Is eliminating the presence of all disease a worthy goal?Gilbert Welch is part of the Dartmouth group of physicians and policy experts who advocate that we're doing too much testing and finding too many diseases. He asks, what exactly does "health" mean, and should it be defined as the absence of disease?Over time, the definition of "normal" has narrowed. For instance, more patients are being diagnosed with ...
August 2009
All Stories
Cheap asthma treatment using a homemade spacer
Do homemade spacers for asthma work?Take a look at how WhiteCoat "MacGyvered" a spacer for a metered dose inhaler, which can cost up to $100. So, instead of this:
You get this:
Brilliant.While keeping in mind that this blog does not give medical advice, consider a study from The Lancet that ...
Countries with worse health care systems than the United States
The United States is often compared, unfavorably, to health care systems of other countries.But it's refreshing to read that, yes, there are indeed countries that are worse off than we are. (via Ezra Klein)Like Russia, which allocates significantly less than the World Health Orgnaization's recommendation of 5 percent of government spending to health care. It's a hybrid public-private system gone wrong:
Ninety percent of Russians are technically covered. ...
Do some patients not deserve health care reform?
That's a controversial question that emergency physician Edwin Leap asks in a recent column.What's missing in the current health reform proposals is language enforcing one's sense of personal responsibility. So, as Dr. Leap writes, "there are people who really don't deserve health care reform . . .The 'elephant in the room' is that some patients (rich and poor alike) do nothing to care for themselves, take no responsibility for ...
Doctors take risks by treating celebrity patients
Treating a celebrity may not be all that it's cracked up to be.In the wake of Michael Jackson's death, a recent piece from American Medical News summarizes some of the dangers physicians face by taking on celebrities.The piece cites a study which concluded that "celebrities were an average 17% more narcissistic than the general public," and perhaps because of this, some "are extremely manipulative, and there is a lot ...
How many radiologists cheat or take short-cuts in their interpretations?
If you aren't following emergency physician WhiteCoat's account of his malpractice trial, you should.During one exchange with an expert witness, here's how he described what a radiologist routinely did at his hospital:
The radiologist that read the film had a habit of going to the surgeons the following day and asking them what they had found. He would open up a blank report so that it looked as if it was ...
Doctors suffer too when they make medical mistakes
Much of the attention, rightly so, is on patients whenever a medical mistake is made.But the toll it takes on doctors can be significant. I've often referred to the statistic, for instance, that 10 percent of doctors who are sued for medical malpractice contemplate suicide.In a recent column in The New York Times, Pauline Chen examines how doctors fare after making a mistake. And the answer is, ...
Will Americans accept a trade-off in medical accuracy for lower costs?
With so much focus on health care costs, it's important to consider the mindset of the American patient.The Wall Street Journal asks whether simple, less expensive, health care strategies that work in developing countries can be implemented Stateside.For example an AIDS clinic in Alabama, by mimicking a similar program in Zambia, decreased its no-show rates by giving prompt appointments and interviewing patients looking for reasons why they may not ...
Should movies receive an R-rating for having smoking scenes?
Extreme? Perhaps not.Over at Better Health, Jonathan Foulds at first dismisses the somewhat radical suggestion that all movies that include smoking scenes should be slapped with an R-rating.But after thinking about it, he realizes it's not as extreme as it appears.He cites the work of anti-smoking crusader Stan Glantz, who reasons that, "movies made to be viewed by kids do not need to include smoking, and therefore should be ...
Should ER doctors be immune from medical malpractice?
Emergency physicians are forced by EMTALA to treat everyone who comes through the ER doors.Should these cases be exempt from medical malpractice? The Happy Hospitalist argues that the standard of care within the community sets an unreasonable bar. Consider this situation, for instance:
The [problem] I see in today's malpractice environment is the irrational standard of care that has been established, not by science, but rather by the ...
Do canes and walkers prevent falls in the elderly?
Not always.Although when used correctly they can help maintain mobility, MedPage Today reports a study showing that they are associated with an increase in falls when used improperly.According to the study, it's "estimated that 47,312 fall injuries associated with walking aids are treated each year among older Americans."And worse, falls associated with canes and walkers resulted in more severe injuries, with a third of these cases requiring hospitalization. ...
Why doctors order so many tests
And it's not always because, as is portrayed in the media, that they get rich from doing so.I, or many other doctors, do not make a dime if I send a patient for an MRI.Rather, it's because there is financial incentive to see and churn through as many patients as humanly, or in some cases inhumanely, possible. Chris Rangel has a nice list, giving 10 reasons why doctors order ...
When fat doctors talk to obese patients
How can doctors counsel obese patients why they themselves struggle with their own weight?That's the question pediatrician Perri Klass discusses in a recent New York Times column. On one hand, doctors who are obese may better connect with patients when they "understand their frailties."But on the other, patients also ignore advice from physicians who can't follow it themselves. Indeed, that's what pediatrician Julie C. Lumeng, an expert ...
Poll: Is Twitter necessary for physicians and other medical professionals?
Twitter has captured the mainstream imagination, with celebrities and news organizations embracing the medium.Will Twitter soon be an essential tool for medical practices?Twitter is a social media service where users can communicate with one another in 140 characters or less. More doctors are using Twitter to connect both with patients and other medical professionals. Some hospitals have "live-Tweeted" surgery, to great fanfare, allowing the public a peek into the operating ...
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...
