My descent into guideline fatigue syndrome (GFS)
It started slowly. My former resident and present colleague, Terry Shaneyfelt first authored Are Guidelines Following Guidelines? The Methodological Quality of Clinical Practice Guidelines in the Peer-Reviewed Medical Literature
This paper alerted us to the problem. But guideline fever continued to rage. Almost every specialty and subspecialty society decided that they needed to join the guideline movement. They needed to tell us the RIGHT way to practice medicine.
While I understood the problems of guidelines (I had found a 40 page guideline on cerumen), it had not yet become visceral. Then the great pharyngitis...
Source: DB's Medical Rants - December 25, 2017 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Why Living in a Rich Country Can Give You Cancer
Shutterstock As a primary care physician, I have counseled thousands of patients to get cancer screening—blood tests to look for prostate cancer, mammograms to detect impalpable breast cancers, and colonoscopies to find precancerous colon lesions. I’ve even tried to find … Continue reading →
The post Why Living in a Rich Country Can Give You Cancer appeared first on PeterUbel.com. (Source: blog.bioethics.net)
Source: blog.bioethics.net - December 22, 2017 Category: Medical Ethics Authors: Peter Ubel Tags: Health Care breast cancer cancer screening Peter Ubel syndicated Uncategorized Source Type: blogs
Screening: Do you follow guidelines or your gut?
The commentary below is meant to invoke meaningful discourse rather than incite an unpleasant argument.
Less than a year ago, I heard Ben Stiller doling out kudos to his heroic doctor who diagnosed him with early-stage prostate cancer by using a simple, widespread screen.
What was interesting was that Stiller was actually underage. What I mean is that the star was not of age to be screened, according to current prostate cancer screening guidelines (American Cancer Association’s guidelines). He was in his mid-forties.
The guidelines are pretty straightforward. Men over the age of 50 can be screened after an informed c...
Source: Kevin, M.D. - Medical Weblog - December 13, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/dana-corriel" rel="tag" > Dana Corriel, MD < /a > Tags: Conditions Oncology/Hematology Source Type: blogs
Health Care Needs Its Rosa Parks Moment
BY SHANNON BROWNLEE
On Wednesday, October 25, 2017 I was at the inaugural Society for Participatory Medicine conference. It was a fantastic day and the ending keynote was the superb Shannon Brownlee. It was great to catch up with her and I’m grateful that she agreed to let THCB publish her speech. Settle back with a cup of coffee (or as it’s Thanksgiving, perhaps something stronger), and enjoy–Matthew Holt
George Burns once said, the secret to a good sermon is to have a good beginning and a good ending—and to have the two as close together as possible. I think the same is true of final keynotes after a...
Source: The Health Care Blog - November 22, 2017 Category: Consumer Health News Authors: Matthew Holt Tags: OP-ED Patients Physicians Lown Institute Overtreatment Right Choice Alliance Shannon Brownlee Society for Participatory Medicine Source Type: blogs
Re-structuring the patient-provider communication process to empower patients
This post is written in response to Ubel, Scherr and Fagerlin’s target article, “Empowerment Failure: How Shortcomings in Physician Communication Unwittingly Undermine Patient Autonomy” published in the November 2017 issue of The American Journal of Bioethics.
by Susanne B. Haga, PhD
Most professional organizations have recommended a shift towards greater patient empowerment and shared decision-making. The result has been a data dump: An increase in the amount of information disclosed to patients. For example, discussion of a prostate cancer diagnosis may include the grading and scoring, followed by di...
Source: blog.bioethics.net - November 14, 2017 Category: Medical Ethics Authors: Blog Editor Tags: Featured Posts Health Care Informed Consent OPC professional ethics health community patient decison-making professionalism Source Type: blogs
Teaching Better Communication: A Bootcamp Experience
This post is written in response to Ubel, Scherr and Fagerlin’s target article, “Empowerment Failure: How Shortcomings in Physician Communication Unwittingly Undermine Patient Autonomy” published in the November 2017 issue of The American Journal of Bioethics.
by Haavi Morreim, JD, PhD and Mark C. Bugnitz, MD
Communication is one of the most important skillsets in healthcare. As Ubel et al. describe in their American Journal of Bioethics article so well, inadequate communication can effectively deprive patients of the medical path that best fits with their personal goals and values – potentially leavin...
Source: blog.bioethics.net - November 13, 2017 Category: Medical Ethics Authors: Blog Editor Tags: OPC Uncategorized Source Type: blogs
We heard you — incontinence affects men too. Here’s what you need to know
As men age, the simple act of urinating can get complicated. Prostate surgery often leaves men vulnerable to leakage when they cough, sneeze, or just rise from a chair. Or the bladder may become impatient, suddenly demanding that you find a bathroom right now. “Thousands of years ago, it was not as much of an issue,” observes Dr. Anurag Das, a urologist at Harvard-affiliated Beth Israel Deaconess Medical Center. “There were lots of trees, and you could just find one and go.”
But tricky bladders can be whipped into shape. The first step is a careful assessment of what triggers those difficult moments. Often your doc...
Source: Harvard Health Blog - November 8, 2017 Category: Consumer Health News Authors: Matthew Solan Tags: Health Healthy Aging Incontinence Men's Health Prostate Health Source Type: blogs
CMS Releases Final Rule for Second Year of QPP
Last week, the Centers for Medicare & Medicaid Services (CMS) released a final rule that makes changes in the second year of the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), including the Merit-based Incentive Program (MIPS) and Advanced Payment Models (APMs). The second year of the QPP continues to build on transitional year 1 policies, noting that a “second year to ramp-up the program will continue to help build upon the iterative learning and development of year 1 in preparation for a robust program in year 3.”
In addition to the final rule, CMS als...
Source: Policy and Medicine - November 6, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
CMS Releases Final Rule for Second Year of QPP - Includes PI-QI CME Improvement Activity
Last week, the Centers for Medicare & Medicaid Services (CMS) released a final rule that makes changes in the second year of the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), including the Merit-based Incentive Program (MIPS) and Advanced Payment Models (APMs). The second year of the QPP continues to build on transitional year 1 policies, noting that a “second year to ramp-up the program will continue to help build upon the iterative learning and development of year 1 in preparation for a robust program in year 3.”
In addition to the final rule, CMS als...
Source: Policy and Medicine - November 6, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Sepsis: The Body ’s Deadly Response to Infection
Your browser does not support iframes.
Although not as well-known as other medical conditions, sepsis kills more people in the United States than AIDS, breast cancer, or prostate cancer combined. Sepsis is body-wide inflammation, usually triggered by an overwhelming immune response to infection. Though doctors and medical staff are well-aware of the condition—it is involved in 1 in 10 hospital deaths—the condition is notoriously hard to diagnose. In this video, sepsis expert Sarah Dunsmore, a program director with the National Institute of General Medical Sciences (NIGMS), describes what sepsis is and how to recognize ...
Source: Biomedical Beat Blog - National Institute of General Medical Sciences - November 2, 2017 Category: Research Authors: Chris Palmer Tags: Physical Trauma and Sepsis Source Type: blogs
Study investigates treatment regret among prostate cancer survivors
As they get older, do men with prostate cancer come to regret the treatment decisions they made? A new study of men diagnosed during the mid-1990s indicates that some of them will.
Richard Hoffman, a professor of internal medicine and epidemiology at the University of Iowa Carver College of Medicine in Iowa City, led a team that reviewed survey data that men filled out one, two, five, and 15 years after they were treated for prostate cancer. All 934 men included in the study were 75 or younger when diagnosed, each with localized tumors confined to the prostate gland. Approximately 60% of the men had low-risk prostate cance...
Source: Harvard Health Blog - October 20, 2017 Category: Consumer Health News Authors: Charlie Schmidt Tags: Cancer Men's Health Prostate Health Source Type: blogs
Time to rethink the debate on PSA testing
For most of us, whether to screen for cancer is a no-brainer. Who wouldn’t want a simple test to prevent cancer or identify it at an earlier, more treatable stage? However, as with many things, the screening decision is more complex than it may appear. For example, the test may not be particularly “simple,” such as undergoing screening colonoscopy. For prostate cancer, even after 30-plus years of using a screening blood test called the prostate specific antigen, or PSA, it still isn’t clear how well it prevents prostate cancer deaths. This has led to conflicting and changing recommendations about whether to screen ...
Source: Harvard Health Blog - September 29, 2017 Category: Consumer Health News Authors: Steven J. Atlas, MD, MPH Tags: Cancer Health Men's Health Prostate Health Source Type: blogs
We Can Improve Care Management
As a physician and CIO, I ’m quick to spot inefficiencies in healthcare workflow. More importantly, as the care navigator for my family, I have extensive firsthand experience with patient facing processes.My wife ’s cancer treatment, my father’s end of life care, and my own recent primary hypertension diagnosis taught me how we can do better.Last week, when my wife received a rejection in coverage letter from Harvard Pilgrim/Caremark, it highlighted the imperative we have to improve care management workflow in the US.Since completing her estrogen positive, progesterone positive, HER2 negative breast cancer treat...
Source: Life as a Healthcare CIO - September 12, 2017 Category: Information Technology Source Type: blogs
Photoacoustics Measures Oxygenation of Tumors to Help Choose Treatment
Different tumors respond differently to radiation and chemotherapy. There’s a lot of evidence that solid tumors that are poorly oxygenated don’t respond well to these therapies. So having a way to assess tumors for tissue oxygenation can help mitigate and avoid therapies that are dangerous to the rest of the body.
At University of Cambridge researchers have now employed photoacoustic imaging, also known as optoacoustic imaging, to identify the concentration of oxygen within targeted tumor tissue. The technology works by directing short bursts of a light beam into tissue. On each burst the tissue heats up slight...
Source: Medgadget - August 29, 2017 Category: Medical Devices Authors: Editors Tags: Oncology Radiology Source Type: blogs
How Does a BRCA Genetic Test Work? – The Dante Labs Review
Dante Labs offered me their BRCA genetic test, which I gladly accepted as I never had an evaluation focused on my BRCA1 and BRCA2 genes. These are very important as their mutations increase the risk of breast cancer and ovarian cancer in women, and prostate cancer in men. Here is my verdict.
The Angelina effect and why BRCA genes matter
The concept and practice of BRCA genetic testing became extremely popular after Hollywood actress Angelina Jolie publicized her results in 2013 alongside her decision to undergo a double mastectomy. A merciless but effective way to avoid getting breast cancer. Researchers even found that ...
Source: The Medical Futurist - August 29, 2017 Category: Information Technology Authors: nora Tags: Genomics cancer gc3 genes Genetic testing genetics Health Healthcare Innovation personalized genetics Personalized medicine Source Type: blogs
