The following is a reader take by Mark Herrmann.
Last month, the Supreme Court held that manufacturers of medical devices approved for marketing by the FDA through the "pre-market approval" process generally cannot be sued by private plaintiffs. The medical device industry hailed that decision. At long last, companies that ran the regulatory gauntlet of FDA approval would no longer have the FDA's decisions ...
March 2008
All Stories
Fear and "condition branding"
Shannon Brownlee: "By constantly reminding us to be on the lookout for illness, doctors and the media have made many Americans feel more anxious. I'm not so sure their warnings have made us any healthier, but they have decidedly eroded our sense of well-being. We worry about every ache and pain; we fret that the least little sign of sadness in a teenager is a symptom of clinical depression. ...
Dosing infants
Can be tantamount to guesswork.
Tanning industry
The new Big Tobacco?
What do Schering-Plough and Spitzer have in common?"
"Both had high-priced whores who turned on them in the end."
Search for a defibrillator magnet
Shadowfax: "Long after the patient had basically expired, long after his heart had lost the ability to beat in any sort of functional pattern, the silly thing kept pacing away and periodically issued a shock, which caused the patient's body to twitch in a manner most distressing to the family."
The fallacy of "more medicine"
Unnecessary tests for no reason simply leads to more invasive diagnostic studies.
Anal retentive . . .
. . . or simply a good surgeon?
Part-time doctors and the physician shortage
An increasing number of part-time physicians are leading to access problems. Is this shades of what's happening in Canada?
Rural medicine
Even loan forgiveness may not be enough to lure doctors.
Hospitalists and referrals
The Happy Hospitalist: "Hospitalist medicine has changed the landscape. New relationships are being formed. Based on respect instead of fear and ass kissing. Some will survive. Those that don't accommodate will die the way of the dinosaur. You could, in fact, say that these are market forces creating respect where none previously existed."
Vytorin: "No added benefit"
Ouch. (via Peter Rost)
Cardiologists doing primary care: "You’re not very good at it"
#1 Dinosaur: "Don't go ordering lipids (which I just did a month ago) and prescribing Chantix (which I've already given him twice) and basically trying to do Primary Care. You don't know what you're doing, and you don't even realize it."
Customer satisfaction
Associating it with job security is simply wrong:
Just telling someone off when they deserved it and not dispensing dilaudid like a dealer should not be grounds for termination in my book.
Surrogate mothers
Newsweek: "Surrogates challenge our most basic ideas about motherhood, and call into question what we've always thought of as an unbreakable bond between mother and child. It's no wonder many conservative Christians decry the practice as tampering with the miracle of life, while far-left feminists liken gestational carriers to prostitutes who degrade themselves by renting out their bodies."
Unnecessary ambulance calls
Washington Post: "The ambulances come screaming down city streets, rushing on calls to burst boils, clip hangnails and check on smelly body parts. At the cost of $700 a visit . . .
. . . Thirty people accounted for 2,400 emergency transports last year."
(via a reader tip)
"The primary care physician has become a classic immigrant position"
David Williams: "A low-paid, unattractive job that Americans won't fill." (via DrRich)
Alternative medicine
Panda Bear: "Expensive, carefully constructed placebo."
Disband the RUC
Jay Parkinson: "If the total number of healthcare visits in the US are 75% primary care visits, 75% of the docs on the RUC should be primary care docs."
Divided America
Why health care reform can never be enacted:
We've circled back to the notion that "the U.S. is different." And once again, that "difference" is not to our credit. Reinhardt is predicting that we cannot"”and will not"”pull together to create and finance a high-quality healthcare system for all Americans because we don't identify with each other. Instead, we live in our separate pods, defined, to a large ...
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...
