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 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....
