So is it Reefer Madness or not? That’s the question researchers are asking against a national backdrop that sees a growing groundswell for decriminalization of marijuana for medical reasons. Could such a legislative move be detrimental to the mental health of some segments of the nation? An article in Time takes a look.

With all the research that’s been done regarding the link between marijuana use and schizophrenia, one would think a few concrete answers would have emerged somewhere along the line. Unfortunately, such is not the case. Odds are that if a study finds a link between some increased risk of schizophrenia or some lowered age of onset, a deeper look at the study will see that link vanish when controls for other factors are introduced.

There does seem to be a correlation between schizophrenia and marijuana use, but is that link a coincidence? Continual examination of the topic has yielded at least one possible conjecture: use of marijuana may, in some cases, exacerbate conditions in some patients with a genetic predisposition toward developing schizophrenia. As to whether there’s more to it than that, the debate and the research continue.

Interested in developing a social media presence for your organization but not sure how to go about doing it? The Mayo Clinic, a pioneer in the field of health care social media use, is looking to extend a hand to you and organizations like yours.

Mayo will be opening a Center for Social Media with the goal of training other health care organizations to use Twitter, YouTube, and Facebook. The workshops, consulting, and conference services held at the workshop will push the social sites as a means of connecting with patients and doctors.

Mayo started podcasting in 2005, and since then has embraced social media as a means of establishing a connection with patients, employees, and the surrounding community. Administrators at Mayo look at their social media presence as something like old-fashioned word-of-mouth marketing. The center will start off with eight staff and an $800,000 yearly budget.

With only one in five or six of the nation’s 5,000 hospitals using social media, the new center is unlikely to be at a loss for clients.

If you’re burnt out on practice, perhaps the thing you need most is... more practice? An article from AAFP News Now tells how one physician renewed his love of medicine by caring for the uninsured.

The National Association of Free Clinics supports free clinics across the nation and sponsors one- and two-day free mobile clinics in order to draw attention to the needs of the uninsured. Volunteering at one of these clinics, the author gained a new perspective on the practice of medicine. The ranks of the uninsured are one thing on a newspaper page or computer screen; but they’re entirely another when they line up outside your clinic by the thousands. Poverty, chronic conditions, treatable illnesses that just need the proper attention: the author saw them all in the course of only a short time practicing for the needy. The surroundings weren’t posh, but he had an exam room, supplies, a medical record, and a nurse attending. What’s more, he had no limit on how much time he could spend with each patient.

The author encourages any physicians on the verge of retirement--or any physicians just looking to rekindle their passion for practice--to strongly consider volunteering at one of these clinics. In such an environment, there is less between you and the patient, and you get the unadulterated gratitude of someone you just helped as reimbursement.

If you haven’t heard of the National Health Care Workforce Commission, you’d do well to familiarize yourself with this newly established government body, as it looks likely to have a sizable impact on the practice of medicine going forward. An article from AAFP News Now takes a look at the commission that may emerge as a dominant force in health care workforce policy.

The commission will be a 15-member, multistakeholder advisory committee making recommendations to Congress, the Department of Labor, and HHS regarding many workforce-related topics, including workforce supply, education, and training. The commission will submit two annual reports to Congress and the president: one a strategic plan for goal achievement, and the other addressing high-priority areas specified by Congress.

Experts contend that the nation currently is stuck in a reactive mode concerning the nation’s health care needs. The commission will have the ability to be more prospective in identifying and communicating issues to legislators and administrators. One of the commission’s first tasks will be addressing not only the shortage of primary care providers, but also the gap between primary care and subspecialty pay.

While such work is bound to step on toes here or there, some contend that it is necessary to have the commission undertake such actions, since otherwise the nation will be left to muddle through problems as they arise and reach crisis point, instead of forecasting them and developing plans for addressing them head on.

Comparative effectiveness research: the best means of determining the best treatments, or a dangerous one-size-fits-all approach to health care? The debate is on even as the government moves to get its comparative effectiveness body in place.

The Patient-Centered Outcomes Research Institute–created by the health reform law–will be charged with setting an agenda for federal comparative effectiveness research. The institute will not issue practice guidelines or coverage recommendations, however.

Critics of comparative effectiveness contend that the policy can promote treatments that are more effective for the broader population at the cost of alternative treatments that work better for smaller populations. They point specifically to the effectiveness of antipsychotic drugs, which were shown to be varyingly effective depending on the patient. A cost-saving move by Medicaid could save the agency money, but that money and possibly more would be spent in hospitalizing those patients less responsive to whichever drug Medicaid determined was most effective.

Proponents counter that scenarios such as the preceding are uncommon and that across-the-board coverage policies are unlikely to emerge from comparative effectiveness research. Still, proponents have their work cut out for them, as the public and physicians are distrustful of bureaucracies when they appear to come between doctors and patients.

Quick question: A patient is in need of medical services, yet is equidistant from your hospital and your biggest competitor. Why do they choose your hospital?

If you can’t answer that question confidently, you’ve probably got the wrong strategy with regard to patient relationships. Patients are consumers and customers nowadays, and the competition for their services is quite stiff. Like it or not, health care services are increasingly commoditized, with patients wanting to choose health care providers the way they choose breakfast cereals. Unless it’s an absolutely critical situation, patients nowadays have choice over where they’re going to get their health care. So, again, why would they choose your organization?

Hospitals need to begin taking a business approach to maximizing the value of treating patients for a lifetime. Instead of simply replicating the business strategies of your competitors, manage relationships with your patients. Give them a reason to come back to your facility. It’s not enough to just stick up a billboard touting the quality of your cardiology services: you must give them a reason to buy.

According to Department of Justice statistics, psychiatrists are more than three times as likely to be a victim of violent behavior than other health care workers. For this reason, it’s important for psychiatrists to understand how to manage aggression and head off the likelihood of an adverse event. An article in Psychiatric Times has details on how to do just that.

A key initial step is risk assessment. Only rarely do patients turn aggressive with no warning. A history of violence, agitation, anger, and disorganized behavior or poor compliance, escalating verbal abuse and increased motor activity, typically pacing, during the interview are all indicators that increase the risk for violence. Detailed or planned threats of violence and neurological illnesses are also things to look out for. No specific combination can fully predict violent episodes, but these symptoms should definitely raise your awareness of the potential of such an episode.

Aggressive patients often become so because they feel trapped, helpless, or humiliated. As a psychiatrist, it is your duty to reduce anxiety and fear by maintaining a humane and respectful manner. Recognize the patient’s affect, validate it when appropriate, and encourage the patient to talk about his feelings. This teaches the patient to verbalize feelings instead of resorting to violence.

It is also a good idea to maintain proper physical distance from patients. Interview patients in a quiet, comfortable setting wherein patient and clinician are both seated. Starting with nonintrusive questions, the physician should begin questioning specifics only when the patient begins to show comfort with the interview.

In outpatient settings, it is appropriate to screen all prospective patients via telephone for fifteen to twenty minutes. Patients with a history of violence or paranoia should not be interviewed in a private office initially. For these patients, select a proper outpatient department for initial interviews.

Violent patients can prove a stressful affair, but the proper technique in handling them with minimal humiliation and helplessness will help ensure that both you and your patient emerge unharmed.