Gary Schwitzer says give me a break.
June 2007
All Stories
"Smoking causes lung cancer. Eventually."
(via Street Anatomy)
Nuvigil: Careful or calculating?
The drug's approved, but not available until 2010. The WSJ Health Blog speculates why:
We can't help noticing that Provigil, a Cephalon drug that alleviates sleepiness and is very similar to Nuvigil, will face generic competition in 2012. As Megan Murphy of Lazard Capital Markets pointed out in a note this morning, bringing Nuvigil (patent protected until 2023) to the market in 2010 would give the company just ...
Insulin in vogue again
Questions about Avandia and Januvia are leading diabetic experts to turn to oldies like metformin and insulin.
Glaxo’s cancer pipeline
The Cheerful Oncologist runs down some upcoming cancer drugs from GSK.
The exploding C-section rate in America
The threat of lawsuits is one reason, and doing C-section can be equated to a form of defensive medicine:
"They're never faulted for doing a c-section," said Faith Frieden, chief of obstetrics and gynecology at Englewood Hospital and Medical Center in New Jersey. "It's never the wrong decision to do a c-section. No one's ever going to say to them, 'why were you so quick to do the cesarean ...
tPA for frostbite?
It has potential:
Only 10% of patients with frostbitten fingers or toes who received tissue plasminogen activator (tPA) required amputation of necrotic digits, compared with 41% of patients who didn't get thrombolytic therapy.
The discharge planner
One of the most important people on the inpatient hospital team.
Radiation exposure and x-rays
Patient demand and defensive medicine has led to an explosion of CT scans and other radiology studies.
A responsible article from the NY Times, highlighting the potential radiation exposure of too many x-rays. Patients take note - more tests does not equate to better medicine:
Advances in radiology have radically transformed medical practice, with CT scans and nuclear medicine exams providing physicians with the ability ...
No ER waits
Some emergency rooms promise no waiting in the ER. I wonder if this would lead to further unnecessary ER use.
Diabulimia
The practice of stopping insulin to lose weight:
Like many teenage girls, Lee Ann Thill was obsessed with her appearance. A diabetic, she was already suffering from bulimia -- forcing herself to throw up to lose weight. But it wasn't enough, and she'd recently put on 20 pounds.
Then one day at a camp for diabetic teens, she heard counselors chew out two girls for practicing "diabulimia" -- not ...
Autism: "Thinking like an animal"
A professor with mild autism explains:
Temple Grandin is an assistant professor of animal science at Colorado State University. She wrote Thinking in Pictures and has made numerous TV appearances. She is mildly autistic, which has given her a unique insight into the way autistics think. She contends it is very similar to the way that prey animals, such as horses and cattle, think.
Dr. Crippen gives a grammar lesson
The battle in the NHS continues:
Please feel free to criticise me in any way you like. I have but one request. Your spelling, your use of commas and apostrophes and your general grammar are embarrassing. All doctors have passed "O" level or GCSE English. Could I suggest you get one of them to glance at your copy before you publish?
How the hell do you expect doctors to ...
The Democrats killed Avandia
That's the word coming out of Glaxo.
The mission against Pharma-sponsored CME
Zealot Dan Carlot starts a blog on the topic. (via Pharmalot)
Lawyers "going bare" in California
Taking a page from Florida physicians, some lawyers are going without malpractice insurance.
Physician recruiters
An OB waxes negative on the experience:
I now believe that most contingency recruiters just do not care. They sell, sell, sell and sell some more. They go for volume, they go for the numbers. The more emails they send out, the more people they contact, the more chances they may have to get an answer and sell one of their jobs. That is why they remind me of ...
"The public’s perception and appreciation of medicine has declined"
On op-ed on the state of medicine today:
The public has been promised perfection in medical care. The wonders of medical science are hailed and the pitfalls that exist in clinical practice are ignored. Illness and hospitalizations that result in poor outcomes are often exploited by malpractice attorneys who stand ready and eager to sue.
PCP time in the US
US patients spend substantially less time in primary care compared to other countries:
The substantially shorter time per capita in the US was the biggest difference we saw in our study. Such a severe shortfall impacts preventive care and management of chronic conditions in the US and could explain why the US does not achieve health outcomes that correspond to its higher level of investment in health care," said ...
Health care: Too important to be left to doctors?
More insight from Richard Reece:
The question reminds one of Clemenceau's famous statement, "War is too important to be left to generals." I, for one, don't equate foreign wars with health care. Nevertheless, the reasoning goes like this. The issues of ware and disease are too big for generals or doctors to grasp or control. Health care may be even more important. It takes 16% of the GNP versus ...
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...
