The highly charged political debates about reforming American health care have provided tempting opportunities to rename the people who receive health services. But because the impetus for this change has been prompted by cost and quality concerns of health care payers, researchers and policy experts rather than emanating from us out of our own needs, some odd words have been called into service. Two phrases commonly used to describe us ...
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Right now hospitals around the country are being asked to reckon with some stark realities regarding readmissions. $17 billion a year is spent on readmissions for Medicare patients alone, and 75% of those readmissions are considered to be preventable. Of all Medicare patients who are admitted to a hospital, 18 percent will be readmitted in 30 days and of those, 50 percent will not have seen a primary care physician ...
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Jennifer was one of my first patients as a new doctor, and she came to see me about an unintended pregnancy. A single mom to a rambunctious 5-year-old girl, Jennifer was struggling economically and battling depression. We talked about the options available to her: continuing the pregnancy and preparing to parent another child, offering the baby for adoption or having an abortion. She chose to continue with the pregnancy, and ...
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We doctors who specialize in psychiatry have a sacred trust. We are given the opportunity to talk to people who are hurting every day, people who trust that we will listen to them, try to understand them, not laugh at them, and not think that they are stupid, crazy, or horrible. A tall order, granted, given that we hear stories that sometimes border on the unimaginable, bizarre and otherworldly. This ...
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As a physician, I experience first-hand the impact that internal communication at a hospital—both good and bad—has on patient care.
If I am able to quickly access clinical systems, analyze patient information and collaborate with colleagues, I can diagnose and interact with the patient much more efficiently and effectively. Conversely, breakdowns and inefficiencies in the communications process can inhibit the delivery of quality patient care by bogging down workflows, creating delays ...
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Do you know anyone who has tried to find an internist recently? Good luck. Internists are either overflowing with patients, switching to retainer medicine, switching to hospital medicine or quitting. Internists are frustrated, burned out, and unhappy with the external transformation of our wonderful profession.
We spend 20 years in school, and then 3 years of residency training. We learned to think and apply our cognitive expertise to the diagnosis and ...
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Part of the KevinMD toolkit series.
"How can I find a doctor online?"
A seemingly simple question, but patients are often confronted with too much information on the Internet, with variable quality.
Finding a doctor a similar to completing a puzzle. Like puzzle pieces, there are many resources available, including word of mouth, hospitals, insurance companies, and physician ...
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Infectious disease is the most hyperbolic of all medical fields, at least when the media gets ahold of such.
Right now we are to fear a new avian influenza virus. Previously there was another avian influenza strain whose outbreak threatened the world and of course SARS and, more distantly, the ebola virus and the threat of bioterrorism. And on the periphery, as these acute threats come ...
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Brought to you by MedPage Today.
1. More Evidence Fecal Transplant Clears C. Diff. Fecal transplant for Clostridium difficile infection is a safe and effective treatment and can alter patients' fecal microbiota to resemble that of donors over time.
2. CT Lung Screens Catch Most Cancers. The National Lung Screening Trial found that CT scans were highly sensitive in detecting lung cancer in ...
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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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"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
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Claire McCarthy, MD | PhysicianPrimary care doctors may no longer be needed
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