Saturday, July 11, 2015

NYTimes: Modern Doctors’ House Calls: Skype Chat and Fast Diagnosis

One night, when her face turned puffy and painful from what she thought was a sinus infection, Jessica DeVisser briefly considered going to an urgent care clinic, but then decided to try something "kind of sci-fi."

She sat with her laptop on her living room couch, went online and requested a virtual consultation. She typed in her symptoms and credit card number, and within half an hour, a doctor appeared on her screen via Skype. He looked her over, asked some questions and agreed she had sinusitis. In minutes, Ms. DeVisser, a stay-at-home mother, had an antibiotics prescription called in to her pharmacy.

The same forces that have made instant messaging and video calls part of daily life for many Americans are now shaking up basic medical care. Health systems and insurers are rushing to offer video consultations for routine ailments, convinced they will save money and relieve pressure on overextended primary care systems in cities and rural areas alike. And more people like Ms. DeVisser, fluent in Skype and FaceTime and eager for cheaper, more convenient medical care, are trying them out.

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Thursday, July 9, 2015

Medicare proposes to pay doctors to have end-of-life care discussions - The Washington Post

Federal health officials are proposing that Medicare begin paying doctors to discuss end-of-life issues with their patients, six years after the "death panel" controversy erupted in the early days of the debate over President Obama's health-care legislation.

The Centers for Medicare and Medicaid Services (CMS) released the new plan Wednesday as part of its annual Medicare physician payment rule. The proposed rule includes reimbursement for "advance care planning." The final rule is due Nov. 1, and payments would start Jan. 1. The discussions would be voluntary.

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Sunday, July 5, 2015

NYTimes: Medical Mysteries of the Heart

Scientists have made enormous gains in reducing deaths from coronary heart disease, the leading cause of heart attacks, but it is astonishing how much they still don't know. That leaves patients and their doctors uncertain about the best way to fight a disease that is still the leading cause of death for both men and women in the United States.

The successes and remaining puzzles in treating heart disease were laid out in recent articles by The Times's Gina Kolata. From 2003 to 2013, the death rate from coronary heart disease plunged by about 38 percent, thanks to better control of cholesterol and blood pressure, a decline in smoking rates, improved medical treatments and faster care of people after a heart attack.

The most surprising gaps in knowledge involve two of the most common treatments: when to use stents — small wire cages — to prop open coronary arteries and how far to drive down blood pressure.

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A doctor's touch - Abraham Verghese - TED Talk

Modern medicine is in danger of losing a powerful, old-fashioned tool: human touch. Physician and writer Abraham Verghese describes our strange new world where patients are merely data points, and calls for a return to the traditional one-on-one physical exam.