Dropped dead waiting outside the ER, 3-hours after being triaged. WhiteCoat Rants comments.
October 2007
All Stories
Catholic pharmacists and the Pope
Duty to the patient or their religion?
Benedict told a gathering of Catholic pharmacists Monday that they have the right to refuse to dispense emergency contraception or euthanasia drugs to people who have been given prescriptions by their doctors. He also said they should inform patients of the ethical implications of using certain drugs.
That's objectionable on many levels. But what next? Will the pope demand that pharmacists ...
Forcing the medical sector to compete for patients
I agree that this would be a helpful approach. I don't see it happening anything soon.
As physician shortages are projected to explode (in primary care anyways), it will be the patients increasingly competing for physicians. For every patient that leaves a primary care practice, 10 more will be in line waiting to sign up.
The system shuts down another PCP
Patients continue to lose, as more of these stories are surfacing:
Lalka, 54, says that with an income of only $60,000 last year, and little opportunity to expand his practice, he no longer is able to make ends meet.
"I am giving up my practice, the love of my life," he said recently as he stared out of his office window . . .
. . . ...
"The best thing this country can do to improve the health care system is to just take better care of itself"
One of the more balanced opinions of our health care systems.
Canadians are willing to jump the queues
If they only could:
* About 71 percent said they would likely or definitely speak to a neighbor who is a secretary at an MRI clinic if it meant getting moved up a list instead of waiting three months
* Some 30 percent would give their surgeon tickets to basketball and hockey games if it meant getting hip replacement surgery faster.
* Just over 50 percent were ...
The overzealous Texas Board of Medicine
Some are saying that the Board is going too far in disciplining doctors and listening to anonymous complaints:
One by one, angry, frustrated doctors from Houston to Laredo took the microphone at a legislative hearing in Austin, spilling woeful tales of overzealous oversight "” grueling, expensive probes, witch hunts, railroading "” allegedly committ(via Every Patient's Advocate)
P4P gone wild in the NHS
Average PCP salary rises to an average of $226,000, most of it due to quality incentives.
Patient perceptions and defensive medicine
One of many reasons why too many tests are ordered:
Some patients have significant misperceptions about the way medicine is, or should be, practiced. Even if these patients have no basis for their misperceptions, all they need to do is complain about an emergency physician and the doctor will hear about it. There is a constant dynamic tension in the ED: administrators and hospital boards want patients to be ...
Should apologies be admissible in court?
There's no real direction on the issue, so physicians often err on the side of secrecy:
"Doctors are very confused," said Dr. Tom Delbanco, an internist at Beth Israel Deaconess Medical Center who recently made a film, "When Things Go Wrong, Voices of Patients and Families. "Some [people] tell them to open their hearts and spill the beans. Others tell them to keep their mouths shut. It depends on ...
The sculpted six-pack
The new rage in plastic surgery:
The suction six-pack costs between $4,000 and $7,000 and is only suitable for certain patients, Aldo Benjamin Guerra, the Arizona plastic surgeon who authored the abstract, told us. "I probably turn down about twice as many patients as I work on," he said. "You have to have a certain amount of fat. If you have too little or too much you're not going ...
Uninsured vets
So much for the pseudo-single payer VA providing universal coverage:
About one of every eight veterans under the age of 65 is uninsured, a finding that contradicts the assumption many have that all vets qualify for free health care through the Department of Veterans Affairs, says a new study.(via The Medical Quack)
Marcus Welby is dead
Older doctors are looking to jump off the Titanic:
When Baby Boom doctors entered medicine they had control over how they practiced and the fee they charged. But the rules changed on them in mid-stream and now many are looking for a ticket out.(via The Medical Quack)
More screening isn’t necessarily better
A mantra I have been preaching for some time. Some untoward effects from newborn screening are starting to be realized:
The recent adoption of widespread screening of newborns for congenital health problems is saving thousands of lives every year, identifying potentially deadly conditions in time to begin treatment. But now, health-care professionals recognize that success has highlighted glitches in the system.
More screening has meant more potential ...
Write 200 prescriptions for a car
Developing countries are ripe for pharmaceutical bribery of doctors:
Gifts include air conditioners, laptops, club membership, domestic cattle, foreign conferences at five-star hotels, brand new cars and school tuition fees, according to the report. Murad Khan, professor and chairman of the department of psychiatry at Aga Khan University, told researchers that in Pakistan "for writing 200 prescriptions of the company's high priced drug, a doctor is rewarded with the ...
Reflecting on the Day of the Dead
Pallimed on embracing mortality as a celebration of life.
Halloween and medicine
Maria does a literature search. Happy Halloween everyone.
No smoking, no health care
height="355" width="425">
(via Catron)
Restless legs syndrome
Disease mongering at its finest?
The impact of foreign physicians
Many would like to see a flood of foreign doctors bring down physician salaries:
In a 2003 study Baker, who is co-director of the Center for Economic and Policy Research, estimates that by adding roughly 100,000 physicians to our current pool of about 760,000, we could pull doctors' salaries down from an average of $203,000 to somewhere between $74,000 and $126,000. For the average middle-class American family of ...
Kevin Pho, MD
-
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...
-
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...
-
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....
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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....
-
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...
-
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...
