Dr. Boyle worries about getting sued for reading too many . . . or too few mammograms
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March 2005
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Medication errors are common at the time of hospital admission
"It's important for patients and families to know that when they come to the hospital they have to bring information about what medications they are taking . . . They should bring the prescription vials or keep a written updated list."
Patients should also carry an updated medication list for every doctor's visit as well.
10 Things Doctors Hate to Hear
So very true.
76% of emergency physicians in a study reported experiencing at least one violent act the previous year
"The acts prompted 42% of the doctors to seek protection, including 18% who obtained a gun and 20% who bought a knife."
More people are going to the ER with "the Bruschi effect"
"In the two days after the New England Patriots linebacker was hospitalized with a stroke last month, Boston hospitals reported a sudden jump in people showing up at emergency rooms complaining of stroke-like symptoms such as headaches, blurred vision, or numbness on one side."
Some are saying AstraZeneca is creating a shortage of Prilosec OTC to boost sales of Nexium
"The shortage of Prilosec has been very good for AstraZeneca's bottom line because it has increased sales of Nexium, a far more expensive prescription heartburn medicine that AstraZeneca also sells."
Private Health Care in Jails Can Be a Death Sentence
"Brian Tetrault was 44 when he was led into a dim county jail cell in upstate New York in 2001, charged with taking some skis and other items from his ex-wife's home. A former nuclear scientist who had struggled with Parkinson's disease, he began to die almost immediately, and state investigators would later discover why: The jail's medical director ...
Where in the world was Dr. Kevin?
I'm back and have some pics from my travels.
Happy Trails to You!
Thanks to Kevin for letting me contribute to his fabulous web log in his absence - bets are being placed as to how long it will take him to raise the quality of his site back to its formerly lofty level...
Hey, why not end with a quotation from one of my favorite novels? Here it is:
''Better learn to listen first! Learn what is to be taken ...
The Black Death and history of the plague
The human race has been under attack for centuries - not from little green men from Mars, but from infectious disease. Mankind is still at risk for massacre from multiple threats such as Ebola, avian flu, anthrax and smallpox. In order to understand how important it is to prevent such a disaster, one can study the most fearful epidemic ever recorded in history - plague. Listen to the voice of ...
Making sense of health reporting
From The Guardian: "How useful is the never-ending torrent of health stories in the daily press? Not very, says Steve Cochrane, who spent a gruelling month sifting through the scary, the serious and the plain silly."
Having spent the past four weeks monitoring the media's coverage of health issues, I am now more or less convinced that I'm about to keel over, that antibiotics won't be able to help me ...
Dad, Can I Get a Computer for My Bedroom?
The International Narcotics Control Board said in its annual report that unlicensed online pharmacies sell several billion doses of medicine illicitly each year and deliver them by post, making them an alternative drug-trafficking route.
Drugs involved in the illegal sales included oxycodone and fentanyl - both strong narcotics, along with "psychotropic substances which act on the mind" (I assume they mean benzodiazepines such as alprazolam or diazepam).
From ...
Perhaps We Should Sit in the Biergarten…
A researcher from Australia has released a study attempting to estimate the number of deaths from passive smoking in the "general workforce and general population" of the United Kingdom.
He concludes that "passive smoking at work is likely to be responsible for...617 deaths per year, including 54 deaths in the hospitality industry" (i.e., pubs and restaurants).
The British Medical Association has cited this study in their quest to ...
Treating Lymph-Node Positive Breast Cancer in Older Women
A new retrospective review of 700 women aged 65 or older shows that taking adjuvant chemotherapy for lymph-node positive breast cancer is associated with a reduction in recurrence of and death from breast cancer.
Although the older women had a higher treatment-related mortality (33 deaths), the authors suggest that "older breast cancer patients ... ask their physicians about the opportunities to receive chemotherapy that might be helpful to ...
What are possible signs of elder abuse?
Yahoo! News - Spouse Most Likely Source of Elder Abuse
Elderly people may be at increased risk of abuse if they're cared for by a spouse, especially if the spouse is coping with his or her own physical or mental health problems, according to a new study.
"Caregiving is stressful, and it breaks down the people that are providing the care -- they wear down," Scott Beach, the study lead ...
Deep brain stimulation for treatment-resistant depression
Yahoo! News: Implanted Electrodes Combat Depression
A procedure that involves drilling two holes into a person's skull and then implanting electrodes in the brain has shown promise in treating individuals who are severely depressed and resistant to other types of treatment.
Four of six patients who received this deep brain stimulation showed sustained improvement six months after the procedure took place, scientists report in the March 3 issue of Neuron.
Waist circumference is a better predictor of cardiovascular disease risk than body mass index
Researchers at the Medical College of Wisconsin have just published a paper showing that the circumference of one's waist is a better predictor of cardiovascular disease risk than the body mass index.
The risk factors identified were lipid profile, blood pressure, and glucose level. A waist circumference of 35 inches [35 inches? Are they kidding me?] conferred a cardiovascular risk comparable to a body mass index of ...
Colon Cancer Screening Guidelines
As a reminder to all, this link from the American Cancer Society reviews the guidelines on screening and surveillance for the early detection of polyps and colorectal cancer.
There are three risk catagories: average, increased, and high. Check out the table at the bottom of the link to see what risk category you fall in.
50,000 people die from colon cancer each year - one every 9.3 ...
The Next Pandemic?
Two people in northern Vietnam have contracted "bird flu" according to officials, bringing the number of victims in Asia to over 40.
The last influenza pandemic was in 1968, and experts think that the next one is slated to appear in the very near future - will it be avian flu? For more information go here.
I think we all need to keep up to date ...
Grand Rounds, 23rd Edition
A feast, at Intueri.
Kevin Pho, MD
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Warren Buffett’s prostate cancer choices aren’t right for every man
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
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Many medical decisions require shared decision making
The following column was published on April 1, 2012 in USA Today. I recently saw a middle-age man in my primary care clinic...
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Patients deserve a medical malpractice early offer
The following column was published on March 25, 2012 in the Nashua Telegraph. Medical malpractice historically has been a contentious issue. Doctors...
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Discussing whether tests actually help patients or cause more harm
The following column was published on April 11, 2012 in CNN. When you visit the doctor, chances are you are given a...
Physician
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Being a good doctor is no more an achievement than being a good Mom
At no other time in my medical training was I as confident that, with hard work and dedication, I could master the...
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The malpractice risk of volunteer medical coverage at sporting events
From Outside Online, an article about how physicians are increasingly hesitant to provide volunteer medical coverage at athletic events: "Last year, 13 Americans...
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What does a perfect pediatrics practice look like?
I had a phenomenal day in clinic yesterday. Imperfect for sure but inspiring, connected, and busy. I felt useful and like anybody...
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Tips to improve your patient satisfaction scores
Recently I was asked, “How can I improve my Press Ganey scores?” Presently this question applies mostly to hospitals as CMS is...
Patient
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What meaningful encouragement can be given to someone who is dying?
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
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Health care journalists have tendencies similar to those of doctors
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
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Adaptation can be painful, but it can also be a gift
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
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Embracing the longing without the outcome
I’m not sure when I stopped missing my husband. I suppose familiarity crept in after 7 years together and I rarely felt...
Policy
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Repairing the tear in health care’s safety net with social media
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
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Look to technology to reduce health costs
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
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How to save a trillion dollars in health care
It is both conventional wisdom and factual truth that, unimpeded, American healthcare cost inflation will bankrupt the United States economically, educationally, socially,...
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How the Affordable Care Act combats preventable hospital infections
As the Supreme Court deliberates the Affordable Care Act, Americans should take a closer look at the commonsense reforms embedded in the...
Tech
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EMR liability needs to go further than just the physician
This example of a disaster waiting to happen, in the form of an error-promoting CPOE, is a poster example of why the...
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AMA: Changes are needed in the stage 2 meaningful use EHR proposal
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...
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EMRs require better user-centered design
Healthcare IT News recently asked, “Do doctors have to be typists to get MU incentives?” That question reminded me that given the...
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Electronic records don’t tell us stories that make cognitive sense
One morning recently, I found another physician standing morosely at one of the mobile computer terminals we refer to as “cows”—computers on...
Social Media
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We need to see the potential harm of social media
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
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Why social media may not be worth it for doctors
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
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Transparency defines social media success for doctors
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
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How Twitter was used in a potential mass casualty scenario
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
