When faced with the prospect of taking anywhere from 4 to 12 years to finish training in a specialty so that they can actually practice, during which time they make a pittance in salary and work ridiculously long hours, even with the 80-hour work-week restrictions, more and more of the best and brightest are deciding it's just not worth it.
June 2006
All Stories
Screening colonoscopies in Canada: What’s the point?
Same old single-payer story. Why have screening guidelines at all if it takes so long to get the test?
Quebecers hoping to be screened for colon cancer are facing up to a year-long wait for diagnostic tests that could save their lives.
That's unacceptable, Barry Stein, head of the Colorectal Cancer Association of Canada, said yesterday.
"You can't just walk in the door and get a colonoscopy. ...
Not all drug addicts fit the stereotype
Case in point.
The "curse" of having a girl in India
An Indian BBC correspondent writes:
If our baby is a girl - her arrival is likely to be greeted, by some, with condolences. A friend - delighted with his new daughter soon became infuriated at comments that his home had been cursed with a girl.
"Relatives arrived laden with gifts of sweet meats," he said. "They cuddled her and shook their heads at our misfortune."
These are ...
Insurers are starting to cover the HPV vaccine
How reimbursement woes hurts patient
Here's a real-life example:
If you pay the front-line doctors they will take on the patients who will then have a place to go when they are sick, which will dis-impact the ERs of the country, encourage doctors to practice in rural areas, help stop disease processes before they get to the stage of needing intervention and decrease the number of hospitalizations.
The entrance into the health care ...
A cure for cancer
At least for cervical cancer. A panel unanimously recommended the HPV vaccine for girls aged 11 and 12.
The hierarchy of a medical team
ATLA: "There is no healthcare crisis"
The ATLA president talks about malpractice:
The only places where people have trouble finding an OBGYN to do any procedure are in rural, poverty-stricken areas, where the OBGYNs don't want to live and practice. I do a lot of obstetrical negligence cases, and the cases seem to come out of poor areas. You see people getting better healthcare in big, urban centers, for the most part -- although mistakes ...
Not enough ER docs?
Just throw money at the problem.
Six "must-have" medical tests for women
I always like to criticize articles on "must-have" medical tests, since they often get it wrong. This one isn't bad. There is a mistake on the bone-density test recommendation:
All women under the age of 65 should have one, but any post-menopausal women with risk factors should have one.It should be all women over the age of 65 should have one.
Obese . . .
. . . or giant cyst?
A doctor is facing a charge of professional misconduct after allegedly failing to recognise a patient had a giant abdominal cyst.Update:
A tribunal heard he told her she was overweight and prescribed diet pills.
The 44-year-old mother was eventually taken to hospital in severe pain, where a 14.7kg cyst was discovered and surgically removed.
Link fixed. Sorry.
A mother kidnaps her child looking for alternative therapy
The child is in need of a kidney surgery, but the mother wanted to find "other options":
The case of a mother who took her 9-month-old child on the lam, frantically searching for alternative therapies as state and medical authorities demanded kidney surgery for the boy, unfolded before the public last week like a high-drama television show. But at bottom, it pitted the rights of a mother and father against ...
shrinkette is leaving us
Sad to see. shrinkette has guest-blogged here several times, and will always be welcome to. She'll be missed.
The top five medical errors in comic books
Resident comic book expert/MD Scott takes an annotated look. For instance:
3. You Cannot Shock A Flatline When the heart goes into asystole (a term for when it stops beating and has no electrical activity), the treatment is NOT defibrillation. To restart a non-beating heart, the recommended treatments are CPR, epinephrine, atropine, and transcutaneous pacing. Defibrillation does more harm than good.
Big Pharma vs generics
The strategy appears to be making their own generics, and trying to put little generic pharma out of business.
The bizarre and savage practice of "breast ironing"
BBC News on Friday examined the practice of "breast ironing" -- which some mothers do to their daughters in Cameroon in an attempt to prevent sexual advances of boys and men -- and a recently launched campaign to curb the practice. According to BBC News, breast ironing involves "pounding and massaging the developing breasts of young girls," most often with a wooden pestle and sometimes with heated bananas or ...
Guess which state has the most expensive health care in the world?
Find out here.
Why single-payer won’t work
From an editorial this past weekend:
A single-payer system would guarantee that health-care services need to be rationed to control costs. Affluent Americans would buy access to health-care services that would be out of reach to lower-income Americans. Reimbursements to providers will decrease because the government is controlling the purse strings, causing fewer physicians to practice and the quality of care to decline. Our tax burden will grow and ...
A pharmacist wonders about prescribing medication
An insightful piece responding to the Canadian controversy allowing pharmacists to prescribe medication:
That said, I would trust a pharmacist over a PA or an NP when it comes to managing complicated drug therapy. There is no question in my mind about that.
There would also need to be a better way to keep (and share!) medical records with other providers. It would be awesome if everyone could ...
Kevin Pho, MD
-
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...
-
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...
-
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....
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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....
-
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...
-
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...
