Chris Rangel wonders whether medical school contains too much harassment and belittlement.
September 2006
All Stories
The good life
Can concierge medicine be this good?
Don’t mess with this nurse
A nurse kills a home intruder with her bare hands.
How much can someone hide up their butt?
Quite a lot, explains Slate:
Doctors find retained foreign bodies in both smugglers and recreational body-packers. One experienced pleasure-seeker told an online body modification magazine that it took two years of training before he could accommodate a wine bottle"”which is about three inches wide. (Now he can handle 4-inch balls.)
Watch for debris
A patient is killed in her hospital bed when a rock that crashed through the roof hits her head.
Informed consent doesn’t shield this neurosurgeon
A physician loses a malpractice case due to a known complication:
At trial, Wagner, OHSU's lawyer, told the jury that Ackerman's injury was a known risk of the surgery, and Ackerman had signed the consent form acknowledging that his doctor had educated him on complications.But of course, "money was never the issue."
The cost of a meritless claim
A physician responds to an editorial in PA:
But defending cases costs an average of $50,000 - even if it never gets to court. These costs, initially paid by the insurance companies, are passed on in premium increases to doctors and hospitals. And the cost of staggering jury awards, also paid by insurance companies, is passed on in premium increases to ALL doctors, even if negligence is found in only ...
Governments forget that medicine is a business
An editorial on Michigan's Medicaid payments: "Make it a bad business and everyone pays more in the end."
A psychiatrist is beaten to death during an appointment
The patient was bipolar and schizophrenic and leads to the question of whether some patients should be seen alone.
The next lifestyle medication
A drug to help premature ejaculation.
The malpractice players on the field
And the battle lives on.
Most don’t really care who their physician is
They would spend more time researching car and computer purchases. Most wouldn't change their habits even if price and quality information were available.
How doctors are fighting Medicare cuts
By going retail: "I really didn't spend 12 years in school to sell glasses, but that's half our income right now."
How to become a standardized patient
Opportunities are arising as medical schools try to improve medical students' interpersonal skills.
A pathologist endorses online patient testing
He actually sees some good in this, damn the USPSTF:
Others see these tests as tools for health-conscious people who want them more often than their doctor orders. Dr. Bruce Friedman is a pathologist.And ...
"As a physician, I'm very enthusiastic about this form of testing," Dr. Friedman said. "I think any kind of testing that allows consumers to take more ownership over their healthcare status is important."
Errors beget errors
Physicians who believe they committed medical errors are more prone to burnout and depression, which increases the risk of future error.
Time pressures = antibiotic overuse?
As time pressures increase for PCPs, expect more of this to continue. It takes less time to give an antibiotic than it is to counsel and test:
About 14 percent of U.S. children visit a health professional at least once a year for serious sore throat, and over two-thirds of these are prescribed antibiotics, according to a survey by HHS' Agency for Healthcare Research and Quality.
But ...
Many patients don’t understand health care instructions
The reason being that they are not written in conversational English:
Many health directions are written at a level that''s above the average consumer, Rudd said. A simple example, she said, would be a can of baked beans at the local supermarket. A consumer may want to know the salt content before buying, but they don't see the word salt anywhere on the label.
The problem with the artificial heart
It just doesn't fit in most patients.
A major reason for overmedicated kids?
Try the parents:
A 15-year-old girl and her parents recently came in for a chat with Dr. James Perrin, a Boston pediatrician, because they were concerned about the girl's grades. Previously an A student, she was slipping to B's, and the family was convinced attention deficit hyperactivity disorder was at fault -— and that a prescription for Ritalin would boost her brainpower.
After examining the girl, Perrin determined ...
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...
