I've always thought that good bedside manner, like personality, is something you can't learn.
So did Pauline Chen, but in her latest NY Times piece, she talks about a study that show us otherwise.
After an 18-month period where doctors met twice a month to practice skills designed to enhance compassion, or "reflected on their own work through discussion and narrative writing," they outscored the controls ...
January 2009
All Stories
Cello scrotum, published in the BMJ, now revealed to be a hoax
The interesting journey of so-called "cello scrotum" has come to an end.
Inspired by "guitarist's nipple," which is a real disease caused by irritation caused to the breast from guitar playing, a doctor submitted the spoof 34-years ago to the British Medical Journal.
Described as "chafing of the scrotum when the instrument was placed between the cellist's legs," the author of the hoax decided to come ...
A concierge ER, or, can EMTALA-free, cash-only emergency departments save hospitals?
Given the financial trouble many ERs and hospitals are facing, concierge emergency care may be on the horizon.
Richard Winters (via GruntDoc) imagines such as scenario, which for a fee, patients receive private rooms, couches and chairs for family, private telephones and internet service, flat-screen television, and events to meet the hospital administration and physicians.
As long as every cent continues to be squeezed out of emergency ...
What’s the equivalent of 911 in Mumbai, India?
Most cities take emergency medical services for granted, but in Mumbai, they're starting from scratch.
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How many babies can one woman carry?
That's a question I was asked more than once, in light of this week's story about the birth of octuplets.
For the answer, I'll refer to this article in Slate. The largest reported number of fetuses in a single womb is 15.
The limit is not so much the number of fetuses, but the combined size and weight. As Christopher Beam explains, "once the total ...
Lost tampon? A doctor with tips and advice on what to do
Internist Doc Gurley confronts "the world's most mysterious medical problem" with an educational video, complete with tips, advice, and a pulsing soundtrack.
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(via ChronicBabe and Duncan Cross)
The lifelong effects of a concussion, can just one hit result in permanent damage?
Researchers are calling recent findings the tip of the iceberg.
MedPage Today reports on a paper from Brain, showing that players who suffered a single concussion playing college-level sports had "greater declines in attention and memory and a slowing of some movements more than 30 years later compared with those who never had a concussion."
The National Football League is currently conducting its own study, ...
Unable to provide proper patient care, emergency doctors are suing the state of California
Emergency physicians are forced to see every patient, and thus, are at the mercy of cutbacks in California's Medi-Cal reimbursements.
Often times, they are paid at half the cost of treatment. With well-publicized stories of patients dying in the waiting rooms, or while waiting to see a physician, doctors are responding by suing the state for $100 million because additional funding is needed to maintain patient safety. ...
How the Office of the Inspector General is investigating end of life care
Imagine if you're the attending on record in the ICU, and find that the federal government is investigating your care in end of life scenarios.
Pallimed discusses an article detailing that exact circumstance at a VA hospital.
Although they found no wrongdoing, they did find "significant variations with the interpretation of appropriate end of life management in the ICU, and recommended the establishment of new guidelines."
Will specialists sacrifice to pay primary care doctors? Are budget-neutral changes the only option?
Both the AMA and ACP advocate against budget-neutral solutions to fund primary care.
In an ideal world, that would be the optimal solution. But I don't see it happening, especially with traditionally physician-antagonistic Democrats controlling Congress, and the fact that we're in a recession.
Rather than start another specialist versus primary care battle, I simply want to acknowledge Bob Doherty's point that budget-neutral changes that benefit ...
HealthCentral buys WellSphere, but did they get a lemon?
The medical blog aggregator WellSphere has been coming under fire for distributing blogger content without sharing traffic or revenues with the authors.Â
Online health site HealthCentral recently announced that it was buying WellSphere, as the consolidation in online health sites continues. Â
Val Jones writes about the treatment she received from WellSphere, and discusses the controversial fine print in the Terms of Service agreement. Â She also notes a ...
Medicare covers more cancer drugs, did they cave in to the pharmaceutical lobby?
Medicare recently expanded their coverage for off-label use of cancer drugs.
These medications are among the most expensive, and especially in cases of end-stage treatment, there may not be a lot of evidence supporting their use.
For the most part, oncologists and patients (via the WSJ Health Blog) have hailed the decision, but others say that the increased ability to give off-label drugs "let physicians avoid ...
Beware of Clostridium difficile hospital outbreaks
Clostridium difficile, or C. diff, is one tough bug.
A study looked at how the bacteria is spread (via Hospital Medicine Quick Hits) throughout the hospital during an outbreak.
Disturbingly, it was found in 15% of non-isolation patient rooms, 31% of physician work areas, and 21% of portable medical equipment, including pulse oximeters, medication carts, and bar code scanners.
The moral? Wash your hands ...
Can you find a kidney through a Craigslist personal ad?
Patients are circumventing the traditional waiting time to find an organ donor by using Craigslist.
In some cases, years have been cut off the waiting times. But are hospitals prepared for the legal and ethical questions that accompany such a non-traditional means of organ donation?
Few medical institutions even consider such cases, with only 10 percent of transplant centers willing to do cases from an ...
What are the recommended vitamins that patients should take?
Recent studies have disproved the benefit of taking many vitamins.
Internist Matthew Mintz goes over the data, and finds that vitamin E has not been shown to improve dementia, and vitamin C does not prevent colds.
Some, like increased doses of vitamin A, can be even dangerous and increase the risk of death.
This is what works: i) folic acid for pregnant women, which prevents neural ...
Should parents who refuse to vaccinate their children be held accountable?
The return of diseases that were previously eradicated is an emerging public health emergency.
Minnesota is currently dealing with an outbreak of Haemophilus influenzae, a disease that should have been eradicated with the appropriate vaccine. There were 5 confirmed cases, with 3 children not vaccinated against the disease.
A 7-month old infant tragically died, becoming the first Haemophilus fatality in the state since 1991.
Two physician-bloggers ...
The sad state of pediatrics in California
What did you expect?
Despite a marked population increase, hospitals are contracting pediatric beds, forcing patients to travel longer distances for hospital care or be admitted to a hospital hundreds of miles from home.
The simple reason is money.
Pediatric reimbursement rates in California rank dead last in the country, and hospitals are shifting their resources into more financially viable services, like adult care. And this ...
Restricting resident work hours leads to a shortage of surgeons
Surgical residents in the United States are currently restricted to working less than 80 hours per week.
If you think that's extreme, consider what's happening the UK, where surgeons are capped at 58 hours per week (via Dr. Wes). Furthermore, that cap is set to go down to 48 hours.
Apparently, these caps are rarely enforced, as "only 25% of surgeons think their human resource ...
How should we pay for primary care?
There's little doubt that strengthening our primary care system is a priority in health reform.
But how do we pay for it?
The WSJ's Ben Brewer (via the WSJ Health Blog, which has an excellent discussion in the comments) comes up with a few ideas, and not all of them are going to go over smoothly.
One involves moving money earmarked for the Medicare Advantage ...
Should pediatricians care about the manners of children?
Some say the Miss Manners approach to parenting is outdated.
But rename "manners" to "social skills," a popular buzzward in autism circles, and things change. Pediatrician Perri Klass wonders about some of the rude kids she sees, "and when you are in the exam room with a child who seems to have [no manners], you begin to wonder what is going on at home and at school, ...
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...
