CBS News with a piece wondering if military and VA physicians should continue to be protected from medical malpractice under the Feres Doctrine.
January 2008
All Stories
Was Glaxo tipped off to the Nissen crusade?
The GSK mole: "Why I sent it is a mystery. I don't really understand it. I wasn't feeling well. It was bad judgment."
A bigger carrot
Someone gets it. To make a difference about quality, you have to make it worthwhile for the physician.
Teleradiology
Bob Wachter: "The growing teleradiology trend, driven by the fact that the same technology that allows me to read my films without going to the radiology department also allows a radiologist in Banglaore to read a film as easily as a radiologist in Bangor. The Indian radiologist earns one-tenth of what the U.S. radiologist earns. If my experience in visiting Radiology World tends to be of the positive, collegial ...
The stoned 6-year old
Great case from the Stanford ER.
Taking aim at P4P
Dr. Wes: "But perhaps a better word for this incentive program is not a reward, but a bribe to do more testing and mindless documentation. Worse, maybe this money is really a kickback scheme to reward the large hospital-owned primary care physician groups (with whom they have contracts); the same groups who already have electronic medical records and teams of gnomes who can sift through these electronically-identifiable 'quality' measures."
Vaccine-autism link, not
Another study debunks the myth. Hear that, Eli Stone?
Paying to remain uninsured
My opinion on individual mandates is "evolving" (as they say in politico-speak). I previously supported an individual mandate approach to universal care, as practiced in Massachusetts. At the time, it was a preferred alternative to the other solutions, such as single-payer or Medicare-for-all. The focus on personal responsibility and encouraging the consumer to contribute to health care costs appealed to me.
Seeing California's attempt fail miserably, ...
How the deck is stacked against patient apologies
A doctor apologizes to the patient, and gets reamed for it:
I can't see where the legal system has helped medicine that much. I'm certainly dismayed to work in an environment where I can't say I'm sorry without first considering the legal ramifications of doing so. Lawyers have succeeded in sucking the notion of friendship and genuine relationship between doctor and patient entirely out of the equation. ...
Universal coverage or cutting costs
Choose one or the other, because you can't have both:
Universal health care has a basic and fatal flaw, you can't simultaneously reduce the cost of a service and increase access to it. If you have universal access, you have to find a way of paying for people to get that access, which raises costs. If you want to keep costs down you can only economize so far before ...
HRC and Barack, are you listening?
AAFP: "The Massachusetts Health Care Reform Plan addresses one critical component of health care reform -- insurance coverage. Without an adequate supply of primary care physicians, however, the plan cannot guarantee timely access to care, creating a gap between coverage and actual provision of services. As a result, waiting times to see a primary care physician can amount to weeks and even months in some instances."
Doctoring by email
A variation on Jay Parkinson's practice, this physician eschews insurance for an internet-based approach to primary care. Wave of the future, or a niche market?
1 physician: 60 inpatients
That's freakin' scary.
EMTALA and "social admits"
Scalpel: "'Social' admits to the 'no-doc' admitting staff are usually about as welcome as a fart in an elevator. Particularly when they are unfunded midnight weekend language-barrier system-abusing complicated social admits of questionable medical necessity.
When patients like you get admitted, you tend to be challenging for the hospitalists to discharge too, so you end up receiving much more medical care than the emergency stabilization which is mandated ...
Why do some physicians embrace alternative medicine?
Partly because of cognitive dissonance and the "conversion phenomenon". #1 Dinosaur with more.
Who’s the President?
Depends on what kind of patient you ask.
Historical medical photographs
Part of a collection stored on Flickr.
(via Healthbolt and Medgadget)
Medicare denies too
Much has been made of Medicare's "vaunted" ability to pay on time. Well, stories like these are not uncommon:
Each time the couple submitted the bill for Terry's procedure, it was rejected. Each time, Medicare would say it wasn't the couple's primary insurer, and each time, the Sampsons would insist it was.
And so it went, month after frustrating month. Harold Sampson said he had the doctor's ...
A joint a day
May be as bad as a pack of cigarettes when it comes to lung cancer.
Template-driven EMRs
Attack of the clones: "What I see constantly when I receive EMR records from other practices (where the patient was first treated elsewhere and the treatments were not successful so they are now coming to me) is that the patients look identical. That is - I can see histories populated from checklists and quick electronic choices . . . The diseases all look the same. There ...
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...
