March 2010

All Stories

Twitter has problems in the operating room

in Social media | 2 responses

Twitter has been making its way into the operating room.I recently wrote about it, saying, "It’s an efficient, and effective, way to transmit medical findings instantly, and to a wide audience." But patient privacy concerns remain, given the relative ease it takes to Tweet news.Cardiologist Wes Fisher, however, isn't convinced. He notes that when a hospital representative is sitting in the corner of the operating room providing ...

Homebirth does not protect against serious maternal infections

by | in Conditions | 11 responses

Homebirth advocates like to tout the many "advantages" of giving birth at home. High on the list is limiting exposure to hospital acquired infections, and since only your "own germs" are in your home, you are protected.Yes, you are protected from hospital acquired infections, but the most dangerous infectious agents are actually those that live inside the mother, not the ones in the hospital. Consider that for newborns both Group ...

Patient costs when making medical decisions

by | in Patient | 13 responses

At my office we provide care for a fair number of patients without medical insurance. Sometimes we are faced situations with no good options.At a patient visit, often times the diagnosis is not clear without doing some diagnostic tests other than the history and physical exam. Many of these tests are ordered from sources outside the office, where I have little or no control over the cost of the test ...

EMR conversion doesn’t always help physician communication

in Tech | 7 responses

by Stuart Sutton, MDOur very large and very integrated health care system is plowing ahead with EMR implementation. All the offices are gradually converting from paper charts and all the hospitals have completed the process.As a member of one of the last offices to be converted to the EMR, I’ve had the pleasure of patients being assured that the notes were sent to me (albeit via the EMR we are ...

Physical exam evidence and whether it’s still useful

by | in Conditions | 6 responses

A number of respected physicians have called for a renewed emphasis on the physical exam. Perhaps most prominently, Abraham Verghese has joined with colleagues at Stanford University to publicize the Stanford 25, a list of physical-exam maneuvers that they hold should be required of internal medicine residents.These calls reflect in part the fear that checklist medicine will lead to doctors' obsession with what Jerome Groopman calls the "iPatient" (the ...

Use iPhone apps for emergency room wait times with caution

in Tech | 2 responses

by Satish MisraEmergency rooms are notorious for their long waiting times – that’s pretty common knowledge. But now the Hospitals of Central Connecticut are looking to a new medical app for the iPhone to help improve their emergency room wait times.Having spent a fair amount of time recently working in an emergency room, I (and probably everyone with similar experiences) can assure you that no one – physicians, nurses, administrators ...

PSA for prostate cancer screening is likely to continue

in Conditions | no responses

Originally published in MedPage Todayby Crystal PhendThe ASCO Genitourinary Cancers Symposium met recently, just after the American Cancer Society updated its prostate cancer screening guidelines to emphasize shared decision making and Congress heard testimony over use of prostate specific antigen (PSA) in prostate cancer screening.PSA for prostate cancer screening is likely to continue Now urology is no stranger to debate. Controversy continues on overdiagnosis, overtreatment, and other issues raised ...

USA Today op-ed: How patient satisfaction influences medical decisions

in Potpourri | 6 responses

My latest USA Today op-ed was published this morning: Patient satisfaction surveys have drawbacks.I discuss how patient satisfaction scores affect physician salaries, which may, in turn, influence medical decision making.  Of course, patient satisfaction is important and should be measured -- but it's a mistake to use them in part to determine physician compensation. Here's an excerpt:

USA Today op ed: How patient satisfaction influences medical decisionsQuality health care sometimes ...

Nursing needs to confront a culture of bullying

in Education | 6 responses

Who knew nursing could be so abusive?Nurse Theresa Brown, in a blog post from the New York Times' Well, reveals the ugly side of nursing.It's known within hospital walls that "nurses eat their young." Indeed, as Brown writes, "the expression is standard lore among nurses, and it means bullying, harassment, whatever you want to call it. It’s that harsh, sometimes abusive treatment of new nurses that is entrenched ...

A patient live blogs his hospital stay, looking for a cure

in Physician | 8 responses

Here's a novel, and incredible, use of social media in health care.A 40-year old man was admitted several days ago with a fever of unknown origin. His significant other, Laura, is live blogging his hospital stay -- hoping to solicit other medical opinions on the case, as there is no clear reason on what is causing his symptoms.Blogging at The Z Update, here's an excerpt of how he ...

PSA screening for prostate cancer debated in Congress

in Conditions | 3 responses

Originally posted in MedPage Todayby Emily P. Walker, MedPage Today Washington CorrespondentA day after the American Cancer Society (ACS) released updated prostate cancer screening guidelines, the group's chief medical officer was before Congress urging the government to fund research into alternative screening methods for prostate cancer.PSA screening for prostate cancer debated in CongressOtis Brawley, MD, an oncologist and chief medical officer for the ACS, told the House Oversight ...

Why doctors should blog with their real name

by | in Social media | 21 responses

Blogging is a great way to get things into an open forum for discussion.  But I still have nagging doubts about doctors who post blogs or replies about healthcare issues without giving their names.As a new blogger, I often look at those replies to my postings that are anonymous and think, “Who are you? Why do you think the way you do? Why will you not put a name and ...

Poetry that your patient can appreciate

in Patient | no responses

by Danielle Ofri, MD, PhDWhen I make rounds with my students and interns, I always try to sneak in a poem at the end. I think poetry is important because it helps convey the parts of the medical experience that don’t make it into textbooks. It’s important because it teaches creative thinking—something of immense value to doctors.It’s important because interpreting metaphors is a critical clinical skill in diagnosis; patients’ symptoms ...

7 ways inmates can receive quality medical care from doctors

by | in Patient | 3 responses

Many non-correctional health care providers will also treat inmates from time to time. This may occur in the office or hospital. How can one best approach the challenges of working with the incarcerated in order to deliver the best possible care while simultaneously managing risk?1. Treat the patient with respect. Not submissive respect, but mutual respect — the way we all want to be treated. I believe that this principle ...

Children with special healthcare needs are underinsured

in Policy | 2 responses

Originally published in MedPage Todayby Chris Emery, MedPage Today Contributing WriterChildren with special healthcare needs are underinsured Nearly a third of children with special healthcare needs are underinsured, and where a child lives strongly influences whether he or she will have adequate healthcare coverage, a new study found.The unadjusted proportion of underinsured special-needs children varied strongly by state, ranging from 24% in Hawaii (standard error=1.75) to 38% ...

Mammogram screening divides doctors and patients

in Conditions | 17 responses

Mammogram screening for breast cancer continues to simmer in the news.The recent USPSTF guidelines, no longer recommending a routine mammogram for women between the ages of 40 and 49, continue to stir controversy between physicians and their patients.In a recent survey from the Annals of Internal Medicine, it looks like the debate between doctors and patients will continue for the foreseeable future:

. . . a divide has emerged ...

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