Most of us went into medicine because, in addition to being good students, we wanted to help people. How many oceans of ink and forests of paper have been used explaining that point to admissions committees we’ll never know. Suffice it to say, it felt very good when our professors wrote us glowing letters of recommendation. Of course, we were also saying, “I want to feel good about helping people. ...
January 2010
All Stories
How a doctor’s office can affect patient trust
Originally published in MedPage Todayby Marianne MatteraTrust is an essential element in the doctor-patient relationship.
You’re well aware of how important it is that you can trust the history the patient gives you. You know the problems that can arise in planning and managing care if you’re working with only part of the story. And you probably even feel a twinge ...
How doctors can look for the right non-clinical medical job
How many physicians do you know who have chosen to leave their clinical practice?There's no doubt that physicians are getting burned out. Many are tired of fighting insurance companies and even more physicians are getting discouraged about reductions in reimbursement. This has caused some physicians to drop Medicare and Medicaid. Others have switched to cash-only or concierge/boutique practice models. Then you have your group of physicians who have simply decided ...
How psychiatrists may be giving their patients too many drugs
Originally published in MedPage Todayby John Gever, MedPage Today Senior EditorPsychiatrists who prescribe drugs for their patients today usually give more than one at a time, often with little scientific basis, researchers said.About 60% of patients with psychiatrist office visits leading to a drug prescription received at least two medications in 2005-2006, according to government survey data analyzed by Ramin ...
Is the Haiti earthquake media coverage impeding rescue crews and supplies?
Originally published in MedPage Todayby Bjoern KilsThe 7.0 magnitude earthquake struck Haiti's Porte-au-Prince at 4:53pm on January 12, 2010.Just 20 hours later, CNN's Anderson Cooper was updating the AC360 blog from the Dominican Republic, while making his way to an airfield to board a United Nations helicopter to take him and his crew into Haiti.While the media plays a central ...
How bad patient outcomes affect physicians
Ms. FR didn’t look so great even when I first met her. She had been admitted to the hospital three times in past 6 weeks for nausea/vomiting and generalized malaise. While the cause of her acute illness was not entirely clear, we suspected that her widely metastatic breast cancer had something to do with it.By the time I met her she had already been in the hospital for 1 week. ...
What diseases can arise from the lack of clean water in Haiti?
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentThe lack of clean water in the stricken Haitian capital fosters conditions that may spawn an epidemic of enteric disease."Having large numbers of people in close proximity and not using appropriate sanitation can potentially spark those epidemics, particularly if people are forced to drink surface water," said Rebecca Dillingham, ...
We are becoming a nation of people with multiple chronic diseases
by Monte Ladner, MDMany Americans are resolving that this will be the year they finally lose weight. Sadly, most of them will reach the end of 2010 heavier than when they started. We continue losing the weight loss game because our efforts are misplaced. The issue is lifestyle.Dr. Dana King of the Medical University of South Carolina recently published two papers on the erosion of American lifestyle ...
Do neuroenhancement pills really improve attention, memory, or cognition?
Originally published in HCPLive.comby Victor G. Dostrow, MDThe Internet is filled with reports of remarkable cognitive enhancement with various nostrums.Many are not regulated, and the pages are typically associated with glowing testimonials and a link to sign up for uninterrupted (and uninterruptible) delivery of the miracle substance. More to the point of this post, other blogs, reports, and forum comments opine as to notable benefits of taking prescription medications ...
Don’t use kitchen spoons to measure drug dosages
Originally published in MedPage Todayby Todd Neale, MedPage Today Staff WriterIndividuals using standard spoons from their home kitchen to dispense liquid medications may be pouring too little or too much of the drugs, researchers found. Among volunteers trying to pour a teaspoonful of cold and cough medicine, using a slightly larger spoon resulted in underdosing and using a much larger ...
Tips for Haiti earthquake relief: How to find the right charity for donations
It’s impossible to watch coverage of the immense suffering in Haiti and not want to help. But many charitable groups seem to have sprung up since the disaster, and it’s tough to know which ones will be most effective at getting your donation to those most in need.To try to sort out the difference between the major aid groups, I asked Haitian-American community organizers, as well as physicians I know ...
Why simply adding more doctors won’t save our health system
It's no secret that without a stronger primary care foundation, the current reform efforts are unlikely to be successful. If anything, it will only delay the inevitable.I wrote last month that one discussed solution, adding more residency slots, won't help: it would simply perpetuate the disproportionate specialist:primary care ratio.A recent op-ed in The New York Times expands on that theme. The authors suggest that not only does ...
Haiti relief effort may be too late to help the earthquake victims
Originally posted in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentTwo days after a powerful earthquake shattered Haiti's capital city, relief workers are finding it tough to provide needed medical care, coordination for the efforts is lacking, and time is running out for those trapped in the rubble."The window they talk about is 48 to 72 hours," said Irwin ...
What doctors should expect with health care reform
What should health care providers be doing in anticipation of the likely passage of an historic health reform bill?There are at least three possibilities: (1) Lament the passing of the good old days and oppose it; (2) Insist that it isn't good enough because it is lacking some key provision (tort reform; SGR replacement; robust public option); or (3) Embrace it, because incrementalism works, and prepare for what's coming down ...
Depression severity predicts how well antidepressant drugs will work
Originally published in InsidermedicineThe benefits of antidepressant therapy increase with the severity of underlying depression, according to a meta-analysis published in 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">
What will the next big medical advance be?
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentIt's tough to make predictions, especially about the future.That famous observation from baseball great Yogi Berra applies in spades to medicine.What technological advance or new insight will shape the next few years? As Yogi noted, it's tough to predict:It could be -- as Leif Ellisen, MD, PhD, thinks -- tumor genotyping.
Why patients shouldn’t believe hospital cancer advertisements
Unlike drug ads that you find on television, cancer advertisements from hospitals aren't subjected to the same data-based scrutiny.And that could be a problem, since they arguably can have more influence on patients than pharmaceutical ads.Cancer ads play on the emotions of patients, and frequently use words like "highest cure rates" and "lowest risk," despite having little data to back up the claims.Patients with cancer, along with their families, ...
Why the Haiti health crisis will be worse than Hurricane Katrina’s aftermath
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentThe powerful earthquake that hammered Haiti Tuesday afternoon has created a medical nightmare, those familiar with the country say."I can't even imagine the kind of horror we're going to see in the next two to three weeks," said Steven Williams, MD, an internist at Allegheny General Hospital in Pittsburgh ...
Balancing the risks and benefits of cancer screening is an individual decision
by Abraham Verghese, MDI can't get over the incredible images generated by our latest CT scans and MRI's. The details of organ anatomy and the 3D reconstructions they can do are just amazing. One side effect of getting such fine resolution, is that more and more we are stumbling onto abnormalities that we were not necessarily looking for--incidentalomas, we call them.Sometimes the discovery is fortuitous and lifesaving. But often ...
The Haiti earthquake damage to hospitals and health care infrastructure
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentThe powerful earthquake that hammered Haiti Tuesday afternoon has left healthcare in the impoverished Caribbean nation in even worse shape than before.Several hospitals have been seriously damaged and others are swamped by casualties from the magnitude 7.0 quake."We are seeing wave after wave of vehicles coming from the Port-au-Prince ...
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....
