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
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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...
