ER and Scrubs get positive comments, while House, M.D. gets almost universally panned.
MedPage Today performed a survey showing that 90 percent of respondents felt that medical shows on television impacted the doctor-patient relationship.
It's interesting to read the almost universal condemnation of Fox's House, M.D., saying that the show "gives a very bad name to physicians and the ...
April 2009
All Stories
The dynamics between the surgeon and anesthesiologist in the operating room
A surgical procedure is truly a team effort.
Along with support staff, the patient outcome depends on how well the surgeon and the anesthesiologist work together.
Dr. T provides a fascinating account of the issues that she faces when behind the screen, and indeed, there is a spectrum of surgical personalities she has to deal with.
Although noting that some surgeons have the patient's best interests ...
Did the pharmaceutical industry pressure CBS to pull a television pilot?
With the decline in network television viewership, sponsorship dollars become more important.
Showtime, the premium cable network, recently canceled a Tim Robbins pilot (via Schwitzer), a show that took a "scathing look at the pharmaceutical drug industry, focusing on a dysfunctional family behind a major drug concern."
It was considered a shoo-in to be on the schedule, so the move came as a surprise.
Showtime's owner ...
Should patients own their medical records?
Personal health records have been in the news lately, with the focus on how inaccurate they can be.
Should patients have complete access to medical records at their physician's office or hospital?
Primary care doctor Rob Lamberts offers some thoughts on the subject. There are some parts of the record that patients shouldn't read. "What if someone comes into the office with a child and I have ...
6 top medical comments, April 19th 2009
Here are some of the more interesting comments readers have left recently.
1. Manalive on quality measures:
It is almost always a leap of faith to apply evidence-based guidelines to the frail elderly, to patients with many medical problems, to alcoholics, to the poorly insured -- in short, to a large percentage of my practice. Accordingly, I have been on the wrong end of too many ...
New reader welcome
Welcome to KevinMD.com, where you'll find opinion, commentary and news from the perspective of a primary care physician. You can read the About page to find out more about me.
Your readership is valued, and I'd like to go over some of the ways you can explore the blog.
Subscribe. Content can be e-mailed to your inbox. Simply enter ...
How to pimp, or, mastering the art of Socratic questioning
Nothing makes a new medical student more nervous than answering a series of medical questions from their attending, known as pimping.
There is a definite art to the tactic. Ask too many questions based in triviality, it can be interpreted as intimidating. However, used correctly, it can be a valuable learning tool.
Over at orthopedic blog Them Bones, we have a detailed history of medical pimping ...
Why health reform is going to be difficult, and the trouble with saying no to American patients
How do we control health spending?
Most strategies boil down to eventually restricting care, for instance, not paying for treatments that haven't been shown to work on a macroeconomic level. That may make sense when you're talking numbers and statistics, but there will be real lives at stake when reform takes hold.
Economist Arnold Kling understands what must be done, but imagines a scenario where his ...
Are the elderly more technologically plugged in than doctors?
Almost half of patients over the age of 65 use the Internet.
Contrast that with the percentage of doctors who use computers in their offices or in hospitals, which is a number hovering around 20 percent.
Of course, that doesn't mean doctors, in general, are computer Luddites. On the contrary, there are many who are trying to push the envelope, integrating the latest in social ...
Turning a cast into a work of art
Who knew that a broken wrist could be turned into a thing of beauty?
(via Street Anatomy)
A 48-hour physician workweek will kill patients
How dramatic.
But it's also true. Stateside, we're already dealing with the repercussions of restricting residents' work to 80 hours per week or less.
The UK is going several steps further, but restricting all doctors to no more than 48-hours of work a week.
First off, there are no studies that suggest restricting work-hours improves patient care. Whatever patient safety gains are made ...
Vitamin sales are booming at the expense of prescription drugs
The recession is forcing people to look for ways to cut their health care costs.
One unfortunate method is bypassing physician visits and prescription medications in favor less expensive vitamins and supplements.
According to the NY Times, here's a typical example: "In flusher times, Ms. Parham said, she spent $50 a month on prescriptions for her asthma, allergies and other chronic problems. Now, she pays $6 a ...
Can the stimulus money save or worsen health care IT?
Billions of dollars are going to be spent modernizing our antiquated medical record system.
However, if these new digital systems fail to talk to one another, it's simply going to balloon costs.
Consider this example, which occurs pretty commonly. A man is urgently rushed to a hospital 25 to 30 miles away from the one he normally goes to. Both hospitals have EMRs, but because they ...
Brain ads for aspirin
Aspirin gets some seriously creative ads in other countries.
(via Street Anatomy)
Should infants be screened for heart defects with pulse oximetry?
A simple, potentially cost-effective screening test to detect infant heart defects is rarely used in hospitals today.
Darshak Sanghavi, the chief of pediatric cardiology at the University of Massachusetts Medical School, is calling for a simple pulse oximetry test to screen infants for heart defects.
He cites a study showing that the test can detect 75 percent of critical heart defects that would have been previously missed. ...
Paying doctors by the hour will increase the adoption of electronic medical records
Less than 20 percent of doctors currently use electronic medical records.
One of the more cited reasons is that, in a fee-for-service payment system, doctors often lose money since the number of patients they see decreases during the long implementation phase.
Paying doctors by the hour will solve that problem. Consider this physician, who said "he had to give up his solo practice after he had ...
Can aspirin with Plavix be a new option to prevent stroke in atrial fibrillation?
Those with atrial fibrillation often have to take blood thinners, like warfarin, to reduce the risk of stroke.
The problem is, warfarin requires close monitoring as well as some dietary restrictions to maintain its effectiveness and reduce the very real risk of side effects, like bleeding. It can be a significant disruption in a patient's life, requiring regular trips to a anticoagulation clinic to have blood drawn for ...
10 primary care posts you may have missed
With entries dating back to 2004, here are 10 classic blog posts on primary care:
1. Why not a down payment for primary care, and problems with the medical home?
2. How connected are you to a primary care doctor?
3. Mid-levels for primary care, but not for surgery?
4. Half of primary care doctors want to quit
5.
Why personal health records may be unreliable
Google Health and other personal health records have been touted as a way for patients to actively keep track of their medical history.
However, some of the information, such as diagnoses and the active problem list, are populated using insurance billing codes. This presents a problem, as these codes are notoriously inaccurate, and can reflect a condition that was entered years ago and has since resolved.
Will the Pap smear soon be replaced by a DNA test to detect cervical cancer?
It appears the days of the Pap smear may be numbered.
A recent study from the NEJM showed that a DNA test outperformed the Pap smear in reducing deaths from cervical cancer.
This has tremendous implications worldwide, where cervical cancer continues to be a significant cause of death. Not only is the DNA test effective, it's also inexpensive, costing around $5.
Pap smears take ...
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....
