Originally published in HCPLive.comby Jeff Brown, MDFiduciary responsibility is the obligation for people entrusted with financial affairs to act in their client's best interest, theoretically being both transparent in their dealings and accountable for them. Typically, this applies to CPAs, lawyers, financial advisers and the like. Would that it were also true for our legislators, but that's a story for another day. To the point, physicians do not usually ...
January 2010
All Stories
How effective is CA 125 and other biomarkers to screen for ovarian cancer?
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentRising blood levels of several biomarkers show the presence of ovarian cancer -- just not early enough.
That's the conclusion of a retrospective longitudinal case-control study of levels of half a dozen proteins linked to the disease, according to Garnet Anderson, PhD, of the Fred Hutchinson Cancer Research Center in ...
Useful Twitter advice for doctors
Thanks to Medscape for including my take in their recent article, "Is Twitter a "must" for doctors?"I discuss some common sense tips doctors should follow while using Twitter:
1. Patient privacy is paramount. Do not discuss individual cases or provide patient advice via Twitter. 2. Use Twitter to point your patients to trustworthy online health information sources. 3. Use Twitter as a tool to promote your practice's brand. More and more patients ...
The story behind a whistleblower doctor license reinstatement hearing
by David Cundiff, MDAfter the LA County + USC Medical Center closed my “Pain and Palliative Care Service” because of budget cuts in 1995, I spoke out publicly about the dysfunctional financial reimbursement system funding charity care in LA County.For example, when my consultation service controlled the pain and distressing symptoms of over 400 terminally ill cancer and AIDS patients per year and discharged them to home hospice programs, the ...
How doctors and nurses can exhibit disruptive behavior
Originally posted in HCPLive.comby Lisa Schulmeister, RN, MN"Behavior problems" were reported by 97% of 2,124 nurses and physicians responding to a survey conducted by the American College of Physician Executives (ACPE).
The most common behaviors included degrading comments (reported by 85.5%), yelling (73.3%), cursing, inappropriate joking, and refusing to work with one another. The ACPE found that in some instances, ...
Despite no cure, progress in the treatment of HIV/AIDS
Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentIt's 1984. A 20-year-old homosexual man walks into the clinic complaining of swollen glands.It could well be a death sentence.It is only three years since the first handful of cases of what would come to be known as acquired immune deficiency syndrome (AIDS) were described. Little is known about ...
When should patients call doctors by their first name?
According to a recent study from the BMJ, more than half of patients preferred that doctors call them by their first name.But what about doctors? Do they mind if patients didn't address them with a proper title?In a piece from the New York Times, physician Anne Marie Valinoti notes some discomfort when patients addressed her as "Anne Marie":
How does one address one’s physician? It is almost always an ...
Public hospitals are the unsung jewels of our healthcare system
by Danielle Ofri, MD, PhDPublic hospitals have a bad rap. They’re viewed by many as hospitals of last resort, and most patients with private insurance do anything to avoid them.As a long-time physician in a public hospital, I’m sensitive to this reputation. I wouldn’t work in my hospital if I didn’t feel that it delivered excellent health care. I’m certainly aware that private hospitals have amenities that public hospitals can’t ...
Will physician and hospital penalties improve patient care?
Originally published in HCPLive.com by Alan Berkenwald, MDIn 1904, the Scottish author Sir James Matthew Barrie sent Peter Pan off to Never-Never Land to escape growing up and to enjoy many-many adventures. As children, we all hoped it really existed. In truth, many of us fantasized, one day, to make the trip ourselves.Well, good news for physicians - that day has arrived! Originally published in MedPage Todayby Michael Smith, MedPage Today North American CorrespondentBrazilian researchers have found three distinct patterns of lung damage in patients who died of the H1N1 pandemic flu. How patients are dying from H1N1 infection
They also found evidence of a so-called "cytokine storm," a runaway immune response associated with the lung damage, according to Thais Mauad, MD, PhD, of Sao Paulo University Medical School, ...
How can we stop the spread of unproven heart scans like CT angiography?
There's no question that CT scans are among the most overused medical tests.One newer application has been using CT scans to detect coronary artery calcification for primary prevention of heart disease. It's a technology of unproven promise, with entities like the USPSTF recommending against it.Worse, especially in light of the recent data suggesting significant radiation exposure from CT scans, it may even be harmful. Patients need to ...
How can medical guidelines be immune from politics?
The recent uproar over the new screening mammography recommendations got me thinking about a lot of stuff. One of the lessons cited by some journalists and pundits is on how potentially volatile information should be presented to the public. The USPSTF was excoriated by critics not only for what it said, but how it said it. While the objections over the former can be dismissed as ravings of loud and ...
How effective is a single dose of H1N1 vaccine for adults?
Originally published in InsidermedicineHealthy adults require only a single dose of H1N1 vaccine in order to be optimally protected, according to research published in 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">
What’s the most popular way to diagnose a pulmonary embolism?
Originally published in MedPage Todayby Chris Emery, MedPage Today Contributing WriterEmergency physicians and radiologists overwhelmingly choose computed tomography (CT) imaging to diagnose pulmonary embolism, a potentially deadly blockage of lung arteries, a new study found. Ninety percent of radiologists and 96% of emergency physicians use CT as their first-line choice for the diagnosis of pulmonary embolism, according to a report ...
The politics of cancer screening make entrenched beliefs hard to change
With the recent changes in breast cancer screening, mammograms have increasingly used as a political tool.Internist Robert Centor points to an article from Politco, which shows how far it's gone. Not surprisingly, polls have shown that 76 percent of women disagree with the new USPSTF guidelines. And politicians are using this to their advantage. Any suggestion to rein in tests, gets re-framed as, in the case of ...
The most popular medical and health blog posts of 2009
Thank you all for making 2009 the most successful year ever on KevinMD.com, with over 1.3 million visits, and 2.2 million pageviews.Here are the most popular blog posts of 2009. Enjoy, and I wish everyone a Happy New Year.Regular blogging will resume on January 4th, 2010.1. How did Michael Jackson die, and the medicine behind sudden cardiac death2. How long are you ...
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...
