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Early dialysis may not improve kidney failure outcomes
by Nancy Walsh
Planned early initiation of dialysis in patients with chronic kidney disease did not improve survival or other clinical outcomes, a multicenter randomized trial conducted in Australia and New Zealand found.
The hazard ratio for death among patients who had an early start of dialysis, when the estimated glomerular filtration rate (GFR) was 10 to 14 mL/min, was 1.04 (95% CI 0.83 to 1.30, P=0.75), according to Bruce A. Cooper, MBBS, PhD, of Sydney (Australia) Medical School, and colleagues.
This was in comparison with patients who had a later start, when the estimated GFR was 5 to 7 mL/min, the investigators reported at the European Renal Association-European Dialysis and Transplant Association Congress in Munich. The findings were concurrently published online by the New England Journal of Medicine.
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No comment | Tags: Specialist | Category: Diagnosis and treatment
Greed is not good when it comes to doctors, patients and medicine
by Chris Rangel, MD
Gordon Gekko is wrong. Greed is not good. Not when it comes to health care providers.
The socioeconomic study of what motivates people is a fascinating field of study, not the least of which is because of how counter-intuitive it is. For example, it seems normal to assume that the more someone is rewarded for their efforts, the more effort they will put forth toward those rewards.
These rewards (increasing salary, bonuses, benefits, status, etc) are known as “extrinsic” motivators and for menial and/or repetitive jobs that have little need for regular complex planning, evaluation, or creative problem solving like unskilled manufacturing, manual labor, or GOP membership, the system works as expected with bigger monetary rewards leading to bigger efforts.
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2 comments | Tags: Health reform, Hospital, Patient | Category: Health policy and politics
When a biopsy cannot completely rule out cancer
by Jeffrey Parks, MD
Pathologists and radiologists don’t have the luxury of spending time with actual patients so they have to render professional judgments and determinations based on indirect data (radiographs, a mashed up slice of breast tissue, etc.).
I don’t envy them; the utter detachment from patient care would make me miserable. But they do have a tough job. They get one shot at getting it right. There’s no patient follow up. They never get the opportunity to explain a missed diagnosis to a patient, to soothe things over. Once they stamp their name on the final report, there’s no turning back. They can’t afford to allow a sliver of a chance that they haven’t “covered” themselves.
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6 comments | Tags: Cancer, Specialist, Surgery | Category: Cancer
Why comparative effectiveness won’t matter to Avastin and Lucentis
by Merrill Goozner
The Center for Medicare and Medicaid Services could save a half billion dollars a year by switching its beneficiaries with macular degeneration to Genetench’s Avastin instead of Genentech’s Lucentis, the Wall Street Journal reported recently. The two drugs are variations of the same molecule.
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2 comments | Tags: Drugs, Health reform | Category: Drugs and pharma
Decision support can help doctors order scans
by Scott Cowsill
A third or more of scans may be unnecessary or repetitive, studies show, and in scans that are medically appropriate, radiation doses could be dramatically reduced without hurting the quality of images.
As pointed out by Robert Centor, MD, “one cannot easily develop rules for testing because the presentations that we see vary so greatly.” That being said, guidelines for diagnostic testing appropriateness have been created, are being continually updated and are proving to show significant value for patients, clinicians, healthcare organizations and the healthcare industry at large.
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1 comment | Tags: Hospital, Radiology | Category: Patient care
Diabetes is responsible for many heart disease deaths
by Kristina Fiore
More than one in 10 heart disease deaths may be attributable to diabetes, researchers say.
In a meta-analysis of more than 100 studies, diabetes was associated with a twofold increased risk of the disease and was estimated to be accountable for 11% of vascular deaths, according to Nadeem Sarwar, MD, of the University of Cambridge in England, and colleagues.
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No comment | Tags: Diabetes, Heart | Category: Diagnosis and treatment
Non-clinical physician job starting salaries
by Joseph Kim, MD, MPH
What are entry-level non-clinical physician job salaries?
Let me clarify what I mean by “entry-level” here: I’m referring to non-clinical jobs that physicians may find if they leave clinical medicine to pursue a non-clinical job in a company (such as a medical communications company, a health IT company, pharmaceutical, biotechnology, or a consulting company).
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3 comments | Tags: | Category: Physician practice
Patricia Handschiegel: The New Power Girls: How Today’s Women In Business Are Making Money And Change
Lucques is one of the chic little restaurants that dot L.A.’s Melrose Avenue towards the west end. It’s tucked next to other local classics like Taste, Comme Ca and Ago, with Cecconi’s just a half mile or so ahead. As I take a seat across an old friend and entrepreneur in the social change arena, the scene is quiet and laid back. Couples and groups mingle and socialize over candle lit tables. A fireplace crackles despite that its August in the city. A few weeks ago, President Obama and his family dined here.
“So what have you been up to,” I ask, digging into the basket of crunchy fresh bread. I’m as much of a carb-skipper as anybody but Lucques includes sea salt with the butter and its almost impossible to resist. My guest shifts in his seat and gets comfortable. He’s been one of the most innovative people I know on the social entrepreneurship scene. It was just that which brought us together years ago. I had just owned my first startup, Stylediary, and was eager to use business to help drive causes and change, he had been working to do the same with his own endeavors. As he shares the details on his latest work, I’m again amazed. “Green” business seems to be everywhere. The business world is learning that it can make money and drive social change.
More than ever, women entrepreneurs are also tapping in.
In fact, studies show that women founders are more likely to work to benefit causes and charities in addition to the bottom line of their business. From using sustainable products and working to empower small and mid-sized farmers to creating programs that give empowerment or give back, today’s new modern women entrepreneurs and executives are very active in using business to make a difference. It comes in companies and organizations of all shapes and sizes, from the Happy Baby Food company to Women 2.0. You name it.
Power Girls know there’s value in giving back.
“The ratio of women owned businesses in the green industry is about 50-50,” shared Eco Bold founder Steffany Boldrini, who creates and produces a web video show that helps consumers live green. Boldrini’s a bit like a Rachel Ray or Martha Stewart of eco-friendly lifestyle. Her videos are informative, fun and entertaining, popular among the site’s ten different video channels as well as ten different social networks.
“Women seem to be more and more worried about what kind of planet they’re leaving their children. In fact, quite a few women that I’ve interviewed started their green companies right after having kids,” Boldrini added.
It’s a trend that’s come a long way since the early days of sustainable t-shirt lines and companies using recycled goods. Today, green products are mainstream. Consumers can find and purchase items across dozen of categories and in most of the top stores both online and offline. It ranges from food to clothing to jewelry and virtually everything in between. Women-owned companies in the arena range from media and content businesses like Eco Bold and Your Daily Thread, to biomedicine and engineering. Most of all, they’re seeing success.
More colleges and universities and government organizations are also supporting green entrepreneurship. They help aspiring founders cut through red tape, find financing and grants and business training on all aspects of running the business. Even female celebrities are starting to tap in. Stars like Alicia Keys, Barbra Streisand, Alicia Silverstone and dozens of others have cause-related efforts and organizations, all in the name of giving back. They join a growing number of male counterparts like Ed Norton and Brad Pitt. The new way of doing business is with an eye on the world — in addition to revenue.
As I hop to make it to a friend’s birthday party at the Roosevelt hotel following dinner, I’m reminded that in a world that seems in it for itself, there is a growing chorus of founders who want the brass ring to give back.
“I forgot how innovative you are with causes,” I text my friend from the back of the taxi ride. “It’s so inspiring.”
With a greater ability — and awareness — that profit and good can be done together, more than ever business is.