The joy has been sucked out of medicine. Here’s why.

November 27th, 2015 by admin

She came to the urgent care center with a sprained ankle. The primary care provider gave her excellent care, expertly applying evidence-based evaluation guidelines to her situation, and, thereby, avoiding unnecessary x-rays. By all measures, the provider’s care was excellent, but the interaction still ended up reducing his salary. You see, that patient’s only medical interaction that year was for this ankle sprain, and the provider was therefore held accountable for all of her primary care needs. Since she had not received a mammogram that year, or received a diabetes screening, he incurred an end-of-the-year penalty for failing to meet these quality standards.

Is it any wonder that many providers — primary care physicians, physician assistants, and even many beleaguered specialists — are increasingly dissatisfied with their jobs? What is happening to medical practice and what can we do to bring the joy back to being a health care provider?

am early into a one-year quest to connect with leading thinkers from inside and outside medical care, so I can better understand why many clinicians are miserable in their careers, and much more importantly, what can be done to help them thrive at work even though an increasing number of outside parties are looking over their shoulder, assessing the quality of the care they provide.

These increasingly burdensome rules and regulations are making it hard to enjoy medical practice these days. Several decades ago, physicians largely practiced as autonomous professionals, governed by standards developed by their professional peers. Physicians underwent intense and prolonged training to develop the knowledge and skills to know how best to help patients with their problems. And the world generally stood back and accepted, on faith, that most physicians would provide excellent care to most of their patients.

Click here to read all of this article originally posted on KevinMD.com

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Many People Who Think They Are ‪Allergic‬ To ‪Penicillin‬ May Safely Take It

November 7th, 2015 by admin

By Julienne Roman,

Researchers found that most people who are told that they are allergic to penicillin were mistakenly diagnosed as such based on initial reactions instead of a confirmatory test.

This mistaken perception led many to opt for more dangerous antibiotics and other treatments for their infections. Researchers pointed out that the patients who were thought to be penicillin-allergic had to take other antibiotics that put them at greater risk for acquiring complications such as colitis and the development of more antibiotic-resistant strains.

Study authors therefore stress the need to specifically test for penicillin allergy on suspected patients.

“Anyone who has been told they are penicillin allergic, but who hasn’t been tested by an allergist, should be tested,”said Dr. David Khan from the University of Texas Southwestern Medical Center.

He added that if patients are determined to be allergic, doctors will be able to determine which treatment options are most suited with the full confidence that it is the best course of action for the patient. But if the tests turned negative, then the patient will be able to take a drug that is just as effective as most antibiotics while being safer and more cost-effective.

Researchers studied data from patients who were reportedly allergic to penicillin but when tested were actually found to be negative. The team later found that the patients could be treated safely with the mentioned antibiotic even through intravenous injection.

“There is often thought to be a higher risk in patients who get intravenous penicillin, but we did not find this to be the case,” Khan added.

The misconception often stems from wrongly interpreting symptoms that manifest after taking the drug as signs of an allergic reaction. This mistake happens about 90 percent of the time among patients.

Penicillin side effects that include nausea and vomiting, mild diarrhea or headache commonly occur while taking the drug but do not herald an allergic reaction or are considered dangerous enough to halt continued taking of the drug.

Ever since its discovery, penicillin still remains a popular antibiotic because of its effectiveness and relatively low level of toxicity on healthy human cells. It comes in several different, non-interchangeable forms, and each one is often used to treat different infections.

However, there are people who are allergic to the drug, and people who report developing a rash, itching or difficulty of breathing while using the drug are advised to report these findings to a physician for a confirmatory test.

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Members of Congress Put Costly Drugs in Their Crosshairs

November 7th, 2015 by admin
  • by Shannon Firth

WASHINGTON — Prescription drug prices are getting more attention on Capitol Hill, with two senators from opposite sides of the aisle announcing plans to investigate while House Democrats declared they were forming a task force on the issue as well.

Sen. Claire McCaskill (D-Mo.) and Sen. Susan Collins (R-Maine) this week announced a bipartisan probe into drug costs, according to a press release from McCaskill’s office. The senators are requesting drug pricing information from four companies whose products’ prices have recently spiked: Valeant Pharmaceuticals, Turing Pharmaceuticals, Retrophin, and Rodelis Therapeutics.

“We need to get to the bottom of why we’re seeing huge spikes in drug prices that seemingly have no relationship to research and development costs,” McCaskill said, in the statement.

According to the release, the investigation will look into:

  • “Substantial price increases on recently acquired off-patent drugs”
  • “Mergers and acquisitions within the pharmaceutical industry that have led to dramatic increases in off-patent drug prices”
  • “The FDA’s role in the drug approval process for generic drugs, the agency’s distribution protocols, and, if necessary, its off-label regulatory regime”

The Senate Special Committee on Aging has scheduled an initial hearing on this issue for Dec. 9.

At a press briefing on Wednesday, Rep. Lloyd Doggett (D-Texas) announced the formation of the “Affordable Drug Pricing Task Force.”

House representatives said they hope to advance legislation that would enable Health and Human Services Secretary Sylvia Burwell to negotiate Medicare prices and to force drug companies to be transparent about the cost of making their products.

Doggett cited the now infamous example of Turing Pharmaceutical’s Daraprim (pyrimethamine), a drug for treating infections common in patients with cancer and AIDS. After the company acquired the drug 3 months ago, the price went from $13.50 to $750 per tablet. On Tuesday, the company said it would lower the price by the end of the year, but did not say by how much.

“But exorbitant drug prices are not about one wrongdoing, or one drug, or one class of drugs; they are a systemic problem that involve a wide range of manufacturers,” said Doggett while standing at a podium flanked by posters of Turing’s CEO Martin Shkrelivilified by the media for his tone-deaf comment that his actions would benefit society — and Michael Pearson, CEO of Valeant Pharmaceuticals.

Click here to read the rest of this article

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Antibiotic use during pregnancy no longer a cause for concern

November 3rd, 2015 by admin

The findings of the largest investigation of its type give the all-clear to macrolide antibiotic use during pregnancy. According to the investigation’s findings, macrolides do not negatively influence the unborn child’s development.


Antibiotic use during pregnancy has been much discussed. Could we finally have a definitive answer?

Thousands of pregnant women across America are prescribed antibiotics during their term; around 4 out of 10 expectant mothers will use them at some point during their pregnancy.

Along with penicillin, macrolide antibiotics are the most commonly used medications in the general population, including pregnant women.

Macrolides are a group of drugs, generally antibiotics, which include erythromycin, fidaxomicin, azithromycin and clarithromycin. They have a slightly wider antimicrobial spectrum than penicillin and can be used in cases where a penicillin allergy is present.

The current study was led by Anick Bérard, PhD, of the University of Montreal in Canda and its affiliated CHU Sainte-Justine Children’s Hospital, and Hedvig Nordeng, of the University of Oslo in Norway.

The team looked at macrolides and their potential adverse pregnancy outcomes, including birth defects. Bérard says:

“With penicillin, macrolides are amongst the most used medications in the general population and in pregnancy. However, debate remained on whether it is the infections or, in fact, the macrolides used to treat them that put women and their unborn child at greater risk of adverse pregnancy outcomes, including birth defects.”

Previous investigations into macrolide safety during pregnancy have produced contradictory results. Some studies have claimed an association between macrolides and cardiovascular malformations. Other studies have drawn links between the use of macrolides during pregnancy and an elevated chance of epilepsy and/or cerebral palsy.

These findings and others in the same vein have led to an avoidance of prescribing macrolides to pregnant women in several Scandinavian countries.

Click here to read all of the article from Medical News Today

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