Well, the best and the brightest will no longer be inclined to enter medicine. Is that really what society wants?
July 2007
All Stories
The deterioration of "free" care in Canada
Physicians are demanding access to private care options in Canada:
Canada's doctors want to be able to work simultaneously in both the public and private systems, a flexibility that critics say could lead to queue-jumping and further depletion of public health care.
It's also a proposal that puts the medical community on a collision course with Prime Minister Stephen Harper, who argues that physicians would have an incentive ...
Kidney transplants: Paying it forward
The concept of paired donation. (via Freakonomics)
Torture inside the Libyan jail
The recently freed doctor gives a harrowing account of the ordeal:
The Palestinian doctor who was held in Libyan custody along with five Bulgarian nurses on charges they infected hundreds of children with HIV, has described in detail how they were tortured during their eight-year ordeal. Ashraf Alhajouj, 38, said he was beaten, held in cages with police dogs and given electric shocks, including to his private parts. He ...
Paying doctors by the hour
"Pay by the hour is the most difficult method to game," says Half Sigma. Makes sense, but without any productivity incentive, appointment shortages may become more dire as the longer visits will fill more physician schedules.
Single fathers and their children’s office visits
Apparently children of single dads make less well-child visits.
Physician recruiters, redux
What to watch out for.
Drug reps on doctors: "Everybody has a price"
More drug detailing tactics:
"It's my job to figure out what a physician's price is. For some it's dinner at the finest restaurants, for others it's enough convincing data to let them prescribe confidently and for others it's my attention and friendship... but at the most basic level, everything is for sale and everything is an exchange," stated former Eli Lilly drug rep Shahram Ahari.
Foreign doctors and US health care
A USA Today op-ed:
I tell you these facts because of the knee-jerk reaction I hear that we should take measures to prevent the entry of foreign-born physicians. This would be a disaster for American health care, and it would not make us safer. We need to increase physician immigration and increase the supply of U.S. medical school graduates. Otherwise, we'll face a future of rationed health care.
SCHIP and Medicare fee reductions
Hidden in the debate over expanding the SCHIP is the fact that the impending Medicare fee cuts will also be abated:
The bill's main Medicare proposals include replacing the impending 2008 and 2009 physician fee cuts (projected to be 10 percent and 5 percent, respectively) with a 0.5 percent update for both years.
"The AMA is proud of Dr. Pou"
The AMA comes out in support of the dropped charges:
"The AMA continues to be very concerned about criminalizing decisions about patient care, especially those made during the chaotic aftermath of a disaster, when medical personnel and supplies are severely compromised."
Pharmacists sue over Plan B
An "opt-out" clause wasn't enough to satisfy these pharmacists:
Pharmacists have sued Washington state over a new regulation that requires them to sell emergency contraception, also known as the "morning-after pill."
In a lawsuit filed in federal court Wednesday, a pharmacy owner and two pharmacists say the rule that took effect Thursday violates their civil rights by forcing them into choosing between "their livelihoods and their deeply held ...
Placebo Television
A hilarious weekly vlog from the writers of Placebo Journal. "Scrotox" is classic.
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Talking about statins
Benjamin Brewer considers the questions when treating high cholesterol. (via The WSJ Health Blog)
Pfizer: Going to the dogs
Having had setbacks with torcetrapib and Exubera, and with generic competition to Norvasc and Lipitor, Pfizer is putting more emphasis into animal drugs.
Clogging the ER
Scalpel on flow-stoppers:
Any patient who requires an interpreter, any time-consuming procedure, patients who are overly demanding, patients with numerous concerned and annoying relatives, patients who want to be admitted but don't need to be, patients who need to be admitted but don't want to be, patients requiring more than one or two calls to other physicians, and so on.
Variance of care and race
Physicians aren't racist, says Chris Rangel. It's about where people go for care:
. . . the poor mostly seek care at urban health centers that tend to be underfunded, understaffed, and overburdened. It's basic economics. Poor people tend not to have the same access to the same quality of housing, cars, consumer products etc. that more affluent people do and health care is no exception . . .
Investing in primary care
"Sometimes you have to invest money to make money," says Robert Centor. Can generalist care be saved?
Treating friends or colleagues
A case where atypical depression was missed - due to the celebrity or VIP bias:
Dr. Groopman observes that V.I.P. or celebrity patients sometimes short-circuit the physician's normal diagnostic thinking. For example, these patients may be spared the doctor's usual tests and procedures. As our "top gun," Mike was just such a patient to me. Even as I entertained grandiose fantasies about curing him, my unconscious may have steered me ...
"Take two tablets twice daily"
What does that mean to you? More patients than you think are confused by drug labels:
Did that mean a total of two, or a total of four? A third of patients who were deemed literate got confused. A more clear instruction would be: "Take two tablets in the morning and two tablets at night."
Kevin Pho, MD
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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...
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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...
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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....
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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
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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...
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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...
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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...
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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
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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...
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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...
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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...
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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
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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...
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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...
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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...
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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
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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...
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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...
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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...
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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
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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...
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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....
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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...
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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...
