by Aldebra Schroll, MDI recently finished reading In Their Own Words: 12,000 Physicians Reveal their Thoughts on Medical Practice in America. It is a summary of a 2008 survey from the Physicians Foundation. I vaguely remember filling out this survey. I was interested to see what my colleagues had to say.Many physicians describe themselves as at the breaking point."I am so mired in this mess that I ...
September 2010
All Stories
Physicians must be aware of what they know they don’t know
St. Augustine: “Fallor ergo sum”
When I was in charge of the medical residency programs in Grand Rapids, Michigan, David Leach introduced me to the expanded Dreyfus Model of how physicians can progress from beginners to masters.I was always struck by how master physicians freely admitted their mistakes and used them as a teaching tool. As a young surgical and cytopathologist, my sanity was saved more than once by University of ...
Health decisions are not entirely based on evidence based data
“Science tells us nothing about the individual.”So said Dr. Susan Pinker, psychologist and author. This perfectly articulated truth puts into perspective popular thinking: To make a decision, the most important thing is evidence-based information: all you need is science. To this I say, that’s a bunch of hooey. Science tells us nothing about the individual. Thank you Dr. Pinker.Creating the expectation that health decisions are entirely based on evidence-based information ...
Should consumers have easy, direct access to genetic tests?
Should consumers have easy, direct access to genetic tests? So asked a recent survey on MedPage Today. After nearly 1,000 people voted, the tally was: Yes 37%; No 30%; it depends on the test 32%.Of course this survey is "unscientific," meaning anyone who sees it may (or may not) vote so there is obvious selection bias. Nonetheless, since the number voting is hefty, it is worth looking at.I am impressed ...
Emergency department utilization and its impact on health care reform
by James P. Davison, DOEmergency department utilization and its impact on health care reform legislation has been a hot topic of conversation in healthcare journals and the blogosphere. It is a tenet of the currant legislation that ER visits and cost growth will go down, contributing to a decreased health cost growth curve.Opponents state the newly insured will flock to the nation’s emergency rooms. Proponents ...
Is pharma providing relevant social media web content?
Some people are disappointed at the latest FDA notice to Novartis over a Facebook button on one of their website pages.The key question that a lot of people fail to ask is “do patients want to have a conversation with a drug company?” From almost one year of qualitative and quantitative research plus other 3rd party research (i.e. Rodale DTC Study) the answer to that is “no.”Now before you get ...
iPhone App Store medical section and real medical apps
There are well over 3,000 apps in the “medical” section of the App Store for the iPhone. Unfortunately, a growing number of them aren’t medical apps. It’s already difficult enough to parse through the litany of apps available to find quality apps – and then when you add apps that shouldn’t even be in the medical category, it makes the job that much harder.Lets start with the“top 10 downloaded free ...
How CPOE violated medical ethics
by MedInformaticsMDAs a result of my mother's health IT-related cerebral hemorrhage and resultant multi-month hospitalization, with transfers to nursing homes then back to acute care due to setbacks, I recently had the chance to observe her care in a small community hospital.This was a hospital that, in her last several days there before going back to a nursing home ...
Patients need more accurate information on their prognosis
Why are doctors so bad at predicting how long a patient has to live?That's the interesting question posed by John Schumann, an internal medicine physician who blogs at GlassHospital, recently in Slate.There are many reasons why doctors evade the question of prognosis:
We don't like to be wrong; we don't want to take away hope for survival or good quality of life in the time that remains; and we just ...
Does the DSM-5 medicalize normal behavior?
by John GeverJust about everyone catches colds, and just about everyone who gets one is able to go to work and cook their meals, and they nearly always recover within a few days whether or not they take anything for it. That's normal.So, is the advice to take aspirin "medicalizing normal behavior"? Are drug companies that market decongestants and fever reducers "medicalizing normal behavior"?The answer ...
Talk to your own doctor when hearing advice on the radio
by Adam LinkerA doctor at Sloan-Kettering Cancer Center recently advised that I submit to genetic testing without ever having met me. It turns out I may harbor a gene that increases my risk of developing prostate cancer.This unsolicited advice was delivered via National Public Radio after a story on the JAMA study of preventive breast and ovarian surgery in women with BRCA1 or BRCA2 genes. Dr. ...
Fact or Fiction: ADHD in America, September 16, 2010
I'm pleased to be invited to provide social media coverage of Fact or Fiction: ADHD in America, a Capitol Hill Forum, on Thursday, September 16th at 12pm to 2pm Eastern.I will be joined in Washington, DC by Val Jones of Better Health and Rob Lamberts of Musings of Distractible Mind.The event will be tweeted live on Twitter, and interviews with the panelists recorded.This event is presented by Shire, in ...
Social science requirements for pre-medical students
I thought I was an oddball in college. I've only recently learned that I was avant garde.Right before beginning college in 1975, I decided I wanted to be a doctor. Being the first-born son – with decent SATs – of an upwardly mobile Long Island Jewish family, I had relatively little choice in the matter. Notwithstanding this predestiny, I felt confident that medicine was a good fit for my interests ...
The emotional resistance to admitting error cannot be legislated away
by Danielle Ofri, MD, PhDIt’s been more than a decade since the seminal report “To Err is Human” by the Institute of Medicine. The report made waves when it estimated that 1.5 million people are affected by medical errors and that nearly 100,000 die annually as a result of medical errors. Some of those numbers have been debated, but there is no doubt that medical ...
Is health care shifting towards convenient retail clinics?
Mark Perry provides an interesting inference from two news stories: a WSJ article that suggests consumers are using less health care and another that reports a big jump in MinuteClinic volumes.
Consumers aren’t necessarily consuming less health care like the WSJ suggests; rather, they are shifting their demand for health care away from expensive, conventional physician offices with limited hours to affordable and convenient retail ...
A primary care physician who knows history and can relate to people
by Marianne MatteraRecently, a press release from Mount Sinai School of Medicine in New York City landed in my e-mail inbox. "Students with Humanities Background Equally Successful in Medical School as Traditional Students", the headline read.The press release summarized the findings of a study published in the August issue of Academic Medicine. David Muller, MD, and Nathan Kase, MD, reviewed data on the Mount Sinai ...
Video preview of what’s happening this week on KevinMD.com, September 13, 2010
Here's a preview of what's happening on KevinMD.com this week.classid="clsid:D27CDB6E-AE6D-11cf-96B8-444553540000" width="430" height="370" id="viddler_81108c4">
All patients will soon become e-patients
by Daphne SwancuttI’m having a weird, visceral reaction to all of the recent brouhaha surrounding the term “e-patient.”For some reason, semantically speaking, the term is slipping in to derogatorium. Up there with “cyberchondriac,” which definitely is derogatory. It’s kind of like research—one day, omigod, it’s Mecca; the next day, it’s the scab on a rotting wound.Whatever.I have a chronic condition—I’m not dying, it’s not fatal, I ...
“A Pediatric Surgeon in Iraq” does not disappoint
by 911Doc, MDI can't help but stand in awe of surgeons. I thought I was going to be one when I went to medical school, but my short attention span and my lack of true interest in the procedures spelled doom for that. Still, when I work in the ER and I have a surgical patient, I especially want to dot my i's and cross ...
Why you need the pertussis vaccine, especially if you have children
A reader wrote, “A friend sent me a link to information regarding the pertussis vaccine for adults. I have a 6 month old. What are your thoughts?”I wrote about vaccines for parents of newborns last year, but recent news about several outbreaks of pertussis make this question especially important. It’s time for an update.Pertussis, also called “whooping cough,” is bad news. For children and ...
Kevin Pho, MD
-
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...
-
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....
-
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...
-
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
-
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...
-
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. ...
-
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....
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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....
