The following is reader take by Half MD.
The third Thursday of March each year is Match Day for fourth-year medical students. There are many smiles and frowns made on this day when soon-to-be doctors discover where they will obtain their first job to continue their medical training. While Match Day is the most famous day of the week, Monday and Tuesday are the ...
March 2009
All Stories
Ten top medical blog posts, March 2009
Here are the top posts from this past month, based on the number of times they were viewed.
1. Is Natasha Richardson brain dead? Was an epidural bleed, or "talk and die" syndrome, to blame after her ski accident?
2. Did the Canadian health system fail Natasha Richardson?
3. Dying from cervical cancer, and the questions surrounding Jade Goody
4. JAMA ...
False positive cancer screening tests doesn’t resonate in Congress
Criticizing cancer screening advocates can be a difficult thing to do.
Gary Schwtizer writes about the case of Rep. Debbie Wasserman Schultz (D-Fla.), who is introducing a new bill advocating breast cancer screening to begin earlier than the current suggested age of 40.
Ms. Wasserman Schultz was diagnosed with breast cancer at age 42, and wants "to educate the public, particularly young women and their doctors, ...
Will gross anatomy soon be rendered irrelevant?
Dissecting a human body is messy, smelly, and expensive.
In fact, more medical schools are resorting to so-called "virtual" gross anatomy, using sophisticated imaging and computer programs.
This is a mistake, says psychiatry resident Christine Montross, in a NY Times op-ed. And she has a point.
"Someday, [doctors] need to keep their cool when a baby is lodged wrong in a mother's birth ...
The American Medical Association investigates JAMA, should Catherine DeAngelis resign?
The water engulfing JAMA's editor-in-chief Catherine DeAngelis is getting hotter.
A recap is here, but the Jonathan Leo flap, and subsequent response, is not going away as JAMA hoped it would.
The WSJ reports that AMA, which normally does not interfere in the editorial decisions of the journal, has asked its Journal Oversight Committee to look into the matter.
Over at Respectful Insulance, academic surgeon-blogger ...
Nighthawks, dayhawks, and the demise of the American radiologist
More hospitals are resorting to so-called "dayhawk" radiology services to read their x-rays.
It's modeled after the "nighthawk" model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.
Now, the phenomenon is happening during business hours as well, which according to radiologist Giles W. L. Boland, means that "some radiologists can no longer assume ...
Is banning industry-sponsored CME a good idea?
I wrote previously that pharmaceutical industry influence should be removed from physician continuing medical education courses.
The American Psychiatric Association is taking that recommendation to heart, announcing that it will end industry-sponsored seminars at its annual meeting.
Good for them.
But, I'd be interested to see how many of these professional organizations can survive the funding cut. For instance, the APA stands to lose ...
Why not a down payment for primary care, and problems with the medical home?
Earlier this week, President Obama argued that we need to spend money now, in order to curtail the spiraling costs that Medicare and Medicaid will reap on future generations.
However, when it comes to primary care, the Congressional Budget Office is not so forward thinking: "Savings from some initiatives may not materialize because incentives to reduce costs are lacking. For example, proposals to establish a 'medical home' might ...
Are firefighters becoming too fat?
A study showed that nearly all of recent Boston firefighting recruits were either overweight or obese.
And, of those who were classified as obese, nearly half failed the required treadmill test. Ordinarily, this probably wouldn't make news, as it's well documented how slovenly American society has become.
But, because firefighters do serve a public safety function, it should be noted that they "depended on one another ...
When will we have a safe and effective prescription diet pill?
The first company that comes up with a effective drug for obesity is bound to make billions.
Prior failures notwithstanding, a trio of small pharmaceutical companies are trying to come up with the next great obesity pill. That means clinical studies are ongoing.
So, what's it like to participate in such a trial? Ed Susman, a contributing writer at MedPage Today, was involved in one, ...
A free colonoscopy contest, but what’s the catch?
CBS is promoting a free colonoscopy sweepstakes, which, I guess, is enough of a prize to pique a person's interest during the recession.
But, as Dr. Wes points out, there are serious issues with the contest. First, take a look at the extensive fine print, with not-so-subtly warns that any information given will be shared with advertisers third-parties.
He also wonders about the posh Center for ...
Most hospitals still use paper records, and why money alone won’t solve the electronic medical record problem
New numbers have recently come out, highlighting how low the adoption rate is for electronic medical records in hospitals.
As reported by MedPage Today, the study from the NEJM found that only 1.5 percent of hospitals surveyed had comprehensive electronic medical record systems. That's a piss-poor adoption rate, and far lower than the dismal numbers in small office practices.
The reasons cited are no surprise to ...
Why can’t young doctors intubate patients correctly? Blame television
It seems that residents and medical students are having trouble intubating patients these days.
Apparently, one of the biggest mistakes is positioning the head incorrectly, and the problem is traced back to the television drama ER. When surveyed, most young doctors and medical students cited television as the main source of tips on how to intubate correctly, specifically, ER.
But when researchers ...
Mid-levels for primary care, but not for surgery?
Do most surgeons think mid-level providers can replace primary care physicians?
That much was implied during recent testimony by the American College of Surgeons' John Preskitt, who said, "With trauma care and surgical emergencies, there are no good substitutes or physician extenders for a well-trained general surgeon or surgical specialist."
The ACP's Bob Doherty took that to mean that there were good substitutes for primary ...
Why is Sweden allowing murderers and rapists to become doctors?
Should a convicted murderer ever be allowed to become a doctor?
Lawrence Altman writes about the strange situation in the NY Times, where, after a convicted murderer was expelled from Sweden's most prestigious medical school, was admitted to a second medical school.
Dr. Altman also points to another case, where a medical student, convicted of rape, was only expelled after exhaustive court action.
What's going on ...
Op-ed: Unbiased research for doctors is good medicine
The following op-ed was published on March 26th, 2009 in the USA Today.As a primary care doctor, I am frequently faced with decisions where the choice is not always clear. Do the latest, more expensive drugs work better than the less costly, older medications? Will ordering an MRI help me treat a patient's lower back pain? Often, the answer to these questions is, "I'm not sure."Because ...
USA Today op-ed: Will comparative effectiveness research help patients?
My latest USA Today op-ed was published this morning: Unbiased research for doctors is good medicine.
I talk about comparative effectiveness research, which was recently allocated $1.1 billion in the recently passed federal stimulus package.
How will it help patients? What are some of the obstacles that may impede the ...
Death of the drug rep, and who will take their place?
Representatives from drug companies are undergoing some hard times, as physicians increasingly are closing their doors to them, or seeing them only via an appointment.
Subsequently, the number of drug reps is predicted to fall from about 102,000 at its peak in 2007, to 75,000 by 2012.
There are a variety of reasons for this, including the fact that more doctors simply don't trust the information that's ...
Create and control your online presence, and I answer 10 questions about heath care blogging
A couple of interviews I recently did have been published.
Over at Modern Medicine (via the Cosmetic Surgery Times, of all places), I talk about pro-actively creating an online presence, and how it can make or break the marketing of your practice:
"Patients are eventually going to find you on the Internet," whether or not you have actively established your Web presence, Dr. Pho points out. ...
Who’s ranked above a full professor at Harvard?
"God."
So says famed Harvard psychiatrist Joseph Biederman during a deposition investigating whether his drug research results were biased in favor of his funder's interests. Was his research supporting the use of antipsychotic medications in children with bipolar disorder tainted?
Certainly, in light of recent events, combined with the pressure on academic physicians to produce studies, established research is now being called into question.
Kevin Pho, MD
-
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...
-
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....
-
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...
-
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
-
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...
-
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. ...
-
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....
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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....




