by Emily P. WalkerPhysicians should record body mass index (BMI) of their pediatric patients during routine offices visits, according to a sweeping new plan laid out by a White House task force on ways to shrink childhood obesity rates over the next 20 years.The inter-agency President's Task Force on Childhood Obesity was formed three months ago as part of the Let's Move! initiative and was given 90 days to draft ...
June 2010
All Stories
6 reasons why people commit suicide
Though I’ve never lost a friend or family member to suicide, I have lost a patient.I have known a number of people left behind by the suicide of people close to them, however. Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced. Pain mixed with guilt, anger, and regret makes for a bitter drink, the taste of which ...
Why stress in doctors needs to be recognized and treated
Do doctors take care of themselves?Sometimes, patients may better follow the advice of physicians that are not obese and don't smoke. That was a question asked in a post last year, entitled, When fat doctors talk to obese patients.According to studies, as reported in the Wall Street Journal, it's a mixed bag:
Physicians as a group are leaner, fitter and live longer than average Americans. Male physicians keep ...
Patients who attempt suicide and withdrawal of medical care
If a person tries to commit suicide, could that be considered as a statement that this person wishes to die and does not want aggressive treatment to save his or her life?Not from a legal standpoint, and not if you are living in the United States.A middle-aged man with a long standing history of depression decides to end his life. He puts a large caliber gun straight to his forehead ...
Patients who are dying and their awareness of death
by Brad Stuart, MDRob Pardi’s comments in Pallimed affected me deeply. His honesty, integrity, and willingness to share were so impressive that I feel reluctant to take issue with anything he had to say. Yet today I find myself somewhat in conflict with his message.Rob’s wife, a palliative care doctor, died of cancer recently and her story, published in the New York Times made it sound as if ...
Questions patients should be asking their doctors
An excerpt from Top 5 Questions to Ask Your Doctorby Sagar Nigwekar, MD and James Sutton, RPA-CTips for Talking to Your Doctor Entering a doctor’s office can be like entering a different world. There are often “rules” and “protocols” that the doctor, nurses, and staff follow that you may not be familiar with. This book offers some very helpful questions for you to have an intelligent conversation ...
Working overtime can increase coronary artery disease risk
by Todd NealeBritish civil servants working three to four hours longer than usual per day appear to have an increased risk of having a coronary heart disease event, a prospective cohort study showed.After accounting for traditional cardiovascular risk factors and other variables, those working 11 to 12 hours per day had a 56 percent greater risk of coronary death, nonfatal myocardial infarction, or angina than those who worked normal hours, ...
Prevention improves health and lowers healthcare costs
Prevention is the key to both better health and lower healthcare costs over the long haul. This is where the nation — and each of us as individuals — needs to put energy and resources. In the long run, it is more important than addressing the high cost of new technologies and drugs or their inappropriate overuse.Today, the U.S. basically has a medical care system rather than a health ...
Some patients think primary care is worthless
How much is a primary care appointment worth?Not much, it appears.Physicians in California decided to embark on an innovative idea, asking patients to simply pay them what they thought the visit was worth.Here's how it worked:
On the day of the events, no insurance was accepted. Care was provided only to the uninsured, who were asked to pay what they could afford. Laboratory tests were provided at cost, and patients ...
My USA Today column on resident work hours
My latest USA Today column is now online and will be in Wednesday's paper: Shorter doctor-trainee hours alone not solution.
I discuss the controversy surrounding limiting resident work hours, and explain why simply instituting a hard 80-hour weekly cap, along with mandatory naps, may not be the answer.There's little question that tired doctors make more mistakes, but the medical errors ...
Academic internal medicine as a physician career choice
I received a wonderful inquisitive e-mail from a 1st year medical student. He aspires to an academic internal medicine career and, as a non-traditional student with an MPH, has realistic goals. He asks:
What scares me is the prospect of going into a relatively low-paying specialty in such a non-lucrative practice environment with such massive educational debt. Are there any other challenges to going into internal medicine that are unique to ...
Nurse practitioners, doctors, and the lost art of diagnosis
The topic of nurse practitioners in the context of primary care has been resurgent of late, most notably in this post by Maggie Mahar. Much of the conversation is dominated by assertions such as this:
…Nurse Practitioners have the needed training and that, in fact, doctors who have gone through the full medical school curriculum are over-qualified for a job that, today, is more about ...
Cholesterol can be improved by eating nuts
by Todd NealeEating nuts improves blood lipid levels, which may help stave off heart disease, researchers found.In a pooled analysis of 25 intervention trials, eating an average of 67 grams of nuts a day (2.4 ounces) reduced total cholesterol by 5.9% and LDL cholesterol by 7.4% (P<0.001 for both), according to Joan Sabaté, MD, DrPH, of Loma Linda University in California, and colleagues.The ratios of total to HDL cholesterol and ...
Clean your healthcare site to become more efficient
Spring cleaning is a tradition in many homes. The occupants open up the home to the spring air, thoroughly clean the home, and sort through the accumulated goods, getting rid of things not used for a long time and which no one wants anymore. It gives one a sense of accomplishment, makes for a more pleasant surrounding and frees up space.Is this something that you do at your healthcare site ...
Why prescription drugs are not taken by patients
How many patients actually take the prescription drugs that their doctors prescribe them?Less than you think.Pauline Chen, in a recent New York Times' column, discusses the worrisome issue of medication noncompliance.And the numbers are stark. According to the data, "as many as half of all patients did not follow their doctors’ advice when it came to medications," and, "more than 20 percent of first-time patient prescriptions were never ...
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...
