Thursday, December 22, 2011

Me and My Doctor: Congress Plays Political 'Chicken' With America's ...

Me and My Doctor: Congress Plays Political 'Chicken' With America's ...: Dan McCoy, MD   Dermatologist, Dallas, TX  Online Radio Host,   Past Chair, TMA Council on Legislation Dr. McCoy speaks ou...

Wednesday, November 30, 2011

From our friends at Baylor Health: 3 things you need to know about diabetes

Check out this very nice video post from our friends at the Baylor Health Care System on the three things you need to know about diabetes. Baylor Health Care System is a network of 25 hospitals with more than 3,400 beds in the Dallas-Forth Worth area. And, its right across the street from our Dallas studio!

Sunday, November 27, 2011

Nice msnbc Video: How patient satisfaction scores in the hospital will be tied to dollars

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So you know that survey you get in the mail after a hospital stay or an outpatient diagnostic test? The one that ask you questions like, "Were you treated politely?" and "Were snacks available without having to ask for them?" Due to requirements in the new Obamacare federal health regulations, Medicare money for hospitals will to some degree be tied to patient satisfaction scores -- most of which will come from those post-encounter surveys. Check out this nice video from msnbc.

Saturday, November 26, 2011

blogtalkradio: We're moving our audio feeds!

As part of our new website upgrade we are migrating our audio feeds to blogtalkradio! Check out this new audio player and let us know what you think. We thought we would profile one of our favorite shows. This is the audio version of an interview with Congressman Dr. Michael Burgess as he talks about his book "Doctor in the House."
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Tuesday, November 15, 2011

Breasts and Hearts -- What's good for one, not necessarily good for the other

The sage advice that having a glass of wine every day might be good for you now may have a foot note attached.

A recent study by Catherine Berkey of Brigham and Woman's Hospital indicates that girls who have a history of breast cancer in the family and who have two glasses of red wine every day may increase their risk of benign breast disease.

Now, I didn't say cancer, but the leap has been suggested.

The study included 7000 girls and among the heaviest drinkers (that was about 1 drink a day in a 22 year old), the risk of benign breast disease was almost three times that of abstainers.

This comes on the heals of an article in JAMA (Journal of the American Medicine Association) earlier this month that alcohol may be linked to breast cancer. In their study, 3.5% of woman who had 13 drinks a week developed breast cancer compared to about 2.8% of those who didn't drink at all.

Many experts contend, though, based on the evidence to date, that stopping drinking would have very little impact on a woman's risk of breast malignancy.

Only time will tell.

And to make matters more confusing -- having a glass or two of wine may lower your risk of heart disease.

The take home message is that data obtained from retrospective studies is always useful, but many times it lacks the clarity of a prospective, randomized study.

- Posted using BlogPress from my iPad

Location:Dallas, Texas

Monday, November 14, 2011

Do protocols and guidelines really offer safer and better medicine?

The instruments were indicating to the two co-pilots at the controls of the Airbus that they needed to pull back on the stick.

They held back on the stick for 54 seconds.

This is the position they were in when the Air France jet plunged into the cold water of the Atlantic killing everyone on board.

The fix?

Recognizing that a protocol or guideline might be giving them wrong instructions, seeing that there might be a stall occurring and the airplane was falling out of the sky -- by applying basic airmanship learned during the early hours of learning to fly -- push forward on the stick, gain airspeed, and fly the airplane out of the stall.

So does this happen in medicine? Are we putting patients in the ground by following protocols and not practicing medicine?

Certainly, protocols have revolutionized patient safety in hospital settings. From central line infections, ICU ventilator management, antibiotic use in surgery, suicide prevention with ER counseling -- there are too many to list.

And these successes have lead to a plethora of committee created guidelines for care and protocols. A physician recently spoke at the American Medical Association meeting that one of the largest and most well respected hospitals in the country now has a protocol and guideline for a Whipple procedure!

This is a complex surgical procedure relating to bowel and pancreas resection and the protocol covers the entire hospital stay. Can a committee really dictate all of the ins and outs of a hospital stay of 10 to 14 days duration?

The protocol discussion has also become a huge issue in the mid-level provider debate. When individuals are attempting to practice medicine without the complete training of a physician, nothing is better than a set of rules to follow. And for visits like well child visits and hypertension management -- these work very well.

But can you really develop protocols and guidelines for complex medical procedures or illnesses?

Or more importantly, what parts of your own healthcare would you want managed with a protocol?

I know that if I'm really sick I want a pilot at the controls that can recognize that this time the protocol doesn't apply.

Because at some point in my life my body will be in the situation of flying out of La Guardia, hitting a flock of geese, and having to be hand flown without power into the Hudson River.

They don't make protocols for patients like me.

- Posted using BlogPress from my iPad

Sunday, November 13, 2011

Patients feel "Medicare is my benefit!"

TMA President Dr. Bruce Malone tells a patient story describing that "Medicare is my benefit!" His testimony was before a reference committee at the interim meeting of the American Medical Association in New Orleans, Louisiana. Dr. Malone was speaking in favor of direct contracting -- allowing patients a choice to see any physician they want regardless if that physician participates in the Medicare plan or not.