On my way onto the plane for my recent flight home from France I picked up a copy of Le Figaro thinking I might enjoy the article about actress Sophie Marceau, who was on the cover of everything while we were in France in celebration of her turning 40.I did enjoy catching up on Marceau - I still remembering watching La Boum in my high school French class - but ...
August 2010
All Stories
Empiric antibiotics in the ICU
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?
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
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
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?
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
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
"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
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
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
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
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
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
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 ...
Health blog posts of the week, ending August 29, 2010
Here are the top posts from this past week, based on the number of times they were viewed.1. Balancing a surgeon’s beliefs with the needs of the practice2. Why family medicine and internal medicine should not merge3. How patients can stop doctors from blaming them for their health4. Americans will need doctors but physicians are leaving primary care5. Why primary care is like air traffic ...
Hollywood, take notice of this primary care doctor
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
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
KevinMD at BlogWorld Expo 2010 Social Health track
I'm honored to be invited back to BlogWorld Expo's Social Health track on Thursday, October 14, 2010.
I'll be joined on a panel with my esteemed blogging colleagues, Kim McAllister of Emergiblog, Bryan Vartabedian of 33 Charts, and Kerri Morrone Sparling of six until me.We will discuss whether social networks are compatible or competitive with the medical blogosphere.Dave deBronkart, ...
Too many young children are medicated with powerful drugs
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?
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 ...
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....
