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How one patient's end-of-life care can affect us all Print E-mail
Written by James C. Salwitz, MD | KevinMD   
Monday, 24 October 2016 00:00

David was 42 when he died from stomach cancer. He spent the last year of his life receiving useless chemotherapy and debilitating radiation. David was in terrible pain all of the time. He stayed in bed for months as cancer destroyed his ribs, back and lungs.

Finally, David was rushed to a hospital, plugged into a breathing machine and pierced by countless IV drips. He died despite a battery of tests, drugs and several rounds of rib-cracking CPR.

His wife - previously positive, happy and successful - never recovered. She quit work, drank heavily and spun into a therapy-resistant depression. 12 months later, she used pills to take her life.

At the time of David's death, his son was 17. The teen found comfort in the kind of pharmaceutical intervention that comes from the bottle and needle.

He was high school dropout and in jail by 20. Although paroled at 23, David's son was back in prison by 26. His life had dissolved to rubble.

David's suffering, poorly controlled during that last year of life, was a direct result of a failure to plan for the inevitable and the inexcusable negligence of his caregivers to provide comfort. That misery transferred to those he loved. David's pain continued after death.

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Double booking the doctor is half-booking the patient Print E-mail
Written by A Country Doctor Writes   
Friday, 14 October 2016 00:00

Not only have we shortened medical appointments to 15 minutes. We also sometimes double book them.

I get the feeling that non-providers think of this as something fairly ordinary, and even reasonable. But it is often a very difficult and destructive thing to do.

The term "double booking" and the way it looks in an ordinary doctor's scheduling grid suggest that the physician might possibly be expected to be in two places at the same time. That is hardly ever the case for those of us who are mere mortals.

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Last Updated on Saturday, 15 October 2016 10:10
A Samurai Physician's Teachings Print E-mail
Written by FHI's Week in Review   
Monday, 03 October 2016 18:09

A Country Doctor Writes about the merits of Traditional Chinese Medicine (TCM) on 9/30/16. The author believes the value of TCM lies in "a certain enlightenment and pragmatism" and that the Chinese approach puts responsibility on the individual, rather than rely on the pharmacological effectiveness of traditional Chinese medicines. 
According to the author:

In the last hundred years, our <American> culture, with its tremendous scientific and technological advances, embraced the notion that our diseases come from invading bacteria, random gene mutations and other causes completely beyond our control. The promise of modern medicine has been that we can understand and counteract these forces through science, with more and more counteractive interventions. But as our treatments get more and more powerful, we have seen many of them cause ripple effects that cause other types of discomfort or disease.

Read more in the current issue of Week in Review>>

Last Updated on Monday, 03 October 2016 18:25
Fixing our EHR mess: What needs to be done Print E-mail
Written by Kevin Campbell, MD | KevinMD   
Thursday, 22 September 2016 00:00

In 2009 the Health Information Technology for Economic and Clinical Health Act (HITECH) was signed into law by President Obama and this law quickly changed the way medicine in the United Sates is practiced. The law was a first step in requiring all physicians to utilize electronic records. The president promised that creating and electronic record mandate for physicians would result in a national, universal electronic medical record system and improve care and communication. Ultimately, the legislation that required EMR implementation in 2009 began the process of penalizing physicians who do not use them and started a lucrative business for healthcare IT vendors such as Allscripts, EPIC, Cerner and many others. The requirements to implement EMR resulted in thousands of physician practices having to make harsh financially motivated decisions - either close the doors or sell out to larger healthcare systems.

Certainly, EMR systems do have their benefits - standardized documentation and portability all improve care. When a patient travels and has an illness care is improved when another hospital and provider can easily access long-term medical records. Communication between physicians of different specialties and organizations is significantly improved.

However, EMR vendors have not yet created exchangeable, universal systems as Mr. Obama promised they would.

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Last Updated on Saturday, 24 September 2016 10:22
Mylan Pharmaceuticals Made these Two Critical Mistakes Print E-mail
Written by Justin Reno, MD | KevinMD   
Thursday, 08 September 2016 00:00

Pharmaceutical companies are brilliant. They make profit off of chemicals that can be potentially life-saving. The list is quite impressive: antibiotics for somebody who would otherwise succumb to sepsis, insulin for someone whose pancreas loses the ability to function, antivirals for chronic viral suppression, antineoplastic agents for somebody whose cells have lost their regulatory mechanisms, just to name a few.

The recipe seems to be quite simple: Charge as much money as insurance companies are willing to pay. And do this as quietly as possible: Don't let the American public know how much a drug costs.

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Marketing in Healthcare: It Ain't What It Used to Be Print E-mail
Written by Jeff Cohen | Florida Healthcare Law Firm Blog   
Tuesday, 30 August 2016 16:25

Healthcare professionals and businesses are routinely barraged with people who claim to be able to generate business for them. The business of healthcare is like none other in its abhorrence of anything that even smells like payment for patient referrals, so professionals and businesses alike have to be extremely cautious and well advised in crafting marketing and related business-enhancing relationships.

The key here is to realize that, while the laws haven't changed, what regulators are doing with them has! The environment of healthcare marketing has never been more treacherous than it is today. So what's changed? How about...

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Last Updated on Monday, 19 September 2016 16:54
Exciting implications of the neuro-immune link no one is talking about Print E-mail
Written by FHI's Week in Review   
Monday, 15 August 2016 00:00

Keith Pochick, MD, in an August 13, 2016 KevinMD post, comments on a recent research paper from the University of Virginia which "may pound the final nail into the coffin of the long-standing medical dogma which rigidly labels diseases as organic or psychiatric".

According to Dr. Pochick:

...The researchers and reviewers of this paper assert that the immune system exerts effects on the brain...what if the reverse is also true?

...After nearly four decades on this Earth and a decade and a half in clinical medicine, I am absolutely certain that the brain influences the health of the body, and the body influences the health of the brain. Every health problem is an organic one. Every health problem is a psychiatric one.

The author queries:

...What if the dopamine and endorphins released after a challenging exercise session are making you even healthier than we thought? What if the serotonin and dopamine released while you eat a meal lovingly prepared by a family member are exerting beneficial effects on your immune system? What if the serotonin released when you perform an act of kindness makes you more likely to fight off infections? What if the dopamine and oxytocin released during satisfying sex with someone you love helps your immune system recognize and destroy cancer cells?

...Couldn't this discovery (and my creative daydreaming) help explain why happy people are generally healthier, and why depression can bring physical illness?

Read more in the current issue of Week in Review>>

Last Updated on Wednesday, 17 August 2016 10:50
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