At no other time in my medical training was I as confident that, with hard work and dedication, I could master the field of internal medicine as when I was a newly minted third year medical student.Fresh from having taken the USMLE step 1, I interpreted my ability to recite the mechanism of penicillin resistance or the role of histamine in the immune response, and describe in great detail the ...
From Outside Online, an article about how physicians are increasingly hesitant to provide volunteer medical coverage at athletic events:"Last year, 13 Americans died during running races, and another eight while competing in triathlons. While those numbers might seem troubling, the deaths are attributable mostly to the booming popularity of endurance sports—13 million Americans enter running races each year, and 2.3 million compete in triathlons. But the rising participation and the ...
This example of a disaster waiting to happen, in the form of an error-promoting CPOE, is a poster example of why the net of litigation needs to be cast far wider than just clinicians when EHR-related errors result in injury or death.This order entry screen, from a production system shows the following. In all fairness, I do note it's unclear if the vendor or the customer's configuration "experts" were responsible ...
This series is brought to you by MedPage Today.1. Docs Win Most Malpractice Cases at Trial. Plaintiffs hardly ever win medical malpractice cases that go all the way to a jury verdict, and only 4.5% of claims filed ever go that far.2. Colon Cancer Screening Studies Flawed, Researchers Say. Studies cited as support for colorectal cancer screening among individuals with a family history of ...
I had a phenomenal day in clinic yesterday. Imperfect for sure but inspiring, connected, and busy. I felt useful and like anybody else, that feels so good to me. Productivity can be defined in various ways and yesterday I fulfilled my personal definition. I wrote an email to a friend and cardiologist this morning where I said, "But I must say, it’s a sincere fortune to be a doctor some days. Yesterday ...
Physicians as guardians of science have an obligation to teach the facts of life to our patients and our legislators. And today the need to dispel ignorance of biologic facts is more urgent than ever. Just as President Obama is deferring legislation on marriage to the states, I will defer the issue of whether the government can or should regulate marriage to legal scholars and our duly elected representatives. However, ...
I’ve received several inquiries from women living in various regions of the country, asking how they should choose where to go for their mammogram, and if it really matters. I cannot emphasize this enough: It matters! Here are a few tips to help your search:The most basic requirement is whether a facility is accredited under the MQSA (Mammography Quality Standards Act). The accrediting body for most states is the ACR ...
A guest column by the American Medical Association, exclusive to KevinMD.com.Continuing our efforts to move medicine forward while prioritizing patient care and minimizing administrative and financial burdens for physician practices, the American Medical Association (AMA) along with 100 state and specialty medical societies submitted a detailed comment letter to the Centers for Medicare & Medicaid Services (CMS). We urged CMS ...
This series is brought to you by MedPage Today.1. Study Confirms Marijuana Helps in MS. Smoking marijuana cuts spasticity and pain that's resistant to conventional therapy in multiple sclerosis (MS), although with some cognitive effects.2. Stress Echo After PCI, CABG Questioned. Repeat coronary revascularization did not improve outcomes in asymptomatic patients with high-risk exercise echocardiography findings after an initial revascularization procedure.3.
The FDA is deciding whether to allow patients to purchase prescription medications over the counter for many common ailments.This idea is controversial.On one hand, deregulation would remove one of the largest barriers to receiving treatment for some conditions – the doctor’s visit. If no doctor’s visit is necessary to receive necessary blood pressure medications or diabetes medications, then patients don’t have to wait for an appointment and the patient/government ...
The trouble with many significant advances in medicine is that that they take us out of our moral depth. They may raise quite different problems from the ones we are used to and, if we are not careful, we may inadvertently undermine the wonderful potential of new technologies by forcing them into existing legal, ethical and institutional frameworks.Transplantation is a case in point. Transplants save and transform lives; but the ...
Recently I was asked, “How can I improve my Press Ganey scores?” Presently this question applies mostly to hospitals as CMS is requiring hospitals to use the HCAHPS as a part of their quality reporting. Press Ganey can manage the HCAHPS for hospitals. Few physicians or physician groups presently survey patients for satisfaction; they should begin thinking about doing so in the near future as it seems likely that CMS ...
Healthcare IT News recently asked, “Do doctors have to be typists to get MU incentives?”That question reminded me that given the many hours of unreimbursed labor performing EMR data entry at end of day, a significant chunk of a clinician’s workday is spent performing medical secretary services. Let me set the record straight, I am a good typist. But EMR data entry interfaces are often unnecessarily cumbersome, so clinicians put ...
This series is brought to you by MedPage Today.1. Age May No Longer Be a Barrier in Kidney Donation. The overhauled United Network for Organ Sharing (UNOS) kidney transplant allocation guidelines will likely remove a controversial age-matching component from its algorithm.2. 'Heart Team' Pairs PCI and Robotic CABG. A surgical robot allows cardiologists and surgeons to work on the same patient with ...
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert. I wasn't in a "backless gown," rolling my IV pole down the hall of some hospital's cardiac care unit. I wore an official lanyard and badge and mixed among health care journalists, yet I felt more like a dugout mom than savvy reporter.My goal was to present the ...
A version of this column was published on April 24, 2012 in USA Today.There has been a recent uptick of elderly men in my primary care clinic asking about prostate cancer, perhaps because they heard of Warren Buffett’s recent prostate cancer diagnosis and his proposed treatment.Patients are wondering if they should also be screened. Other patients who already have ...
This morning started off like any other. I parked my car, walked into Starbucks and pulled up my iPhone app while waiting in line. The usual suspects were already there -- the elderly fellow that always flirts with the baristas, the business man with his freshly pressed suit and the tired-looking mother. As I approached the counter, I ordered my usual summer morning beverage and went through the motions to ...
As a teenager in the mid-late 1990s, my father, an engineering educator, and I would talk about the ills of the healthcare system and how physicians lost control of healthcare: primarily because they concentrated on medicine rather than the forces changing healthcare delivery. I realized this was due to an outdated medical education system and reforming it might actually improve healthcare in this country. That was my Sputnik Moment.Since graduating ...
Facebook recently announced on Good Morning America that users in the U.S. and the U.K. can enroll as organ donors through links to official registries, making it easier for people who want to donate their organs to sign up. They're working with Donate Life America, a nonprofit alliance of national organizations and state teams across the United States committed to increasing organ, eye and tissue donation.But deciding to become an ...
He had yellow nails, leather neck, stained teeth and a deep cough. He wheezed slightly, breathed too quickly and occasionally sprinkled the white handkerchief red. No surprise his ticket to my office was a lung mass to match. We talked about tests, treatment and prognosis. About the future, probably short. Devastated, he was not surprised. He was reaping the reward of 30 smoking years. He sadly admitted, “I knew better, ...
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
The following column was published on April 1, 2012 in USA Today. I recently saw a middle-age man in my primary care clinic...
The following column was published on March 25, 2012 in the Nashua Telegraph. Medical malpractice historically has been a contentious issue. Doctors...
The following column was published on April 11, 2012 in CNN. When you visit the doctor, chances are you are given a...
At no other time in my medical training was I as confident that, with hard work and dedication, I could master the...
From Outside Online, an article about how physicians are increasingly hesitant to provide volunteer medical coverage at athletic events: "Last year, 13 Americans...
I had a phenomenal day in clinic yesterday. Imperfect for sure but inspiring, connected, and busy. I felt useful and like anybody...
Recently I was asked, “How can I improve my Press Ganey scores?” Presently this question applies mostly to hospitals as CMS is...
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
I’m not sure when I stopped missing my husband. I suppose familiarity crept in after 7 years together and I rarely felt...
Can you say “reactance”? Don’t feel bad, I wasn’t familiar with the term either until recently. But as you will see, anyone...
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
It is both conventional wisdom and factual truth that, unimpeded, American healthcare cost inflation will bankrupt the United States economically, educationally, socially,...
As the Supreme Court deliberates the Affordable Care Act, Americans should take a closer look at the commonsense reforms embedded in the...
This example of a disaster waiting to happen, in the form of an error-promoting CPOE, is a poster example of why the...
A guest column by the American Medical Association, exclusive to KevinMD.com. Continuing our efforts to move medicine forward while prioritizing patient care and minimizing...
Healthcare IT News recently asked, “Do doctors have to be typists to get MU incentives?” That question reminded me that given the...
One morning recently, I found another physician standing morosely at one of the mobile computer terminals we refer to as “cows”—computers on...
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
