". . . how in the hell is it going to run our entire health care system that comprises approximately 15% of our nation's GDP and has much more at stake than a badly done New York Strip?"
(via The Happy Hospitalist)
June 2008
All Stories
Boss
How doctors can be good ones.
Your first attending gig
Shadowfax with sage advice. A must-read for those graduating residency.
How David Catron would fix health care
That all looks good to me.
When you know we’re in a recession
ER Stories: "I can now get a plastic surgeon to come in for a simple 1"³ lac in the blink of an eye! . . . Some of the new guys are trying to take EXTRA call would you believe! If one guy 'steals' as case from the guy on call, all hell may break loose!"
Impossible intubation . . .
. . . and the not-on-call ENT physician who saves the day.
When you go above and beyond . . . and still get sued
A physician is sued, against the patient's wishes:
You are the reason I am standing here today, the reason I'm not dead. I do not want you to be named in the lawsuit."
I thumbed through the chart, gathering my thoughts to come up with a careful answer. His words surprised me only a little, and I chuckled inside the way one does after locating a lost wallet ...
How do you remove a nail from the skull?
With a hammer, of course.
Steven Nissen was wrong about Avandia
Dr. Mintz: "Between RECORD, ADOPT, DREAM, ACCORD and VADT; there have been over 26,000 patients studied for over 3.5 years, of which more than 15,000 patients took Avandia and showed absolutely no difference in heart attacks or myocardial ischemia. I think it is clear based on the inherent limitations of Nissen's findings and the substantial evidence from the aforementioned studies that Avandia is not, and has never been associated ...
A genetic test to identify smokers who will develop lung cancer
Doug Farrago: "The bottom line is that those who choose a suicidal lifestyle like smoking already know the answer to stopping their impending cancer. I guarantee quitting smoking is a better predictor of those not getting lung cancer than this genetic test."
Can Viagra enhance sports performance?
Roger Clemens thought so:
Some athletes may have turned to Viagra to increase stamina. A study in the the Journal of Applied Physiology found that Viagra helped improve lung function and blood flow to cyclists' muscles during training at high altitudes.
The MGH psychiatrist scandal
Akin to money laundering?
Why it is so easy to onder unnecessary tests
Ten out of Ten: "While the justification to withhold testing tends to be nebulous and distant, the reasons to just go ahead and order the scan are anything but, surrounding me in the ER. And while no one has ever thanked me for not ordering a test, failing to order one on the wrong patient would result in people lining up to publicly speculate as to ...
Inevitable
Sid Schwab: "Despite the inevitable comments that doctors are overpaid, ego-driven, profit-taking purulent pustules of putrefaction, isn't it logical to think that we're heading for trouble? Is it reasonable to think there's a point, for even the most selfless of people in any walk of life, at which the graphs of increasing hassles and of decreasing rewards (monetary and otherwise!) cross, and drive current workers out and turn away ...
"Tell me about your health"
See where open-ended questioning leads to.
Diabetes Reloaded
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(via Diabetes Mine)
General surgeons as "internists who can operate"
A dead breed?
Medical marijuana and college students
Theresa Chan: "Another problem associated with liberal marijuana prescribing is the impact on local students. Our local state university campus has the highest drop-out rate of all the California state universities. I know an administrator at the university, and she has told me that the school has no effective statistics to track why students drop out, but she suspects that many of them just stop showing up ...
A quarter of medical students don’t match in Air Force residencies
Half MD: "That's a pretty disheartening statistic to read, especially given that more than 94% of applicants match through the civilian route. I remember being a naive pre-med who bought into the lies told by recruiters that 98% of medical students enter the specialty of their dreams. If I had known then that I'm about to spend several years as a general practitioner, I never would have accepted the ...
The illusion of virginity
The issues surrounding hymenoplasty and Muslim women.
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...
