Good to keep handy when travelling to China.
November 2006
All Stories
Are medical specialists biased?
Of course they are, says this doctor:
Now, it's a mathematical certainty (and simple common-sense) that the more the tests you perform, the higher the likelihood that at least one will be abnormal. If you perform a panel of over 20 tests for any woman, at least one (or even more) are going to be "abnormal". This condition, when the result of the test is abnormal, but the patient ...
A doctor gives a woman 300mg of IV Phenergan for nausea
This is a lethal dose. An osteopathic surgeon (not exactly sure what that is - a DO perhaps?) had to change his name due to the 110 other malpractice suits against him.
Racial differences in end-of-life care
A study suggests that black patients are more likely than white patients to prefer life-sustaining care when confronted with an incurable illness or serious mental and physical disabilities.
Hospitals banning cellphones for profit?
Recent studies have demonstrated the safety of cellphones in the hospitals. Banning them forces patients to pay the hospital for telephone access:
But it reveals that Health Service authorities have prohibited their use after signing deals with private telephone providers.
These firms, which have installed bedside entertainment systems under the Government's 'Patient Power' policy, have made millions by charging up to 75p a minute for incoming calls ...
An 11 year-old boy with leukemia is selling ad space on his forehead
He wants to raise money for the Bone Marrow Registry:
The sixth-grader said many people have visited his Web site but there have been no bidders.
"I hope that people start bidding on it now, before it ends Dec. 6 and that's all I can hope for," Pedraja said. "Bidding will not only help you by advertising, it will also help save a bunch of lives."
Confessions of a phlebotomist
Some stories from the hospital "vampires":
It never seems to amaze me in the winter, people walk in with the big, bulk coat sit in the draw chair, and then say "oh, do I have to take my coat off?" how do you expect me to get the blood, I love to say, "no keep the coat on, it may take me 15 times to hit the vein, but ...
An EMT punches a psychiatric patient
No matter what the circumstance, this is not allowed.
Physicians and conflict of interest: Patients don’t care
A vast majority just want to get better:
Medical and professional societies have increasingly urged doctors to reveal all such conflicts of interest so patients can judge whether their doctor may have more than their health at heart. But perhaps because they are already overwhelmed by the challenges of their disease, most patients said they did not need to know those details and trusted that rules were in place ...
So, does $41 billion help with wait times in Canada?
Uh, they don't seem to know.
Hooray New Hampshire!
First state to offer the HPV vaccine free to girls 11 to 18. It's nice to be in the Granite State.
A health risk of prayer
Praying-induced oromandibular dystonia:
This general kind of problem is called "focal dystonia". It's the involuntary fluttering of muscles that one ordinarily controls masterfully. It arises, somewhat mysteriously, in a few extraordinarily unlucky people who perform "a highly stereotyped and frequently repeated motor task". It's what happens in writer's cramp, and in the eyelid twitching known as blepharospasm, and very occasionally in certain specialised professions. Doctors have seen it in ...
Importance of a second opinion
Eye-opening stat. More than half of breast cancer patients had their treatment plan changed after being reviewed by a tumor board:
Researchers looked at the records of 149 consecutive patients referred to the U-M Cancer Center's multidisciplinary breast tumor board for a second opinion. The patients had already been diagnosed with breast cancer after having undergone initial evaluation, breast imaging and biopsy, and they already had a treatment ...
"Everyone wants to be a plasticologist"
More doctors are leaving their fields for cosmetic medicine. Blame Medicare and third-party reimbursement for this:
Five years ago, cosmetic medicine was primarily the domain of plastic surgeons, facial surgeons and dermatologists "” medical school graduates who undergo several years of training in facial skin and its underlying anatomy. But now obstetricians, family practitioners and emergency room physicians are gravitating to the beauty business, lured by lucrative cosmetic ...
UK’s P4P from the front lines
Dr. Crippen says doctors are in a no-win PR position:
My pay has gone up approximately 25% over the last two years. That extra money has been earned by hitting government targets. The targets were set by the government, not by us, and mostly have little to do with health care, but a lot to do with "process" and bogus but quantifiable "healthcare achievements".
We told the government at ...
Better than the real thing?
Pillowy SSRIs:
(via Unbounded Medicine)
Goodbye Google Answers
Google Answers announced that it is shutting down. This 4-year old service comprised a passionate community of 800 or so researchers answering questions of all varieties.
Although I haven't been an active researcher recently, it is where I got my "start", so to speak. It opened up web-related avenues for me, ranging from Med Help to this blog you're reading.
So, thanks Google Answers ...
P4P in UK leads to an increase of 30% in physician salary
Can this be a viable way to increase primary care compensation, thus re-attracting medical students to the field?
Health care today: Payment and fear of malpractice takes priority
Well, it definitely isn't like it used to be:
The first question I get asked when I pursue medical treatment is who is your insurance company and the responsible party. There is no one who is willing to give you any simple advice or reassurance for fear of being blamed for wrongdoing or sued for malpractice. The doctor that I had for 25 years, all my adult life, recently quit ...
Instant first aid
Some good tips when an ER or doctor isn't handy, like rubbing an onion on first-degree burns.
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...
