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Inside Health Care: Exploring Accountable Care Organizations

CFAH Staff | November 30, 2010

Doctors, lawyers, researchers, and hospital CEOs all have something to say these days about Accountable Care Organizations (ACOs). A collection of web posts includes: Frank Pasquale with Concurring Opinions, Anna D. Sinaiko and Meredith B. Rosenthal in The New England Journal of Medicine's November Perspectives, Vince Kuratis on The Health Care Blog, Jim Sabin on KevinMD, and Paul Levy on Running a Hospital.

Patient-Experts at Medical Conventions

Andrew Schorr | November 30, 2010

Increasingly, you are finding real patients who have the conditions discussed at conventions, in scientific sessions, and around exhibit halls. Patients like me want to be where that news breaks; we want to ask questions and thanks to the Internet we have a direct line to thousands of other patients waiting to know what new developments mean for them. PR types and social networking media analysts take note: we are a new force to contend with.

Book Review: Bad Science by Ben Goldacre

Connie Davis | November 29, 2010

I've been following evidence-based medicine for many years and I've been appalled by the way it is playing out. We have pay-for-performance that does not understand that the reliability we are after is not in reliably (read blindly) applying a guideline to a patient population, but rather reliably considering how the evidence applies to the individual in a health care interaction. We have guidelines that are based on expert opinion, often influenced by drug company funding, or based on bad science. And we have a news media that seems unable to present medical findings in a balanced and understandable way.

Inside Health Care: A Doctor, a Nurse, and an Intern Weigh-In on EMRs on KevinMD

Inside Health Care | November 24, 2010

KevinMD hosts a range of clinicians who comment on the electronic medical record. Guests include: Dr. Christopher Johnson, pediatric intensive care doc, who blogs on ChristopherJohnsonMD; Jared Sinclair R.N., an ICU nurse and pre-medical student, who blogs at jaredsinclair + com; and Angienadia M.D., a Yale intern, who blogs at Primary DX. Read what they have to say about EMRs.

Does Long-Term Care Insurance Have a Future?

Trudy Lieberman | November 23, 2010

The decision by Metropolitan Life to stop selling long-term care (LTC) insurance once again calls into question the viability of that product as a way to pay for nursing home, assisted living and home care needed by the growing number of elders. MetLife was a solid company'big and reputable, with a knack for selling policies to workers whose employers offered the coverage as an extra benefit. It was a name that people trusted in an industry characterized by many small sellers, some of whom became insolvent.

Patient Perspectives: Crowdsourcing, Ice Cream, a Fourth Devastating Diagnosis, and Medication Side Effects

CFAH Staff | November 22, 2010

A collection of patient voices from around the web. This week's roundup includes: Red Maxwell, founder of the online diabetes community, D-Mom Leighann Calentine, patient empowerment advocate Trisha Torrey, and WarmSocks from "infinity-itis".

After Visit Summary - Little Things Mean a Lot

Jim Sabin | November 19, 2010

When I was in high school, the singer Kitty Kallen had a #1 hit - "Little Things Mean a Lot." The ballad is decidedly uncool by current standards, but as a teen-ager I liked its romantic dreaminess. The song popped into my mind as I was musing about the after visit summary I was given at the end of an appointment with my primary care physician yesterday.

Social Media Approach To Healthcare Disparities

Chris Gibbons | November 17, 2010

Chris Gibbons, MD, CFAH Board Member, interviewed by CNN on using social media and web coupons for health care.

Prepared Patient: Your Doctor's Office, Demystified

Health Behavior News Service | November 17, 2010

Long gone are the days when all nurses sported identical uniforms and only physicians wore white coats and scrubs. Today, when visiting your doctor's office, it can be difficult to know with whom you're speaking and what role they play in your health care.

GoodBehavior!: Evidence That Engagement Does Make a Difference

Jessie Gruman | November 15, 2010

There is tremendous intuitive appeal in the idea that people must be engaged in their health care to benefit from it. To date, however, there has been little direct evidence to support the claim that our engagement affects health outcomes.

Integrating Patient Experience into Research and Clinical Medicine: Towards True Personalized Medicine

David Gorski | November 12, 2010

We advocate science-based medicine (SBM) on the Science-Based Medicine blog. However, from time to time, I feel it necessary to point out that science-based medicine is not the same thing as turning medicine into a science. Rather, we argue that what we do as clinicians should be based in science. This is not a distinction without a difference. If we were practicing pure science, we would be theoretically able to create algorithms and flowcharts telling us how to care for patients with any given condition, and we would never deviate from them.

Conversation Continues: Health News We're Watching

CFAH Staff | November 12, 2010

Slate picks up on news about the recent Lung Cancer CT Scan study, which was also covered by Gary Schwitzer and others, in this Explainer column: Full-Body Scam: Should you ask your doctor to CT scan you from head to toe?

Inside Health Care: Physicians Put on a Gown and the Power of Touch

Inside Health Care | November 12, 2010

A collection of professional voices from around the web including Dr. Herbert Mathewson in The Health Care Blog, Dr. Kevin Pho of, and Dr. Rob Lamberts on his blog, Musings of a Distractible Mind. These highlight the patient experience from a professional perspective and the power of touch.

Doctors and Their Speaking Fees

Trudy Lieberman | November 11, 2010

Would you keep using a doctor who collected $300,000 or even $300 in speaking fees from drug companies for saying a good word about their products? That's the question the non-profit, investigative journalism outfit ProPublica is inviting thousands of patients to ponder.

Patient Perspectives: Dogs, Seeing a New GP, D-Blog Day and Mechanics v. Docs

CFAH Staff | November 11, 2010

A collection of patient voices from around the web. This week's roundup includes: Dana Jennings of the New York Times, RA Warrior Kelly Young, Leighann Calentine from D-Mom Blog: the Sweet Life with a Diabetic Child, and the Patient Empowerment Blog's Trisha Torrey.

Health News Stories We're Watching:

CFAH Staff | November 10, 2010

Two new posts by Gary Schwitzer on the Health News Review Blog this week. One on the promotion of CT screening after the release of the recent Lung Cancer CT scan study and the other on new investigative reporting by ProPublica. Both evolving health stories that touch on key hot health care reform debates: Comparative effectiveness research, entitlement programs, marketing to the public, and more.

Consumers v Patients

Donna Cryer | November 9, 2010

Much is made of what to call those of us actively engaged in pursuing and receiving medical care from health professionals, and this post does not intend to settle that issue. But I've discerned a shift towards using "consumers" as the catch-all term to describe people who actually have different experiences, needs, views, and behaviors within the health care system. Although often used interchangeably, I believe there are distinctive differences between consumers, patients, and patient warriors in the context of health care.

Inside Health Care: Dichotomies: Quality or Familiarity? Empower or Manage?

Inside Health Care | November 8, 2010

Gale Fisher's Missed Diagnosis (Almost)

Andrew Schorr | November 8, 2010

As Gale Fisher approached her late 60's, she remained active - playing golf and walking, but pain in her right calf made walking difficult, and it was getting worse. Gale eventually saw her doctor who suggested fusion surgery. Gale sought a second opinion from a vascular surgeon. He proposed a major surgery that would require 10 days in the hospital to open the blood flow. Gale sought out third opinion. The information she received changed her life.

Friends, Fatigue and the Slow Slog Back

Jessie Gruman | November 5, 2010

I have much experience with serious illness. And so I am a connoisseur of fatigue: the sleepless edginess of post-radiation fatigue; the heavy constancy of cardiac fatigue; the blur and blues of chemotherapy-related fatigue.

Sharing the Burden

Richard Sloan | November 4, 2010

Jessie has written about her perspective as the patient in an extremely stressful situation. I can add a different one: that of the husband of my seriously ill wife.

Hospital Discharge Without a Net

Jessie Gruman | November 3, 2010

By the time I reached the sixth day of my hospitalization for stomach cancer surgery, I was antsy to go home and I quizzed each nurse and physician who came into my room about what must happen for me to be liberated the following day. Their responses were consistent: my surgeon would visit in the morning and write orders for my release. Then I would have a comprehensive discussion with my nurse about my discharge plan, after which I could leave.

Patient Engagement on the Med-Surg Floor

Jessie Gruman | November 2, 2010

Three times a day, as though responding to some signal audible only to the generously medicated, we rise from our beds to join the slow procession around the perimeter of the unit. Like slumped, disheveled royalty, each of us blearily leads our retinue of anxious loved ones who push our IV poles, bear sweaters to ward off the harsh air conditioning and hover to prevent stumbles. Some make eye contact. Few talk. Each of us is absorbed in our suffering and our longing to return to our bed.

Contemplating Safety While Lying Down

Jessie Gruman | November 1, 2010

You have to get out of this hospital it's a dangerous place, each of my physician friends exclaimed when they came to visit me during my recent stay after surgery for stomach cancer.