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GLG News by this Author

My experience as a Primary Care provider

April 20, 2009

Analysis of:Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. | linkinghub.elsevier.com.ezproxy.its.uu.se

We are quite fortunate to have several orthopods who do this procedure at our Yale affiliated teaching hospital.  We have had Grand Rounds on this procedure (intended to "sell" us on the concept) and I have had 2 office details by Reps in the past from Kyphon.  I just had a recent case of a 92 year woman with 2 vertebral fractures who got relief in 2-3 days, but has now had problems with a shifted "X-Stop" device she is scheduled to have removed soon.

This makes a lot of cents...

August 8, 2008

Analysis of:Blood pressure drugs may protect against Alzheimer's | www.washingtonpost.com

I think that we primary care doctors have known all along that controlling several risk factors that we commonly see not only makes people live longer, but also more "intact" as they age.  I can look back over the last 28 years of practice and see that those patients who went downhill faster were usually suffering from the usual suspects:  diabetes, hypertension and high cholesterol.  With a little smattering of bad life style choices, they really deteriorated quickly, and either died too young or wound up in bank account draining nursing homes.

I agree that EMRs are not ready for most of us primary care doctors...

June 23, 2008

Analysis of:Most Doctors Aren’t Using Electronic Health Records | www.nytimes.com

EMRs are quite expensive, possibly one of the bigger outlays of cash I can think of.  EMRs are also a work in evolution, much like operating software:  who wants to invest a lot of money on Vista when rumors of a new and better program are out there?  The enormous stress of putting one of these systems in action, if you can even find the right one, simply terrifies me.  One little thing goes wrong and I have fears of all my data going south.

I find it hard to believe...

May 29, 2008

Analysis of:New data show Tekturna HCT® is twice as effective at reducing blood pressure than the diuretic HCT alone | www.novartis.com

I have used this medication a few times and, although good, it is not a powerhouse like some others. It looks to me as if the claim of "double" the potency with HCTZ is more smoke and mirrors.              

Not Surprised

October 29, 2007

Analysis of:U.S. veterans dept to limit Glaxo's Avandia: report | www.reuters.com

In spite of GSK's best efforts, I am feeling the vibes, both in myself and in those doctors around me, that damage control is not working.  I just attended a Teleconference with C. Beck the other night, and the moderator soundly trounced Avandia, even allowing for his being paid to speak for Takeda's Actos that evening. I heard no dissent amongst the 20 or so doctors on the phone that night. 

A Winner, maybe...

September 24, 2007

Analysis of:Electronic Prescription Drug Act of 2007 | www.thomas.loc.gov

I tracked down the proposed law online, and seems to still be in a very rough draft state;  I find it hard to believe that a doctor will be paid $1.00 per electronic prescription.  That can actually add up to a lot of money per month, and actually make me NOT groan when, at the end of a visit, the patient whips out a long list of medications he forgot to tell you he needs written out for mail order (and maybe a set of the same for 30 days at the local pharmacy, just in case!). 

An Ominous Trend

July 26, 2007

Analysis of:An Innovation in Health Care Opens at CVS/Pharmacy Stores in Knoxville and Chattanooga | money.cnn.com

This seems to me, as a board certified practicing Internist, as yet another intrusion into the successful continuing concept of private practice.  As Internists, we don't just treat Lupus, heart failure, renal failure, strokes, etc.  Those conditions do require our skill and training levels, as well as the the number of years in practice each doctor has accumulated, making him all the more competent in those areas. Now we have, I would guess, relatively new younger providers with only a nursing degree (albeit advanced), who are looking to funnel away our "easier" bread and butter illnesses that help make up the extra uncompensated time we spend on the very ill patient.  Also, I am SURE that CVS is going to love having whatever RX the nurse writes filled right there in the store;  hmmm, self referral in sheep's clothing??? 

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