The price of cancer drugs is soaring, with little relation to the cost of developing or making the drugs.
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March 2006
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You can't win. Sleeping too much, or too little, may be tied to diabetes. Apparently 7 to 8 hours is just right.
Regulation of residents' hours makes patient handoffs a source of error. This is a problem in the UK as well:
Agreeing that missing information could sometimes put patients at risk, he said: "If you don't follow up on certain test results or if you are not aware of certain conditions that have been discovered then you can miss the opportunity to do something about it."
Another problem ...
You're probably undercoding. Here are two sample office notes:
CC: Cough
HPI: 75-year-old male with productive cough for five days, worse at night. Patient also has fever and chest pain. Patient using cough syrup without improvement.
PH: Non-smoker.
ROS: Denies shortness of breath or heart palpitations.
EXAM: Vitals: temp 101.5, BP 140/80
ENT: negative
Neck: negative
Chest: rhonchi bibasilar, pain on deep inspiration
CV: negative
The opposite of defensive medicine - not doing enough tests in the UK:
The father had taken her to the GP earlier in the week, and the GP had told him that he was "wasting his time", and that the child would soon put the weight back on. The father asked for the child to be sent to the hospital, and the GP refused this.
We got the child ...
Backlash against the ridiculous idea of blended payment rates:
"Paying a blended rate (an average of several CPT codes determined by the health plan) for Levels 3, 4 and 5 office visits contradicts the concept of a resource-based relative value scale upon which the Medicare rates are based," said the letter. Higher-level office visits cost more for a reason: Not only does the physician spend more time taking the patient's ...
Life behind bars for a doctor is not good enough for a malpractice plaintiff:
Even though the doctor will most likely spend the rest of her life behind bars, the victim's mother is unhappy.
"My heart breaks that he was not found guilty for my daughter's death," said the mother of 52-year-old Julia Hartsfield, Connie Yelie.
This doctor successfully uses the power of placebo:
So that night, in a pretty loud voice, I asked the older nurse, "Now give me the magic towel". She had no clue either, but she knew I needed an aperture drape, which is a sterile cloth sheet with a hole big enough to work through in its center. As she was unfolding it, I loudly and slowly explained to her ...
Kate Steadman thinks defensive medicine doesn't exist:
The bottom line is that while the evidence isn't crystal clear that defensive medicine plays no part, there's nothing that shows defensive medicine is dictating doctors' behavior. More contemporary research needs to be done (the majority of these projects were in the late 1980's and early 1990's), but there's no indication of a rash of doctors performing unnecessary procedures and tests because ...
Like any small business, physicians need enough incoming revenue to keep practicing. That's why monetary incentive is so strong:
The way cancer doctors are paid may influence the choice of drugs they use in chemotherapy, a study published yesterday has concluded.
Payment methods do not seem to affect whether doctors favor chemotherapy over other treatments, the study's authors said. But once they decide to use chemotherapy, the ...
A doctor wants to random drug-screen the hospital staff:
"It sounds as if he's accusing all the doctors here of being alcohol or drug addicts, or protecting others who are," he said.
According to the lawsuit filed Feb. 28 in U.S. District Court, Couch asked for all staff to undergo random drug and alcohol testing in 2002. He claims that one former doctor, not named in the lawsuit, failed ...
Seven traits of the "ideal" doctor: "confident, empathetic, humane, personal, forthright, respectful and thorough."
Beware the Ambien driver:
Ambien, the nation's best-selling prescription sleeping pill, is showing up with regularity as a factor in traffic arrests, sometimes involving drivers who later say they were sleep-driving and have no memory of taking the wheel after taking the drug.Are lawsuits far behind?
Canadian rationing woes: "There is a wait before patients even get on the waiting list."
The AMA warns against spring break:
Kathleen Fitzgerald, a 21-year-old junior at Illinois State University, said the AMA's effort to raise awareness is a good idea, but probably won't do much to curb drinking during spring break.
"I think a lot of students wouldn't really pay that much attention to it," Fitzgerald said. "They would just be like, 'Duh, that's why we do it.'"
Another patient advocate who demands perfect physicians:
The word "diagnosis" is simply a fancy word for "opinion." In a medical environment, that opinion is based on accumulated evidence, including your symptoms, test results and previous medical history. Your doctor's evaluation of that evidence should yield an accurate diagnosis, which should result in the most effective treatment decisions.
But "should" is the operative word. "Should" could end up meaning ...
Jail inmates have to pay a $10 co-pay to see a doctor. "The move comes in response to too many inmates making frivolous medical visits, county officials said."
A man talks about his time in hospice:
I don't know if this is true or not, but I think some people, not many, are starting to wonder why I'm still around. In fact, a few are sending me get-well cards. These are the hard ones to answer.
So far things are going my way. I am known in the hospice as The Man Who Wouldn't Die. How ...
Miracle Workers is going to further promote overtesting:
"It sounds scary, frankly," said Dr. Richard Deyo, professor of medicine and health services at the University of Washington and co-author of "Hope or Hype: The Obsession with Medical Advances and the High Cost of False Promises."
The "Miracle Workers," he said, "sounds like it's destined to create wild expectations on the part of people watching ...
Kevin Pho, MD
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Warren Buffett’s prostate cancer choices aren’t right for every man
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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
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Physician
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How we deliver bad news is critical to how families deal with grief
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His father’s suffering had already been too great
He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I...
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Diversity provides color to the tapestry of human experience
I was recently appointed the Assistant Director of the Yale Cancer Center with the portfolio of Diversity/Disparities. While I’m not sure I’m...
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Necessary is a word best defined when looking back in time
How do you define a “good” doc? I was reading the patient responses to an article here on KevinMD.com and was saddened...
Patient
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How death can be a beautiful experience
I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law...
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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....
Policy
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Hospitals around the world aim to remain relevant to patients
"It was the best of times, it was the worst of times ..." So begins a story called A Tale of Two...
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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
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Tech
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Doctors, use Google to get more patients in less than 7 minutes
Every month, hundreds of thousands of people look for a doctor on Google. As an amazing practitioner, your site deserves to be...
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The user interface for EHRs should be uniform
The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with...
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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
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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
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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...
