Or as the Boston Globe says, "Americans may be too fat, but at least their cholesterol is low."
December 2007
All Stories
The nuclear isotope shortage
Nuclear scans around the world are being put on hold. A look at the Canadian politics behind the situation.
The government has already proven itself
A small sample of what will happen once we hand over the healthcare reins to the government:
Perhaps we could give the government a trial run as a healthcare insurer by letting it handle a smaller prototype to see how it would do. Oh, wait. Medicare reimbursement is going to decline 10 percent (did any of my expenses decline 10 percent last year?); our local government-run city hospital ...
Mammogram accuracy
Apparently, it varies by radiologist:
They found that sensitivity -- the ability to accurately detect cancer -- ranged from 27 percent to 100 percent. False positives ranged from 0 to 16 percent.Those are some pretty big ranges.
Those who support Medicare-for-all
Conveniently forget how we got to this mess in the first place.
Nursing home care
In some cases, it's a disgrace:
The staff in nursing homes are very poorly paid, therefore you can't attract and retain high quality people - for example: a nurse my hospital fired for falsifying documentation and coming to work with alcohol on her breath now works at the local SNF. Those corporations are going to hire the minimum amount of staff they can get away with.
Obama vs the liberal bloggers
Anyone who takes on Paul Krugman gets high marks in this corner. Obama did, and now is facing the wrath of the progressive bloggers. See how this is a good thing:
Obama's greatest strength may be in understanding the views of other political groups far better than those who attack him. Seeing Obama pursue a liberal agenda while still managing to differ from the orthodoxy of the Democratic ...
Eli Lilly and risk management
Daniel Carlat uncovered a potential scandal. Roy Poses with further analysis:
It seems that many trusted medical or health care institutions are now connected to some favored health care corporation(s), and many physicians, academicians, and academic, government, and not-for-profit health care leaders have part time gigs for such companies. The complexity of such relationships sometimes defies understanding. Who can you trust? Who really is for patient care, education, ...
The RUC is responsible for the destruction of American health care
With a disproportionate composition of sub-specialists, this shadowy group is skewing the reimbursement pot against primary care:
The story of the RUC often reminds me of conspiracy theories. They (we never really know who they are) determine the fate of the world (or at least the economy). The RUC has disproportionate power and has apparently taken a reasonable idea (RBRVS) and may have corrupted it.
Licensing drug reps
Washington DC is thinking about this. A good step if it goes through.
Dead en route to the ER
The decision whether to bill for the encounter or not.
Striking a nerve
Scalpel, as always, does a good job of that.
Too many doctors?
Dartmouth has long advocated that there are too many physicians. Perhaps some clarification is in order. There are too many proceduralists, not enough generalists. If primary care is appropriately incentivised and its numbers increased, the cost problem will be solved right there.
29 chest x-rays, 9 CT scans
All for one patient in one year. No wonder the system is going bankrupt.
The two types of people that exist in the world
Those that make money and those that cost money. Where do physicians fit in?
OTC statins
Third time the charm?
The "mid-adult woman"
Political correctness run amok at Merck.
Circumcision and the rights of baby boys
Is the procedure a human rights violation?
Full body scans
"At best useless and at worst dangerous."
Is universal health care immoral?
Lin Zinser and Paul Hsieh argue this point.
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...
