Tag Archives | doctor

The Cyberchondriac: Managing the Difficult Patient

There is an interesting series over at QuantiaMD on Managing the Difficult Patient. Presentations are available for viewing as long as you sign up for with your email. One such presentation was originally called The Patient Who Knows too much but has been changed to The Cyberchondriac. http://quantiamd.com/player/wywzswwh?courseid=31844 Mary Modahl  who is QuantiaMD Chief Communications Officer said after the original title was added  “‘The Patient Who Knows Too Much’ is a very poor title. Certainly a patient can never know too much. In every way, we’re supportive of doctors meeting their patients’ need for care.” Dr. Joseph Scherger, vice president for primary care at Eisenhower Medical Center in Rancho Mirage, California, defines a Cyberchondriac in the presentation: “This is a patient who is on the internet…indiscriminate with the material they are reading…they consider themselves an expert yet often their true medical knowledge is limited…they are pushing you to do things based on their information.” Dr. Scherger takes a jab at Cyberchondriacs and says “…sometimes these patients are very overweight, they are on the internet all the time…” He also says that if a patient is going to bring in a stack of materials from the internet they should send it in […]

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Health Care Costs in America

I came across a very interesting graphic illustrating many of the myths and facts about healthcare in the United States. The graphic illustrates some reasons for the high costs of healthcare including the myths and the truths. The myths include 1) americans smoke and drink too much, 2) america has a larger elderly population, 3) obseity in america skyrockets costs, 4) malpractice is out of control. I actually slightly disagree with #3 and #4. I think being obese in the U.S. is a real problem, see this graph from the OECD. Further one has to account for defensive medicine (as in doctors being scared of getting sued  and ordering more tests than really needed) in malpractice lawsuits. Graph below illustrates the % obese in each country shown. Source: OECD Factbook 2010: Economic, Environmental and Social Statistics. I believe the truths are all legit including 1) providers charge more because they can, 2) administrative overhead, 3) expensive outpatient costs, and 4) overpaid doctors. I have previously briefly mentioned overpaid doctors see http://blog.teethremoval.com/the-lack-of-importance-of-research-in-oral-and-maxillofacial-surgery-residency-programs/ I would also add the invasion of our Southern Border as another reason for higher costs see http://blog.teethremoval.com/the-death-of-the-united-states-of-america/

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The Well Informed Patient

In a recent editorial in the Journal of Oral and Maxillofacial surgery (vol. 69. page 1263, 2011),  titled “Shouldn’t All Clinical Research Be Scientific?”, Dr. Thomas B. Dodson,  talks to his fellow oral surgeon colleagues and says “Not only do we face rapid advances in science and technology, but we have new accountability from economic, legal, and regulatory challenges, as well as a new brand of well-informed patient.” I personally would hope that the well-informed patient are patients who are being informed by oral and maxillofacial surgeons and dentists. However, I do not believe that is really the case here. One question to ask is why patients in the past were not well informed? The other and more pressing question to ask is why are these patients still not being properly informed today? (This also applies to other doctors and physicians as well). One of the reasons for this is due to the legal standard of informed consent in the U.S. as stated in “Toward The ‘Tipping Point’: Decision Aids and Informed Patient Choice” by Annette M. O’Connor et al., appearing in Health Affairs, pages 716-725, May/June 2007. “The [U.S.] states are largely divided between two categories of informed-consent standards: […]

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Malpractice Liability Damage Caps and Their Effects on Rural Doctors

According to a paper by David A Matsa. who is an economics professor their is an effect on medical malpractice liability damage caps. In other words, the amount of money you can get if you sue a physician if something goes wrong is capped and you can only get X amount back as determined by a law in your state. (I have discussed this issue on my website about the legal standpoint of wisdom teeth removal.) Matsa finds that “Back-of-the-envelope calculation using estimates presented… implies that the enactments of damage caps are responsible for approximately 17 percent of the increase in frontier rural specialists in these states since 1970.” Even so, Matsa finds that there really is no significant effect on physician supply for most Americans (those who do not live in rural areas). If you are interested in the entire paper you can access it through several sources through the Social Science Research Network. http://papers.ssrn.com/sol3/papers.cfm?abstract_id=920846. The paper dates from June, 2006, and is titled “Does Malpractice Liability Keep the Doctor Away? Evidence from Tort Reform Damage Caps. “

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Family Doctor’s Not Happy and How to Boost your Immune System

I found two great articles. The first deals with how (primary-care) family doctors are not happy with the current bussiness in the U.S.  According to a recent survery “49 percent [of family doctors] said they’d consider leaving medicine. Many said they are overwhelmed with their practices, not because they have too many patients, but because there’s too much red tape generated from insurance companies and government agencies.” There is expected to be a shortage in the tens of thousands within the next 15-20 years. In addition current medical students are not interested in pimary care and want to enter other alternatives. To read the entire article visit http://www.cnn.com/2008/HEALTH/11/17/primary.care.doctors.study/index.html A current practicing primary care physician named James Hubbard has cited “anxiety and hassel” as the reasons he is currently part time. He publishes his own magazine called Family Doctor Mag. On his website ELIZABETH A. PECTOR, M.D., a family physician has written an excellent article on how to boost your immunity system this upcoming winter. The key take aways from the article include eating well, avoiding second hand smoke, regular exercise, lack of stress, and vaccinations. I feel that vaccinations should be taken with a cautious approach as I have watched […]

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