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March 2008
All Stories
Lamp oil
Keep it away from babies.
Urinary retention in a 14-year old
Re-using single-use instruments
Dr. Wes: "If re-used instruments are being used in a laboratory, I believe that patients should be made aware and have this included in their informed consent, with any potential risks spelled out. Further, if a patient knew they could apply some of the cost savings of re-processing toward their procedure costs, then perhaps they'd be more willing to agree to the practice."
Spiriva and the FDA
Matthew Mintz: "The FDA release give such little information that your doctor will not likely be able to tell you much more, and may suggest stopping it simply because he or she is too worried about getting sued."
Full disclosure and bias
Daniel Carlat: "But a funny thing happens on the way to CME programs: even with full disclosure, they continue to be commercially biased. Why is that? Why doesn't disclosure solve the problem?"
Pay primary care by the hour, again
One of Graham's suggestions to fix primary care:
Pay primary care doctors for their paperwork"“and I think it would pay primary care doctors better, allow them to provide better care for their patients, and encourage more medical students, residents, and other already-trained doctors to go into the field.
Allergic to water?
Jeffrey Benabio: "The allergy is a rare condition called aquagenic urticaria. People who have it develop intensely itchy, even painful hives when their skin comes into contact with water. The itchy wheals or hives develop within minutes of exposure and can persist for hours afterward."
OpenEMR
The best and the brightest
Are going into dermatology:
The vogue for such specialties is part of a migration of a top tier of American medical students from branches of health care that manage major diseases toward specialties that improve the life of patients "” and the lives of physicians, with better pay, more autonomy and more-controllable hours.
"It is an unfortunate circumstance that you can spend an hour with a patient treating ...
My take: NPs, solving health care, generics vs brand name drugs
1) Marcia K. Flesner responds to my op-ed, commenting that I "failed to give a solution" and how nurse practitioners are the answer.
My take: Perhaps she neglected to read the section after I wrote, "How do we fix this problem?"
Our nurse practitioner colleagues play a vital role in health care delivery. Asking them to take over primary care as a permanent solution is not the ...
Congrats Shadowfax
Bald for a good cause.
"This guy really meant it"
Suicide attempts and emergency treatment.
Medical school debt
Graham Walker: "Maybe we make it a choice. You can choose to pay full price, or pay no price, with either a guarantee that you make less money for life or have required service time for the country."
If you have good credit, and balls of steel, many a medical student have engaged in credit card arbitrage (i.e. shifting loans between 0% promo-rate credit cards) for 0% ...
Hospitals buying the news
Blurring the line between reporting and advertising.
Palliative surgery
Sid Schwab: "Nobody wins much, and it often challenges one's ability to think clearly, let alone to tell the truth. Sometimes, I think, it borders on the deceptive; it makes me wonder who's the object of comfort. And yet, when there's nothing else to do, it's often just the right thing. I hate it."
Is supply really to blame for health care costs?
The Happy Hospitalist: "I think supply is the result of the demand, which is a result of the open spigots of money paying for our unmanaged expectations of our medical culture."
Defense expert on the Ritter case
Samuel Shubrooks thinks the case was about the money.
The male primary care physician
Endangered: "'We're a dying breed,' says Dr. Ian Young, a 39-year-old family physician in Barrie, Ont.
Young is among a minority of young men choosing to go into family practice, where women already make up half of doctors and will soon dramatically outnumber men. Two-thirds of residents in family medicine are female, according to the 2007 Canadian Medical Education Statistics."
A sleeping-pill "junkie"
Laurie Sandell: "Several times I had tried to quit by using sheer willpower: Usually by day three I gave in. "F"”k it," I would say aloud, twisting the cap off the bottle with force and tossing the pills into my mouth. I'd quit at some point in the future: when I didn't need to get up early for work, when my life became more serene, when I had a ...
Kevin Pho, MD
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Why Priscilla Chan may become the country’s most influential doctor
Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from...
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Confused about prostate cancer screening? Make a shared decision
In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men. Case closed, right? Hardly. The prostate...
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When it comes to doctors and social media, hospitals fail miserably
When it comes to medicine and social media, much of the attention is negative. Doctors losing their hospital privileges because of Facebook....
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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...
Physician
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Why test recalls should not be considered cheating
I was appalled recently by the coverage of radiology “test recalls” by CNN, amplified by Dr. Gary Becker of the American Board...
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Why physicians are susceptible to hardball tactics
I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the...
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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...
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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What should America’s health care vision be?
America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the...
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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...
Tech
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When patient care becomes secondary to filling out the medical record
The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above...
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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...
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...
