Originally published in Insidermedicine
Young, otherwise healthy people who contract H1N1 flu can rapidly deteriorate into a critically ill state in a manner that is eerily reminiscent of the 1918 Spanish flu pandemic, according to research published in the November 4 issue of the Journal of the American Medical Association and presented at the annual meeting of the European ...
October 2009
All Stories
Interruptions when doctors see patients and how that affects care
Getting interrupted while in the doctor's office can be annoying, both for the patient and physician.In an essay in The New York Times, pediatrician Rahul Parikh notes that, in an average primary care office visit, doctors were interrupted twice. And in the ER, "emergency room doctors experienced an average of 10 interruptions an hour, compared with 4 an hour for primary care doctors."Having a computer in the room, ...
What health reform can learn from Regina Holliday
by Rahul Parikh, MDIf you want to get insights into the problems of our health care system, look at a mural by Washington DC resident Regina Holliday.
Holliday is a 37-year old mother of two and an art teacher. Last summer, her husband, Fred, died from kidney cancer at the age of 39. The Hollidays' experience is a ...
Does robotic surgery for prostate cancer help patients?
Originally published in MedPage Todayby Peggy Peck, MedPage Today Executive EditorMen who opt for minimally invasive prostate surgery -- often with a helping hand from a robot -- are twice as likely to have genitorurinary complications as men who have a traditional prostatectomy.
That finding is especially troubling because the use of robotic-assisted minimally invasive prostatectomy has increased exponentially in ...
What having the H1N1 flu feels like
CNN's Sanjay Gupta went to Afghanistan to cover a story, and got infected with H1N1 influenza.His blog post on the experience is quite eye-opening, and consistent with the cases that I've seen here. Much has been made on how the virus attacks younger patients with healthy immune systems. Dr. Gupta was previously healthy, but being sick from H1N1 was a miserable experience. Writing in his blog, ...
Poll: How can we increase the supply of donor kidneys?
The United States has almost 60,000 patients with end-stage renal disease who need a kidney transplant. Every year, almost 4,000 people will die waiting for that transplant.How can we increase the supply of donor kidneys?Though some economists suggest a legal organ donation "marketplace," where kidneys can be legally bought and sold, opponents envision the wealthy buying their way to the front of the line, and the poor resorting to selling ...
Scenes from Blog World Expo 2009 and the future of medical social media
One of the largest gatherings of medical bloggers took place this past week at Blog World Expo 2009 in Las Vegas.The panel discussions were enlightening and insightful, and it was wonderful to meet so many of my fellow medical bloggers in person.I participated in a panel discussion talking about the history of medical blogs, entitled, The State of the Health Blogosphere: We’ve Come A Long Way, Baby. Simply having ...
Is emergency department boarding associated with undesirable events?
Originally published in Journal Watch Emergency Medicineby Richard D. Zane, MD, FAAEMNearly 30% of ED boarders at a single tertiary care hospital experienced undesirable events. 
Emergency department boarding — inpatients in the ED awaiting a hospital bed assignment — is common across the U.S. Although boarding is inconvenient and demoralizing for both patients and providers, few studies have examined outcomes ...
Op-ed: Reasons why health care workers need to receive the H1N1 flu vaccine
The following op-ed was published on October 5th, 2009 in The New York Times’ Room for Debate blog.Not only are patients asking me whether they should receive the H1N1 influenza vaccine, but it’s a question doctors are asking themselves.Recent polls say doctors and nurses may be more resistant to getting vaccinated than most Americans. The British Medical Journal published a survey showing that less than half of health care ...
Do heart attack patients benefit from an implantable cardioverter defibrillator (ICD)?
Originally published in Insidermedicine Implanting a cardioverter-defibrillator (ICD) is no better at saving lives than simply providing optimal medical therapy for individuals who suffer damage to the heart from a heart attack, according to research published in the latest issue of the New England Journal of Medicine.id="play_continuous_flvs" classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="385" height="239" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
How the patient-centered medical home can improve our health care system
Dr. Paul Grundy is on a mission -- a mission to promote the patient-centered medical home model that he has been instrumental in developing and rolling out, in his dual role as Director of Healthcare, Technology and Strategic initiatives for IBM Global Wellbeing Services and Health Benefits, and President of the Patient-Centered Primary Care Collaborative.I had the opportunity to speak with him last month (here's the transcript and ...
Doctors need to fix the health care system that they had a hand in breaking
by Daniel A. Graubert, MDMedicine has changed so dramatically since I graduated medical school in the 1980's, that it is hardly recognizable.Certainly, there has been an enormous growth in knowledge which is often beneficial, but has often led us down the wrong path. For example, when advanced imaging techniques such as CT scans and MRIs became available, we were able to see the inside of large numbers of patients ...
Texting young liver transplant patients to take their medications
Originally published in MedPage Todayby Todd Neale, MedPage Today Staff WriterHere's a case where texting may actually improve a teenager's health: Text message reminders appear to be effective in getting young liver transplant patients to take their immunosuppressive medications, a small study showed. In 41 patients with a median age of 15, there was a significant improvement in medication compliance ...
Unnecessary hospital admissions cost money and can harm patients
When the elderly go to the emergency room, more often than not, they are admitted to the hospital.Stuart Turkewitz, a geriatrician posting at his platintiff attorney brother's malpractice law blog, explains why. Often times, it's because emergency doctors aren't familiar with the baseline state of his elderly patients. Subsequently, "the urge to recommend admission is overwhelming," and the "attending physician often at the other end of the phone, ...
Embracing the change coming to our health care system
As Bob Dylan sang so long ago, The Times They Are A-Changin’. Some like change; some do not.Consider these change scenarios:* One of the important scenes of change for health care providers is the national debate on health care coverage currently playing out in Washington D.C. Some are very vocal in their support. The media covers many of the vocal opponents. Certainly some sort of change will come out of ...
One way to treat patients with severe H1N1 flu
Originally published in MedPage Todayby Todd Neale, MedPage Today Staff WriterMost patients who underwent extracorporeal membrane oxygenation (ECMO) for respiratory failure survived their struggle with pandemic H1N1 flu, according to a study by researchers from Australia and New Zealand.Of the 68 patients treated with ECMO during the Southern Hemisphere's winter, 54 were still alive as of Sept. 7, according to ...
Two nurses face jail time for reporting a doctor to the Texas Medical Board
There's a disturbing case in Texas, involving two whistle-blowing nurses who reported a physician to the Texas Medical Board (TMB).Apparently, they took offense at the physician who was peddling herbal medications in the emergency room, among other deeds. Unable to convince hospital administration to discipline him, they reported him to the Board.And here's where it gets disturbing.Angered by the action, the physician then filed a criminal complaint, ...
Should medical journals use the term nauseous, nauseated, or nauseating?
by Phil SeftonWriters and editors rushing to meet deadlines know the feeling. The effects of stress, a few too many cups of coffee, and perhaps a candy bar or bag of chips in place of a meal can conspire to make the most steely-nerved wordsmith feel a tad nauseated. Or is it nauseous? And what of that stress, that coffee, that ill-chosen meal replacement—are its effects nauseating or nauseous?Grammarians with ...
How H1N1 pandemic flu will affect intensive care units
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentThe winter wave of the pandemic H1N1 flu hit intensive care units in Australia and New Zealand hard, researchers said, and may offer lessons for doctors bracing for the pandemic's return to the Northern Hemisphere. All told, 722 people with confirmed pandemic flu were admitted to one of the ...
Dating advice from an oncologist
How do you know if a couple is right for each other?Watch how they interact in a cancer clinic.So says this oncologist in a poignant column from the Boston Globe. As Robin Schoenthaler writes, "When you’re a single woman picturing the guy of your dreams, what matters a heck of lot more than how he handles a kayak is how he handles things when you’re sick. And one ...
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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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...
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The problem of insurance gaps in cancer patients
Why are cancer organizations waiting until it starts to rain before they suggest buying an umbrella? “Join my Medicare Advantage plan and...
Tech
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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...
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Google knows more about certain diseases than physicians ever will
Professor Gunter Dueck, is a calm and eloquent german mathematician who’s also the CTO of IBM Germany. He studied mathematics and philosophy...
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....
