By Guy A. Lee, MD
Middle-aged and older patients commonly present with neurogenic claudication, the classic nerve-related radiating leg and buttock pain caused by lumbar spinal stenosis. Imaging will typically show degenerative factors, including the narrowing of the midline sagittal spinal canal and possibly also narrowing between the facet superior articulating process, the posterior vertebral margin and nerve root canal.
The narrowing and compression of spinal stenosis is believed to cause leg, buttock and groin pain for about 1.2 million Americans. Those who experience mild or moderate symptoms typically have pain that …

By Andrew M. Star, MD
Hip arthroplasty has been a successful procedure for more than four decades. Yet, as doctors performing this surgery, we continually found ourselves repeating a list of “don’ts” to our patients as they faced the long recovery after hip replacement surgery: “Don’t get in a car,” “Don’t bend over,” “Don’t sleep on your side,” and other restrictions.
This discouraging, but important, post-operative advice was a by-product of standard  arthroplasty, in which the surgeon removes the hip joint using a lateral or posterior approach, cutting muscles, ligaments and tendons …

Changes to Medicare will give the Feds control of surgical decisions
By SCOTT GOTTLIEB
Senate Democrats are touting the American Medical Association’s endorsement of their health bill as evidence that doctors support the reforms, but there are important reasons why the American College of Surgeons and 18 other specialty groups remain opposed.
The plan’s most tangible efforts to restrain medical costs are through its controls on specialist physicians. Based on the government’s premise that specialists often make wasteful treatment decisions, the health-care legislation in Congress will subject doctors to …

By John T. Gill, MD
As an orthopaedic surgeon in private practice for over 21 years, I have seen firsthand how decisions in both Washington and our state capitols can directly impact my ability to take care of patients.  It is essential that physicians take an active role in developing effective health policy and the key to that is maintaining a close working relationship with your elected members of the legislature.
Since a chance visit to my state capitol in 1999 ended up with my giving testimony on a health care bill …

By Jonathan L. Fox, M.D., MBA

Can America’s great health care debate be resolved by promoting transparency and fairness for all stakeholders?  Perhaps, but for this to happen, health care reform must be approached from the bottom up, not top down.  As a physician, I propose the following original plan which views health care through the eyes of its end-users.
Suppose medical care providers such as myself were treated like any other businessperson in America.  Suppose we were paid when services were rendered; in other words, payment upon demand.  Since we then …

By Elizabeth Lee Vliet, MD
The Democrats are the bullies in the healthcare sandbox, assisted by the AMA, AARP and unions who stand to gain financially. They are kicking sand in the faces of all us other “kids” on the healthcare playground and keeping everyone else out of theirsandbox.  Who do I think are the “other kids” around the healthcare “sandbox” who are NOT being allowed to participate in the Democrats bully box?
-          Republicans with creative ideas for free-market solutions rather than government run healthcare
-          Dozens of state and some national medical societies with …

Anne Brewster, a Boston internist, has multiple sclerosis, an autoimmune disease of the central nervous system. One day, she decided to risk disclosing something about herself to a patient:  “I have the same disease,” I told my patient over the telephone. There was a pause, and then a sigh. “That makes me feel so much better,” she said.
Boston’s NPR station, WBUR, did a story on Dr. Brewster and the question of whether physicians should disclose to their patients information about their own health.  Dr. Brewster said, “In revealing personal information, …

By Steven A. Fassler, MD, FACS, FASCRS
Until just a few years ago, a moratorium prevented laparoscopic colectomy—the removal of a cancerous colon by minimally invasive surgical techniques—from being used instead of traditional open surgery.  At the time, there was concern that the laparoscopic procedure would not produce as good results as open surgery for many patients.
Those of us who were involved in laparoscopic clinical trials during that time, and who received extensive training in minimally invasive methods, knew that study results would bear out the benefits of laparoscopic colectomy.  That …

Since President Obama mentioned tort reform last week, several studies have been cited as to whether such reforms would make a difference in the overall budget.  Few studies seem to consider the effect on the physician or their practice.
Business Week reports that costs associated with malpractice lawsuits make up 1% to 2% of the nation’s $2.5 trillion annual health-care bill and that tort reform would barely make a dent in the total.  A comprehensive new report from Northwestern’s Kellogg School of Management, using a database of employer-sponsored health plans covering …

By Elizabeth Lee Vliet, M.D.
While hundreds of  thousands of Americans marched against the government’s hijacking of health-care in Washington Saturday, President Obama was in Minnesota promoting his own myopic version of health-care reform.  During his speech, the President referred to a woman in Texas whose undisclosed pre-existing acne precluded her from getting the double mastectomy she so desperately needed. “By the time her insurance was reinstated,” Obama said, “her breast cancer had more than doubled in size.”
The President’s facts were incorrect on the medical reasons for the insurance delay in this situation, …