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Archive for patient outcomes

The Smoking Gun

A just-breaking piece in the Lancet suggests that in the UK, patients who receive the lungs of smokers have a better overall chance of survival than those who remain on waiting lists, despite the fact that they tend to survive for a shorter period after transplantation than those who receive the lungs of non-smokers.   While this intuitively makes sense to me, it still gives me the creeps! Read more

Is ‘good’ cholesterol actually bad?

Remember when we learned that hormone replacement therapy might harm—rather than help—postmenopausal women?  Or when the new PSA testing guidelines turned conventional wisdom on its head?  Remember the droves of anxious patients who worried that they had been mistreated, overtreated, or misled?  Read more

Taking the Patient Into Consideration

I just read a very thought-provoking article in a recent New England Journal of Medicine that discussed the concept of goal-oriented patient care. Read more

Removing Barriers to Diabetes Treatment

The Diabetes Working Group, composed of representatives from various medical associations, recently released a white paper containing recommendations for addressing barriers that prevent providers from delivering appropriate care to patients with diabetes. Read more

Bug news….

Two infectious disease articles caught my eye this week.  The first was published in JAMA  and the second was published in NEJM.   Read more

The Patients Have Spoken…

In overwhelming numbers, patients express interest in exploring the notes that their primary doctors write about them after an office visit, but doctors worry about the impact of such transparency on their patients and on their own workflow, according to a study just published in the Annals of Internal Medicine. Read more

Social Barriers Impact Health, Too

An on-line survey of 1000 primary care physicians suggests that social barriers–such as a lack of access to basic housing, transportation, and nutritious foods–can impact patient health as much as access to direct medical care.  The survey was conducted in September and October 2011 on behalf of the Robert Wood Johnson Foundation.   Read more

When “More” is not “Better”

Once again, it appears that ‘more’ medical care is not necessarily the ‘best’ medical care. Read more

Do We Really Need to Screen All Children for High Cholesterol?

An expert panel has recently recommended that all children, regardless of family history, undergo universal screening for elevated cholesterol levels. The panel recommends that adolescents undergo lipid screening for non-fasting non-HDL-cholesterol levels or a fasting lipid panel between the ages of 9 and 11 years followed by another full lipid screening test between 18 and 21 years of age. Read more

Health Insurers Fall Flat with Information Websites

ForeSee, a customer analytics firm, has released its fourth annual healthcare benchmark.  The new survey shows that according to consumers, health insurance websites vastly underperform other kinds of healthcare sites.  Health insurance companies received an aggregate satisfaction score of 51 on the report’s 100-point scale, placing the industry far behind other healthcare categories measured in the benchmark, including health information websites (78) and hospital and health system websites (78). In fact, health insurance is among the lowest of the nearly 100 benchmark categories that ForeSee tracks. Only websites for cable companies, telephone utilities, and cell phone companies have aggregate scores lower than health insurance companies.

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Revisiting the Mammography Controversy

Great controversy ensued in 2009 when the U.S. Preventive Services Task Force recommended that asymptomatic women undergo mammography every 2 years starting at age 50.  A new study sheds some surprising light on the fall-out from those recommendations.
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Profit vs. the Public Good

Kudos to our friends in California for banning young people under the age of 18 from tanning salons.   With today’s early release of CDC data reinforcing that melanoma is the third most common cancer in adolescents and the fact that intentional sun exposure is the most preventable risk factor, I applaud the California legislature for their forward thinking.   Read more

Simulation Training–Time to Move On

A research team from the Mayo Clinic reports that simulation-based training is an effective way to teach physicians, nurses, dentists, emergency medical technicians and other health professionals–with no discernible improvement in patient outcomes.

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Getting it Right Among Diverse Communities

An American friend works for an NGO that is building a health clinic in a remote area of South America.  The patients are older and many have chronic diseases such as diabetes, asthma, or heart disease.   The clinic is staffed by young physicians and healthcare providers who speak the local dialect.  Unfortunately, the adherence rate is much lower than anticipated and there has been no real improvement in patient outcomes.  What went wrong? Read more

Is primary care ‘defensive’ medicine?

A new study in the Archives of  Internal Medicine cites the statistic that 28% of primary care physicians are practicing more aggressively than they would like and that 42% of their patients receive too much medical care.    Read more


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