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Top stories in health and medicine, June 24, 2014
From MedPage Today: Mrs. Obama’s Lunch Plan: Not So Fast. In the guest blog post, Steven Horvitz, DO, a primary care physician in Moorestown, N.J., responds to MedPage Today’s coverage of the Michelle Obama-led White House roundtable criticizing Congressional efforts to reverse nutrition requirements in public schools. More Than 750 Hospitals Face Patient Injury Crackdown. During a hernia operation, Dorothea Handron’s surgeon unknowingly pierced her bowel. It took 5 days for doctors to determine she had an infection. By the time they operated on her again, she was so weakened that she was placed in a me...
Source: Kevin, M.D. - Medical Weblog - June 24, 2014 Category: Journals (General) Authors: Tags: News Diabetes Endocrinology Hospital Obesity Source Type: blogs

Ebola is yesterday’s news, but should the media move on?
Remember when we were trying not to panic about Ebola? Seems like that was only yesterday. Oh wait — it was only yesterday. But it already seems as if we are trying to remember that we were trying not to panic. I listened to my favorite news radio station out of New York City while driving to the office recently. They address all of the major news stories in the first eight minutes of every hour and half hour. I listened from the top of the hour for the full eight minutes, until traffic and weather rolled around again. Ebola did not make the cut; it was not mentioned. Continue reading ... Your patients are rating y...
Source: Kevin, M.D. - Medical Weblog - November 17, 2014 Category: Journals (General) Authors: Tags: Conditions Infectious disease Source Type: blogs

8 tips to save money on generic drugs
80 percent of prescriptions in the U.S. are for generic medications. Generics are supposed to be less expensive alternatives to brand name drugs. However, prices for certain generics are rapidly increasing. 50 percent of generic medications increased in price in the last year and 10 percent more than doubled in cost during the same time period. Among them are thyroid replacement hormone, doxycycline, digoxin and other heart medications, tetracycline, albuterol (pill form), and certain medications for blood pressure and high cholesterol. Continue reading ... Your patients are rating you online: How to respond. Manage you...
Source: Kevin, M.D. - Medical Weblog - December 6, 2014 Category: Journals (General) Authors: Tags: Meds Medications Patients Source Type: blogs

Top stories in health and medicine, December 18, 2014
From MedPage Today: OmniCarb Study: Cutting Carbs No Silver Bullet. Overweight and obese people who followed a low glycemic index diet in the context of an overall DASH-type diet had no greater improvements in insulin sensitivity, lipid levels or systolic blood pressure compared to study subjects who ate high glycemic index foods. Men Still Drive STD Increases. The CDC’s annual snapshot of sexually transmitted diseases (STDs) has both good news and bad news for 2013. WHO: True Ebola Toll Hidden. The toll in the West African Ebola epidemic is now more than 18,000 reported cases and 6,800 known deaths, the World Heal...
Source: Kevin, M.D. - Medical Weblog - December 18, 2014 Category: Journals (General) Authors: Tags: News Infectious disease Obesity Source Type: blogs

Doctors sometimes don’t inform patients of bad news.  Why?
Doctors and patients bond over time. Information exchange, education and sharing of expertise are critical activities that add to the effective practice of medicine. Delivering bad news is, unfortunately, an unpleasant part of a physician’s job. Honesty, empathy, and clear communication are essential to delivering news to patients and their families — even when the news is unpleasant or unexpected. While communication is an integral part of the practice of medicine, not all health care providers are able to relay information or test results in a way that is easily digested and processed by patients. Continue readin...
Source: Kevin, M.D. - Medical Weblog - April 22, 2015 Category: Journals (General) Authors: Tags: Physician Primary care Source Type: blogs

Why are affordable drugs so expensive?
In the old days, blockbuster drugs were moderately expensive pills taken by hundreds of thousands of patients. Think blood pressure, cholesterol and diabetes pills. But today, many blockbusters are designed to target much less common diseases, illnesses like multiple sclerosis and rheumatoid arthritis or even specific subcategories of cancer. These medications have become blockbusters not through the sheer volume of their sales, but as a result of their staggeringly high prices. Tens of thousands of dollars per patient, per year. Continue reading ... Your patients are rating you online: How to respond. Manage your online ...
Source: Kevin, M.D. - Medical Weblog - May 1, 2015 Category: Journals (General) Authors: Tags: Meds Medications Source Type: blogs

Top stories in health and medicine, May 5, 2015
From MedPage Today: Whooping Cough Epidemic Hit Vaccinated Kids Hard. The 2012 pertussis epidemic in Washington state affected a surprising number of adolescents who were vaccinated on schedule. 3-Year Curriculum: The Cure for Med-Ed’s Ills?. In response to complaints that medical education costs too much, takes too long, teaches the wrong things, and distorts the physician work force, schools are reconfiguring themselves in a variety of ways — with revamped curriculums, new teaching styles, individually shaped courses of study, and shortened study periods. Are Expensive, High-Tech Wearables for Babies Taking...
Source: Kevin, M.D. - Medical Weblog - May 5, 2015 Category: Journals (General) Authors: Tags: News Infectious disease Twitter Source Type: blogs

The fascinating journey of new immunotherapy drugs to treat cancer
Question: What do all these cancers have in common: melanoma, lung, kidney, bladder, ovarian, head and neck, Hodgkin lymphoma, stomach, breast (and others)? Answer: They have all shown evidence of meaningful, durable responses when treated with one or more of the new immunotherapy drugs. And that is truly amazing, not to mention very unexpected, even by the experts who know this stuff. That’s the message that is coming out of the 2015 annual scientific meeting of the American Society of Clinical Oncology, where thousands of doctors, researchers and others from around the world make the annual trek to Chicago to shar...
Source: Kevin, M.D. - Medical Weblog - June 16, 2015 Category: Journals (General) Authors: Tags: Conditions Cancer Source Type: blogs

Drugs and devices are getting more expensive and less useful. Why?
A few weeks ago I was feeling angry and disappointed when I noticed that many of the articles I was reading in my favorite medical journal were funded by companies who made the products those articles evaluated. This is nothing new, but it looks to me like there are increasingly more of these articles which celebrate products and fewer interesting articles about the science of medicine. The other thing that is particularly irritating about this trend, if it is a trend, is that the drugs and devices that are being sold are increasingly more expensive and benefit fewer and fewer people. The reason they benefit fewer people i...
Source: Kevin, M.D. - Medical Weblog - August 27, 2015 Category: Journals (General) Authors: Tags: Meds Medications Source Type: blogs

3 ways to improve your delivery of bad news to patients
On July 3, 2015, at approximately 2:00 a.m., I was awakened by my mobile phone ringing.  I looked at the number the call was originating from and was fearful this was the call I was dreading to receive.  My mother’s long-term care facility was calling, and the news was not good.  My mother was found without a pulse and was rushed to a local hospital. I called the emergency department of the local hospital and spoke to a physician. He proceeded to tell me all the medical procedures done to my mother.  He said nothing worked and mother did not make it.  He was friendly, yet business-like in his tone.  He said he woul...
Source: Kevin, M.D. - Medical Weblog - September 12, 2015 Category: Journals (General) Authors: Tags: Patient Primary care Source Type: blogs

Are new cancer drugs really worth their price?
Cancer drugs have become increasingly expensive in recent years. No one blinks anymore when a new lung cancer or colon cancer treatment comes to market priced at more than $100,000 per patient. In part, we don’t blink because we have simply gotten used to such prices — the shock has worn off. Moreover, many of these new treatments are targeted therapies that only work for patients whose cancers express specific mutations, targeting the specific genetics underlying their neoplasms. Because these treatments are targeted, we know that only a subset of patients will receive them, thereby limiting the overall cost of th...
Source: Kevin, M.D. - Medical Weblog - October 19, 2015 Category: Journals (General) Authors: Tags: Meds Cancer Medications Source Type: blogs

Natural drugs aren’t necessary safe. Don’t make that mistake.
According to a study published in the New England Journal of Medicine, the use of dietary supplements sends an estimated 23,000 Americans to the emergency department each year. Approximately 25 percent of the ER visits that were supplement related were by adults who were using herbal weight loss products. Another 10 percent were caused by adults consuming “energy products” (although people using energy drinks were excluded from the study). Most of the people came in complaining of cardiac symptoms: palpitations, chest pain or rapid heart rate. Not all preparations that caused problems were for weight loss or improved e...
Source: Kevin, M.D. - Medical Weblog - November 17, 2015 Category: Journals (General) Authors: Tags: Meds Medications Primary care Source Type: blogs

Overdose on news? These 6 tips will help.
The drama in Syria captivates much of the world. We sit and watch horrified as innocent civilians and children suffer. The pictures coming out of the devastated city are truly heart-wrenching and the fabric that nightmares are created out of. As if to add to that unbelievable suffering, a bomb exploded in a Coptic church in Cairo, Egypt targeting women and children. Their only crime was going to attend the morning liturgy in church. In Germany, another bomb blast detonated in a Christmas village killing shoppers. Around the world, atrocities cry out, and the earth calls out for justice. Many of us watch in shock, plunging ...
Source: Kevin, M.D. - Medical Weblog - January 18, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/linda-girgis" rel="tag" > Linda Girgis, MD < /a > Tags: Physician Mainstream media Source Type: blogs

The exploding cost of prescription drugs
The amount of prescribed medications and the number of individuals taking them are increasing rapidly. The share of Americans taking one or more prescription drugs has risen among all age groups. According to the IMS Health Study, the total spending on prescription drugs in the U.S.  reached $310 billion in 2015. This is almost three times more than total drug expenditures in the year 2000. It is forecasted that the U.S. spending on medicine will reach $370 to $400 billion in 2020. Moreover, several drug makers have notably increased their drug prices in recent years. Meanwhile, 76-year-old Ethel must choose between groce...
Source: Kevin, M.D. - Medical Weblog - February 25, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/homayoun-l-daneschvar" rel="tag" > Homayoun L. Daneschvar, MD < /a > Tags: Meds Medications Source Type: blogs

The pitfalls of prior authorization for prescription drugs
A guest column by the American College of Physicians, exclusive to KevinMD.com. One of the things that I dread the most about January 1 is that it’s the start of “prior authorization (PA) season” for prescription medications. It is time consuming and frustrating, plus it often jeopardizes patient safety and quality of care. A recent Viewpoint in the Journal of the American Medical Association (JAMA) describes PA programs, including “step therapy,” the requirement that patients try and fail a specific number of preferred drugs before a more expensive covered drug or a non-formulary drug will be approved. The artic...
Source: Kevin, M.D. - Medical Weblog - March 29, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/yul-ejnes" rel="tag" > Yul Ejnes, MD < /a > Tags: Meds Medications Source Type: blogs