Articles related to All Specialties

The FDA’s controversial approval of Recarbrio in 2019 marked a deviation from the expected standards of drug effectiveness. Before 1962, US drug approvals didn’t require pre-market proof of effectiveness. Following Senate hearings and the Thalidomide disaster, however, the law changed. Nowadays, FDA approval for new drugs requires substantial evidence of effectiveness from well-controlled investigations. Strikingly, a National Academy of Sciences review found over 30% of pre-1962 drugs to be ineffective, highlighting the importance of these regulations. FDA’s regulations provide a detailed explanation of what constitutes substantial evidence. Though not perfect, these regulations reassure prescribers, patients, and payers of the scientific basis of drug efficacy claims. It’s important to note that an FDA review found 59% of rejected NDAs had deficiencies in efficacy evidence. Nevertheless, the FDA’s controversial approval of Recarbrio in 2019 raised eyebrows. This drug, a combination of imipenem, cilastatin, and relebactam, was approved despite lacking substantial evidence of effectiveness and proper clinical investigations. Disturbingly, FDA officials cited animal and laboratory studies as substantial evidence, a move contrary to legal and regulatory norms. Moreover, the Recarbrio approval showcased other troubling departures from regulatory principles. The FDA failed to require proof of each active component’s contribution to the claimed effect. […]

Physician burnout: A rising concern in the medical field, driving doctors to explore alternative career paths. Physician burnout has reached an alarming stage, with doctors increasingly contemplating leaving their medical practices. This exodus has primarily been influenced by the intense stress, emotional trauma, and overwhelming challenges they face in their careers. Importantly, the trend is not just an individual crisis, but a looming threat to the healthcare system. According to recent studies, 20% of physicians express intentions to quit their current practice within two years, and a third aim to cut down their working hours significantly. These statistics could precipitate a healthcare crisis, with the Association of American Medical Colleges predicting a potential shortage of 37,800 to 124,000 physicians by 2034. It’s worth noting that the reasons for this growing disenchantment extend beyond the physical and mental toll of the COVID-19 pandemic. Instead, doctors attribute their dissatisfaction to various issues tied to the broader healthcare landscape. They report frequent clashes with insurance companies, dwindling physician autonomy, bureaucratic hurdles, hostility from patients, lack of support from hospital administrations, and an inability to practice the art of bedside medicine. Physicians are not walking away from their professions because they can’t handle the […]

Navigate the rapidly changing landscape of patient communication, as we explore the ins and outs of charging for MyChart messages. The COVID-19 pandemic has swiftly transformed the dynamics of healthcare communication. Consequently, healthcare providers increasingly rely on telehealth visits and digital communication tools to connect with patients. A significant offshoot of this shift is the growing trend of charging for MyChart messages. Healthcare systems have begun charging for the time providers spend responding to messages. Some hospitals have even expressed plans to bill up to $50 for MyChart messages. This new approach was permitted through changes to the 2020 Current Procedural Terminology (CPT) codes. The revised codes introduced three new time-based categories, thereby allowing providers to bill for time spent addressing patient-initiated messages over a week. Despite these changes, not all services come with a price tag. As per the Cleveland Clinic, any work taking under five minutes or any service that leads to an in-person consultation will not be charged. Furthermore, no fees apply to prescription refill requests, appointment requests, and follow-up care related to a surgery performed within the last 90 days. However, specific services can be billed. For instance, messages necessitating a clinical assessment, ordering a test […]

The case involves a 73-year-old patient, Ms. B, who had a history of rheumatoid arthritis and was taking prednisone for adrenal insufficiency caused by a pituitary tumor. She was treated by an internist, Dr. R, for various ailments over a period of four years. In November 2016, Ms. B was diagnosed with severe community-acquired pneumonia and admitted to the hospital, where she was treated with levofloxacin. After being discharged, she continued taking levofloxacin and suffered an acute rupture of the gluteus medius tendon, resulting in significant disabilities. Ms. B filed a lawsuit against Dr. R, alleging negligence and failure to inform her about the risks and contraindications of the medication. Dr. R sought a summary judgment to have the case dismissed but was denied by the court. The court ruled that a Boxed Warning on a medication, such as the one associated with levofloxacin, can create a triable issue of fact regarding a physician’s departure from accepted medical practice. Dr. R claimed he was unaware of the risks and relied on the hospitalists’ choice of medication, but the court found that he should have been knowledgeable about the specific risks and suitability of the medication for his patient. The case […]

Physician salaries in 2023 have increased across all specialties, with primary care physicians earning an average of $265,000 and specialists earning $382,000. The highest-paying specialties include plastic surgery, orthopedics, cardiology, urology, gastroenterology, otolaryngology, radiology, oncology, anesthesiology, and dermatology, while the lowest-paying specialties are public health and preventive medicine, pediatrics, family medicine, infectious disease, diabetes & endocrinology, internal medicine, rheumatology, allergy & immunology, physical medicine & rehab, and psychiatry. The gender pay gap persists but is starting to narrow, with male primary care physicians earning 19% more than their female counterparts, and the gap for specialists being 27%. Despite ongoing challenges such as staffing shortages, reimbursement pressures, and administrative burdens, the majority of doctors (73%) express satisfaction in their profession and highlight the rewards of being skilled practitioners, fostering patient relationships, and making a positive impact on the world.

Index funds replicate the composition of a financial market index, like the S&P 500, but their returns can be adversely affected by the poor performance of a small number of large-cap stocks, which could lead to lower overall returns. Nevertheless, physicians may find index funds appealing due to their affordability, low maintenance requirements, and historically strong performance.