be ...
Source: EM Physician - Backstage Pass - September 8, 2015 Category: Emergency Medicine Authors: Taylor Source Type: blogs
Maybe health costs should be a quality measure
How do we measure a doctor? Hospital length of stay? Infection rate? Flu shot compliance? Waiting time? These reality surrogates do not tell us how a patient feels or the quality of life. They are complex to measure, require major data crunching and may not focus on an individual physician. This week, two patients reminded me of a basic screening tool for good care:Â How much is the bill?
15 years ago, I took care of Melissa for gallbladder cancer. She received surgery, radiation and has been in remission ever since. In fact, because she has no need of a grouchy oncologist, I have not seen her in years. Melissa works full ...
Source: Kevin, M.D. - Medical Weblog - August 25, 2015 Category: Journals (General) Authors: James C. Salwitz, MD Tags: Conditions Cancer Source Type: blogs
Brenda’s Wheat Belly deflation
Brenda first contacted me because she had been following all the strategies of Wheat Belly and Wheat Belly Total Health, yet was not experiencing the weight loss like other people. She detailed her diet to me and it was nearly flawless. Likewise, she had added the Wheat Belly Total Health strategies such as vitamin D, iodine, and fish oil. I therefore advised her to drop her doctor and find one who would help her identify what was wrong with her health that could be stalling weight loss.
I share Brenda’s story because her experience provides three valuable lessons:
Even when weight loss is modest or does no...
Source: Wheat Belly Blog - August 2, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories autoimmune gluten grains hypothyroidism Weight Loss Source Type: blogs
Over-Reliance on Tests: Why Physicians Must Learn to Trust Themselves & Their Patients
The post below ran yesterday on Better Health.
I met my newly admitted patient in the quiet of his private room. He was frail, elderly, and coughing up gobs of green phlegm. His nasal cannula had stepped its way across his cheek during his paroxsysms and was pointed at his right eye. Although the room was uncomfortably warm, he was shivering and asking for more blankets. I could hear his chest rattling across the room.
The young hospitalist dutifully ordered a chest X-Ray (which showed nothing of particular interest) and reported to me that the patient was fine as he was afebrile and his radiology studies were unremarkable...
Source: Disruptive Women in Health Care - July 28, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Consumer Health Care Health Professions Patients Policy Source Type: blogs
Over-Reliance On Tests: Why Physicians Must Learn To Trust Themselves And Their Patients
I met my newly admitted patient in the quiet of his private room. He was frail, elderly, and coughing up gobs of green phlegm. His nasal cannula had stepped its way across his cheek during his paroxsysms and was pointed at his right eye. Although the room was uncomfortably warm, he was shivering and asking for more blankets. I could hear his chest rattling across the room.
The young hospitalist dutifully ordered a chest X-Ray (which showed nothing of particular interest) and reported to me that the patient was fine as he was afebrile and his radiology studies were unremarkable. He would stop by and check in on him in the m...
Source: Better Health - July 27, 2015 Category: American Health Authors: Dr. Val Jones Tags: Health Tips True Stories Blood Tests Correct Diagnosis False Negatives False Positives Lab Tests Physical Exam Radiology Trust Source Type: blogs
When it comes to poop, doctors don’t know sh*t
It all started with a routine fecal transplant.
The case report was published earlier this year: a thirty-two-year-old female suffering from Clostridium difficile colitis resistant to multiple rounds of antibiotics was given a fecal transplant and quickly recovered from the debilitating bouts of diarrhea and abdominal pain that had plagued her for months.
That wasn’t what made headlines, though. Using fecal transplants to treat resistant cases of C. diff. colitis has been around for years. The procedure, which involves administering fecal matter from a donor to a patient via colonoscopy, endoscopy, or enema, is meant to ...
Source: Kevin, M.D. - Medical Weblog - June 22, 2015 Category: Journals (General) Authors: Alberto Hazan, MD and Anthony Carrozza, MD Tags: Conditions GI Source Type: blogs
My Wheat Belly turning point
Many of you know that the Wheat Belly concepts got their start when I was trying to help patients in my cardiology practice obtain better control over risk for coronary disease. An exceptionally common combination of abnormalities in people with heart attacks, survivors of sudden cardiac death, those who have undergone stent implantation or bypass surgery, or have high coronary calcium scores (an early quantifier of coronary atherosclerotic plaque): large quantities of small LDL particles and high blood sugars (high fasting glucose and/or hemoglobin A1c, HbA1c, reflecting long-term blood sugar fluctuations).
Because wheat...
Source: Wheat Belly Blog - June 11, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories cholesterol gluten grains lipids lipoproteins ulcerative colitis Weight Loss Source Type: blogs
The potential pitfalls of open access endoscopy
While I consider myself to be an ethical practitioner, I am not perfect, and neither is the medical profession. I will present a recurrent ethical dilemma to my fair and balanced readers and await their judgment.
Our gastroenterology practice, like all of our competitors, has an open access endoscopy option. This permits a physician to refer a patient to us for a colonoscopy, without the need for an initial office visit.
Continue reading ...
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 3, 2015 Category: Journals (General) Authors: Michael Kirsch, MD Tags: Conditions GI Source Type: blogs
Value-Based Care’s Data Problem
By RACHEL KATZ
Lisa is an administrator at an Accountable Care Organization, or ACO — a new healthcare payment model that encourages coordinated, high-quality, and efficient care. Lisa’s ACO facilitates the program at about 100 clinics around California, and her mission in the first year of operating might seem elementary to an outsider: to report a set of metrics to Medicare that indicate the health of patients who had been seen at these clinics.
At the start of 2015, Lisa received a panel of patients to review. She had expected a list of about 600, but instead there were 2,400. For each, she needed to report o...
Source: The Health Care Blog - May 21, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
Sherri found the Wheat Belly Fountain of Youth . . . and bowel health
Sherri shared her amazing “before” and “after” Wheat Belly lifestyle photos and story:
“The pic on the left is from June, 2014 and the pic on the right is May, 2015. I started the Wheat Belly lifestyle in August, 2014 after reading how giving up wheat/gluten can help with arthritis pain.
“In Wheat Belly Total Health, you talked about people who were chronically constipated, I think the term was “obstipation.” Well, that was me. I thought that maybe as a ‘side effect’ I could get my gut working right, as well. I wanted to post because I was one of those people who...
Source: Wheat Belly Blog - May 12, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories bowel health constipation gluten grains Weight Loss Source Type: blogs
MKSAP: 55-year-old man with gastroesophageal reflux symptoms
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 55-year-old man is evaluated for a 6-year history of typical gastroesophageal reflux symptoms treated on an as-needed basis with a proton pump inhibitor. However, the frequency of his reflux symptoms has recently increased and his episodes do not respond to treatment as completely as in the past. An upper endoscopy is scheduled to evaluate the cause of this change in his symptoms.
Endoscopy reveals a 4-cm segment of salmon-colored mucosa in the distal esophagus. Biopsy from the salmon-colored segment reveals i...
Source: Kevin, M.D. - Medical Weblog - March 29, 2015 Category: Journals (General) Authors: mksap Tags: Conditions GI Source Type: blogs
Which is More Uncomfortable: The Colonoscopy or Treatment for Colon Cancer?
Michelle was a healthy, active 47 year old. She tried to eat right and she exercised. It looked like the hard work was paying off: no health issues and lots of energy. Her work in the healthcare field motivated her to see her doctors regularly for checkups, to get mammograms and to have her blood work done annually. She knew she was getting close to the magical age of 50 and that soon she would need to get a colonoscopy to screen for colorectal cancer. Since she had no family history of the disease she wasn’t worried. She felt certain that, just as all her previous testing had come back normal, this one would too.
...
Source: Disruptive Women in Health Care - March 18, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Cancer Source Type: blogs
