August 2010

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Empiric antibiotics in the ICU

by | in Meds | one response

Last year, I commented on the ironic sameness of ICU infectious diseases — that incredibly sick, complex patients entered the ICU with vastly different problems, then over time, seemed to converge, presenting similar kinds of clinical issues and management challenges for the ID doc.Or, as a visiting medical student said to me, “My ICU attending said that every patient in the ICU should be on vancomycin and Zosyn.”Which brings up ...

What is Glenn Beck’s macular dystrophy?

by | in Conditions | 4 responses

During a recent speech from his American Revival tour, Glenn Beck, 46, announced that he has an eye condition called macular dystrophy that could cause him to go blind. Speaking in front of a large group at his “Revival America” tour, the Fox News pundit told the crowd:“A couple of weeks ago I went to the doctor because of my eyes, I can’t focus my eyes…he did all kinds of ...

A fundamentally new approach to treating glioblastoma multiforme

by | in Conditions | one response

Only rarely does an experienced editor get a spine tingle from a new paper. For the first time ever, today, I predict that a Nobel Prize for medicine will be awarded to J. Martin Brown, DPhil, Oxford, a professor at Stanford University School of Medicine.Professor Brown and his colleagues have discovered and reported a fundamentally new approach to the treatment of solid tumors, beginning with the devastating glioblastoma multiforme.Here is ...

How JetBlue can improve your medical practice

by | in Physician | 11 responses

I got a chance to fly JetBlue for the first time recently. Since I had heard so many good things about the airline, I was looking forward to experiencing the JetBlue, well, experience.I took four flights in total with them. While outbound, they lost my bag. While inbound to Chicago, my last leg was delayed about 2 hours. I then I had to wait another 80 minutes for my bag ...

Should physicians undergo random drug testing?

by | in Physician | 34 responses

Lucian Leape MD, a public health professor at Harvard, wants to subject doctors in America to strict random and periodic drug testing to help identify those physicians who are impaired. All in the name of patient safety, of course:

"I'm very much in favor of random testing," Dr. Leape says. "We have a responsibility to identify problem doctors and bring them into treatment." And to protect patients in the process.
Ok, I ...

iPad health care use by doctors, a comprehensive infographic

by | in Tech | 2 responses

MobiHealthNews released a comprehensive infographic on physician use of the iPad, a distillation of their report on the issue.The iPad has been covered previously on this site. The form factor holds tremendous potential, as this Dartmouth physician noted, "the iPad offers a 'low profile' that doesn't seem intimidating to patients during exams." That's especially important as it can allow doctors to maintain eye contact with their ...

Watchful waiting pays off for a torn ACL

by | in Conditions | 6 responses

"Why golf," my friends often ask. They, like too many Americans, assume it is a sport for the country club set, and have a hard time fathoming why someone like me -- liberal, somewhat intellectual, decidedly anti-elitist -- would passionately embrace the game.My answer is always brief and direct. When I was 35, I tore my right knee's anterior cruciate ligament during one of my twice-weekly pick-up basketball games in ...

Whooping cough and pertussis tips you need to know

by | in Conditions | 5 responses

As a whooping cough epidemic hits California, you may be asking yourself, “hey, weren’t we all vaccinated for that?” Even as the headlines imply a Victorian-level outbreak of hacking and coughing, perhaps you’re looking around and wondering where, exactly, this epidemic is located. And what you should know about whooping cough to protect you and yours.Here are some fun, weird, and sometimes worrying tidbits to know about whooping cough. Pass ...

Southern states may block the government from delivering health care

by | in Policy | 7 responses

I have lived on the Gulf Coast for all but 5 of my 50 years. I grew up in Baton Rouge, Louisiana and now live in Mobile Alabama.I was educated in the public schools during the height of the desegregation battles and my experiences were colored by those battles in a number of ways. I ran track in high school and was in the racial minority on that team (as ...

Root beer bonds a chemotherapy patient with his oncologist

in Conditions | 5 responses

by Krupali Tejura, MDI am treating a patient for head and neck cancer -- which can be one of the most harrowing therapies.To receive chemotherapy and radiation concurrently can be pretty debilitating. Swallowing foods can be next to impossible, and the taste changes and saliva changes are brutal. It's one of the harshest areas to treat ... and I warn the patients beforehand: ...

Why the sustainable growth rate formula (SGR) is here to stay

by | in Policy | 8 responses

According to the Washington Post, it is highly unlikely that Congress will undo the planned "sustainable growth rate formula" (SGR) mandated Medicare fee schedule cuts. While there's an outside chance of a fix, the American Medical Association, as well as other organized physician groups, can't be happy about the constant threat of the 20% payment reductions.Recall that the SGR was signed into law back in 1998. It was designed to ...

Effect of the Massachusetts Gift Ban law on area restaurants

by | in Meds | 13 responses

I recently debated Steve DiFillippo, owner of Davio's and Avila's restaurants, on the WGBH program Greater Boston, hosted by Emily Rooney. The topic? The effect of the Massachusetts Gift Ban law on area restaurants.On one level, it was a friendly debate on the economic impact of the law on those restaurants that depend on drug company sponsored dinners for a chunk of their income.But on another level, this is a ...

Computerized Physician Order Entry (CPOE) affects patient safety

by | in Tech | 6 responses

Recently, yet another alarming Computerized Physician Order Entry (CPOE) study made headlines.According to Healthcare IT News, The Leapfrog Group, a staunch advocate of CPOE, is now sounding the alarm on untested CPOE as their new study "points to jeopardy to patients when using health IT." Up until now we had inconclusive studies pointing to increased and also decreased mortality in one hospital or another following CPOE implementation, but ...

Hollywood, take notice of this primary care doctor

in Physician | no responses

Doug Farrago is a family physician in Maine, and the editor of the entertaining Placebo Journal.He uses his Placebo Journal media platform to show his audience what primary care is all about. In this video, Doug Unplugged, he gives us a little taste of that journey.Hollywood, take notice.classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="425" height="344" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">

What’s new on KevinMD.com

in Potpourri | no responses

I want to thank you all for reading KevinMD.com. The conversation sparked by the posts has been sometimes controversial, but always insightful.A special thanks to the regular contributors, now numbering over 125 health care professionals and patients who add their own distinct voice to the health care discussion.Here's what's new on the site.1. KevinMD.com on LinkedIn. In addition to the 23,000 who follow on Twitter, and 3,800

Too many young children are medicated with powerful drugs

by | in Meds | 7 responses

Recently while cleaning out my office in anticipation of my new job, I discovered that I had unknowingly been witness to to an historic moment in child psychiatry. I found a binder from a course I had taken in June of 2001 sponsored by Harvard Medical School on Major Psychiatric Illnesses in Children and Adolescents.Though I did not remember until I looked at my scrawled notes in the margins, on ...

Does a stereotypical surgical personality exist?

in Physician | 8 responses

by Shawn VuongRecently, our class learned and practiced how to correctly 'scrub' for surgery. During this little lab activity, we were all gowned up and washing our hands when a couple of classmates asked if I was going to be a surgeon.I said I didn't really know yet, although I did find surgery pretty fascinating. With that, they told me that they thought I would make a good surgeon. due ...

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