Chris Carpenter and patient Chris Carpenter, MD, of Boston Children’s Hospital’s Global Pediatrics Program (GPP), sees the world a little differently than most people. When faced with news stories about poverty and suffering in Africa, many of us see tragedy; Carpenter sees an opportunity to help. Now he’s sharing his vision with the world, through the eyes of a camera. His documentary film, “Born in Goma” captures his time in the war-ravaged Democratic Read More...

By Kathryn Michalski Peter When my son Peter and I go out, it’s not unusual for people to fawn over him a bit. “What a happy kid.” “He’s so smart.“ “It makes me smile when I see him,” we often hear. As a mom raising a child with as many health issues as Peter has faced, these comments brighten my day. Peter was born with an arteriovenous malformation (AVM) in his liver, meaning his veins and arteries weren’t connected properly. When he was just seven Read More...

by Kenneth H. Cohn Last week, while facilitating the Chief Quality Officers healthcare roundtable, I listened to a provocative talk by Nate Kaufman on the future of healthcare delivery, in which he stated that a tsunami is approaching, for which we must prepare. He said that fee-for-service reimbursement has resulted in a feeding frenzy and made an analogy to the 2004 USA Olympic basketball team who won a bronze medal, despite outstanding players, because they chose not to play together as a Read More...

by Scott Kashman Prior to going into healthcare management, I served as a psychiatric counselor. No doubt, I’ve heard some of the offhand remarks about my role and how it helps me in the world of management. But it was a great experience learning how to do things differently when reimbursement or our “subsidy” changed. You see, we saw patients in need of more than 30 days of care quickly get cut to a seven-day stay. If our organization didn’t act rapidly, the negative Read More...

In 1949, the English-born physician John Wild, working at the University of Minnesota, discovered that he could determine the thickness of bowels injured in the war by bouncing sound waves though the abdominal wall. Over the next 30 years, medical ultrasound technology improved markedly, ultimately leading to the many uses we’re all familiar with. Once [...] Read More...

Leave it to the French to come up with a totally effective way to get people to exercise.  Take this to your spinning class! Read More...

Jack C. Westman, M.D., President, Wisconsin Cares, Inc., and Professor Emeritus of Psychiatry at University of Wisconsin School of Medicine and Public Health seeks your advice.  Here’s the background: Jack is writing a book that describes why we all need to care about the 4% of parents who abuse and neglect their kids, and in which he proposes solutions. He asks for help to find a title that would capture the interest of thoughtful people. Please read the synopsis and vote on a Read More...

By Rob Lamberts, MD I saw a gentleman in my office recently.  He was having severe pain radiating from his lower back, down to his calf. I was about to describe my plan to him when he interrupted me saying, “I know, Doc, I am overweight.  I know that this would just get better if I lost the weight.”  He hung his head down as he spoke and fought off tears. He was clearly morbidly obese, so in one sense he was right on; his health would be much better if he would lose the pounds.  On Read More...

By James Salwitz, MD A frightened Diane called me today.  She was in big trouble.  Her primary doctor’s office had called with terrible news.  The MRI showed Diane had a lesion.  Desperate, she reached out to an Oncologist for help. A lesion?  Yes, a lesion.  What could that mean?  What did she need to do?  What was going to happen?  With trepidation Diane asked, “Do I have cancer?” Medicine prides itself on accurate, specific, scientific analysis.  We have delineated more Read More...

I am the mother of a child who died. And that makes Mother’s Day very hard. Recently I was talking to a mother whose child had just died. “What about Mother’s Day?” she asked, through tears. It was hard to know what to say, because it’s a terrible day for those of us who have lost a child. Other days of the year you can maybe make it a few hours without thinking about your loss; other days of the year you can pretend that you are an ordinary person and that life is normal. But not Read More...

A few months ago I had another one of those amazing experiences that makes me feel so lucky to be a doctor.  These don’t come every week or every month but they do come, and they are life-affirming. I was … Continue reading → Read More...

Due to the many wondrous talents and skills by Children’s Hospital of Wisconsin physicians and nurses, I am alive today, and I will continue to live day after day after day. I have not been to every clinic and specialist (knock on wood, please), but I’ve been to quite a … …Continue reading → Read More...

My daughter Maureen (Mo) has Loeys-Dietz Syndrome, a connective tissue disease similar to Marfan syndrome. Loeys-Dietz syndrome is complicated. It affects the connective tissue that runs throughout the body—organs, muscles, and blood vessels. You name it. It’s present. When the tissue is weakened and defective, it is bound to wear … …Continue reading → Read More...

We have all received emails from consulting firms and law firms with the following type of message printed at the bottom: This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. A question for the lawyers Read More...

Turning back now to the dueling health care bills pending in the state legislature here in Massachusetts, there is one thing on which the two houses agree:  It is all right to impose new taxes on the industry in the name of decreasing costs. Huh? You heard it right. The language is dense, but here is what I read.  (Apologies in advance if I have gotten any of this wrong.) The Senate bill establishes the “Health System Benefit Surcharge,” which assesses payors $40,000,000 Read More...

Tonight at 8 pm, HBO will debut a four-part documentary series, The Weight of the Nation, an unflinching look at the severity of the obesity crisis in America, and its crippling effect on our nation’s health and economy. HBO and the Institute of Medicine of the National Academy of Sciences have joined forces to bring together the nation’s foremost experts on weight and weight loss for a frank and educational look at obesity in America. The series explains how weight became such Read More...

Feeling "a little" pinch is a small price to pay for good healthcare. But we can do more to reduce the discomfort. (UNICEF Sverige/Flickr) I remember distinctly both of my boys’ 4-month-old well visits. Mostly because of the shots: all four of them. Neither boy was particularly happy about being poked that much (though the shiny Band-Aids afterward did help a little). My wife and I would have loved to help ease the pain of the shots, but we didn’t have any idea how. Read More...

By Shannon Brownlee and Joe Colucci

When most of us think about Facebook, the first phrase that comes to mind probably isn’t “good Samaritan.”  Facebook is an easy way to keep in touch with friends, and it can be a gigantic time-suck, for sure, but last week the site did something that could truly benefit a lot of people. On May 1, Facebook launched an initiative to encourage users to become organ donors, and within 24 hours there had been a spike in the number of people volunteering their body parts for the good of others.

California’s registry saw almost two months’ worth of people sign up within the first day after the Facebook put up the feature.

Organ transplantation is one of the miracles of modern medicine, but there simply aren’t enough organs to go around for all the patients who need them. According to the United Network for Organ Sharing (UNOS), there are 72,900 people on active lists waiting for an organ. Compare that number to the 2,263 transplants that took place between January 2011 – 2012. Last year, more than 6,000 people died waiting for an organ.Obviously, increasing the number of organ donors could have a huge impact on the number of transplants – and on the lives of thousands of people.

Why don’t more people become donors? Some object on religious grounds, but the biggest obstacle is inertia. Most of us who sign up to be organ donors (I’m one of them) do so when we renew our driver’s license, by checking a box on a form saying we want to donate our organs. If you don’t mark the form, it’s assumed you don’t want to donate. Most people only encounter this choice every few years, when their driver’s license is up for renewal, and it’s hard to think about such a decision while standing at a Department of Motor Vehicles counter.

Some countries, such as Spain, Australia and Germany, have opt-out systems. It’s assumed that you are willing to donate unless you’ve said you prefer not to. Rates of donation in those countries are sometimes higher than in the US, although some presumed-consent countries have much lower rates. (Factors other than the number of donors, like the availability of surgical facilities and transplant surgeons, can affect the number of actual transplants in different countries.)

(more…)

By JOSHUA ARCHAMBAULT Are the House and Senate giving us a false choice for how to control health care costs in Massachusetts? Aren’t there other options? A few major themes have emerged from the two payment reform proposals and highlight the fact that they fail to align incentives for patients to be more involved in the purchase of their health insurance and their health care. For example, even with full transparency of cost and quality (which is a huge lift on its own) for many patients, Read More...

I love good radio, and I was reminded the other day of a series entitled 11 Central Ave produced by Susan Shepherd a few years ago.  It was called a radio comic strip, and it was excellent.Listen to this episode about Anneliese, Nat and Christine’s seventeen year old daughter, who is on her way to graduating from high school.  Her mother has some plans for how she can get into the right college. While 11 Central Ave is no longer in production, I know we can count on Susan Read More...

Corbin Klett is a recent graduate of Georgia Tech.  He gave this commencement speech, which I highly recommend.  Some excerpts: We will be the hero generation — We will reclaim and rebuild institutions; we will rise up with social activism, collective competence, civic engagement, and servant leadership; our main contributions will be revitalizing communities and advancing technology; we may be the next great generation. Speaking of his classmates, he noted, What I like Read More...

By Aza Raskin Privacy policies are long legalese documents that obfuscate meaning. Nobody reads them because they are indecipherable and obtuse. Yet, these are the documents that tell you what’s going on with your data — how, when, and by whom your information will used. To put it another way, the privacy policy lets you know if some company can make money from information (like selling you email to a spammer). Creative Commons did an amazing thing for copyright law. It made it Read More...

Recall your last credit card statement.  On it is the hotel charge from your last out of town CME excursion.  Below the total charge you were expecting, is a separate line item for a $75 “recreational fee.”  You call the … Continue reading → Read More...

In this analysis of 2 primary PCI centers, the rate of false+ activation of the STEMI team was 36%. This over activation of STEMI teams are likely a result of public reporting of time to PCI. Reducing time to appropriate PCI, and avoiding unnecessary activations, is a difficult balancing act (abstract) Read More...

In the largest meta-analysis to date (82 trials, >11,000 participants), probiotics reduced antibiotic associated diarrhea by 42% (RR 0.58, CI 0.50 to 0.68, p<.001). Although this still does not settle the debate about the best probiotic preparation, there is substantial evidence that they reduce antibiotic associated diarrhea (abstract) Read More...