My friend, the Buckeye Surgeon, has resisted reforms in medical residency training programs, that have eased some of the inhumane exhaustion on young interns and residents.I have a different view on the subject. This issue generates spirited debate in the blogosphere and in teaching hospitals across the country.Not all medical education reforms, however, provoke controversy. I learned recently from an Ohio medical student that they are now being taught ...
May 2010
All Stories
Social media starts the patient dialogue with doctors and nurses
A patient apologized to me for asking so many questions. There is no need to apologize, I said to the patient; it’s wonderful that you have so many questions concerning your health care. I mentioned to her that she is an “empowered and engaged patient,” and that is a good thing.It’s no secret that health consumers are turning to the internet for health information.In a recent article from MediaPost News, ...
Children with fever may not receive antibiotics in the ER
by John GeverUp to one-third of children with febrile bacterial infections failed to receive antibiotics in a large emergency department, while 20% of youngsters without such infections received antibiotics unnecessarily, Australian researchers said.A computer algorithm based on standard test results could do a better job of assigning feverish children to the correct treatment sooner, Jonathan C. Craig, MBChB, PhD, of the University of Sydney, and colleagues reported online in BMJ.Although ...
False patient contact information worsens emergency care
One of the biggest emergency room problems is contacting patients after they leave.Patients sometimes leave false contact information -- which makes it difficult for the emergency room staff should problems arise after the visit.The issue was illustrated in a piece from msnbc.com. Many times, results like blood cultures or x-ray findings take time to return. And if there's something that needs to be acted upon, contacting the ...
Medical malpractice deposition survival tips for doctors
An excerpt from How to Survive a Medical Malpractice Lawsuit: The Physician's Roadmap for Success.by Ilene R. Brenner, MDThe most important part of your case is upon you: the pretrial deposition. If you do a poor job, you can ruin your case and make a defensible lawsuit become indefensible.So what is a deposition? It is the sworn testimony of a witness taken before trial, in a location ...
10 top health blog posts, April 2010
Here are the top posts from this past month, based on the number of times they were viewed.1. Bret Michaels has a subarachnoid hemorrhage, and what that means2. iPad review for doctors: A hands on guide for medicine3. Neosporin and other OTC drugs to avoid4. Primary care doctors are saying farewell5. An iPad should be mandatory in medical school6. iPad in the ER, a ...
Online dermatology visits for acne can be effective
by Chris EmeryAcne patients who received online treatment from dermatologists had similar outcomes to patients who were treated in the doctor's office, a new study found.Patients who participated in "e-visits" with dermatologists experienced similar reductions in inflammatory lesions as those who had office visits, Alice J. Watson, MBChB, MRCP, MPH, of the Center for Connected Health in Boston, and colleagues wrote in the report, published online April 19 in the ...
How PCOS can be diagnosed and treated in primary care
Hypothetical case scenario27-year old female presents to the office with a complaint of irregular periods. Menarche was at age 15, and periods occur about 1-2 times a year. Breast development began at age 9, followed shortly by axillary & pubic hair. Growth spurt was at age 13. She’s been trying to get pregnant for the last one year now, and has never been seen before for her irregular periods.On physical ...
A cartoon guide to non-clinical jobs for doctors
What awaits some physicians who decide to quit medicine.
(via A Cartoon Guide to Becoming a Doctor)
MKSAP: A 21-year-old man is evaluated for painful mouth sores
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 21-year-old man is evaluated for painful sores in his mouth. Episodes of these sores have occurred two to three times yearly since he was 16 years old, and he believes they are associated with stress. They usually appear on the inside of his mouth as a single, round, painful lesion, lasting for 5 ...
Hiatal hernia in women can present with heartburn
by David Edelman, MDHeartburn and acid reflux disease are common problems affecting women of all ages. The problem develops when acid in the stomach backs up into the esophagus. There is a muscle known as the diaphragm that separates the chest from the abdominal cavity. When you eat or drink, the food goes from the mouth down the esophagus, through the diaphragm and into the stomach. ...
Indoor tanning can be an addictive behavior
by John Gever"Jersey Shore" wannabes beware: some people crave the indoor tanning experience so much that it qualifies as an addiction, researchers said.Among 229 college students completing a survey, 39.3% met DSM-IV criteria for addiction, reported Catherine E. Mosher, PhD, of Memorial Sloan-Kettering Cancer Center in New York City, and Sharon Danoff-Burg, PhD, of the State University of New York at Albany, in the April issue of Archives of Dermatology.Participants ...
Dying of old age in the era of modern medicine
He is 93 and has numerous medical problems, most of which involved aging blood vessels, as well as multiple orthopedic issues, including compression fractures and diffuse arthritis. The bony issues have resulted in a severely compromised mobility of late.Despite ongoing treatment with both aspirin and clopidogrel, he presents after numerous hours of focal neurologic symptoms. A CT scan shows no evidence of bleeding and the diagnosis is a major stroke ...
Non-clinical physician jobs frequently asked questions
I speak with many physicians who are interested in leaving clinical medicine to pursue an alternative career (non-clinical job) and they always seem to ask the same types of questions. Let's dig into some of those "Frequently Asked Questions (FAQs)" by exploring some common questions that are rooted in myths and misconceptions.Here are some questions that I get all the time from physicians who are considering a career transition:1. How ...
Explaining chronic medical treatment to patients
Although some psychiatric conditions are acute and transient, most are chronic. They may wax and wane, but most of them do not go away. Likewise, psychiatric medications can significantly improve people’s functioning and quality of life, but they manage, not cure, mental illness.It’s therefore not surprising that a common conversation that patients and psychiatrists have revolves around the question, “Do I have to be on this medication ‘forever’?”I’ve previously written ...
Autistic enterocolitis may not be real
by Todd NealeThe status of a new inflammatory bowel condition identified in the retracted Lancet paper that linked the MMR vaccine and autism -- autistic enterocolitis -- appears to be in limbo.The 1998 paper by Andrew Wakefield, MBBS, and colleagues was fully retracted by The Lancet in February, although the alleged and repeatedly disproven vaccine link was dropped in 2004 ...
A pre-medical student writes to her gross anatomy cadaver
A letter from a pre-medical student honoring her gross anatomy cadaver.Letter to the other side by Hana LowThank you for donating your body to science and medical education. It's so generous to give yourself to those you will never meet. I hope you're having a good time, up there or wherever you are.Working with your body has made me acutely conscious of the dangers in my everyday environment. I have to ...
Patients and doctors are affected by missed appointments
No-shows are a problem for both doctors and patients.When a patient misses, or fails to schedule, a follow-up or specialist appointment they are not receiving the care recommended by their doctor.And for physicians, when a patient no-shows, they're left with an empty appointment space -- which can be fiscally damaging in a predominantly fee-for-service payment system.The Wall Street Journal cites a study on the issue, which "tracked nearly 7,000 primary-care ...
China medical school and residency training
by Vineet Arora, MDMy husband and I recently traveled to Wuhan Medical School in the Hubei Province in central China.Our medical school has partnered with Wuhan to help inform their curricular reform efforts. We spent 4 days touring the hospitals and teaching facilities, meeting students and faculty, going on rounds, and giving talks. Although the language barrier was challenging, we had incredible translators who worked to translate every ...
Calorie counts in health reform is significant for patients
by Danielle Ofri, MD, PhDCounting calories as part of health care reform—who knew? But apparently it’s there on page 455 of the health-care reform act, according to Marion Nestle, Professor of Nutrition at NYU, writing in the New England Journal of Medicine. There will now be a national effort at posting calorie counts in chain restaurants.There are many ways to improve the overall health of Americans, but tackling obesity ...
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....
