August 2009

All Stories

How to make industry influence transparent in continuing medical education

in Education | 11 responses

by Larry Husten, Ph.D.A recent hearing of the Senate Aging Committee on continuing medical education (CME) should scare anyone who might need to see a doctor in the next few years. But you don't need to be a Washington policy wonk to discover that there's a huge problem with CME.Just walk into the lobby of any major downtown hotel when a large medical conference is in town and you will ...

Can stealing in childhood be normal, and when should parents worry?

in Patient | 4 responses

Parents are often worried when they catch their children stealing, or worse, shoplifting.When it occurs in toddlers, it's often phrased as "a child who doesn't want to share." But, if the behavior continues, when should parents start to worry?That's the subject of a recent article by pediatrician Perri Klass. She talks with a variety of child experts, who all say that most children under the age of ...

Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?

in Conditions | 38 responses

Recent reports have said that Michael Jackson died from a propofol overdose. Is that really the case?Here's what happened, according to the published timeline.

-- At about 1:30 a.m., [Dr. Conrad] Murray gave Jackson 10 mg of Valium. -- At about 2 a.m., he injected Jackson with 2 mg of the anti-anxiety drug Ativan. -- At about 3 a.m., Murray then administered 2 mg of the sedative Versed. -- At about 5 ...

Is health care a public good?

in Policy | 41 responses

by Jeoffry B. Gordon, MD, MPHThe public policy and current political action around changing the system overlooks two important technical fallacies:(1) That health care is most efficiently distributed by a free market mechanism; and, (2) That medical services are an ordinary commodity.The commercial market model is a failing economic and public policy ideology used to rationalize and justify corporate control of the health care system to profit from the enterprise. ...

Situs inversus, and the difficulty of operating on patients with reversed anatomy

in Physician | one response

Operating is difficult enough, but imagine doing on someone's organs that were transposed on the other side.1 in 10,000 patients have a condition known as situs inversus, where, despite the non-traditional placement of organs, patients function without clinical symptoms.In this interesting piece from MedPage Today, several surgeons are interviewed about their experiences performing procedures on such patients. For instance, when talking to a heart surgeon who knew ...

Will nurses solve the primary care crisis?

in Physician | 39 responses

by Derek MaziqueBetween “death panels,” a NICE-style cost effective analysis board, and Obama’s slowly graying hair, one conspicuously absent part of reform are reimbursement rates. Medicare and private insurance typically reimburse for expensive procedures, which ultimately rewards procedure-heavy specialists while discourage those cognitive-heavy services like primary care docs.The result? As a recent Baltimore Sun op-ed and this very blog pointed out, a combination of pay and burn-out are ...

Did the oral polio vaccine cause an outbreak in Nigeria?

in Conditions | 5 responses

by Matthew Bowdish, MDThe World Health Organization (WHO) reports that approximately 180 Nigerian children have become paralyzed by polio as a result of widespread vaccination efforts in Africa’s most populous country. The outbreak is from the use of an oral polio vaccine (OPV) that contains a live-attenuated form of the poliovirus.OPV was initially developed by Albert Sabin in the 1950s. A live-attenuated poliovirus vaccine is ingested and stimulates ...

What can John Mackey and Whole Foods learn from publicizing their views on health reform?

by | in Policy | 18 responses

Today's health care communications lesson is brought to you courtesy of Whole Foods ... I mean John Mackey.John Mackey's stepped in it again. Last week, Mackey, the libertarian CEO of natural-foods behemoth Whole Foods, wrote an op-ed piece on health reform for The Wall Street Journal. But Mackey felt it necessary to republish it on his blog because the Journal editors lightly edited it, Journal headline writers wrote a ...

Why the elderly are against health reform

in Policy | 20 responses

One of the storylines in the health reform debate is how the Medicare population is fighting the current reform efforts.It's ironic, in a way, since if the status quo continues, fiscally sustaining current Medicare benefits will be a near-impossibility.In his regular column, The New York Times' Ross Douthat provides some insight as to the mindset of the Medicare recipient. He says, rightly, that, "At present, Medicare gives its ...

Do patients really need their complete lab and radiology reports?

in Conditions | 31 responses

Most prefer the bottom line, sparing them the raw data.Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.So, borrowing this image from Dr. Rob, I'm not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):Do patients really need their complete lab and radiology reports?

CNN op-ed: What good is having health insurance if you can’t find a doctor to see you?

in Physician | 63 responses

My latest opinion piece was published on CNN this morning.CNN op ed: What good is having health insurance if you cant find a doctor to see you? Entitled, Why the doctor won't see you now, it should be familiar to regular readers of KevinMD. Here's an excerpt:

Although it is a moral imperative for every American to have access to health insurance, alleviating the shortage of primary care providers is of equal importance. The prospect of ...

A doctor in Cuba becomes a nurse in the United States

in Physician | 14 responses

When physicians in other countries come to the United States, they often become nurses or lab technicians, rather than re-taking rigorous board exams to remain doctors.One example includes doctors from Cuba. According to this story in The New York Times, "6,000 medical professionals, many of them physicians, have left Cuba in the last six years." Cuban doctors, who often earn $25 per month, find it significantly more ...

The consequences of doing everything in end-of-life-care

by | in Physician | 30 responses

Fear-mongering about health care reform killing grandma really burns me: I have delivered "everything", I know what "everything" looks like. I know its dark side. I also know that these deliberate and self-serving lies will ultimately hurt not only grandma, but the rest of us too. Here is what I mean.When I was in practice I cared for critically ill patients. I loved the ICU for its complex physiology and ...

At what point do surgical innovations give diminishing returns?

in Policy | 2 responses

One reason why health care costs are rising is the demand for the latest medical technologies.And when it comes to surgery, the latest techniques may not be worth the costs. General surgeon Jeffrey Parks talks about gallbladder surgery, where, the laparoscopic approach reduced hospital stays and diminished surgical scarring, and as Dr. Parks puts it, "the innovation has inarguably justified its increased cost."But when talking about so-called "natural ...

Should the informed consent discussion be formally taught?

in Education | 6 responses

Most medical students don't take classes on how to discuss informed consent, that is, talking about the risks and benefits of a medical procedure with a patient.Pauline Chen remembers such conversations, where she "bumbled through each consent on [her] own, picking up certain phrases and dropping others through a sometimes painful and often awkward process of trial and error."That's often the case, as "young doctors rarely have formal mentorship ...

Is it fair to compare American health care with systems in Europe or Canada?

in Policy | 44 responses

by Ralph Silverman, MD, FACS, FASCRSI am tired of the comparisons people make between health care in the United States and other countries. For instance, there are those who think that we should have universal health care because some European countries and Canada do.It is true that those countries do have universal health care, but is it a fair comparison?Who does Canada rely on to defend its borders? When the ...

Is reducing medical errors similar to improving transportation safety?

in Physician | 8 responses

According to a recent op-ed, Jim Hall, former chairman of the National Transportation Safety Board, says, "Because American medicine accepts error as an inevitable consequence of treatment, our hospitals, insurers and government do little to respond to unnecessary deaths. If we are to address the problem in a serious manner, we must first change this culture."But a simple solution to reduce medical errors may be elusive, says emergency physician ...

When it comes to health care reform, winners and no losers?

in Policy | 2 responses

And that's precisely what's obstructing any meaningful reform.Princeton economist Uwe Reinhardt talks about how the American people wants to have their cake and eat it too, and devises an "all-American wish list" of what ideal reform should look like to the American public.It includes such items as, "Cost-effectiveness analysis should never be the basis of any coverage decision by public or private third-party payers in health care, for to ...

Page 2 of 41234

Kevin Pho, MD

See all in: Pho

Physician

See all in: Physician

Patient

See all in: Patient

Policy

See all in: Policy

Tech

See all in: Tech

Social Media

See all in: Social media

Meds

See all in: Meds

Conditions

See all in: Conditions

Education

See all in: Education