Happy Halloween, courtesy of an inpatient unit with entirely too much time on their hands.
(via Dr. Wes)
October 2009
All Stories
Is the impending physician shortage worse than we thought?
Originally published in MedPage Todayby Charles Bankhead, MedPage Today Staff WriterThe physician workforce in the U.S. is growing smaller and younger, according to data from the Census Bureau, but conflicting estimates make it difficult to determine just how many doctors are out there -- and how many the nation will need.
The census survey showed 67,000 fewer physicians than estimates based ...
Implementing an EMR or health IT system is harder than it looks
In 2001, when my colleagues and I ranked nearly 100 patient safety practices on the strength of their supporting evidence (for an AHRQ report), healthcare IT didn’t make the top 25. We took a lot of heat for, as one prominent patient safety advocate chided me, “slowing down the momentum.” Some called us Luddites.Although we hated to be skunks at the IT ...
Health reform ignores primary care doctors at its own peril
I would like to introduce you a remarkable article by Edward J. Volpintesta, MD, a 65-year old solo primary care doctor in Bethel, Connecticut. Dr. Volpintesta is a veritable writing machine and has been published in The Wall Street Journal, the New York Times, medical journals, and other publications. His articles cry for a deeper understanding of primary care dilemmas.In the October issue of Connecticut Medicine, Dr. Volpintesta hits the ...
Depression is bad for your heart
Originally published in Journal Watch Psychiatryby Steven Dubovsky, MDAnd attaining remission significantly improves mortality risk in patients with acute coronary syndromes. 
Depression is common after myocardial infarction (MI), and medical outcomes are worse in depressed patients. These researchers addressed long-term survival in a 6.7-year follow-up study of 361 patients with acute coronary syndromes (ACS) and major depression. The patients had ...
Are doctors getting enough skin cancer exam training?
Originally published in MedPage Todayby Nancy Walsh, MedPage Today Contributing WriterOpportunities to learn how to perform skin cancer examinations during medical training are inadequate, a survey of residents found. More than half (55.3%) of residents said that they had never observed a skin cancer examination, 75.8% said they'd never been taught to perform one, and 57.4% had never practiced doing ...
Health care reform needs to improve physician satisfaction
Of the myriad of proposals meant to change the health care system, including switching to electronic records, paying for performance, and adhering to evidence-based standards, very little attention is being paid to how they will be implemented, and the unintended consequences that may arise.Annie Brewster, an urgent care provider in Boston, outlines this in a nice commentary: "Reform should make my job more, not less, satisfying. Of course, doctors should ...
ACP: How to fix the primary care problem in health care
The following is part of a series of original guest columns by the American College of Physicians.by Steven Weinberger, MD, FACP
Many would argue that lack of universal coverage is the primary problem with health care in the United States, accompanied by the logistical and financial difficulties of obtaining coverage for someone with a pre-existing medical condition. Others would argue ...
An obsession with making money can be a sign of physician burnout
Originally published in HCPLive.comby Jeff Brown, MDPhysician burnout has a tremendous effect on the financial bottom line and is far more common than docs want to talk about.
When I say the bottom line, I am referencing studies that have been done on "workaholics," another softly defined term, that show in spite of increased hours and apparently focused activity, productivity ...
Beware using the web for H1N1 pandemic flu drugs
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentThe Internet can be a great source of information about the pandemic H1N1 flu, but it's also the mother lode of swine flu scams, the FDA is warning. The agency says consumers should beware of products sold over the Internet that claim to diagnose, prevent, treat, or cure the ...
Doctors have a duty to engage in social media
Some physicians may be hesitant to participate in social media outlets, like Facebook and Twitter.Well, get over it.Great post by pediatrician Bryan Vartabedian who addresses this topic. Indeed, physicians have lost control of the online message, especially with, according to recent data, 60+ percent of patients visiting the web first when looking for health information.Instead, anti-vaccine proponents and homeopaths have embraced the Internet, and now exert tremendous influence ...
Are specialists preventing the government from spending more on primary care?
After a painful, summer-long labor, Senate Finance eventually had to be induced before it gave birth to a health reform bill of its own. But give birth it finally did, and the products of its conception now stand alongside the offspring of 4 other proud Congressional committees.But please! Save the silver spoons and bunting! None of the quintuplets does enough to assure there will be enough PCPs out there to ...
This is why children need the H1N1 flu vaccine
by Crystal Phend, MedPage Today Senior Staff WriterThe pandemic H1N1 influenza virus continues to disproportionately attack the young, the CDC warned. Children and adults under age 25 have accounted for 53% of hospitalizations for laboratory-confirmed H1N1 and 23.6% of related deaths since Sept. 1, the agency reported at a press briefing.Seniors, on the other hand, have accounted for just 7% of ...
Medscape op-ed on how to help today’s tense, frustrated doctors
My latest opinion piece, co-written with Placebo Journal's Doug Farrago, was published in Medscape today.
Entitled, Help for Today's Tense, Frustrated Doctors (registration required), we discuss how doctors benefit from finding a ray of humor, despite the glum practice environment many physicians find themselves in:
Patients also can benefit from some levity during their doctor's visit. We've heard ...
Incentives promote unnecessary, excessive tests in the ER
A professor of medicine visits the emergency department with a seemingly routine case of shingles, and gets the million dollar workup.Writing in the Washington Post, Jack Coulehan describes how he was subjected to neurology and ophthalmology consults, several MRIs, and a CT scan. All for shingles, a disease that is diagnosed clinically, and treated with an anti-viral medication, pain relievers, and in some cases, steroids.Soured from the experience, ...
Have drug companies really curbed gifts to doctors at medical conferences?
by Roberta Friedman, PhDBanning pharmaceutical companies from handing out token items to doctors at conferences is so tip of the iceberg.I have tales to tell of conferences past, where the excesses were beyond farcical. As a medical reporter covering such meetings, I have seen everything. When my kids were young, I enjoyed roaming the floor of the exhibit hall along with the docs, collecting such swag as bouncy balls that ...
Is the newest, long-lasting insulin necessarily the best?
Originally published in HCPLive.comby Anita Ramsetty, MDWe are very fortunate to have a number of newer insulins available for our patients. For years we had animal insulins only. NPH and Regular, then we had Ultralente. The development of analog insulins marked the upswing in technology that we would sustain for a period of time. The most recent big blip in ...
What does H1N1 pandemic flu as a national emergency mean?
Originally published in MedPage Todayby Michael Smith, MedPage Today North American Correspondent President Barack Obama's declaration that the H1N1 pandemic flu is a national emergency doesn't mean the course of the outbreak has changed, health experts said.But as the volume of cases increases, the declaration allows doctors and hospitals more flexibility in handling the expected surge in patients, they said."I ...
Doctors lose a part of their training when resident work-hours are capped
The restrictions on resident work-hours arguably most impacts the field of surgery.I understand that fatigue increases the risk of medical errors, but in this excellent post, Jeffrey Parks notes some benefits of being immersed in the hospital. Something is lost as doctors are scuttled out of the hospital when the 81st hour starts.Dr. Parks notes that "there's more to being a doctor/surgeon than just learning how to fix a ...
How teamwork can improve patient care
I spent the entire day in meetings today. One would think that is a boring or unproductive way for a physician to spend time, however these meetings made me proud to be a doctor and proud of my colleagues in medicine.The morning was spent with nurses, respiratory therapists and quality experts who came together to celebrate success with patient safety and quality initiatives that have saved at least 151 patient ...
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...
