by Kristina FioreJennifer Goodman Linn, 39, has been through five surgeries and six rounds of chemotherapy since 2004, trying to control the sarcoma that keeps growing in her abdomen.
Tips for patients during an emergency department visit
An excerpt from Treat Me, Not My Age: A Doctor's Guide to Getting the Best Care as You or a Loved One Gets Older.by Mark Lachs, MDOver my twenty-five-year medical career, the route by which people are admitted to the hospital for an overnight stay has subtly evolved in ways that most patients (and even many doctors) may not realize. Specifically, the proportion of ...
Marginal treatments at a high emotional cost from families
My father passed away about two weeks ago after battling a brain tumor for some time.Initially diagnosed with an extensive inoperable mass one and one-half years ago, upon presenting with a focal seizure, he did well with only one medication for seizure control for about ten months. Around Christmas of 2009, however, he landed in the hospital in status epilepticus that took three days to control. After these days of ...
Doug Farrago in the New York Times and a Tough Medicine demo video
Congratulations to the Placebo Journal's Doug Farrago, recently profiled in the New York Times.The piece highlights his work at blending humor and medicine, as well as his attempt at getting a family physician-based reality show off the ground. A Supernanny, of sorts, for primary care.Here's a demo for the show, called Tough Medicine. Enjoy, and best of luck Doug.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">
When patients are willing to share their stories
We say we exchange words when we meet. What we exchange is souls. -Minot J. Savage It was Monday evening. The shelves in the electronics department overflowed with different styles, prices, and brands of headphones, all displayed in sealed plastic cases. I was in the mood to buy but was baffled by the array of options in front of me. This was not going to be as simple as I had thought.A young ...
How you can avoid skin cancer risk
Skin cancer is the most common form of cancer diagnosed in the United States.There are three major types: basal cell, squamous cell and melanoma. Of those, basal cell and squamous cell are most common, accounting for about 3.5 million cases in the United States per year. Although, these types typically do not metastasize, they can be quite disfiguring, particularly after resection when they occur on the face. On a population ...
Why the expansion of Alzheimer’s may not be helpful
You probably saw the July press reports: balmy tropical breezes, azure surf, cerebral plaques and tangles, and new criteria for Alzheimer's.Who could deny an opportunity to spend some time at the best non-oil-spoiled beaches for those who toil at the benches and bedsides for Alzheimer's victims -- and on taxpayer money yet.It seems to me like, just as human hip and knee joints and premolars and molars are not preprogrammed ...
Fact or Fiction: ADHD in America, panelist video interviews
On September 16, 2010, I attended Fact or Fiction: ADHD in America, a Capitol Hill Forum, along with Val Jones of Better Health and Rob Lamberts of Musings of a Distractible Mind.The event, coinciding with ADD/ADHD Awareness Week, was a panel discussion discussing the impact ADHD has on our society.It was sponsored by Shire, in partnership with the Entertainment Industries Council (EIC) and the Lab School of Washington [Disclosure: ...
10 cancer signs women shouldn’t ignore
by Karen Lu, MDIf you’re relatively young and healthy, gynecologic cancers probably aren't on your radar. But they should be.This year, more than 80,000 women in the United States will get a gynecologic cancer, such as endometrial (a.k.a. uterine), ovarian or cervical cancer. In general, gynecologic cancers occur more frequently in women after menopause, although they can occur in younger women. While all women should ...
What motivates health care workers is needed to explain health care costs
As part of the new health care legislation, the government has instituted Medicare's Physician Quality Reporting Initiative (PQRI) in an attempt to motivate health professionals to do the right thing.According to the legislation, PQRI asks physicians to report how the care they furnish aligns with evidence-based clinical guidelines for a variety of medical conditions, such as diabetes or heart disease. In 2010, physicians who successfully report these measures will receive ...
DTC advertising is annoying but should it be banned?
Should the public be shielded from medical information that can mislead it?Many argue against direct-to-consumer (DTC) advertising, which is omnipresent in print and on the airwaves. Opponents of this practice argue that it promotes the use of expensive medications when patients ask their doctors if the "drug is right for them," the tag line that appears at the end of every ad. This phrase is the drug company’s limp disclaimer ...
Switching diabetes patients from Avandia to Actos
I have a lot of diabetes patients and have been an avid user of the thiazolidinediones (TZD) class. There are many reasons to like the TZD's:
- The older, generic medicines like metformin and sulfonylureas are known to fail over time. After 3 years, most patients on one of these drugs lose control of their blood sugar. In contrast, patients on TZD's maintain glycemic control (at least up to 4-5 years which ...
The Night Shift: Real life in the heart of the ER, an excerpt
An excerpt from The Night Shift: Real Life In The Heart of The E.R. ©2010 by Dr. Brian Goldman. Published with permission from HarperCollins Publishers Ltd. All rights reserved.Fear and Loathing12:47 a.m.Two police detectives were waiting for me near the main triage desk; one was a tall male in a sleek black suit, probably in his early forties. He was ruggedly handsome in the manner of Jean-Paul Belmondo, the ...
Prevention is the best influenza protection
For years, we have heard (and I have often said) that an average of 36,000 Americans die from influenza annually.This figure is based on data from 1990-1999. Now the CDC is telling us that the range of annual deaths is too wide to continue using that single number. Based on a lot more seasons (1976-2007), the average is closer to 24,000 with a range of about 3,300 to ...
Preoperative evaluation can lead to unnecessary tests and may waste money
What's one of the biggest culprits for the rise of unnecessary medical testing?Preoperative evaluation.Before most patients undergo surgery or an invasive procedure, they are normally sent to their primary care physicians for a "preoperative evaluation." This is a visit to determine if they are medically stable enough to undergo the operation.Tests like bloodwork, an EKG, or a chest x-ray are frequently ordered. For those with suspicion of coronary artery ...
ACP: Primary care education and training: Time for change?
A guest column by the American College of Physicians, exclusive to KevinMD.com.by John Tooker, MD, MBA, MACP
The Annals of Internal Medicine recently published an article by Mullan and colleagues on the social mission of medical schools. In the article, medical schools were ranked on their record of educating and training physicians to care ...
Health reform vaults the USPSTF into prominence
The most visible impact of Affordable Care Act is surely the expansion of health insurance coverage to 30 million uninsured Americans, but a lesser known provision in the overhaul will have far-reaching implications as well.The provision catapults the US Preventive Services Task Force (USPSTF) from an obscure agency that produced unenforceable guidelines about screening and preventive services into one whose recommendations directly impact reimbursement.According to the terms of the new ...
How can anyone deny scientifically sound treatment for breast cancer?
I just don’t understand how someone can live in this day and age and deny the effectiveness of scientifically sound medical treatment when dealing with breast cancer. I was completely flummoxed when I came across the in-depth and thoughtful post “A horrifying breast cancer ‘testimonial’ for ‘holistic’ treatment” on Respectful Insolence, written by a surgeon and scientist who uses the pen name Orac.Like others who came before and surely will ...
When does a headache need to be seen at the hospital?
by Chaim Colen, MDAs a neurosurgeon, I encounter a lot of people who are concerned with ruptured brain aneurysms (blood vessel blisters). Ruptured brain aneurysms typically present with severe headache. I am incessantly asked, “When is a headache more than just a headache? When should I go to the hospital?"A headache is considered to be pain located anywhere in the region of the upper neck ...
Social anxiety assumptions and their solutions
Social anxiety refers to the fear of being around people due to the threat of embarrassment.People who are socially anxious frequently freeze and are unable to seek the very company their hearts desire. They may make adaptations: they may decide that they “hate” being around people; they may isolate and play video games; they may absorb themselves in their work, but no matter what they do, this anxiety always exists ...
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....
