More patients are on the web researching health information, and for the most part, this is a good thing.But are doctors in danger of being "phased out" by Google and other search engines?In an interesting perspective piece by Pamela Hartzband and Jerome Groopman in the New England Journal of Medicine, the answer appears to be no.Data without expertise in interpretation is largely meaningless. Consider this patient the authors ...
April 2010
All Stories
Neosporin and other OTC drugs to avoid
Most people use non-prescription medications without giving much thought to the potential side effects or problems that may be associated with their use.Here are 5 popular OTC meds you should avoid, and better alternatives. I bet most of you use one or more of these. Neosporin, Topical Vitamin E, Afrin nasal spray (or other short acting nasal decongestant sprays), daily headache medications, and sedating antihistamines.1. Neosporin: Neosporin in the most ...
Placebo effect power, as shown by a magician
Magician Eric Mead shows us a magic trick and talks about the placebo effect at TEDMED 2009.classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="430" height="295" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
Emergency departments are frequently used by young adults
by Kristina FioreTwenty-somethings rely on emergency departments (EDs) for care far more than do other age groups, researchers have found.In 2006, nearly a quarter of all young adult healthcare visits -- 22.1% -- took place at an ED, compared with 12.6% for children and adolescents and 8.3% for patients over 30.That rate has significantly increased over a 10-year period, Robert J. Fortuna, MD, MPH, of the University of Rochester Medical ...
iPad review for doctors: A hands on guide for medicine
The iPad has finally been released and we’ve got our hands on one so we can provide the medical community a healthcare perspective of the device. Here are my initial impressions.
Fits in your white coat
The iPad should fit comfortably your white coat. If you continue on to the rest of the review you’ll see pictures of the device easily settling into ...Recertification doesn’t help doctors improve patient care
I'm due to recertify in Internal Medicine soon, so a recent perspective from the New England Journal of Medicine caught my eye.Of the many criticisms of the Maintenance of Certification Exam, one that stands out is whether the format and questions were relevant to modern clinical practice.It's not.Two contrasting opinions were written, and I'm inclined to agree with the dissenting commentary. There is little data correlating those who ...
iPhone medical apps may be medical malpractice targets
by Satish MisraMedical practice is a big business. Conservative estimates put the total cost of medical malpractice at nearly $35 billion annually and, according to a Kaiser Family Foundation report, nearly $5 billion is paid in claims each year. With an average claims payment of about $300,000 and up to 50% of that going to the lawyers representing the patient, its not surprising that practically every show on cable ...
10 top health blog posts, March 2010
Here are the top posts from this past month, based on the number of times they were viewed.1. Free iPhone medical apps that every doctor can use2. Match Day and how each medical school celebrates3. Nurse practitioners will not solve the primary care shortage4. Medicare cuts will strengthen doctors’ negotiating position5. Medicare slashes pay to doctors, and what that really means6. CRNA salaries surpass ...
Flu may be associated with seasonal deficiency of vitamin D
by Michael SmithIf you look at the world map, the shapes of South America and Africa look as though they should fit together. Maybe they were once together and then drifted apart.That theory was first put forward in the late 1500s by a Dutch map maker, but it wasn't until the 1960s that the discovery of plate tectonics finally put the idea on a -- well, ...
Can house calls be revived under health reform?
Beginning in the 1970s, the house call began a slow death. As the medical-industrial complex (MIC) burgeoned, with bigger hospitals and a surfeit of technology, it became incumbent on patients to come see us rather than us going to see you.Yet there are pockets of house calls still left in the U.S.For the geriatric age group, there has been growth in the care-at-home sector, especially for homebound elders. They can ...
Statistical analysis in medical journals should be unbiased
by Todd NealeEditors of medical journals should unite in requiring independent statistical analyses of industry-sponsored clinical trials, according to the two top editors of the Journal of the American Medical Association.Such a measure would help prevent any inappropriate influence from the study sponsors on data analysis and reporting, wrote Catherine DeAngelis, MD, MPH, editor-in-chief of JAMA, and Phil Fontanarosa, MD, MBA, executive deputy editor ...
Cell phone use and driving requires attention that few have
by Crystal PhendOnly one person in 40 has an extraordinary ability to do safely what many take for granted in daily life -- talk on a cell phone while driving.These "supertaskers" excelled on a simulated driving exercise and a demanding, simultaneous test of memory and math skills conducted over the phone without any loss in performance on either, according to Jason M. Watson, PhD, and David L. Strayer, PhD, both ...
Op-ed: Patient satisfaction doesn’t mean the best medical care
A version of this op-ed was published on March 15th, 2010 in the USA Today.If you recently saw a doctor, you might subsequently receive a survey in the mail asking whether your physician was friendly, spent enough time with you, or showed the appropriate level of concern for your medical issues.Patient satisfaction surveys are being increasingly used in hospitals nationwide. Press Ganey, a leading organization measuring patient satisfaction, counts more ...
Children who are traumatized need more than medication
In the Academy Award winning film, Precious, the main character’s transformation comes about largely through her ability to tell the story of her trauma, specifically in the form of writing. In this endeavor she is encouraged by a loving teacher.In the book History Beyond Trauma, two French psychoanalysts argue that symptoms their patients exhibit represent the horrors of war that are not spoken of, sometimes for generations. The patient is ...
Patient beliefs and their role in non-adherence
Patient non-adherence is a big problem. Non-adherence among chronic disease patients is associated with higher rates of hospital re-admissions, higher costs and poorer outcomes.Research has identified over 200 possible factors thought to influence patient adherence. According to the experts, these factors can be categorized into two groups:1. unintentional non-adherence 2. intentional non-adherence.Unintentional non-adherence is related to a patient’s ability and resources to take their medication (e.g., problems with manual ...
Retail clinics are starting to do more primary care
by Joyce FriedenRetail clinics aren't just for strep throats any more; they'll also be managing diabetes and other chronic diseases."It's a new service strategy," Sandra Ryan, CPNP, told attendees at a meeting on retail clinics sponsored by the Convenient Care Association and the Jefferson School of Population Health."We're evolving our clinic offerings," said Ryan, chief nurse practitioner officer for Take Care Health Systems, which operates retail clinics inside Walgreens pharmacies, ...
Should doctors Google their patients?
It's well known that patients Google their doctors, a practice that's performed with increasing frequency.But what about doctors researching their patients on the web?It's an interesting idea that I hadn't thought of. I have never Googled a patient, and can't see any reason to in a primary care setting. But the context of the piece, which I first saw in the WSJ Health Blog, was in psychiatry. ...
AMA: Health reform victories for physicians and what still needs to be done
A guest column by the American Medical Association, exclusive to KevinMD.com. by J. James Rohack, MD
As our country turns the corner on the historic path toward health system reform, many physicians are left with questions as to how this new law will affect them and their patients.The AMA has been an active participant in the health reform debate since ...
Medicine residency survival tips during pregnancy
by Dr. Whoo, MDQ. I just found out last week that I'll be a new mom in November, making me an official mother in medicine! I've been reading the blog for a while, because I love hearing what all of you have to say about your lives. Here's my question: What tips would you give for surviving residency while pregnant, especially 30-hour calls (without caffeine)?-- From a future mom and ...
Advance planning helps families cope with loss
by Crystal PhendAdvance planning improves end-of-life care for elderly patients and helps families cope with the loss, researchers found.In a randomized trial, hospitalized patients over age 80 who were formally assisted with documenting their end-of-life treatment wishes and with designating a surrogate were almost three times more likely to have those wishes followed (86% versus 30% in usual care, P<0.001).Family members of patients in the advance planning intervention reported significantly ...
Kevin Pho, MD
-
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...
-
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....
-
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...
-
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
-
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...
-
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. ...
-
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....
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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....
