The predictive rule recommended termination of automated external defibrillator and basic life support efforts when there was no return of spontaneous circulation, no shocks were administered, and the arrest was not witnessed by emergency medical services personnel.
Using that predictive rule, 776 patients were recommended for termination of which four survived (0.05%), which was significantly lower (P=0.04) than ...
August 2006
All Stories
Reading Kevin, M.D. at work, but shouldn’t be?
Click here to make the site look like a Word document. (via kottke.org)
Medicare reimbursement in Alaska
Patients are losing out:
"One doctor in our office, he's 75, he's retiring. His patients are coming to the front desk, crying, because they can't find another doctor. ... He had 90 percent Medicare patients. We're taking some, but I can't possibly take them all."
President Bush passes his 4-hour, 9-doctor physical
He apparently gained some weight. I analyzed last year's physical here.
Stossel on trial lawyers: "For every little guy they help, they hurt thousands"
I couldn't have put it better myself:
For the lawyers and people like me, a lawsuit is just another part of our work, but for most people, it's a life-wrecking experience. Nurses are terrified. Doctors can't sleep. Their hard-earned reputations are trashed by newspapers quoting plaintiffs' lawyers, who paint deceitful pictures of the doctors' incompetence and negligence. The doctors are forced to hire defense lawyers who eat up ...
Malpractice lawsuits forces a hospital to close
A tragic case, and in the end the patients lose:
We often contend that America needs a better system for dealing with dangerous doctors, instead of "jackpot justice" litigation that makes lawyers millionaires. Perhaps impartial adjudication could compensate for injuries at much lower cost. But as long as officialdom doesn'Â’t head off such practitioners, and no better method is created to resolve their outrages, the risk of bankrupted hospitals ...
Most obese people think they eat well and exercise enough
No wonder the problem isn't going to go away soon:
About 40% of obese people also said they do vigorous exercise at least three times a week, the telephone survey found.
"There is, perhaps, some denial going on. Or there is a lack of understanding of what does it mean to be eating healthy, and what is vigorous exercise," said Dr. David Schutt of Thomson Medstat, the Ann Arbor-based ...
Doctors offer amputation to help beggars
They even suggested introducing gangrene to justify the amputation:
Three doctors are being investigated by Indian medical authorities for offering to amputate beggars' healthy limbs so that they attract more money.
They were secretly filmed by the news channel CNN-IBN apparently offering to remove a leg for £120 and were said to be colluding with the crime gangs that control begging in cities.
One doctor, from a government ...
A UK hospital is fined for treating people too quickly
They should be rewarded instead:
Ipswich Hospital, in Suffolk, which is more than £16m in the red, accidentally breached an agreement to ensure all patients had similar waiting times.
Ipswich Hospital agreed with the East Suffolk Primary Care Trusts, which fund treatment, that patients should wait at least four months for treatment.
However, doctors had treated patients inside that time and the trust refused to pay the ...
John Mack wonders about free lunch for patients
The ultimate direct-to-consumer approach. (via PharmaGossip)
Medicare bows to the medical device makers
They allowed themselves to be bullied for the sake of profits.
Men who breastfeed
Bizarre. (via Fat Doctor)
Is Mel Gibson manic depressive?
And will he use this as an excuse for his tirade?
A surgeon removes a kidney instead of the gallbladder
It took 3 days before the mistake was noticed:
A physician assistant and a nurse present during the surgery said the surgeon "was working in the exact location you would expect...(the gallbladder) to be located," according to the DPH'Â’s investigation report.
However, the patient had a lot of internal inflammation and an unusual internal anatomy, which made the surgery more complex, Muller said.
"From a medical standpoint, absolutely ...
A doctor is shot by his own patient
That's gratitude for you:
Police say they found a suicide note in Edeen's pocket in which the shooter complained about bad doctors in Nevada.
Ostrowsky, a 55 year old endocrinologist, was hit in the neck, jaw and shoulder. He has a bullet lodged dangerously close to his spine, but he survived the shooting and he thinks there's a reason for that . . .
. . . Edeen ...
Minute clinics: If you can’t beat ‘em . . .
Hospitals and physicians' offices want a piece of the action:
The Wall Street Journal on Wednesday examined how an increased number of traditional health care providers -- "driven by the threat of new competition, the opportunity to recruit new patients" and quality of care issues -- have begun to compete with and enter agreements with retail clinics -- low-cost, walk-in facilities often located in supermarkets, pharmacies and large retail ...
Speculation on Fidel Castro’s surgery
A duodenal ulcer is a leading possibility.
The tough talk of JAMA’s editor in chief
She certainly has her enemies:
"This idea that money is evil and academia is made up of saints is nonsense," Dr. Stossel said. "Some of my vaunted academic colleagues would run their grandmothers over." He favors disclosure, too, he said, but journal editors "have acquired halos and become arbiters of scientific morality."
"There's this myth that if Mother Teresa, the Dalai Lama and Catherine DeAngelis got up and ...
Doctors without patients
Dr. Zuger writes about how they thrive:
Doctors without patients: can such creatures really exist? Or do they automatically negate themselves into some other sphere of existence, a cloudy existential plane where teachers without students and merchants without customers all wander around in search of a new identity?
It is a purely rhetorical question, because not only do doctors without patients exist, they thrive. They top most heaps: ...
"How to eat American food responsibly"
Workshops are available to orient immigrants and refugees to the American diet:
One of the major challenges for organizers is to change the way the refugees think about food. Many of the new arrivals suffered from malnutrition and came from places where food was scarce.
Some want to make up for a lifetime in which they were denied meat. Others gravitate towards the fizzy orange drink and crisps, ...
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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How we deliver bad news is critical to how families deal with grief
As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during...
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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
It is both conventional wisdom and factual truth that, unimpeded, American healthcare cost inflation will bankrupt the United States economically, educationally, socially,...
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
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...
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...
