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 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....
