Courses at almost $1,000 a pop are moneymakers benefiting from the byzantine coding rules.
November 2007
All Stories
Colostomy gone wrong
A malpractice suit alleging a botched colostomy reversal that led to "passing gas and liquid stool from the penis."
Coding complexity redux
Sometimes you need a math degree to analyze RVU values.
JCAHO hoop of the week
"Sometimes I wish stupidity were painful."
Residents
Two approaches, with markedly different results.
Medical school admissions
Some common-sense talk.
Unsavory specialists
"Don't refer to them in the future" isn't really good advice for a PCP.
"Standard of care changes every few years"
Precisely the problem with government regulation, which is slow to keep up.
Extra time
Time spent on the patient outside the office visit is common, and often not compensated.
PDAs for physicians
PDAs are going out of style. My Dell Axim broke a year ago, and I have yet to replace it.
Clinical Cases with a couple of suggestions to replace your PDA.
Hand wipes and alcohol abuse
Temptation of alcohol in the hospital?
The alcohol in infection-control hand wipes used in hospitals and nursing homes may entice alcoholics or be a risk for confused patients, researchers here found.
In a search of a toxicology database for poison-control reports related to children and adults exposed to alcohol hand wipes after their use became widespread, 66% were thought to result from intentional abuse
Daniel Carlat goes counter-detailing
"Dr. Drug Rep" is going on a mission to give evidence-based drug talks to physician offices:
I received many helpful suggestions for how to part with my "dirty thirty." I've decided that the most logical solution is to donate time to "counter-detailing," which is essentially the opposite of giving drug talks. Pioneered as "academic detailing" by Jerry Avorn at Harvard Medical School, counter-detailing involves visiting doctor's offices and teaching ...
"10 Things Your Primary-Care Physician Won’t Tell You"
I was interviewed for this article in SmartMoney Magazine, which is now online:
Interest is so low that the number of primary-care internal medicine residency positions dropped by more than 50% in the past decade. "We're not really getting the best and brightest in primary care," says Kevin Pho, a Nashua, N.H., physician who writes the blog Kevin, MD. "And that's where they're needed." . . .
. ...
Nosebite
How to write off a $1.2 million hospital bill
Get your story published in the WSJ.
Grady Hospital: "The slowly-boiled frog"
If this is how the government treats a safety-net hospital, I'd hate to think what would happen if they were responsible for all our health care.
Penalized for appropriate coding
EMRs are causing physicians to code appropriately, and resulting in higher payments. So why are doctors being penalized?
Vicodin ES #180, 1 tab q4hrs prn pain x 4 refills
Who's comfortable writing something like this? According to The Angry Pharmacist, some physicians are.
Thought Process
A Sid Schwab short story.
Virtual hip replacement
Now's your chance to be a surgeon.
(via ScienceRoll)
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...
