The stress of returning to work on a Monday morning can trigger a dangerous increase in blood pressure
"It may explain why deaths from heart attacks and strokes tend to peak on a Monday morning.
There are 20% more heart attacks on Mondays than on any other day."
January 2005
All Stories
NEJM with a medical mystery
"A male infant was born at 38 weeks and 1 day of gestation with a weight of 3430 g. When the child was five months old, his mother noticed an unusual weight gain and a rash. He was referred for medical treatment at seven months of age. His weight was 8450 g, and his blood pressure was elevated, at 114/52 mm Hg. What is ...
There really shouldn't be any circumstance where chaperones aren't used during intimate examinations
Nonphysicians eager to prescribe medication
"'A person who is not a physician ought to be able to practice within their training,' Dr. Nelson said. 'If they want to increase their scope, they should do it through education, not legislation.'"
Agreed. If you want to prescribe medication, go to medical school. Or get a DO, NP, or PA degree. People should adapt to the system instead ...
North Carolina Republican Sen. Richard M. Burr favors reforms in the legal system to rein in medical malpractice lawsuits, which he blames for the inflation in medical costs
I much prefer his stance than that of the man he replaced, John Edwards.
Some hospitals are picking up the tab for malpractice premiums
Proof that tort reform works
"Because of tort reform, malpractice lawsuits no longer can be counted on to police the profession.
In Harris County, the numbers of medical malpractice lawsuits have dropped precipitously since October 2003, when limits on non-economic damages (awards for "pain and suffering") went into effect.
For the previous eight years, the number of malpractice suits averaged in the high 400s. In 2003, they spiked ...
Kaiser bans painkiller Bextra
"It is the first time the nation's largest HMO has refused to dispense a drug approved by the Food and Drug Administration."
I wonder when Celebrex will be next.
Chris Rangel opines on how marketing worsened the Vioxx debacle
However, because of the heavy direct to consumer advertising by Pfizer and Merck a huge number of patients came to their doctors asking for these drugs even if they needed only short term treatment for aches and pains and had no history of and no increased risks for gastrointestinal side effects. If anything, direct to consumer advertising proved that it ...
Blogborygmi talks about the computer glitch that caused the urology match to be re-run
Urology happens to be one of the harder specialties to match in. I wonder how many dreams were shattered by this.
CodeBlueBlog calls Canadian health care consumers morons
". . . when people are not responsible for their health care they become health care morons. You see, if someone else pays the bills then one doesn't comparison shop, and one doesn't compare results. One doesn't get educated. You stay stupid."
Bill Frist writes about a utopian future of medicine in ten years
"I would like you to meet a patient from the year 2015. He lives in a world in which years ago America's leaders made tough but wise decisions. They built on the best aspects of American health care and unleashed the creative power of the competitively driven marketplace. These changes resulted in dramatic improvements to the U.S. ...
Away
I'll be away from blogging for a few days. Have a nice weekend everyone!
The New Yorker writes about Merck and Vioxx
"While that kind of weighing of risk and benefit may be medically rational, in the legal arena itÂ’s poison." (via PointofLaw.com)
Day 4 of the Susanna Martens trial brings out an expert witness for the plaintiff
This case was initially discussed here. Some highlights from today's proceedings:
An expert witness testified today that Susanna Martens and her baby would have survived if Martens were given antibiotics at her initial doctor visit on March 14, 2000.
Martens and her unborn baby died the next day.
Dr. Sebastian ...
AstraZeneca sued over Nexium
"The lawsuit, filed in Massachusetts Superior Court, alleges that AstraZeneca's deceptive marketing persuaded patients to switch from Prilosec, whose patent was about to expire, to Nexium, a new, nearly identical drug."
I'm happy to see people rising up against pharmaceutical advertising. Nexium is one of the worst offenders of deceptive advertising.
Man Declared Dead Found Alive In Morgue
"A medical examiner was studying injuries to Larry D. Green's body in a morgue when he noticed Mr. Green was breathing."
Scary stuff.
More on athletes putting pressure on the medical staff
"Sports doctors are often asked to compromise their care so athletes can return to their sport, say researchers."
"Chest pains at 3 a.m.? Call a lawyer."
The tort reform battle in South Carolina is starting to get ugly.
Kevin Pho, MD
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How I approach ovarian cancer screening with patients
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
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Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
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Should Google censor anti-vaccine claims?
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
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Radiologists who cheat on their board exams: Who’s to blame?
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
Physician
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Why an anesthesiologist would be needed for organ donation
I've only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case...
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5 ways to avoid a misdiagnosis
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to...
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Benefits of the Medicare Adult Wellness Visit
One of the things I love about family medicine is that I get to care for people of all ages. I almost...
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Cancer has a way of teaching us poignant life lessons
I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by...
Patient
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In love there is a life giving force
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
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How to get ready for death
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
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The long term cost of a pain in the neck
One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an...
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Preparing for your visit with someone in hospice care
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives....
Policy
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AMA: Advocating for Medicare, military and fiscal responsibility
A guest column by the American Medical Association, exclusive to KevinMD.com. This week, I’m joining hundreds of physicians and medical students in Washington, DC...
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A critical look at value driven health care
Everyone in the world is talking about “value-driven health care.” Or so it might seem if you pick up a medical journal...
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Surviving the new landscape of physician reimbursement
CNN recently posted an article titled "Doctors Going Broke." It described several cases of independent physicians who are near bankruptcy although they once...
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Doctors lobby Congress to repeal the SGR
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate...
Tech
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There is a patient attached to that implantable defibrillator
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going...
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The pitfalls of email communication with patients
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively...
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Why adoption of EHRs is a transformational event for physicians
Paul Conslato, MD, director of clinical affairs for Lancaster General Medical Group, recently was quoted in the PAMED Better Health Network eZine...
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Why EMR is a dirty word to many doctors
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and...
Social Media
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Using Twitter to deliver health improvement messages
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
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Addressing comments on your medical practice’s Facebook page
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
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The Internet is where patients go for pre-visit consultations
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
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5 ways doctors can benefit from professional connections
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
