Does Your Doctor Use an Electronic Health Record?

This week's New England Journal of Medicine publishes a health policy report about electronic health records (EHRs).  The article reviews the potential benefits of EHRs to patients and to physicians and laments that as of 2005 only about 23% of physicians used them. The reasons for the slow adoption of EHRs provide an instructive illustration of deep problems in our healthcare marketplace.  EHRs are exp...
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Acute Bronchitis

"I think I have bronchitis.  I probably need some antibiotics." All primary care doctors hear that phrase very frequently.  A patient develops a productive cough that lasts for several days, malaise, and slightly elevated temperature.  Then the patient sees her physician with a clear and predetermined expectation of the correct treatment -- antibiotics.  Knowing that antibiotics are not indicated for acute bronchitis, the physician is then forced to balance practicing appropriate evidence-based...
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For Severe Sciatica, Back Surgery Can Be Considered Sooner

Sciatica is the common term for lower back pain that radiates down one leg.  It is a very frequent cause of missed work and disability.  Sciatica is almost always caused by a lumbar disk that has been pushed out of its normal location and is impinging on a nerve. The typical treatment for sciatica is anti-inflammatory pain medication and physical therapy.  Most patients recover entirely with this conservative therapy.  For those who continue to have pain, injections to numb the effected nerve f...
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