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 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...
