Among medical specialties, some are more prestigious than others. You can generally tell which ones are more prestigious by how well they pay. Surgery and cardiology, for example, rank at the top of the prestige scale. Psychiatry and dermatology are near the bottom.One can also ask if some diseases are considered more prestigious than others, in the opinion of doctors.A Norwegian doctor, Dag Album, has been investigating the prestige ...
July 2010
All Stories
How to treat patients who want everything
by Lyle Fettig, MDThe Annals of Internal Medicine had a perspective article by palliative medicine communication gurus Drs. Tim Quill, Bob Arnold, and Tony Back which details an approach to discussing treatment preferences with patients who want "everything."When I think of a patient requesting "everything," I typically think of it as a response to a physician who offers the patient the choice of "doing nothing" if the patient's heart ...
Post-traumatic stress disorder (PTSD) may increase dementia risk
by Todd NealeOlder U.S. veterans with post-traumatic stress disorder (PTSD) appear to have an increased risk of developing dementia, a retrospective study showed.Compared with those without PTSD, predominantly male veterans with the disorder had a 1.77-fold (95% CI 1.70 to 1.85) greater risk of developing dementia, according to Kristine Yaffe, MD, of the San Francisco Veterans Affairs Medical Center and the University of California San Francisco, and colleagues.The results were ...
Physicians have no excuse for years of unread echocardiograms
At least 200 patients whose echocardiograms went unread by a cardiologist for as long as three years have died, according to a new article in the New York Times by Anemona Hartocollis.Equally troubling, a cardiologist reading some of the tests says that he has found “life-threatening diagnoses” on some of the tests.The Times reports that medical officials said that “none of those patients needed ‘follow-up care.” But the cardiologist, ...
Euthanasia in dogs and the moral lessons for doctors
We had our dog put down yesterday.Simon joined our family when our son was 10 years old as a two year old that we adopted from the Purdy Prison Pet Parole Program and was with us until he developed status epilepticus forcing our decision to have Simon euthanized.Simon had been getting old, lame, nearly blind, and uncomfortable most of the time, but we felt he still had some enjoyment in ...
Florida EMTs may go bankrupt because of a malpractice lawsuit
An ambulance service was recently held liable for failing to “do what was necessary” before accepting emergency transport of pregnant patient.A child was born at 25 weeks gestation -- 15 weeks premature -- and was not breathing. Babies born at this age have a viability of 50-70%. In other words, up to half of children born at this age of gestation die. The family called 911. The paramedics arrived, ...
Drinking and smoking associated with migraine headaches
by Kristina FioreDrinking coffee and alcohol, smoking, and lack of physical activity all appear to be associated with migraine and tension-type headaches in teenagers, researchers found.High consumption of cocktails appeared to put students at the greatest risk for these headaches, increasing the odds almost three-and-a-half-fold, Astrid Milde-Busch, PhD, of Ludwig Maximilians University Munich in Germany, and colleagues reported online in the journal Headache."Rather unexpectedly, recommendations to increase fluid intake as ...
A medical home does not guarantee increased patient satisfaction
One of the more notable findings from the special report on the TransforMED National Medical Home Demonstration project was that “patient satisfaction doesn’t automatically go up.”Terry McGeeney, CEO of TransforMED, attributed the lack of increased patient satisfaction experienced by the 18 participating physician practices to a variety of factors, chief of which “was the turmoil of change experienced by patients as practices implemented after-hours access, quick access to laboratory results ...
Op-ed: Paying patients to stay healthy widens the wealth gap
The following op-ed was published on June 15th, 2010 in the New York Times' Room for Debate blog.In an effort to control health spending, companies are spending more money than ever to keep their employees healthy. More than half of large businesses, for instance, offer financial incentives to employees who complete smoking cessation or weight management programs.When you consider that over 40 percent of premature deaths ...
Chemicals that cause cancer can’t be accurately studied
Nicholas Kristof in the New York Times writes about a new report from the President’s Cancer Panel calling attention to the role common chemicals may play in the development of cancer.The overarching message is that we should be exercising much more caution in our trust of chemicals.I am not familiar with the nuances of regulatory policies for chemicals, but (as Kristof points out) the “existing regulatory presumption [is] that ...
Customer service needs to be a priority in health care
What do Enterprise Rent-a-Car, KeyBank, and the Cleveland Clinic have in common?They all make customer (patient) satisfaction a top priority.They accomplish this in industry-specific ways, but together their emphasis on service as a passion shares common themes:1. Buy-in for a service culture comes straight from the top, and permeates the entire organization. 2. Copious resources are delegated to building a service culture, starting with hiring. 3. Employees are “hired for fit.” If ...
Children of lesbian mothers have healthy psychological growth
by Kristina FioreChildren born to lesbian mothers appear to have healthy, if not better, psychological development when compared with average American children, researchers have found.In the first prospective cohort study of its kind, these children were found to have better social, academic, and overall competence and significantly fewer social problems than typical American children, according to Nanette Gartrell, MD, of the University of California, San Francisco, and Henry Bos, PhD, ...
Infant symptoms that worry parents in the first week of life
There are several things that parents will notice the first week of life. Most of these concerns are related to physical appearance.Fortunately, these are all normal and anxiety is not warranted.Flea-bite rash. Infants will often have a rash that looks like several flea bites at various places on the body. This is called Erythema Toxicum. The name sounds awful, but the rash is of no significance. It goes away in ...
What doctors can learn from Dave Weigel and Journolist
Dave Weigel was formerly a blogger at the Washington Post who covered conservative politics.He was ousted from his position after incendiary statements made on Journolist, a left-leaning listserv maintained by the liberal blogger at the Post, Ezra Klein.Journolist is no more, but there's fallout from this episode that physicians should be wary about.Jeffrey Parks first made the connection about a similar, closed community that physicians participate in. Namely, ...
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....
