I had been laid off a few months when my ulcerative colitis kicked in, and my doctor and I struggled to get it under control. After trying a variety of medicines, my health continued to deteriorate and I agreed to take Remicade.
Remicade is a potent drug, administered through an IV infusion at the oncology center that comes with a whole host of potential side effects. The dosage requires an initial ...
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Everybody hates curbside consults – the informal, “Hey, Joe, how would you treat asymptomatic pyuria in my 80-year-old nursing home patient?”-type questions that dominate those Doctor’s Lounge conversations that aren’t about sports, Wall Street, or ObamaCare.
Consultants hate being asked clinical questions out of context; they know that they may give incorrect advice if the underlying facts and assumptions aren’t right (the old garbage in, garbage out ...
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This past November, the New England Journal of Medicine published results from the “Advancing Quality” program in the United Kingdom: hospitals in the northwest of England were paid up to 4% more based on quality scores for treating several common medical conditions. Patient outcomes were compared to other National Health Service hospitals not eligible for the bonuses, and several other conditions that were not explicitly measured in the same ...
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Like it or not, measuring physician performance is now a key part of the conventional wisdom on improving our health care system. Borrowing from management guru Peter Drucker’s mantra “You can’t manage what you can’t measure” health care policy makers have embraced performance measurement as being central to managing our heretofore unmanageable health care system. But there is a small but seemingly growing group of Don Quixote-like dissenters who are ...
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One Saturday morning at the Salt Lake City Veterans Affairs Medical Center, I got out of a call room bed and realized I had done it. The year everyone dreads, the year everyone says, “you just need to get through” was finally over. I had completed my write-ups on all the patients I admitted overnight. My emergency room consultation requests had been seen. I checked my pager for missed pages: ...
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My interview series continues, this time with local litigation attorney Andrew Thompson, Esq. The topic this time is medical malpractice. I asked him a bunch of questions. He answered. See what you think.
1. In your opinion, is there a medical malpractice crisis in this country?
No. This is not even a close issue. The concept of a “crisis” or dramatic increase in the number of medical malpractice cases is ...
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Brought to you by MedPage Today.
1. Asthma Tied to Sleep Apnea. Patients with asthma were also more likely to develop obstructive sleep apnea.
2. 5-Day Steroid Tx Works in COPD. A short-term course of systemic glucocorticoid therapy in patients with acute chronic obstructive pulmonary disease (COPD) was as effective as treatment of longer duration.
3. Cyberbullying, Risky Sex Hike Teen ...
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The cabdriver pulled up to take me to the community hospital where I work several weeks each year. Settling into the back seat, I made my request before he reached the intersection: "Could you please take 93 South?" He was quick to ask me why, and I hesitated. I had taken this route dozens of times and had usually found it to be faster than the alternative, I said, but ...
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One of my students told me about his experience at TEDMED, the future-oriented medical conference that bills itself as "a celebration of human achievement and the power of connecting the unconnected in creative ways to change our world in health and medicine."
He recounted how one speaker showed off the Remote Presence Virtual + Independent Telemedicine Assistant, which news outlets quickly dubbed the "Robo-Doc." This high-priced gadget is designed ...
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Should doctors be able to write?
At first glance, this might seem like a question with an easy answer.
Yes, you might say, doctors receive a doctorate and are trusted with communicating to and about people at critical moments in their lives. Or you could reply, No, they are scientists and so need to be functional communicators able to write basic notes and prescriptions, and ...
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On April 14, The United States Preventive Services Task Force concluded that women with an elevated risk of breast cancer – who have never been diagnosed with breast cancer but whose family history and other medical factors increase their odds of developing the disease–should consider taking one of two pills that cut that risk in half. The Task Force is an independent panel of medical experts who review the ...
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When Angelina Jolie announced that she'd undergone a bilateral mastectomy to prevent the breast cancer for which a genetic mutation puts her at high risk, I found myself, as a doctor and as a woman, full of admiration and gratitude for her... and also, in retrospect, for Betty Ford.
In a single New York Times op-ed piece, Ms. Jolie used her celebrity ...
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“J.T.” is 92 and clearly a soul who lives to the beat of a different drummer. She has no children and her closest relative is a niece who she despises. Despite this the niece oversees her care, sending in a full time aide and her personnel assistant to run the household. J.T. will not come to the office for a visit. If I call and make an appointment to see ...
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Brought to you by MedPage Today.
1. Medical Home Transition Long but Worth It. The path to becoming a patient-centered medical home is long, rough, and varies for each practice, but getting there is essential to providing high-quality, affordable healthcare to all Americans.
2. Any Bed-Sharing Puts Baby at Risk for SIDS. Bed-sharing is associated with a five-fold increased risk of sudden infant ...
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Women are undertreated and underserved when it comes to cardiovascular disease and stroke. Now, more than ever, this may even be more important due to several recent studies that have been published recently.
Several investigations have demonstrated two troublesome facts. In certain areas of the country, life expectancy for women is decreasing and women who smoke are much more likely to have lung cancer than men who smoke. These facts argue ...
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A few years after I entered my practice as a newly certified internist, about two decades ago now, I started to burn out. I felt I was becoming a documentation drone and a guideline-following automaton. I was embarrassed for some of the care I gave--attempting to fit patients’ round needs into the square peg of the medical model. Patients who came to talk about depression were marched through a complete review ...
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With the announcement that the FDA granted 510(k) approval for the AliveCor EKG case for the iPhone 4/4S, the device became available to "licensed U.S. medical professionals and prescribed patients to record, display, store, and transfer single-channel electrocardiogram (ECG) rhythms."
While this sounds nice, how, exactly, does one become a prescribed patient? Once a doctor prescribes such a device, what are his ...
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Recently, over 520 of our doctors began sharing their office visit notes with patients.
All primary care doctors and general pediatricians, and selected physicians within pediatric subspecialties, dermatology, endocrinology, pulmonology, nephrology, rheumatology, cardiology, cardiothoracic surgery, vascular surgery, neurosurgery, and women’s health—including obstetrics and gynecology and gynecologic oncology—are participating in OpenNotes.
That means tens of thousands of our patients will have access to the notes doctors write about them. After each ...
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In a word, no (unless you have cancer). So, let’s take cancer out of the picture and discuss hysterectomy for non-cancerous (benign) reasons.
First of all. A hysterectomy (removing the uterus) can be done via one of the 4 methods:
1. Vaginal, a small incision at the top of the vagina and the uterus is removed entirely through the vagina without any incision on the abdomen.
2. Laparoscopic surgery, where incisions are made ...
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“Something bad has happened. I’ve got eyelash extensions,” singer and actress Kristin Chenoweth confessed on the "Late Show with David Letterman" last year while wearing large dark sunglasses, and visibly drowsy on Benadryl. “Here’s the problem: The glue has formaldehyde in it, and I’m allergic,” Chenoweth said. “I swelled up and I’m sneezing. . . . It looks like I have lips ...
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"A comprehensive and extremely useful roadmap for doctors."
-Eric Topol, MD, author of The Creative Destruction of Medicine
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Past 6 Months
Dear lawmakers: This is what it’s like to be a doctor today
Matthew Moeller, MD | PhysicianA gun owner responds to Sandy Hook
Edwin Leap, MD | PhysicianIs Chris Christie too obese to run for president?
Jeffrey Parks, MD | PhysicianIf I’m wrong about guns, can you please explain why?
Claire McCarthy, MD | PhysicianPrimary care doctors may no longer be needed
Doug Olson, MD | PhysicianWalgreens moves into primary care, and it’s our own damn fault
Kevin Pho, MD | Kevin's Take