Hot MedFax

We're all so used to picking on our kids for playing video games but the next time he's in the ER, you just might be happy that doctors do it, too. According to new research, video games improve doctors' recognition and triage of severe trauma patients, newswise.com reports. Playing an adventure video game featuring a fictitious, young emergency physician treating severe trauma patients was better than text-based learning at priming real doctors to quickly recognize the patients who needed higher levels of care, according to a new trial led by the  University of Pittsburgh School of Medicine .  The results held, even though doctors assigned to the game enjoyed it less than those assigned to traditional, text-based education. This indicates that if game enjoyment can be improved, the already favorable results might be enhanced, the web site notes.  “Physicians must make decisions quickly and with incomplete information. Each year, 30,000 preventable deaths...

I remember it well.  A week before Christmas, an ice storm.  And a fall out running that broke my wrist. Now a new study says that patients with immediate medical needs tend to perceive doctors as emotionless. Mine was really a funny story.  I hit a bus on my way to the ER (it pulled out in front of me).  I was in such pain I just kept going. But sitting in the exam room, waiting for the doctor, two cops walked in to tell me I was being investigated for hitting a bus.  It turned out to be minor -- we had clicked mirrors, no damage -- but that added to the enjoyment of the day. Anyway, since I was at an immediate care center that didn't offer surgery (if needed) or high-caliber pain-killers, I was told to drive myself to the local hospital, that did.  Back in the car I went, only to arrive there to wait 13 hours to have my wristbone yanked three times to try to put it back in place. Oh my God. So I'm not sure it mattered too much whether my doc ...

Here's a connection you may not have made in the past.  Doctors and guns. But a new survey of North Carolina doctors has found that many are concerned about the increasing number of requests they are receiving to assess their patients’ competency to carry concealed weapons. In particular, a majority of physicians who responded to the survey said they were worried about the potential ethical consequences in the doctor-patient relationship if they participated in the concealed-weapon permit process, according to newswise.com. “This is not a small problem,” the Web site quotes Dr. Adam Goldstein, corresponding author of the study and a professor in the Department of Family Medicine at the University of North Carolina School of Medicine. “More than 20 percent of the physicians we surveyed have been asked to sign competency permits for concealed weapons, and a majority of them do not feel they can adequately assess the physical or mental competence of their patients to ...

Guess who's making house calls again?  If you guessed technical support for your wireless device, wrong.  It's doctors. For many, if not most of you reading this, you're probably thinking, so, what's the big deal?  But I can remember Dr. Cunningham (who smelled like a pipe) coming over to treat my brother for something or other when we were kids and that it was nothing unusual. But the thought of a doctor coming over today, well, they just don't have the time if they're going to make money.  With doctors having to see volumes of patients just to pay the bills, it's been a trend that went out with One Direction (who think they're still bigger than the Beatles). Yet here it is.  "The house call — is returning to favor as part of some hospitals’ palliative care programs, which are sending teams of physicians, nurses, social workers, chaplains and other workers to patients’ homes after they are discharged," writes Milt Freudenheim at The New ...

Big surprise.  In a recent survey doctors skipped over their most lucrative -- but unsuccessful -- procedures when asked to suggest which of them should be eliminated. According to Kaiser Health News, " When America’s joint surgeons were challenged to come up with a list of unnecessary procedures in their field, their selections shared one thing: none significantly impacted their incomes." The  American Academy of Orthopaedic Surgeons discouraged  patients with joint pain from taking two types of dietary supplements, wearing custom shoe inserts or overusing wrist splints after carpal tunnel surgery, Jordon Rau reports. "The surgeons also condemned an infrequently performed procedure where doctors wash a pained knee joint with saline," he writes. "They could have chosen many surgical procedures that are commonly done, where evidence has shown over the years that they don't work or where they're being done with no evidence," Dr. James Rickert, ...

I don't know about you but a doctor has to do something really bad (like miss a second cancer) for me to consider switching.  But a new study has found that p atients with an existing relationship with a doctor in a lower performing segment of the marketplace "were no more likely to switch doctors than patients with higher performing doctors," according to newswise.com. Other parts of the study found that p atients with doctors ranked in lower performing tiers were more likely to switch health plans than other patients. The Web site reports that m any health insurers now rank their physicians into tiers based on quality and cost and provide financial incentives to members for choosing a doctor in a higher tier. These tiered networks are designed to promote competition and quality improvement among providers. Research showed that,  while patients selecting a tiered doctor for a first-time visit, patients were likely to "choose one ranked in the best performing ...

So, your kid's about to have his tonsils out and you want to know if your doctor's the right one to do it.  Ask friends?  Look into malpractice suits?  Check those flashy magazine covers that claim to have discovered your state's best doctors list (read: they take out a lot of ads)?  Find out his mortality stats? Good luck.  According to The Washington Post, it's easier to find out your neighbor's social security number than to get a really reliable forecast of how your child's surgery will turn out, under the doctor you pick. Unfortunately, there’s no foolproof way to vet your doctor, physician Michael Carome, director of the health research group at Public Citizen, a consumer advocacy organization based in Washington, tells writer Christie Aschwanden. But there are some basic steps you can take to look into a doctor’s credentials and record.  She notes that you should first check your state's medical board's Web site, which allows you to search...

I don't know if you're like me but when I get a new symptom or diagnosis from a doctor, I rush online to check out what it is.  Usually, Wikipedia comes up first, and even though I knew better, I usually believe whatever it says. Now doctors are saying that a lot of that information is just, well, wrong. "I think that's the double-edged sword of Wikipedia," Dr. Amin Azzam tells NPR's Arun Rath, as reported at the Robert Wood Johnson Foundation (RWJF). "Because anyone can edit, we don't necessarily know the expertise of the people doing the editing. One the other hand, the reason it's so popular is because everyone can contribute." Azzam is a professor of psychiatry at the University of California, San Francisco. He teaches a course that encourages fourth-year medical students to use their knowledge to improve Wikipedia, one article at a time, as RWJF notes. Azzam tells NPR there's a lot of room for improving the quality of Wiki...

We know them by their white coats. But with hospital-acquired infection   (HAI)  rates galloping out of control, with over tens of thousands of deaths per year, they may go the way of well, wikipedia. A new study  has found that doctors' white coats are great carriers of infection as they pass from hospital room to hospital room, according to newswise.com.  “White coats, neckties, and wrist watches can become contaminated and may potentially serve as vehicles to carry germs from one patient to another,” the Web site quotes Mark Rupp, M.D., chief of the division of infectious diseases at the University of Nebraska Medical Center and one of the authors of recommendations issued by the Society for Healthcare Epidemiology of America (SHEA), one of the world’s top infection control organizations. Rupp acknowledges that there is not incontrovertible evidence that this is true but " Until better data are available, hospitals and doctor’s offices should first conc...

If you're anything like me, if a doctor says something that insults  or embarrasses you, you may never go back, a new study has found. I can remember when I was lugging around 30 post-partum pounds and a new internist I was planning to start seeing told me I really needed to lose weight.  I dropped the pounds (he was actually my incentive to join Weight Watchers) but I never went back. But not everyone gives up on a doctor who challenges them.  Some people lie the next time they see the doctor ("Oh yes, I cut 'way back on my calories"), while others decide to draw the wagons around and take the advice. Shame and guilt as a direct result of interacting with a doctor are quite common, says Christine Harris, professor of psychology in the UC San Diego Division of Social Sciences, as are both positive and negative reactions at newswise.com.  Gaining insight into patient reactions is important, the she and her co-authors write, because “more than one third of all...

Do you meditate ?  I know, I know.  It calls to mind girls with long dirty hair wearing love beads, VW vans and the sharp acrid smell of mj everywhere.  It's what the Baby Boomers thought they discovered.  And now it's being rediscovered by, well, just about everyone, and for a really good reason. It turns out doing it has actually proven to be good for your health. According to medicalnewstoday.com, it can actually change your genes -- or how they're expressed, or activated.  A new study has found " specific molecular changes in the body after a period of mindful meditation," the Web site reports. You may also have heard of mindfulness, which can be part of meditation, but we'll get to that later.   For the study, researchers compared the effects of a day of intensive mindful-meditation in a group of experienced meditators with a group of untrained subjects who enjoyed a day of quiet, non-meditative activities, medicalnewstoday.com notes. " Aft...

Mindfulness .   The concept has been kicked around for some time.  You know, closing your eyes (or not) and just letting thoughts come in and out of your mind without following them, just being there, in the moment.  It's kind of like meditation but that word scares a lot of people away, so mindfulness was coined. You'd certainly want your doctor to do a little of this, before surgery, wouldn't you?  Well, now, Pauline Chen, herself a doctor, is writing at her New York Times blog that practicing it may just may help physicians avoid stress and burnout. " Research over the last few years has revealed that unrelenting job pressures cause two-thirds of fully trained doctors to experience the emotional, mental and physical exhaustion characteristic of burnout," she reports. "Health care workers who are burned out are at higher risk for substance abuse, lying, cheating and even suicide. They tend to make more errors and lose their sense of empathy for others....

I don't know whether this is good or bad, but the placebo effect apparently works. According to fastcompany.com, " A growing body of research shows that treatments ranging from sugar pills to the 'ritual of medicine''really do improve patient health." To Ted Kaptchuk , fastcompany.com reports, "the placebo effect is brought about by much more than sugar pills and saline injections. It's about the whole 'drama' or 'theater' of medicine--essentially the context of the encounter between patient and physician--as much as treatment itself." The Web site credits Kapchuk, who heads Harvard's placebo program, for "investigating placebos . . . and expanding the scope of the field." fastcompany.com quotes Kaptchuk, "The placebo effect is the effect of everything surrounding the fake pill, or the real pill. It's the compassion, trust, and care. It's the ritual and symbols. It's the doctor-patient inter...

Here's a scary thought.  Thousands of doctors who have been banned by hospitals can still obtain medical licenses in other states. According to Peter Eisler and Barbara Hansen, USA TODAY, "Despite years of criticism, the nation's state medical boards continue to allow thousands of physicians to keep practicing medicine after findings of serious misconduct that puts patients at risk, a USA TODAY investigation shows." Yes, many of the doctors have been barred by hospitals or other medical facilities, but hundreds have paid millions of dollars to resolve malpractice claims, the two report. "Yet their medical licenses — and their ability to inflict harm — remain intact." This isn't true in every state but the alarming fact remains, "State and federal records still paint a grim picture of a physician oversight system that often is slow to act, quick to excuse problems, and struggling to manage workloads in an era of tight state budgets." • E...

Your son has a hacking cough and you want an antibiotic to soothe it.  You know colds are caused by viruses and therefore, not treatable with penicillin. But you want it, anyway. My husband, too, a dentist, sometimes prescribes antibiotics for patients when they're not really needed. But a new study  has found that doctors are prescribing 'way too many antibiotics -- and sometimes even, the wrong ones. All leading to, as we know, a huge wave of drug-resistant illnesses that may someday end up killing us because the meds just won't work anymore. "Recent studies have shown that doctors are over-prescribing broad-spectrum antibiotics, sometimes called the big guns, that kill a wide swath of both good and bad bacteria in the body," according to Sumathi Reddi. But they're not against all antibiotics, it turns out.  Narrow-spectrum antibiotics, like penicillin, amoxicillin and cephalexin, can usually clear up many infections, while targeting a smaller number o...

You're going in the hospital.  You've covered all the bases -- your insurance will cover, you stopped paper delivery, and you have someone to bring you home after your procedure is done.  But you're scared to death once you put on the gown.  How do you make sure no one screws up? U.S. News & Review, which just released its rankings of the so-called best hospitals in the country,got  the Robert Wood Johnson Foundation, a leading patients rights organization, to give some tips : Use the Internet, though that comes with a caveat.  Only use resources that come from a highly reputable, reliable source like  http://www.nlm.nih.gov/medlineplus  or  http://www.mayoclinic.com/health-information  (webmd.com is fine but don't use it for your primary source of info). Research, research, research -- look for outcome stats for the procedure you're having for your doctor and hospital, and complication rates Have a list of questions: How long ...

Admit it.  Wouldn't you love to know what your doctor's saying about you when he taps away on his iPad? Is it that you need to lose weight?  Or see a therapist? Or, God forbid, you smell?  Or is he secretly just checking his email? Well, now, in some parts of the country, you can.  According to fastcoexist.com, a new app, OpenNotes, allows doctors to share their notes with patients as part of treatment. If you're a patient at Boston’s Beth Israel Deaconess Medical Center, rural Pennsylvania’s Geisinger Health System and Seattle’s Harborview, you're one of the lucky ones.  These medical centers recently completed the first trial of OpenNotes and 14,000 patients got to see immediately after their appointments the electronic notes penned by their doctors and nurses, the story notes. Here's the best news of all.  The study found that 60% of patients reported they took medications more regularly (up to 30% of prescriptions are usually not filled and up t...

So it was just decided by the American Medical Association (AMA) that obesity is a disease. Say what? The New York Times reported today that this move "could induce physicians to pay more attention to the condition and spur more insurers to pay for treatments," not just make fat people feel better. To me a disease is breast cancer, or anemia or diabetes, not something that you can control.  But then I suppose that's part of the argument (and I certainly know as well as anyone), that weight isn't always a matter of making it move up or down. But if we classify it as a disease, doesn't that give people who need to lose weight more of an excuse not to?  "I have a disease, so I can't help it," is the first thing that came to my mind. Now maybe that's just me.  But I know when I was really overweight, I tried to blame it on my under-active thyroid, my genetics, even my breast cancer, just so I'd have a reason to feel better about not ...

Really.  A new survey says there are two reasons patients are having difficulty understanding, or getting their  medical conditions right. One, they rely too much on the Internet (to which, I can personally attest, after being diagnosed with breast cancer), where the information is often, if not inaccurate, not always applicable to every person.  And two, the reading level of educational materials medical professionals have on hand are often confusing and too hard to understand for most anyone who's not a doctor. According to a story at Reuters Health, "The average reading level of the online materials by groups ranging from the American Society of Anesthesiologists to the American Psychiatric Association fell anywhere from ninth grade to the sophomore year of college." What's the level recommended by the American Medical Association?  Fourth to sixth grade.  While that sounds pretty low, keep in mind that we're talking about very technical terms and situa...

I remember leaving a doctor I loved because I couldn't stand the hour or more wait while he was wined and dined by pharmaceutical salespeople . I'm not kidding.  This guy would take anyone who wandered in with a loaded briefcase right into his office and sit and joke and laugh with them while we patients stewed outside.  When I needed a prescription, guess what?  It was always one of the drugs these people peddled. A story today in The New York Times pointed out that all this electronic assembling of medical records is feeding right into the hands of pharmaceutical companies, giving them the lowdown on everything from the meds doctors prescribe to how often you refill your prescriptions (and if you do) to what color underwear you're wearing (just kidding, but that's probably coming, too). Databases that would have been sealed to them in the past are now open as medical records switch over to electronic health records.  And this allows drug companies to target t...