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 ...
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 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...
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Doctors: Don’t be ashamed about going bankrupt
Are doctors really going broke? According to this piece from CNN Money, some are: "Doctors list shrinking insurance reimbursements, changing regulations, rising...
Physician
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Patients will understand an honest mistake if the doctor tells the truth
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned...
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Diagnosing an illness is an art
Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. ...
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Physicians have a natural role as advocates
As physicians, we are often called upon to be advocates for our patients. Sometimes they have no other person to turn to....
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Our society expends huge sums on futile care
Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for "feeling good", but...
Patient
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How will the Baby Boomers age and die?
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in...
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Patient engagement is the holy grail of health care
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a...
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Why do doctors delay hospice referrals?
This is a response to Deb Discenza's article requesting a one page informational sheet informing a patient about hospice or palliative care. This would...
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How touch can calm patients
So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence. The following passage really caught my attention: "Question is: are...
Policy
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Improve patient safety to improve healthcare quality
It has taken 13 years for us to revisit the issues in To Err Is Human, the 1999 landmark government report that...
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A lack of incentive for medical schools to train primary care doctors
A social media movement is happening before our eyes with action starting to take shape. The #occupyhealthcare movement has begun within to...
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What should be the stated aim of health care in America?
The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering...
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How Moneyball applies to healthcare
The storyline is familiar. An organization is challenged to achieve better results without spending more money. An executive is committed to obtaining...
Tech
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New classes of devices to diet and exercise
For many celebrities, their livelihoods depend on their physical appearance and they rely on armies of personal assistants, schedulers, stylists, trainers and...
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Repetition is the curse of the doctor-patient engagement
How many times as a doctor do you ask the same questions over and over again as part of the routine process...
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Why the prognosis of patients is difficult
Many clinical decisions in older persons are dependent on life expectancy. For example, as life expectancy declines, cancer screening is likely to...
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Innovative technologies can markedly enhance safety
“To Err Is Human” is the title of the now famous book from the Institute of Medicine on patient safety published about...
Social Media
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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...
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Twitter Is my third office location
The physician’s decision to first dive into social media can be stress-inducing. Issues of time management, maintaining professionalism, and determining a return...
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The impact of social media on a physician assistant
The impact of social media on medicine could arguably be compared to the impact of the industrial revolution on the human condition....
