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General Medicine / 23.09.2025

Life gets busy, and it’s easy to push your health to the bottom of the to-do list. Many people believe that if they feel fine, there’s no reason to see a doctor. The fact is, serious conditions often go unnoticed because symptoms don’t appear until much later. High blood pressure, diabetes, and hearing loss are just a few examples of problems that can go unnoticed for years. That’s why regular health checkups are such an essential part of staying well. These visits aren’t only about treating illness, they’re about prevention, early detection, and giving you peace of mind. Today, healthcare providers focus on making routine exams more personal and accessible, from primary care visits to specialized services that check your hearing, heart, or overall wellness. Knowing that these resources are available in your community makes it easier to stay proactive about your health. That’s where the value of trusted clinics comes in, offering professional care that keeps you on track.

Why Routine Checkups Matter

Even if you feel healthy, your body may be telling a different story. Many conditions progress quietly and only show symptoms after damage has already occurred. Routine checkups help you catch risks early—before they complicate your life. That includes hearing health: gradual hearing changes, tinnitus, or balance issues often creep up over months or years. A periodic screen can flag concerns early and guide simple next steps, just like regular blood work does for cholesterol or a quick cuff check does for blood pressure. Early action means fewer surprises, lower costs, and more control over your day-to-day well-being. A yearly hearing exam, with services like device care and balance screening offered at Big Sky's clinic is a simple way to stay proactive about your health. You’ll get patient-centered care that uses advanced tools to pinpoint issues, plus concrete support afterward, including comprehensive hearing tests, guidance on treatment options, in-office cleanings, timely repairs, and yearly checkups to keep everything performing as it should. If dizziness or unsteadiness is part of your picture, specialized vestibular testing (such as VNG) can help clarify what’s going on so you can address it early and get back to normal routines. This kind of steady, preventive attention turns “I think I’m fine” into “I know I’m on track.” (more…)
General Medicine / 05.09.2025

If you spend time in medical sales, you’ve probably heard about the NPI registry. Some reps know it well, others sort of nod along and secretly Google it later. Either way, it’s one of those resources that makes your job a lot easier once you actually know how to use it. Let’s break down what it is, why it matters, and the practical steps for running an NPI lookup without getting lost in government-site purgatory.

What the NPI registry actually is

The registry is a public database that lists every provider and organization with a National Provider Identifier. Think of it as the giant phone book of healthcare professionals, except it’s federally maintained and built for compliance rather than convenience. Doctors, nurse practitioners, dentists, physical therapists—you name it—they all have an NPI number if they bill Medicare or most commercial insurance. For a sales rep, it’s less about billing and more about clarity. When you’re sorting out which “Dr. Smith” is which in your territory, the registry saves you from cold-calling the wrong office. It tells you not just the provider’s name but also practice addresses, taxonomy (specialty), and sometimes the organizations they’re tied to. (more…)
General Medicine, Health and Wellness / 05.09.2025

Embracing Holistic Health in Primary Practice

Demand for integrated wellness blended with traditional medicine is no longer fringe. Surveys show over half of patients now seek physicians who address mind, body, and lifestyle in one place. Primary care is the logical anchor point. It connects the dots between diet, sleep quality, mental resilience, and clinical intervention. Ignoring one domain risks undoing progress in another. A holistic approach is not soft science; it’s strategic prevention. Physicians who integrate physical exams with nutrition counseling and mental health planning extend the fuse on chronic disease. The result is a foundation for sustained, resilient health rather than patchwork fixes. (more…)
Author Interviews, General Medicine, Infections / 14.08.2025

Maintaining high hygiene standards is essential to healthcare safety, yet those efforts can be undermined by shortcomings in cleaning and laundry routines. While surfaces may look clean, unseen risks from poorly executed protocols can endanger both patients and staff. The Overlooked Role of Laundry in Preventing Contamination Linens, scrubs, and other textiles in healthcare settings are constantly exposed to contaminants like bodily fluids and harmful pathogens. Without precise cleaning and handling, these items can transfer infections between individuals. Simple mistakes—such as washing at the wrong temperature or storing items improperly—can turn everyday laundry into a contamination source. Commercial laundry services are built to meet strict healthcare hygiene requirements. They use high-grade detergents, specialized washing methods, and secure handling practices to ensure textiles are thoroughly sanitized. Any deviation from these standards, whether through cost-cutting or human error, can compromise safety. (more…)
Author Interviews, General Medicine, Infections / 14.08.2025

In healthcare environments, patient rooms, exam tables, and surgical tools receive rigorous attention and rightly so. But there are equally important areas that often escape scrutiny: the non-clinical zones. Hallways, break rooms, reception desks, and admin offices may not appear critical to infection control, but they are frequently trafficked, highly interactive areas that can compromise the integrity of a facility’s overall hygiene strategy. These shared spaces are more than just pass-throughs or places to grab a coffee; they’re the connective tissue of a healthcare facility. Staff travel through them constantly, often in and out of clinical settings, without always thinking about the residue they may leave behind or pick up. In fact, the transient nature of these spaces makes them potential conduits for cross-contamination, impacting both staff well-being and patient safety. Healthcare is about more than treating illness; it’s about creating a safe, welcoming environment for healing. That includes every square foot of the building, not just the areas marked “sterile.”

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Complementary Medicine, Concierge Medicine, General Medicine, Mindfulness / 05.08.2025

Health isn’t just about fixing symptoms; it’s about creating balance in the body and mind. That’s where integrative treatment comes in. This approach combines traditional medicine with complementary therapies for a more complete path to wellness. Instead of treating just one aspect of you, it focuses on the whole person, encompassing physical, emotional, and lifestyle factors. For individuals seeking to enhance their health naturally and effectively, integrative care provides lasting solutions.

A Personalized Approach to Care

One of the main benefits of integrative treatment is that it’s tailored to your needs. Functional Medicine plays a key role in this process because it considers your unique health history, lifestyle, and goals before creating a plan. You’re not just given a standard solution; you receive care designed specifically for you. It goes deeper than symptom management, searching for the root causes of illness and imbalance, by focusing on the “why” behind your health challenges, this method creates targeted strategies that lead to lasting improvement. (more…)
General Medicine / 19.07.2025

The Shifting Landscape of Physician-Controlled Clinics

Medical practice ownership has fractured, and that’s no accident. Rather than opting for the treadmill of hospital-employed work, more physicians are reclaiming autonomy through private clinics. “Physician-controlled clinics” are not just about seeing patients; they're about physicians calling the shots—both clinically and operationally. According to a 2023 AMA report, nearly 47% of physicians now practice in physician-owned settings. The pendulum is swinging back. (more…)
Dental Research, General Medicine / 08.07.2025

In the intricate system that is the human body, not all signs of trouble announce themselves with urgency. A faint twinge here, a nagging ache there—many people chalk up these seemingly minor discomforts as everyday inconveniences. However, dismissing subtle symptoms can be like ignoring the tip of an iceberg, unaware of the massive structure lurking beneath the surface. Just as an iceberg conceals its true size below water, minor physical discomforts may be indicators of more complex, underlying health problems. Whether in a bustling city or a quiet town like Naperville, recognizing these signs early can significantly alter the trajectory of one’s long-term well-being. Beneath the Smile: Subtle Symptoms in Oral Health Oral health often mirrors the overall state of a person's body, yet it is one of the most neglected aspects of healthcare. A slight gum irritation, minor bleeding while brushing, or persistent bad breath are frequently overlooked as temporary or harmless. But these seemingly minor issues can point to deeper concerns like periodontal disease, systemic infections, or even diabetes. One of the most common examples of this "iceberg illusion" is seen in jaw alignment and dental crowding. Individuals may dismiss occasional jaw pain, mild clicking sounds when chewing, or pressure in the mouth as inconsequential. However, these issues can signify malocclusions or orthodontic irregularities that, if left untreated, may lead to severe headaches, temporomandibular joint disorders (TMJ), or chronic tooth wear. People often tolerate these symptoms until they begin to interfere with their daily life. Yet, early intervention through dental assessments can catch developing conditions before they become complex. In such cases, the best approach is proactive care. Start by searching for Naperville orthodontics near me online to book an appointment. Recognizing the value of regular orthodontic checkups, even for seemingly minor issues, can lead to early diagnosis and streamlined treatment strategies. (more…)
ASCO, Author Interviews, Cancer Research, General Medicine, Pediatrics / 01.06.2025

MedicalResearch.com Interview with: Alique Topalian, PhD, MPH Research Scientist Family & Community Medicine | College of Medicine University of Cincinatti MedicalResearch.com: What is the background for this study? Response: Adolescent and young adult (AYA) cancer survivors are diagnosed between the ages of 18-39. We have seen increases in cancer diagnoses in this younger population of about 1-2% per year with an estimated total increase of 30% between 2019-2030.  Adolescent and young adult (AYA) cancer survivors experience early development of chronic medical conditions compared to healthy peers. Due to their young age at diagnosis and living decades beyond treatment, they are also at higher risk for second primary malignancies (SPM) and late effects than older adult-onset cancer survivors. Primary care providers are responsible for most long-term care of survivors and many are unfamiliar with the effects of cancer treatment in younger populations. (more…)
General Medicine, Technology / 17.04.2025

In the modern healthcare landscape, pediatric practices are constantly seeking innovative solutions to streamline operations, reduce administrative burdens, and enhance patient care. One such solution is the integration of virtual medical receptionist services. These services offer pediatric practices the flexibility and efficiency they need to manage patient interactions, appointments, and inquiries while maintaining the high level of care that children and their families expect. This article explores the benefits and considerations of customizing virtual reception services for pediatric practices, emphasizing how these services can be tailored to meet the unique needs of pediatric care.

The Growing Need for Virtual Receptionists in Pediatric Practices

The role of a receptionist in a pediatric practice is critical. From managing appointment schedules to answering phone calls and assisting with administrative tasks, the receptionist is often the first point of contact for patients and their families. However, the growing demands on pediatric practices—combined with the increasing need for efficiency and cost savings—have led many healthcare providers to explore virtual receptionist services. A virtual medical receptionist offers all the capabilities of an in-office receptionist, but with the added flexibility of working remotely. For pediatric practices, where time-sensitive issues and emergency situations can arise frequently, a virtual receptionist provides an essential level of availability, reducing the likelihood of missed calls and ensuring that parents receive timely responses. (more…)
Electronic Records, General Medicine, Health Care Systems / 16.01.2025

Let’s be real—running a private practice has changed. The days of doing things “the way they’ve always been done” are long gone. Patients expect more. Providers are juggling tighter margins, growing admin work, and tech that’s supposed to help—but often just clogs up the flow. You’re working harder to deliver quality care, but what about the business side? If your practice is still operating like it’s 2019, you’re leaving opportunities—and possibly revenue—on the table. Rethink Your Digital Front Door If you’re thinking, “We have a website; we’re good,” you’re already behind. Patients aren’t just stumbling onto your practice anymore—they’re shopping for care like they shop for shoes: scrolling through reviews, comparing options, and judging whether you’re worth their time (and money) before they even pick up the phone. Your digital presence is your front door, and it’s not just about looking professional—it’s about feeling approachable. Think user-friendly scheduling where no one has to dig through four menus just to find an open slot. Think virtual check-in that cuts out that awkward clipboard shuffle in the waiting room. Think SEO that makes your practice pop up when someone searches for “best pediatrician near me” at 2 a.m. Every friction point—every glitchy “Contact Us” form or slow-to-load page—is sending patients straight to the next provider in their search results. Digital-first convenience isn’t a luxury anymore. It’s a dealbreaker. (more…)
General Medicine, Primary Care / 20.11.2024

Frustrated with the rising costs and recurring treatments, patients are increasingly seeking solutions that prioritize their long-term well-being. In response, the healthcare sector is shifting its focus towards preventive care in primary care settings. The Growing Importance of Preventive Care in Primary Care Practices This proactive approach not only addresses immediate health issues but also emphasizes the prevention of future ailments, reshaping the healthcare landscape. By integrating preventive measures into routine care, providers are transforming patient outcomes and establishing new healthcare efficiency and effectiveness standards.

The Evolution of Preventive Care in Primary Care Settings

The traditional healthcare model, which often centered on treating illnesses as they emerged, is being transformed by a proactive approach to preventive care. This shift towards prevention is not only a medical necessity but a financial imperative, particularly as healthcare costs continue to escalate. As more patients seek primary care physicians near me who prioritize preventive care, healthcare providers are adapting their practices to meet this growing demand. By focusing first on the prevention of diseases before they have the chance to take hold, care providers can manage individual and public health in a far more sustainable manner. The evidence supporting this shift is strong, demonstrating that preventive care not only reduces healthcare costs but also dramatically and positively affects patient-centered health outcomes, including a reduction in hospital admissions due to chronic diseases. (more…)
General Medicine / 26.09.2024

  Have you ever noticed something off about your body and wondered if it's serious? We’ve all been there. Sometimes, it’s easy to brush things off or chalk them up to “getting older,” but paying attention to what your body is trying to tell you can make all the difference. While not every symptom is cause for alarm, some may indicate underlying issues worth investigating. Here’s a breakdown of ten common health symptoms and what they could mean for you.

1. Headaches

Headaches are incredibly common, and most of us experience them at one point or another. But not all headaches are created equal. A mild headache after a long day might just be due to dehydration or tension, while severe or persistent headaches could point to something more serious, like migraines or even a neurological issue. If you experience sudden, intense headaches or headaches that don’t respond to over-the-counter pain relief, it’s always a good idea to consult a professional. There are some amazing services where you can ask a pharmacist 24/7 for quick advice to see if it’s something that needs medical attention, but be sure to discuss your headaches with your health care provider. (more…)
Author Interviews, General Medicine, Health Care Systems, Heart Disease, JAMA / 26.06.2023

MedicalResearch.com Interview with: Dan P. Ly, MD, PhD, MPP Physician and an Assistant Professor Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? Response: Cognitive biases, or ways of thinking that may deviate from rationality, are thought to influence physician decision-making, but there has been little large-scale evidence of their existence clinically. There is some large-scale evidence of the availability heuristic, under which the likelihood of an event is affected by how easily it comes to mind, but there’s little large scale evidence of other cognitive biases affecting physicians.  (more…)
Author Interviews, General Medicine, Sleep Disorders / 06.10.2020

MedicalResearch.com Interview with: Nathan Warren is a Ph.D. candidate in marketing at the University of Oregon. His research examines how people respond when social norms, such as masculinity norms, are disrupted by social change. He hopes that his research can empower people who are struggling to adapt to changing norms to live healthier, happier, and more productive lives. For more information on his research, please visit: www.nathanwarrenresearch.com Dr. Troy Campbell is a behavioral scientist (PhD, Duke University), former marketing professor (University of Oregon), former art, film, and psychology scholar (UC Irvine), professional designer and researcher (Netflix Insights, Disney Imagineering, UnitedHealth) and currently chief scientist at On Your Feet.  Troy believes everything can be awesome when you start with the right science and follow with the right creative process, and he hopes his professional services or public guides can help his clients make something awesome and impactful. For more information on Troy Campbell, please visit: www.troy-campbell.com MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In the United States, the average American sleeps less than the minimum seven hours of sleep per night recommended by the Center for Disease Control, and nearly half of Americans report negative consequences from insufficient sleep. This problem appears to be especially prevalent in men, who report getting significantly less sleep, on average, than women. A cultural complication is the notion that getting less than the recommended amount of sleep signals something positive about an individual. For example, US President Donald Trump has boasted about getting less than four hours of sleep per night and regularly derogates his political opponent Joe Biden as “Sleepy Joe.” "The Sleep-Deprived Masculinity Stereotype," a new paper in the Journal of the Association for Consumer Research, examines a possible stereotype connecting sleep and masculinity along with its underlying mechanisms and its social implications. Authors Nathan B. Warren and Troy H. Campbell conducted 12 experiments involving 2,564 American participants to demonstrate that a sleep-deprived masculinity stereotype exists.  In one experiment, participants were asked to imagine seeing a man shopping for a bed. Then, a salesperson asked the man, “How much do you normally sleep?” The results found that the mean masculinity rating for participants in the lots of sleep condition was significantly lower than the mean masculinity rating for participants in the little sleep condition. In another experiment, participants were asked to ascribe different attributes to a male character, assigned to either a “very masculine and manly” man or a “not very masculine and not very manly” man. Participants in the masculine condition described their character sleeping 33 minutes less sleep per night than the characters described in the not masculine condition. A final experiment showed that participants who imagined stating they sleep more than average felt significantly less masculine than participants who imagined stating they sleep less than average. Collectively, the experiments found that men who sleep less are seen as more masculine and more positively judged by society. The same patterns were not consistently observed for perceptions of women.   (more…)
Author Interviews, Dermatology, Environmental Risks, General Medicine, JAMA, Melanoma, Stanford / 07.10.2019

MedicalResearch.com Interview with: Eleni Linos MD MPH DrPH Professor of Dermatology and Epidemiology Stanford University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We know that tanning beds are harmful: people who use tanning beds are more likely to get skin cancer. Sexual minority men are much more likely to use tanning beds and also more likely to get skin cancer. In a separate study we discovered that one reason sexual minority men use tanning beds is if it is convenient: e.g. if close to home, cheap, and easy. (https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.17684). Recent research showed that tobacco retailers cluster in LGB neighborhoods: https://sph.unc.edu/sph-news/more-tobacco-retailers-in-lgbt-neighborhoods-may-explain-smoking-disparities/. This made us wonder if tanning salons also cluster in neighborhoods with more gay men.  (more…)
Author Interviews, Cost of Health Care, General Medicine, Hospital Readmissions, JAMA, Race/Ethnic Diversity / 02.04.2019

MedicalResearch.com Interview with: Teryl K. Nuckols, MD Vice Chair, Clinical Research Director, Division of General Internal Medicine Cedars-Sinai Medical Center  MedicalResearch.com: What is the background for this study?   Response: Healthcare policymakers have long worried that value-based payment programs unfairly penalize hospitals treating many African-American patients, which could worsen health outcomes for this group. For example, policy experts have suspected that the Medicare Hospital Readmission Reduction Program unevenly punishes institutions caring for more vulnerable populations, including racial minorities. They've also feared that hospitals might be incentivized to not give patients the care they need to avoid readmissions. The study Investigators wanted to determine whether death rates following discharges increased among African-American and white patients 65 years and older after the Medicare Hospital Readmission Reduction Program started. (more…)
Author Interviews, General Medicine, Heart Disease, Science, Weight Research / 04.02.2019

MedicalResearch.com Interview with: Vitor Engrácia Valenti, PhD Professor São Paulo State University Marília MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Autonomic modulation and cardiorespiratory variables are influenced by numerous factors. Abdominal fat tissue is a relevant variables related to metabolic and cardiovascular disorders, including diabetes mellitus, dyslipidemia and hypertension, which are associated to increased risk of morbidity and mortality. We evaluated cardiorespiratory variables and autonomic nervous system before and during recovery from exercise in healthy physically active men divided according to with waist-stature ratio (WSR): G1 – between 0.40 and 0.449 (N = 19), and G2 – between 0.45 and 0.49. This metholodigcal procedure is able to provide important information regarding the risk for developing cardiovascular disease in the future. Our main findings indicated that healthy physically active men with waist-stature ratio values close to the risk limit (between 0.449 and 0.5) presented slower return of autonomic and cardiorespiratory variables to baseline values after moderate exercise. It suggests that this group present an elevated probability of developing cardiovascular disease in the future compared to the groups with lower values of waist-stature ratio. (more…)
Author Interviews, Electronic Records, General Medicine / 28.07.2017

MedicalResearch.com Interview with: Macda Gerard M.D. Candidate | Class of 2021 Wayne State University School of Medicine MedicalResearch.com: What is the background for this study? Response: As electronic health records proliferate, patients are increasingly asking for their health information but little is known about how patients use that information or whether they encounter errors in their records. This comes at a time when we’re learning that understanding the patient and family experience, especially what is most valued in exchanges between doctors and patients is important and has many benefits. To learn more, we developed a formal mechanism for patients to provide feedback on what they like about accessing the information in their health records and to inform their clinical team about things like inaccuracies and perceived errors. So that’s the gap we tried to fill. The patient feedback tool is linked to the visit note in the electronic health record (EHR), and it’s part of a quality improvement initiative aimed at improving safety and learning what motivates patients to engage with their health information on the patient portal. Over the 12-month pilot period, 260 patients and care partners provided feedback using the OpenNotes patient feedback tool. Nearly all respondents found the tool to be valuable and about 70 percent provided additional information regarding what they liked about their notes and the feedback process. (more…)
Author Interviews, Cognitive Issues, General Medicine, JAMA / 26.07.2017

MedicalResearch.com Interview with: Jochen René Thyrian, PhD German Center for Neurodegenerative Diseases (DZNE) Greifswald, Germany MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dementia presents a challenge to the health care systems worldwide. People with dementia (PWD) need comprehensive medical, nursing, psychological and social support to delay the progression of disease and sustain autonomy and social inclusion. Evidence-based interventions alleviate the burden of disease for PwD and their caregivers, as no curative treatment is currently available. Involving caregivers is important because they provide the largest proportion of care for PwD. General physicians in residency have been identified as the first point of contact for PwD and is thus a promising setting for identification, comprehensive needs assessment and initiating dementia-specific treatment and care. In this study we tested the effectiveness and safety of a model of collaborative care, Dementia Care Management (DCM) on patient-oriented outcomes in n=634 people screened positive for dementia in primary care. DCM is provided by specifically trained nurses, supported by a computerized intervention management system, in close cooperation with the treating physician at the people´s homes. Recommendations for improving treatment and care were based on a comprehensive needs assessment, discussed interprofessionally and their implementation monitored/ adjusted over the course of 6-12 months (more…)
Author Interviews, General Medicine, Primary Care / 26.07.2017

MedicalResearch.com Interview with: Christine D. Jones, MD, MS Assistant professor Director of Care Transitions, Hospital Medicine Group University of Colorado School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is that referrals to home health care at hospital discharge have increased over recent years.  Yet, care coordination including information exchange and communication is often suboptimal between the hospital and home health care and may contribute to medication list discrepancies and even hospital readmissions. We spoke with focus groups of home health nurses and our main findings were that improvements in key areas could care coordination after hospital discharge. Specific solutions included: 1) Clearly defining the accountability for home health orders after discharge between hospitalists and primary care providers 2) Changes to insurance requirements that currently only allow physicians to write home health orders so that nurse practitioners and physician assistants can also write home health orders 3) Enhancing access for home health agencies to hospital electronic health records and direct phone lines 4) Encouraging liaisons from home health agencies to meet patients in the hospital to align clinician and patient expectations 5) Direct coordination between home health nurses and clinicians or pharmacists to resolve medication discrepancies 6) Ensuring that detailed information about cognitive and behavioral health is included in information provided to home health from referring hospitals (more…)
Author Interviews, General Medicine, Orthopedics / 15.03.2017

MedicalResearch.com Interview with: Darwin Chen, MD Assistant Professor, Orthopaedics Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Total hip and knee replacement surgery are among the most commonly performed orthopaedic procedures today. Although success rates are high, complications can occur and some may be preventable. The goal of our research was to assess the impact of gender on complications within the first 30 days after hip and knee replacement. (more…)
Author Interviews, General Medicine, JAMA, Outcomes & Safety / 19.06.2015

Samuel Pannick, MA, MBBS, MRCP Imperial Patient Safety Translational Research Center, National Institute for Health Research and Imperial College London, London, England West Middlesex University Hospital National Health Service Trust, Middlesex, EnglandMedicalResearch.com Interview with: Samuel Pannick, MA, MBBS, MRCP Imperial Patient Safety Translational Research Center, National Institute for Health Research and Imperial College London West Middlesex University Hospital National Health Service Trust Middlesex, England Medical Research: What is the background for this study? What are the main findings? Response: Improving the quality of general medical ward care is a recognized healthcare priority internationally. Ward teams have been encouraged to structure their work more formally, with regular interdisciplinary team meetings and closer daily collaboration with their colleagues. Some early studies suggested that these changes might benefit patients, and help ward teams work more efficiently. However, team interventions on medical wards have been reported with numerous different outcome measures, and prior to this study, it was unclear what their objective benefits were. We showed that there is little agreement on the objective outcomes that best reflect the quality of interdisciplinary team care on general medical wards. Changes to interdisciplinary care aren’t reflected in the outcome measures that researchers choose most often, like early readmission rates or length of stay. Complications of care - although harder to record - might have more promise as a measure of the quality of inpatient team care in these specific medical areas. (more…)
Author Interviews, Brigham & Women's - Harvard, General Medicine, Hospital Readmissions / 11.06.2015

Jeffrey C. Schneider, M.D. Medical Director, Trauma, Burn & Orthopedic Program Assistant Professor, Dept. of Physical Medicine and Rehabilitation Harvard Medical School Spaulding Rehabilitation Hospital Boston, MA 02129MedicalResearch.com Interview with: Jeffrey C. Schneider, M.D. Medical Director, Trauma, Burn & Orthopedic Program Assistant Professor, Dept. of Physical Medicine and Rehabilitation Harvard Medical School Spaulding Rehabilitation Hospital Boston, MA 02129 Medical Research: What is the background for this study? What are the main findings? Response: Hospitalizations account for the largest share of healthcare costs in the U.S., comprising nearly one-third of all healthcare expenditures.  In 2011, readmissions within 30 days of hospital discharge represented more than $41 billion in hospital costs.  Financial penalties for excess 30-day hospital readmissions were instituted by the Centers for Medicare and Medicaid Services in 20124; more than 2,200 hospitals were fined a total of $280 million in reduced Medicare payments in fiscal year 2013. Most readmission risk prediction models have targeted specific medical diagnoses and have utilized comorbidities and demographic data as the central risk factors for hospital readmission. Yet, large U.S. administrative datasets have demonstrated poor discriminative ability (c-statistics: 0.55-0.65) in predicting readmissions. However, few studies have considered functional status as potential readmission risk factors. There is increasing evidence that functional status is a good predictor of other health outcomes.  To date, acute care hospital administrative databases do not routinely include functional status measures.  Therefore, inpatient rehabilitation setting is an ideal population in which to examine the impact of functional status on readmission risk, because: (1) inpatient rehabilitation patients often have complex care transitions after acute care discharge, and represent a significant proportion of total readmissions; 2) inpatient rehabilitation facilities routinely document functional status using a valid instrument—the FIM®; and (3) a majority of U.S. IRFs participate in one of the only national datasets that contain standardized functional data—the Uniform Data System for Medical Rehabilitation. Limitations of prior work include small and single-center study designs, narrowly defined patient populations, and defining readmissions beyond the 30-day period.  Overall, there is a lack of literature on the utility of function as a readmission predictor in a large population of medical patients. Moreover, function is a modifiable risk factor with potential to impact readmission outcomes if function-based interventions are instituted early. Therefore, the objective of this study was to compare functional status with medical comorbidities as predictors of acute care readmissions in the medically complex rehabilitation population. We hypothesized that acute care readmission prediction models based on functional status would outperform models based on comorbidities,and that the addition of comorbidity variables to function-based models would not significantly enhance predictive performance. (more…)
Author Interviews, Breast Cancer, General Medicine / 31.05.2015

MedicalResearch.com Interview with: Bruno M. Heleno MD The Research Unit for General Practice and Section of General Practice Department of Public Health University of Copenhagen Medical Research: What is the background for this study? What are the main findings? Dr. Heleno: False positive mammography causes psychological distress. Several observational studies have shown this, and their results have been summarized in systematic reviews. However, it was unclear whether women requiring invasive tests (needle or surgical biopsy) were more distressed than women only requiring non-invasive procedures (clinical examination or imaging). Contrary to previous research, we found that these two groups of women were equally distressed during the 36 months of follow-up in our cohort. The best estimate for the difference for 12 related measures of distress was always close to zero. (more…)
Author Interviews, Diabetes, General Medicine, Statins, UT Southwestern / 08.05.2015

Ishak Mansi, MD Staff Internist, VA North Texas Health System. Professor in Department of Medicine & Department of Clinical Sciences, Division of Outcomes and Health services Research, University of Texas Southwestern, Dallas, TXMedicalResearch.com Interview with: Ishak Mansi, MD Staff Internist, VA North Texas Health System. Professor in Department of Medicine & Department of Clinical Sciences, Division of Outcomes and Health services Research, University of Texas Southwestern, Dallas, TX MedicalResearch: What is the background for this study? What are the main findings? Dr. Mansi:  Statin use is associated with increased incidence of diabetes, and possibly increased body weight, and less exercise capacity. Data on the long-term effects of these associations in healthy adults are very limited. Additionally, the effects of these associations on diabetic complications have not been adequately studied. Dr. Mansi at VA North Texas Health System, Dallas and Professor of Medicine and Clinical Sciences at the University of Texas Southwestern, Dallas, TX and his colleagues found that among generally healthy individuals, statin-users in comparison to non-users had a higher odds of being diagnosed with new onset diabetes, diabetes with complications, and overweight/obesity. The researchers examined the records of tens of thousands of Tricare beneficiaries, during the period from 10/1/2003 to 3/1/2012. After excluding patients who had at baseline a preexisting cardiovascular diseases or severe chronic diseases that may be life-limiting (including diabetes mellitus), they identified a cohort of 25,970 patients as “healthy cohort”. They, further, matched 3,351 statins-users and 3,351 nonusers on several baseline characteristics to ensure comparability. There are 3 main important findings for our study:
  1. Statin use was associated with significantly higher risk of new onset diabetes even in a very healthy population. Whereas the risk of diabetes with statins is known, it was thought that this may be due to the overall multiple risks of statin-users (that caused them to receive statins as a therapy).
  2. Statin use was associated with very high risk of diabetes complications in this healthy population: this was never shown before.
  3. Statin use is associated with higher risk of obesity: this also is widely unknown. However, few studies have noted this (one study using patient survey noted this, another study using Mendelian randomization showed it, and post-hoc analysis of a clinical trial showed that statin user gained more weight). Our study, which used a different methodology (retrospective cohort study) add another piece of evidence. Obesity is at endemic level in the US and treatment options are limited.
High-intensity statins was associated with greater risks of all outcomes. This article is published in the Journal of General Internal Medicine (JGIM). JGIM is the official journal of the Society of General Internal Medicine. (more…)
AHA Journals, Author Interviews, General Medicine, Heart Disease, Women's Heart Health / 26.02.2015

MedicalResearch.com Interview with: Gregory YH Lip MD, FRCP (London, Edinburgh, Glasgow), DFM, FACC, FESC Professor of Cardiovascular Medicine, Adjunct Professor of Cardiovascular Sciences, Thrombosis Research Unit, Aalborg University, Denmark; Aston Centre for Cardiovascular Sciences City Hospital Birmingham England UK Medical Research: What is the background for this study? What are the main findings? Prof. Lip: Women with atrial fibrillation are at higher risk of stroke than men with atrial fibrillation. The reasons for this elevated risk remain unclear. The results from our worldwide study suggest that women are treated no differently to men in terms of anticoagulant therapy for stroke prevention. Thromboprophylaxis was, however, suboptimal in substantial proportions of men and women, with underuse in those at moderate-to-high risk of stroke and overuse in those at low risk. (more…)
Author Interviews, General Medicine, Journal Clinical Oncology, Leukemia, Pediatrics / 29.01.2015

MedicalResearch.com Interview with: Jun J. Yang  Ph.D. Assistant Member Dept. of Pharm. Sci. St. Jude Children's Research Hospital Memphis, TN 38105 Medical Research: What is the background for this study? What are the main findings? Dr. Yang: Mercaptopurine is highly effective in acute lymphoblastic leukemia (ALL) and essential for the cure of this aggressive cancer. However, it also has a narrow therapeutic index with common toxicities. Identifying genetic risk factors for mercaptopurine toxicity will help us better understand how this drug works and also potentially enable clinicians to individualize therapy based on patients’ genetic make-up (precision medicine). In addition to confirming the role of TPMT, we have identified another important genetic risk factor (a genetic variation in a gene called NUDT15) for mercaptopurine intolerance. Patients carrying the variant version of NUDT15 are exquisitely sensitive and required up to 90% reduction of the normal dose of this drug. TPMT variants are more common in individuals of African and European ancestry, whereas NUDT15 variants are important in East Asians and Hispanics. (more…)