September 2010

All Stories

Forgiveness shaped by the stories of people’s lives

by | in Patient | 33 responses

If you had asked me what I thought forgiveness was when I was a young adult, I probably would have said that it is something you do for others—others who have wronged you in some way, to give them a break and let them know that you are no longer angry or upset with them.As I’ve matured emotionally over the years, my view of forgiveness has evolved significantly. Some of ...

Anecdotal accounts of patient experiences with local physicians

in Patient | 6 responses

by Liz O’BrienA long time ago -- when managed care-style employee healthcare benefits were a new thing -- we worker bees learned we might have to throw our old family doc under the bus.We were given a booklet of providers on the network panel, and if the faithful retainer who had served our family for years wasn't on that list, it was sayonara -- unless we ...

Improve patient safety and cut costs with clinical pharmacists

in Patient | 7 responses

by Emmanuel King, MDWhat if you could improve patient safety, cut costs, broaden your medical knowledge and find 20% more time in your workday?  On October 1, 2010, that is just what we can expect when clinical pharmacists move from the back room to the bedside in ten general medical units at the Hospital of the University of Pennsylvania.As we all know, medications play an intensely complex and ever-growing ...

Empathy is still at the heart of medicine

by | in Physician | 5 responses

Treat the patient, not the disease.

Care more particularly for the individual patient than for the especial features of the disease. — William Osler
We enter medical school eager to help the sick and the dying. Over the years this golden objective is transmuted into the base lead of disease-specific diagnostics and therapeutics. Our absorption in the strangeness of the manifestations of a remarkable pathophysiological process may distract us from its impact on ...

Why are hearing aids so expensive, and reading glasses so cheap?

by | in Conditions | 40 responses

I am currently 53 years old, but I recently found an imperfection in my near-vision.  I was probably laboring for a year or so before caving in: purchasing reading glasses. I am using them right now and they have made all the difference.In the space of a few months, I went from no reading glasses to seven pairs. I bought all seven online together as a package recently, for the ...

Some MRI places have good quality machines, others are obsolete

by | in Conditions | 2 responses

"Dave" showed up at my office last week with neck pain, worsening weakness in his arms and legs, and changes in his bladder control. All signs pointed to something gone bad in his neck.His internist had already thought of this, because he'd ordered the appropriate MRIs. And they'd all been read as normal, leaving me without a cause.Here is where the problem began. Everything about Dave's exam and story pointed ...

Stop eating before you become obese

by | in Conditions | 34 responses

We all know that obesity is a huge and growing (no puns intended) problem in the U.S. and most other developed countries.The proven harmful consequences of obesity to the individual and the public health, as well as to the national treasuries, are devastating. The solutions are both simple and complex.For most adults who are of normal weight (BMI under 25), simply maintain your normal weight. If you are overweight (BMI ...

Cosmetic foot surgery can have serious downsides

by | in Physician | 3 responses

How far will some women go to fit into high heels? The menu of services at Beverly Hills Aesthetic Foot Surgery in Studio City, Calif., provides a clue.There's the trademarked "Cinderella Procedure"—a preventive bunion correction that makes feet narrower. The clinic also offers the "Perfect 10! Aesthetic Toe Shortening" that invisibly trims toes that hang over the end of sandals or have to be crushed into tight shoes. There's also ...

Defensive medicine costs less money than physicians think

by | in Physician | 16 responses

Nothing polarizes the heath care debate more than defensive medicine. A recent study from Health Affairs will only add more fuel to the fire.Here's what I wrote a couple of years ago in USA Today: "When you consider that rampant testing is a major driver of escalating health care dollars, addressing defensive medicine should be a primary goal of cost containment."Is that still true?Well, yes and no.MedPage Today summarizes ...

How to use your CPAP machine when traveling

by | in Conditions | 2 responses

One of the most common excuses for not wanting to use CPAP is that "I travel a lot." Even after I explain that many people travel just fine with their CPAP machines, some people are stll reluctant.With advances in technology and increased awareness by the lay public, government officials and medical professionals about the importance of using CPAP for obstructive sleep apnea, traveling with CPAP, although initially a challenge, can be ...

Insurance companies affect patients with paperwork for tests

in Policy | 17 responses

by Jeoffry B. Gordon, MD, MPHI have always considered it to be my professional responsibility and ethical imperative to fight for my patients with the insurance companies to get approval for every test and medication that I think is medically necessary.My batting average is close to 100% Lately, the insurance companies have been trying to draw the noose tighter and make the task of getting ...

Multiple assessments are needed in the face of repeated testing

by | in Conditions | no responses

At a recent weekly case conference at our hospital, we heard about a young woman with an elevated testosterone level. The patient was evaluated by James Hennessey, FACP, prior ACP governor from Rhode Island and currently director of clinical endocrinology at Beth Israel Deaconess Medical Center, along with an endocrine fellow, Laura Sweeney, MD.Case study: Polycystic ovarian syndrome suspectedThe patient was a 19-year-old art student at a local university. She ...

Moments of internal struggle in the ER

by | in Patient | 5 responses

I walked into Room 22 to find a very interesting patient who presented to our ER with complaints of abdominal pain and associated nausea and vomiting.The patient sat on her cot with her pant legs rolled up above her knees, refusing, according to her nurse, Gwen, to put on a treatment gown. Her left leg hung in the air, her ankle crossed over the knee of her right leg. Her ...

Acute gonorrhea in Congo

by | in Conditions | no responses

Year: 1984Setting: Ouesso, Congo Position: Timber consortium medical expertWe landed in Brazzaville and took a private jet to Pointe Noire where we spent the night. The next day, the group is assigned six 4x4 Toyotas to take through the Mayombe Mountains, Brazzaville and the plateau to reach Ouesso near the Cameroon border.The journey is eventful, particularly when I drove the pickup truck into a river from a bridge to avoid children ...

Wound infections and the Surgical Care Improvement Project (SCIP)

by | in Physician | one response

The Surgical Care Improvement Project (SCIP) and its antecedent, the Surgical Infection Prevention project, have been around for several years.In short, these consist of several rules issued by various self-appointed agencies with important-sounding names and the Centers for Medicare and Medicaid Services (CMS), a federal agency. The main rules are 1) administer the correct prophylactic antibiotic before surgery, 2) give the antibiotic within one hour before the skin is incised ...

Are physicians today active in the arts?

by | in Physician | 15 responses

Physician/poets such as William Carlos Williams are an honorable tradition in the history of medicine, following in the footsteps of Keats, Schiller, and Oliver Wendell Holmes (of “Chambered Nautilus” fame). Physicians have also been writers, painters, musicians, philosophers, and – at least in more recent times –photographers.Yet in 1980 the historian G.S. Rousseau expressed concern that modern physicians no longer embodied the humanist tradition of their predecessors. Now that medicine ...

Are opioids any less safe or effective in non cancer patients?

in Meds | 14 responses

by Drew Rosielle, MDRecently, the New York Times reported of the movement in Washington State to officially do something about prescription opioid abuse, coming on the heels of course of the FDA rejecting the current risk evaluation and mitigation strategy plan as, essentially, not going far enough.The article basically discusses the discussion in Washington about what to do; no formal new plans have been ...

Don Berwick is a patient centric, consumer oriented radical

by | in Policy | 68 responses

The recess appointment of Dr. Donald Berwick as head of CMS has incited a furor among politicians outraged at what they claim are his advocacy for rationing and fondness for Britain's National Health Service.To support their claims, these politicians are using Berwick's own words, in a way eerily reminiscent of the recent Shirley Sherrod debacle.It started with Glenn Beck, master of the one-word quote, and then slipped over ...

Page 7 of 812345678

Kevin Pho, MD

See all in: Pho

Physician

See all in: Physician

Patient

See all in: Patient

Policy

See all in: Policy

Tech

See all in: Tech

Social Media

See all in: Social media

Meds

See all in: Meds

Conditions

See all in: Conditions

Education

See all in: Education