Nearly one-third of the American population is obese, and 5 percent is classified as morbidly obese, defined as more than 100 pounds overweight.The obese are more likely to have health issues, and, subsequently require more frequent trips to the hospital. Ambulance workers say that patients weighing over 350 pounds present additional challenges to transport, and require specialized equipment and additional workers.Where should the money come from to cover the ...
November 2009
All Stories
Who’s dying from the H1N1 flu pandemic?
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentAlthough the pandemic H1N1 flu tends to strike younger people, it can be life-threatening when older people are infected, California researchers said.
In the first four months of the pandemic, 1,088 people in the state needed inpatient care or died of the pandemic flu strain, according to Janice Louie, ...
Saying no to a re-tweet request, and whether Twitter as a legitimate news source
The other day I re-tweeted a tweet from someone whose Twitter activity I enjoy very much. I like where his links take me, and I appreciate the intellectual and emotional honesty of his own writing. The message I re-tweeted was about Gardasil, Merck’s HPV vaccine marketed in the US.Diane Harper of the University of Missouri is a prominent researcher who was heavily involved in the Gardasil development program. Over the ...
Thanksgiving Drive concludes, and KevinMD on your mobile phone
Thank you for making the first Thanksgiving Drive a success.
I have received 592 new Twitter followers and 200 new Facebook fans during the Drive. A total of $1,000 was donated to the United Way of Greater Nashua, which includes a generous contribution by Joan Allen.I would like to thank Epocrates, for donating an ...
Medicine needs to get back to hands-on basics, rather than focusing on technology
by Rahul Parikh, MDThere is plenty to criticize in our bungling trek toward health reform. Leaders on the right, left and at 1600 Pennsylvania Avenue have sidestepped the crucial conversation of controlling the cost of care, in favor of partisan rhetoric about "death panels" and "rationing care." Worse, the entire focus of reform has centered on spending billions of dollars on technology solutions that will only ...
AMA’s democracy in action at this defining moment in the history of medicine
The following is part of a series of original guest columns by the American Medical Association.by J. James Rohack, M.D.Delegates Vote to Continue AMA’s Commitment to Reform, Medicare Vote Pending in U.S. House of Representatives 
Twice a year, physicians come together for an exhibit of democracy at its best through the AMA House ...
Does television make toddlers more aggressive?
Originally published in InsidermedicineBoth watching television and having a television on in the household are associated with a higher level of aggression in three-year-olds, according to research published in the latest issue of the Archives of Pediatric and Adolescent 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">
Surgeons don’t receive enough training when resident work-hours are capped
by Crystal Phend, MedPage Today Senior Staff WriterLimiting surgical residents' work hours has compromised both surgical education and patient safety, according to an analysis concluding that an 80-hour work week isn't enough. The maximum 80-work week imposed in the U.S. for residents is too little to provide mastery in surgery, Gretchen Purcell Jackson, MD, PhD, and John L. Tarpley, MD, ...
Can universal health coverage be sustained long-term?
With health reform looking more likely, it's worth looking at the Massachusetts model to predict what's going to happen nationwide.I've written several times that the lack of primary care access will simply shift newly insured patients to already crowded emergency departments, where care is exponentially more expensive. And in the end, it is that lack of spending control that will make the costs of universal coverage unsustainable.According to ...
How teamwork is essential in the emergency department
I recently cared for a patient who raised my heart-rate a bit. Of course, any emergency physician will tell you, the potentially difficult and complicated cases often come at the end of the shift, as you’re trying to clean up all of the paperwork and ‘head for the house.’ Nurse Ginger came to me and said, ‘we need a doctor in room 11.’ I snarled, snatched the paper, grumped and ...
Many women report nerve-related persistent pain after breast surgery
Originally published in InsidermedicineNearly half of women who undergo surgery and other treatments for breast cancer report having persistent pain in and around the treatment area a year or more later, probably because of nerve damage, according to research published in the November 10 issue of the Journal of the American Medical Association.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">
Will video cameras in the OR decrease the rate of wrong-site surgery?
by Kristina Fiore, MedPage Today Staff WriterRhode Island Hospital, located in Providence, will pay $150,000 and install video cameras in all of its operating rooms after performing its fifth wrong-site surgery since 2007, according to the state's Department of Health. The hospital will also have to open its ORs to an inspector who will observe surgical procedures and protocols for at ...
The decision not to test is often the more difficult choice
Ordering that head CT scan is the easy way out.In a piece from Newsweek (via Bryan Vartabedian), Yale emergency physician Christopher Moore details a common scenario: should he order a CT scan in an asymptomatic 15-year old who was hit in the back of the head while playing soccer?Dr. Moore encapsulates his thought process: "In a case like this, evidence shows the chance of a life-threatening injury is ...
Patients who want the H1N1 vaccine need to be triaged
by Kairol RosenthalI am a young adult cancer patient who waited five and a half hours for the H1N1 vaccination along with 1200 other Chicagoans in a city college hallway. I do not have the trained eye of a public health analyst, yet it was easy to spy the glaring flaws that occurred in the whimsical distribution of this short supply vaccine. One of these oversights was the absence ...
How do people with dementia die?
Originally published in HCPLive.comby Victor G. Dostrow, MDDementia is a terminal illness. However, people with advanced dementias often languish in skilled nursing facilities, far from the ministrations of specialists. And, with reasonable luck, they have directives that specify that they are not to be taken to the hospital in the event of a respiratory arrest. Consequently, most of us are not privy to the mechanisms of demise in such ...
Will the abortion restriction survive the Senate health reform bill?
Originally published in MedPage Todayby Emily P. Walker, MedPage Today Washington CorrespondentAfter a controversial amendment to restrict abortion was approved as part of the House healthcare bill over the weekend, senators are grappling with the abortion language in their legislation. Senate Majority Leader Harry Reid (D-Nev.), who personally opposes abortion, said the issue was being negotiated."I expect the bill that ...
What would dissecting Hello Kitty look like?
There's something strangely disturbing about the anatomical imagining of cute Hello Kitty's insides.
(via Street Anatomy and Dr. Romanelli)
How should doctors discuss healthcare reform with patients?
Originally published in HCPLive.comPhysicians are increasingly bringing their views on healthcare reform into the examination room. Others are distributing flyers or taping up signs in the office. Given that healthcare reform has become such a contentious subject in the United States, it is not surprising that conflicts have arisen between physicians and patients who hold different views.
The St. Petersburg ...
Doctors and patients need to learn to live with health insurance companies
by Marie CooperConsider two patients with the same managed care plan.One has multiple sclerosis and receives an infusion of Tysabri every month. It needs pre-certification. The requirements are black and white. The patient qualifies if they have relapsing/remitting MS and have failed other therapies. The drug costs $2,000, the infusion center is another $1,000. The infusion center is a contracted provider that has ...
KevinMD Live Q&A today at 2:00pm Eastern
I'm doing a live Q&A today at 2:00pm Eastern.Any topic is on the table. Health reform, blogging, Twitter and Facebook, or my new Verizon Droid. Click on the window below to leave your question.
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....
