| | PRESIDENTIAL POLITICS & MEDICINE | | |
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| Medicare one of several hot-button issues that physicians want answers on from candidates McCain, Obama
| | Not surprisingly, Medicare is something that physicians want to see addressed in this year's presidential election. And many in the medical community are looking to the next president to inspire systemic changes that will remove the obstacles that hinder quality patient care. The presidential candidates, Sens. John McCain and Barack Obama, are generally in agreement that the next administration should work toward reducing health-care costs, delivering high-quality patient care, placing an increased emphasis on prevention, and providing coverage for an estimated 46 million uninsured Americans. Senior Editor David Bennett provides an overview. |
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| | TOPIC: TOO CLOSE FOR COMFORT? | | |
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| Treating family, friends, and colleagues raises questions
| | | More than three quarters of 465 physicians responding in a 1990 survey reported diagnosing a family member's medical illness and prescribing medications for them, according to a study in the New England Journal of Medicine. Subsequent findings in the intervening years suggest those numbers weren't an aberration and still haven't changed much despite more recent efforts by medical organizations to highlight the attendant problems, ethical, legal and otherwise. Anecdotal information suggests that informal caregiving among health care providers is common, and one study found that 85% of medical and family practice residents had written a prescription for someone who was not their patient; virtually none were aware of federal and state regulations prohibiting the practice. |
|  | A new type of preventable medical error, says Medical Editor Fredrick Sherman, MD, MSc
| | | Physicians treat their relatives, friends and other close associates very commonly, taking great risks with often undocumented consequences. We need to seriously consider the doctor/relative/friend relationship as a preventable medical error. To avoid this new type of error, hospitals, nursing homes, health plans, group practices, and clinics should program their computers to find and flag patients with admitting physicians or consultants who have the same last name. Similarly, pharmacy software should reject and query physicians who call in or submit prescriptions for family members with the same last name. |
|  | Legal Q & A with John Dinardo, RPh, JD: Can pharmacist fill those Rxs for family members?
| | | When a pharmacist is presented with a self-prescribed prescription, or a prescription written for the prescriber's family member, it should immediately raise a red flag and requires close scrutiny. Is the prescription valid? If not, can the pharmacist be disciplined for filling it? The short answer is the infamous "it depends" – on whether the script is valid or not. If it's invalid and the pharmacist fills it - not an uncommon practice - disciplinary action could and should result. |
|  | Case & Commentary: Ann Williamson, RN, PhD, on informal caregiving among colleagues
| | | Here's a close look at one case that's typical of requests for advice/treatment between professional health care colleagues. And among many other personal anecdotes: nurses reveal that physicians often ask them for analgesics, antibiotics, or other medications to get them through busy shifts when they are feeling ill. In turn, physicians tell of frequent requests for prescriptions by non-patient colleagues. Both doctors and nurses recount professional requests for health care "favors" include taking blood pressures, checking blood glucose levels, performing phlebotomy, administering intravenous infusions, and performing electrocardiographs, to name a few. |
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Who's providing all that long-term elderly care
(and what's on their minds?) Geriatrics readers include more than 20,000 medical directors, consultant pharmacists, directors of nursing, and nurse practitioners who provide care for the elderly residing in nursing facilities and assisted living facilities. Of another 49,000-plus physicians who receive Geriatrics, 83% see patients in long-term care facilities. To this end, Geriatrics' editors felt it would be helpful to share the results of The Senior Care Digest Interdisciplinary Report: A Survey of Long-Term Care Health Professionals, part of the sanofi-aventis Managed Care Digest Series. The survey illustrates the work, practices, and attitudes of these health care professionals regarding key and provocative issues in long-term care. | |
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Geriatric health care--managing the "crisis"| Throughout his medical career, Dr. Carl Hammerschlag has challenged conventional thinking. This is evidenced by his philosophy and execution of his medical practice, his lack of pretense, and his conviction that embracing change is the only way to manage it. In this 5-minute Consult, aka the Geriatrics interview, Dr. Hammerschlag shares his insights on how physicians and other health care providers can engage and assist patients and their families in the practice of geriatric medicine, especially in light of the Institute of Medicine's (IOM) recent report on the state of the geriatric workforce. And here's another good 5-Minute Consult: An interview with Peter J. Whitehouse, MD, MA, PhD, and Daniel George, MSc, who have written The Myth of Alzheimer's: What You Aren't Told About Today's Most Dreaded Diagnosis. | 
Dr. Hammerschlag |
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September 2008 | | 
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July 2008 |
For fully-searchable contents of complete issues go to Digital Editions. | |
| | | | Type 2 diabetes treatment trials highlighted at EASD
Results of the first comparison trial between the dipeptidyl peptidase 4 (DPP-4) inhibitor sitagliptin and exenatide in type 2 diabetes patients already taking metformin show that exenatide exerts significantly better glucose control. In addition, researchers reported that sitagliptin (Januvia) taken for 18 months to 2 years was not associated with increased adverse or ischemic events. Both studies were presented during the recent European Association for the Study of Diabetes in Rome. | | Study confirms benefit of 2-drug therapy for Alzheimer's disease
Extended treatment with Alzheimer's disease drugs can significantly slow the rate at which the disorder advances, and combination therapy with 2 different classes of drugs is even better at helping patients maintain their ability to perform daily activities. Results from the first long-term study of the real-world use of Alzheimer?s drugs were published by researchers from Massachusetts General Hospital in the July/September issue of Alzheimer Disease and Associated Disorders. | | Cholesterol drug effective for at-risk elderly, too
Although elderly patients—in whom the majority of strokes and coronary heart disease (CHD) events occur—are less likely to be prescribed statins, less likely to take them, and less likely to stick with the regimen over time, a cholesterol drug can lower the risk among patients 65 or older of having a second stroke to the same degree as younger patients. | | Continuous glucose monitoring a benefit in type 1 diabetes
Compared to the old-fashioned way of glucose monitoring with finger sticks and a home glucose meter, continuous glucose monitoring using 3 different brands of devices—all some type of glucose oxidase-based electrochemical sensor and a receiver—produced significant better results among adults of maintaining blood sugar levels within desired ranges. | | Proton pump inhibitors increase risk of osteoporotic fracture
The use of proton pump inhibitors increased the risk of hip fracture after 5 or more years of continuous exposure, and the risk of any osteoporotic fracture was increased after at least 7 years of continuous exposure to proton pump inhibitors, according to an August 12 study in the Canadian Medical Association Journal. | |
|  More News |
| | | | | England's Compulsory Psychiatric Admissions Rise Sharply
At a time when the number of beds is falling, there has been a sharp increase in the number of compulsory admissions to psychiatric wards in England, according to research published online Oct. 9 in BMJ. | | NSAIDs May Reduce Breast Cancer Risk
Although non-steroidal anti-inflammatory drugs (NSAIDs) are associated with risk reduction in breast cancer, the relationship is not a gradient-dose response where increasing dose confers a protective effect, researchers report in the Oct. 15 issue of the Journal of the National Cancer Institute. | | Families May Prefer Prolonged Life-Support Withdrawal
Incremental, or "stuttering," withdrawal of life support in the intensive care unit may be associated with greater family satisfaction with a dying patient's care, according to an article published in the Oct. 15 issue of the American Journal of Respiratory and Critical Care Medicine. | | Herbal Extract Protects Against Stroke Damage in Mice
A Ginkgo biloba extract can protect against neuronal injury in a mouse model of stroke, according to the results of a study published online Oct. 9 in Stroke. | | Ranolazine Safe and Effective to Treat Angina
Ranolazine, a new and unique anti-anginal drug, is safe and effective when used to treat patients with chronic stable angina, according to an article published in the Oct. 11 issue of The Lancet. | |
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Keep visiting geri.com for fresh content, news, opinions, editor's blogs and more.  |
 | If you're an MD, how much reading do you do each week? Take our survey and get immediate feedback on how your reading compares with other doctors. Then visit Geri.blog to jog your memory on how much you used to read in medical school and during your residency. You'll also find some other interesting thoughts on the reading habits of successful doctors. And, of course, you're welcome to share your comments, opinions, and insight. | | |
Which answer comes closest to the average time you spend each week reading medical journals and texts (in print and online) in relation to time spent reading non-medical books?
| | | ≤2 hours medical journals, texts / ≤2 hours non-medical books | | 16% | | | 2 to 4 hours medical journals, texts / ≤2 hours non-medical books | | 19% | | | 4 to 6 hours medical journals, texts / ≤2 hours non-medical books | | 6% | | | ≥6 hours medical journals, texts / ≤2 hours non-medical books | | 13% | | | ≤2 hours medical journals, texts / ≥2 hours non-medical books | | 13% | | | 2 to 4 hours medical journals, texts / ≥2 hours non-medical books | | 16% | | | 4 to 6 hours medical journals, texts / ≥2 hours non-medical books | | 8% | | | ≥6 hours medical journals, texts / ≥2 hours non-medical books | | 10% | |
| |  | | | | Click to go to Geri.blog on reading habits |
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