Privacy Matters

Sometimes consumer watchdog and whistleblowers do a good thing (actually they do it a lot). Several Consumer Advocacy Groups have filed an action before the Federal Trade Commission: “Request for Investigation, Public Disclosure, Injunction, and Other Relief” against none other than: Google, Microsoft, Quality Health, WebMD, Yahoo, AOL, Health Central, Health line, Everyday Health, and Other web companies, including a litany of consumer oriented marketing scams. All physicians should be pleased that someone has done this for our patients and the medical profession. The motion requests that the Food and Drug Administration investigate these sites The plea includes as one portion of its plea the following, Physicians, nurses and other...

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The Physick Story

  Take a trip on Marketplace  and visit City Hall, The Print Shop, The Surgical Amphitheater, The home of George Guild, the Oculist Philadelphia: The Birthplace of Healthcare How did Benjamin Franklin help launch the pharmaceutical industry? How did Philip Physick, who invented dozens of early surgical instruments, also invent an economic instrument that enabled surgeons to get paid? And how did an idealistic eye doctor at the turn of the century help launch what's now a multi-billion dollar screening industry? Early Philadelphians transformed the money side of health care. It's too fantastic a story to bring you with radio alone -- so health care reporter Gregory Warner and intern Mara Zepeda corralled Philadelphia artists,...

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A Moment of Silence for Tom Turkey

  Health Train Express is almost to the TurkeyDepot.  I won’t be posting until Monday, November 29,2010. I leave  you with this thought. A Poem  for Thanksgiving   Thanksgiving Friends Thanksgiving is a time For reviewing what we treasure, The people we hold dear, Who give us so much pleasure. Without you as my friend, Life would be a bore; Having you in my life Is what I’m thankful for. By Joanna Fuchs Belly Stuffer Thanksgiving brings a terrible chore, 'Cause I’m forced to eat and eat some more. If I don’t eat it up right down to dessert, I fear the cook’s feelings will surely be hurt, So I do my part, even though I suffer; To be a good guest, I’m a belly stuffer. By Karl...

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Why We Do Need Or Do Not Need HIT Or EMR

  Bad Fonts         Font you Some of us may remember college, med school, and post graduate training.  I remember my handwriting deteriorating in medschool as I attempted the losing battle of taking hand written notes. I also remember looking forward to the progression of chart notes and the time when I would write that last note, below. There is no justice in this world!   EMR will have a profound negative effect on medical students, by reducing motivation to become an attending. For those interested trainees you can obtain “bad handwriting font” for  EMR notes. ...

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Health Train Express LTE 4G

G et what you pay for G et better quality G et government out of health care G et more primary care physicians Next will be: G et EMR This is what Health Train needs.  Perhaps this will cure what ails health care in America img alt="" galleryimg="no" onload="var downlevelDiv = document.getElementById('47e760c3-3dad-47bc-9983-0ea4995fc716'); downlevelDiv.innerHTML = "";" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzTpJ3lpkE46r9b5HTJBjXGljxDalbqQmnWweWfSzQx1XYpfEgsrYxEm6CBq2WhxRigMNQ6dUHow-jZKQ2BvVTvvJIK7XTBIjEQ8j8sEXBH4B3XewfpkVubnCcmzc_-fNDRDKE2HbDrKU/?imgmax=800" style="border-style: none">The Christmas Gift we all Wish for.   Don’t we all wish it could be this simple?...

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Important News Today Top Stories

  FDA Approves New Stem Cell Line Advanced Cell Technology (ACT), of Marlborough, Mass., announced that it has received FDA approval to begin treating children with Stargardt's macular dystrophy using retinal cells derived from ESCs. (Photo: A fluorescent microscope image shows human embryonic stem cells at Stanford University  March 9, 2009/California Institute for Regenerative Medicine)   Eat Your Fruits and Veggies HHS Releases New Insurance Rule   HHS Releases Final Medical Loss Ratio Regulations   So Long, Darvon and Darvocet: FDA Requests Pain Meds Be Pulled     Non invasive Fat Removal   Has The Obama Administration Created a Monster del.icio.us Tags: accountable care...

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Accountable Care, or Count the Care?

                 The consolidations have started. Humana announced it will purchase Concentra. Humana has been a health insurance carrier. Concentra, a privately held health care company based in Addison, Texas, delivers occupational medicine, urgent care, physical therapy and wellness services from more than 300 medical centers in 42 states. The transaction involved a cash price of 790 million dollars.Concentra earns about $800 million in annual revenue. Humana projects that the acquisition will add slightly to its earnings for the year ending Dec. 31, 2011. For Humana, the deal signals that the health insurer is branching back into its origins as a health care provider,...

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ACOs Junk-it

  The latest round of junkets for hospital administrators, management consultants, is regarding ACOs or Accountable Care Organizations. Like managed care which became renamed “mangled care”  ACOs will earn a new moniker soon as well.  I will rename it, “Anonymous Care Organization” for want of a better term.  Who is going to run this ‘entity’ designed for who knows what? Some say it will control cost, improve outcomes, and balance the federal budget.   Some say our country will not survive without reducing the percentage of GDP utilized  by Health Care.   Health care expenditures have increasedd to somewhere between 16.0% and 17.9% of GDP according to  Market Watch, Time Magazine,...

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Medline Plus Connect

  Sometimes paying taxes does bring a dividend. One giant time saving feature is being offered by the National Library of Medicine for those physicians who use EMR. Medline Plus Connect is a free service of the National Library of Medicine (NLM) and the National Institutes of Health (NIH). This service allows any electronic health record (EHR) system to easily link users to Medline Plus, an authoritative up-to-date health information resource for patients, families and health care providers. Medline Plus provides information about conditions and disorders, medications, and health and wellness. Medline Plus Connect accepts requests for information on diagnoses (problem codes) and medications. NLM has mapped Medline Plus health topics...

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Tumultuous Friday

  From the LA Times: Reporting from Washington — The Senate agreed Thursday to postpone for a month a giant cut in Medicare payments to doctors that had been scheduled to take effect Dec. 1. The bipartisan deal is expected to clear the House, sparing physicians a 23% fee cut — at least for now. Doctors who care for the elderly under the federal program will be paid at current rates until Dec. 31. But the compromise falls short of the 13-month solution sought by physicians groups and advocates for seniors. Unless Congress passes further legislation next month, doctors will face another massive cut Jan. 1.   a href="" target="_blank">' target=_blank>The Rand Paul  Spitzer Debate img alt="" galleryimg="no" onload="var...

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Medicare and the SGR

  My apologies, for the next week I will be running the same post to link to twitter and facebook to spread this  urgent message to patients. As you may know, on December 1st, Medicare physician payments will be reduced by 23 percent if Congress fails to act. If the December 1st deadline passes without congressional intervention,  it will mark the fourth time this year that Medicare physician payments have been cut more than 20 percent. While Congress retroactively stopped these payment cuts on each occasion this year, this uncertainty has made for a very unstable financial situation for surgical practices and for the patients they serve.   Physicians in all specialties continue to strongly advocate that Congress...

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Health Train Express and the impending SGR Adjustment

As you may know, on December 1st, Medicare physician payments will be reduced by 23 percent if Congress fails to act. If the December 1st deadline passes without congressional intervention,  it will mark the fourth time this year that Medicare physician payments have been cut more than 20 percent. While Congress retroactively stopped these payment cuts on each occasion this year, this uncertainty has made for a very unstable financial situation for surgical practices and for the patients they serve.   Physicians in all specialties continue to strongly advocate that Congress immediately stop these cuts, but the College needs the grassroots support of Fellows around the country. I urge you to contact your Senators and Representative...

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A Look Down the Road at Medicare Cuts

Moody’s Investor’s Report: Doctor, your credit score will suffer. You will freeze plans for investing in capital assets, personnel, EMRs, and new equipment leases. There will be multiple and extended domino effects triggered by health insurance reform. I do not believe anyone should call the APPA health care reform.  It is clearly not so. Medicare pays more than $300 billion to providers annually, covering the care of more than 40 million Americans. About 70% of corporate health providers rely on Medicare and Medicaid for more than one-third of their revenue. Certain industries stand to face the sharpest cuts in government money, Moody’s says, namely home health, as well as oxygen and durable equipment companies. Hospice care, nursing...

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Statistics From United Nations International Health Organization

  It seems there is a serious discrepancy being bandied about by our health reformers.  In this report from the U.N.I.H.O. their proclamations about quality and availability of health care in the United State do not match these statistics A recent “Investor’s Business Daily” article provided very interesting statistics from a survey by the United Nations International Health Organization. Percentage of men and women who survived a cancer five years after diagnosis: U.S. 65% England 46% Canada 42% Percentage of patients diagnosed with diabetes who received treatment within six months: U.S. 93% England 15% Canada 43% Percentage of seniors needing hip replacement who received it within six months: U.S. 90% England...

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Health Reform for Idiots, or Chicken Soup for Health Reform

I found a very nice simple animated explanation which distilled 1200 pages of the Health Reform Act. A terrific little animated video created by the Kaiser Family Foundation surfaced today, explaining in layman's language what's in store for us with the recently passed Health Reform Law. Narrated by the wonderful Cokie Roberts, this video attempts to simplify the vastly complex law, with the emphasis on those portions of the bill that impact us as regular folks and as healthcare providers. del.icio.us Tags: health train express,cokie roberts,health reform,kaiser family foundation...

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What does the Border have to do with Accountability?

  as Posted on The Health Care Blog Does This ACO Thing Really Mean We Need to be ‘Accountable’? By VINCE KURATIS Last month The American College of Physicians (ACP) released a well-reasoned and thorough position paper, The Patient-Centered Medical Home Neighbor: The Interface of the Patient-Centered Medical Home with Specialty/Subspecialty Practices. As I’ve written before, the Big Idea behind ACOs (Accountable Care Organizations) is the notion of accountability, not the specifics of organizational structure. The purpose of the ACP position paper is to address the gaps that exist in care coordination when a physician refers a patient to a specialist. The obvious and logical answer proposed is to develop “Care Coordination Agreements”...

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Future of Health Reform

  Today on CSPAN the Robert Wood Johnson Foundation presented a summation of the current environment in congress and future possible modifications to the health reform law. Dean Rosen, former assistant to Bill Frist, MD, the former speaker of the house, Norman Ornstein, resident scholar at the American Enterprise Institute, and  Ed Howard, from the Alliance for Health Reform each give their expertise on current events. VIDEO PROGRAM  CSPAN...

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KevinMD hosts Health Train Express

  Just a pat on my back (spraining my shoulder) and a thanks to KevinMD for hosting Health Train tomorrow—Friday....

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Politicians know S %@*t about Health Care

  A good friend and colleague sent me a link to a video.  I advise you that there is a lot of foul language in it.  I thought it was outrageously funny and exactly on point.  When I thought hard about it I thought, What the f#%!k .  If Obama doesn’t understand it or get it by now he never will).  Thanks again to Xtranormal,  the do it yourself  internet Pixar of the  21st Century.   img alt="" galleryimg="no" onload="var downlevelDiv = document.getElementById('d13b669f-e2db-447d-8ea4-6353ec03dbe8'); downlevelDiv.innerHTML = "";" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-mHabWk5t-cqY69DH6wy9x2dsX_-NjZ2APwyiFZFqrIjO4CtoOvGOVM2aoGTweEgOEKzOfJuOBhoKMXV3LWyd91TYvXyNY_730m7in2fImATGm0-2bvTAY8CAKcKiYKfP24xd4S6Ojbw/?imgmax=800"...

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Cleaning up The Health Train Express

  In an effort to speed up loading the landing page of my blog I have deleted many links, ads, and unnecessary ‘noise’.  Hopefully this will speed up your access, reduce internet traffic between sites.  This is my effort to make the internet more green.  For the time being I have left the blog links alone. I will be playing with the overall design in the coming week. Anyone who has a strong feeling or opinion can leave a comment.   GML...

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Video Game and Butchers, What do they Have in common?

  The '” boys “  over at  The Healing Blade  and  Nerdcore Learning bring new multimedia strategy to the healing arts. Turn on your wide screen HDTV and get your controllers ready! img alt="" galleryimg="no" onload="var downlevelDiv = document.getElementById('b7fc135e-66a3-4981-9377-8bc1fc41d25f'); downlevelDiv.innerHTML = "";" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9krmV90is-5wnR9fjEvHARIfl-nyTEeyahWBLqI10XNo7gZyb3p_EV9-e_gA2dVP0j0PB1NgA5Cgv6ibLGWO9fZwl3f28mBSSsRhOdP1SR79pk-wHrZ2y4t14IoVbiWqMAW1CG0VJa5s/?imgmax=800" style="border-style: none">   Those  long hours in the video game room may be paying dividends in learning as well as improving surgical skills. The...

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Health Train caught in an Earthquake???

    Hospital Seismic Safety Report  February 2010   We all know about the seismic risks to buildings in California, including health care facilities.  The California Healthline recently  reported the summary information available as of November 6, 2010. Unfortunately, although mandates for seismic retrofit was established many years ago, the vast majority of hospitals have not been officially evaluated for potential collapse in a major seismic event. California does not require hospitals to determine their collapse risks, but facilities can do so voluntarily. Hospitals also do not need to determine collapse risks for each of their individual facilities, making it difficult for some hospitals to determine...

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Medicine from 40,000 feet

  Way back in the mid 20th century when I graduated from George Washington University with an M.D. degree I imagined that I had “arrived”.  I remember my classmates selecting different specialties and eventually going off to clinical training. I could not imagine doing anything other than clinical work, and perhaps dabbling in some clinical research.  Some of my friends were studying ‘epidemiology’ and a new field ‘public health’.  At that time, it mostly  was dedicated to ‘epidemics’, vaccinations, preventive medicine, and things that to me did not really involved patient care. Turn the page, 50 or 60 years. This specialty has morphed into having an MPH (Masters in Public Health), and perhaps an MBA in health administration.. ...

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Disruptive Luddites

  For Ophthalmology Times: The past year has seen a rapid acceleration and implementation of electronic medical records in medical practices. While some ophthalmologists long ago installed EMR it was for the reason of establishing a reliable medical record, and also to improve the efficiency of their practices, improve reimbursement and eliminate paper. Most ophthalmologists lagged in EMR usage due to lack of affordable solutions and the fear of disruptive technology. During the second and rapid phase of adoption of new technology we have gone beyond 'early adopters', and the remainder of ophthalmology is adopting for political/financial incentives or social influence. Social influence plays a large role in the selection process of the EMR. Ophthalmologists and many physicians rely...

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When Do We Get to The Next Stop?

  Did I miss my station?  I’ve been riding the Health Train Express for several years. I seem to have missed many stops and find myself at the end of the road. Somewhere in between I have vague recollection of stops along the way,  SGR, HMO, PPO, IPA, PQRI, ARHQ, CMS, HITECH, PACA,NHIN, HIE. EMR, RHIO,HHS. What does it all mean? Jane M. Orient, M.D., is an On Air contributor speaking on Healthcare Reform. Dr. Orient has appeared on NBC, MSNBC, ABC and many major broadcast venues throughout the US, as well and her Op-eds have been printed in hundreds of local and international newspapers, magazines and followed on major blogs. She has been in solo practice of general internal medicine since 1981 and is a clinical lecturer...

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Some Funny, Some Sad, Some Ridiculous

  Todays’ post is a potpourri of health related blogs. Medical care and Art by Ted Bacharach MD (retired) 3D CT scan of a 300-year-old pocket watch by Vijay ECRI Institute Receives Contract for Monitoring Health Care Technology Billion Dollar Home In Mumbai by Indian Mukesh Ambani (Videos) Cathy's Scarf Quilt Major Victories In the War Against The Obese Top 3 stories in health and medicine this morning, November 5, 2010 The Town hall Raising our voices, throwing our weight A Few Extra Bucks (the online doctor still meets the same patients) Ask Not What Your Country Can Do For You, But What You Can Do for Your Patient AARP Raises Insurance Costs for Employees The Health Care Blog...

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Election day Aftermath

del.icio.us Tags: election,hmo,healthcare reform,obama care,constitution,redistribution,health train express Here we are one day post election.  It was reported that 1.6 billion dollars was spent for the benefit of politicians and free spending businesses, lobbyists, and some well meaning citizens who buy into their lies, promises and grandiose ideology and plans for the republic. No doubt many of these companies, and individuals had some self serving sinister motives. Campaign financing laws are easily thwarted,  to attain these levels of spending a mid-term election.  There is a great deal of American Wealth at stake, your wealth as our politicians fight to obtain your money for their purposes, without regard as to whom...

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