Dr. Kevin

1. Office visit by webcam
   Imagine being able to see your doctor, on demand via your computer. A company is looking to make this scenario a reality, where patients can "visit" a doctor for a 10-minute, online consultation via webcam. Malpractice is covered, and the cost is low enough that health plans are paying for it.It's ...
   Wed, 19 Nov 2008 21:41:22 -0600
   
   

2. Does the AMA really support the medical home?
   The specialist-heavy physician organization says all the right things regarding the proposed primary care medical home, but will their support withstand "budget-neutral" payment reforms?An emergency physician comments that "current compensation mechanisms for health insurance in federal plans . . . ...
   Wed, 19 Nov 2008 17:00:01 -0600
   
   

3. A real Dr. House, or did this physician benefit from prior studies?
   A family physician diagnoses an ependymoma from listening to a patient.That's an incredible diagnosis and kudos to the doctor, who wastes no time in patting himself on the back: "By the time I saw her it was very clear."Doug Farrago however is more skeptical, and wonders if the 5 months of prior stu...
   Wed, 19 Nov 2008 15:00:01 -0600
   
   

4. How poor physician communication leads to medical mistakes
   Communication errors can arise when patients are transferred from the emergency department to the medical floor. Because of a "fundamental disconnect of expectations," between the emergency department and hospitalists, there can be confusion as to who is responsible for the patient. Information may ...
   Wed, 19 Nov 2008 21:31:50 -0600
   
   

5. What is the rate of medical error on days that JCAHO visits?
   It's something that emergency physician Edwin Leap wonders as a surprise visit sends his ED into disarray.He wonders if the fear that accompanies the Joint Commission is really the best way to improve patient care by disrupting normal workflow where doctors and nurses do their absolute best to care ...
   Wed, 19 Nov 2008 12:09:46 -0600
   
   

6. How to save money in primary care
   Revenues must exceed expenses. It's a basic business tenet that even doctors must abide by to keep their doors open. Get a programmable thermostat. Call and remind patients of their appointments. Use medical assistants during their internship. Buy supplies at Costco. Consider remote deposit cap...
   Wed, 19 Nov 2008 09:00:02 -0600
   
   

7. A bad day for New Hampshire drug reps
   Drug companies are not able to see a physician's prescribing habits in New Hampshire, according to Tuesday's ruling in a federal appeals court.Reps often would have a detailed dossier on the doctor prior to any interaction, and can tailor their pitch and approach based on prescribing trends. It wou...
   Wed, 19 Nov 2008 07:00:01 -0600
   
   

8. Ginkgo biloba should not be used to prevent dementia
   Another herbal medication bites the dust. The largest randomized trial thus far declared the drug ineffective for the prevention of mild dementia. In fact, in those who had a history of baseline cardiovascular disease, Ginkgo actually raised the incidence of dementia.With bleeding is a potential ad...
   Wed, 19 Nov 2008 05:00:00 -0600
   
   

9. When should you worry about your baby's fever?
   Unfortunately, there is no clear answer in those only a few months old.Pediatrician Perri Klass writes about the gray zone in infants between 1 and 3 months old having fevers right around 100.4 Fahrenheit. There are no strict guidelines in these borderline cases, as both conservative and more aggre...
   Tue, 18 Nov 2008 21:00:00 -0600
   
   

10. When doctors rely on the government to get paid
    For those who back Medicare for all, consider this.From the WSJ Health Blog, here's a story saying that doctors would go bankrupt if 20 to 25 percent of their patients were Medicaid. Not only are payments low, it may take months to get paid. States with quicker payments had a higher proportion of ...
    Tue, 18 Nov 2008 19:00:00 -0600
    
    

11. Does paying for quality actually work?
    Reforming the physician payment system to focus on health outcomes is an idea common to most plans.The more fundamental question is whether paying doctors more to meet quality measures actually benefits patients.So far, no definitive data suggests that's the case. Jason Shafrin points out that the ...
    Tue, 18 Nov 2008 15:35:41 -0600