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, MDThe bathroom: This is the most dangerous place in the home, what with hard surfaces, water that makes floors slippery, nothing but your birthday suit between you and the tile and tub, and, to top it all off, poor ...
October 2010
All Stories
A physician seeing the husband and wife together
As a medical provider, while seeing a husband and wife, or a couple, regardless of gender, one comes across several situations that may be considered difficult to handle and that require a good deal of tact and confidentiality.This is the case with seeing a husband and wife or (couple), together, for an examination. Ultimately, it depends on the rapport that the couple shares. If they ...
Unintended consequences from healthcare reform
In early October, the New York Times published two articles that addressed a pervasive problem from slightly different perspectives. Boiled down to its essence, the problem is the unintended consequences of some provisions of the new healthcare reform legislation.In his well crafted article, entitled "Health Care's Uneven Road to a New Era," David Leonhardt explored the impact caused by the introduction of new regulations into a "status quo" system.So-called "mini-med" ...
USA Today op-ed: Online doctor ratings could be improved
My latest USA Today column was published today: Online doctor ratings aren't very helpful.
Can patients reliably choose a good doctor online?I briefly discuss the piece in the video below, along with a preview of the week's posts on KevinMD.com.id="viddler_704534be" classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="430" height="370" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
How Apple can fix the usability problem in healthcare
I want clinicians to buy more Apple products. I want Macbooks to replace your PCs. Other than promoting Apple and angering PC-lovers, why would I say this?I say this because my mind was opened to a new world when I started using Apple products -- usability. Usability means making tools easier-to-use so you can complete your job quicker or easier than you previously could.Windows-based PCs are notorious for their usability problems. Even ...
Abdominal aortic aneuryms (AAA) in women
by Thomas Maldonado, MDAbdominal aortic aneuryms (AAA) are responsible for 15,000 fatalities annually in the USA and are the 10th leading cause of death. Approximately 5-7% of adults over 60 years old are affected by AAA. Although it appears to be twice as common in men than in women, the risk of risk of rupture in women is actually four-fold that in men. When an AAA ruptures, it carries a ...
EMTALA and why this emergency physician is against it
by 911Doc, MDAmerican medicine will die or be reborn in the next ten years. Correction, it will either continue an accelerated slide into banal mediocrity, or be reborn. The battle is finally joined, and it has been joined by the specialists. Thank you, doctors, for drawing the line in the sand. I hope you win. Honest.I am cheering against my own college here because they have ...
Price influences patient acceptance of generic medication
A simple study from the March, 2008 issue of the Journal of the American Medical Association illustrates something important about the way we perceive the effectiveness of medication.82 adult volunteers were recruited. They were told they were taking part in a trial of a new pain medication, testing its effectiveness using a standardized, well-established protocol using low-voltage shocks as a painful stimulus.All ...
Pull & Pray – the Safe Sex Song
Hospitalist ZDoggMD and Dr. Harry perform Pull & Pray - the Safe Sex Song.As one commenter writes, it's "500 kinds of awesome." Enjoy.width="430" height="266" classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0">
Medical malpractice immunity from clinical practice guidelines
Ezra Klein calls Peter Orszag's proposal in a recent New York Times column a "new idea on medical malpractice reform."Except it's really not.The idea of immunizing doctors who follow strict clinical practice guidelines was floated by the AMA back in May of 2009. I supported the idea back then, saying the AMA is
acknowledging and embracing the data that is very influential in the White House, as well ...
Specialist and primary care pay per hour
Authors of a recent study from the Archives of Internal Medicine are unlikely to endear themselves to specialists.As reported by Reuters, and provocatively titled, Do specialist doctors make too much money?, the study gives a per-hour breakdown of how much doctors make.I think this is a good approach, since annual salary figures do not account for the number of hours doctors work -- and in the case of primary ...
Technology empowered direct pay primary care
by Anar MikailovBy now it is common knowledge that primary care is an undesirable field for newly graduating medical students.Additionally, many current primary care physicians are closing shop and either enter early retirement or seek non-clinical professions. According to the American Academy of Family Physicians, the 2010 Residency Match showed that 1,184 U.S. medical grads chose Family Medicine, less than half of the available positions ...
Post traumatic stress disorder after the Haitian earthquake
In the months since the Haitian earthquake, psychologists from around the world have been traveling to the island, hoping to help a population in shock and at risk for post-traumatic stress disorder. Many are veterans of crises such as Hurricane Katrina, and have extensive experience responding to disasters.But Dr. Guerda Nicolas, a Haitian-born researcher who has conducted landmark studies examining how Haitians experience depression and cope with disasters, has a ...
How to command respect in any medical setting
It’s a simple question, but it has stirred some controversy. It’s the word “friendly.”Colleague and fellow passionate advocate Bart Windrum got (as my mother would say) his blood in a bubble after reading an article about engaging a patient advocate to help you navigate your healthcare, published in a Tampa newspaper.In a list of tips about how to advocate for someone else, one tip said, “In ...
Senior leaders need to periodically reflect on their role
Leaders often think about succession plans for their direct reports, but what about themselves?What if I had a serious health problem or accident that impaired my ability to lead my IT organizations? Here's my brief analysis.Beth Israel-Deaconess Medical Center My role at BIDMC is to document the strategies prioritized by our governance groups, ensure our organizational chart structure is optimized for executing the strategies, ...
ACP: Doctors as leaders – the value of civility
A guest column by the American College of Physicians, exclusive to KevinMD.com.by John Tooker, MD, MBA, MACP
The campaigning for the mid-term elections reminds us once again of the state of civility – or lack of civility - in American politics. By civility, I mean showing regard for others. We are beset by campaign attack ...
Will the accountable care organization (ACO) be a durable part of reform?
by Jim Sabin, MDMagic bullets come and go in the world of health policy, but the accountable care organization (ACO) is likely to be a durable reform. Except for group practices like Geisinger, Harvard Vanguard, Kaiser Permanente, systems like the VA, and local communities in which independent practitioners have established cooperative collaborations, health care has been grotesquely uncoordinated in the U.S. ACOs speak to ...
Physicians need to consider a digital resume
As a physician coach to doctor clients making the transition from clinical practice and seeking out new careers, I latched onto a recent article in the Los Angeles Times business section.Titled "Revive your Resume" by Emily Hughey Quinn, it hints at the death of the traditional paper resume. In its place is the digital resume you create on sites such as LinkedIn and VisualCV.Take special note - if you're a ...
Why the Florida Medical Association (FMA) is angry with the AMA
At an Orlando meeting recently, Florida Medical Association (FMA) members fumed that their parent, the AMA, isn’t adequately representing Florida’s private practice doctors. After talk of secession and forming a new group, they settled for writing a stern letter urging the AMA to straighten up.The FMA dustup began with a resolution written by Douglas Stevens MD, a Fort Myers cosmetic surgeon – you can’t make this stuff up – complaining ...
Will a higher demand for generalist doctors save primary care?
by Ali Khan, MD“So, why didn’t I take the ROAD again?”It’s a question that I regularly hear from many of my co-residents in internal medicine – and no, we’re not questioning our travel routes to the hospital.We all know why we chose internal medicine: the intellectual challenges inherent in treating across organ systems, the excitement of primary scientific investigation and diagnosis and the like. As we ...
Kevin Pho, MD
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How patient satisfaction can kill
Patient satisfaction is all the rage. Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country...
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How I approach ovarian cancer screening with patients
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
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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....
Physician
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The analogy between baseball hierarchy and medical systems
From age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but...
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Saving patients from Internet health information
Lately, I get the feeling that I’m doing something wrong. I’m supposed to form a partnership with my patients. My patients are...
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Understanding what patient centered care really means
There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He...
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A letter of thanks to my organ donor
I have tried to write a letter of thanks but don't know what to say or even how to begin. I don't...
Patient
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Why patient engagement is reciprocal
It is said that "turn around is fair play." So if providers (physicians, hospitals and other health care professionals) expect patients to...
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Question the price of drugs and medical procedures
Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure...
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In love there is a life giving force
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
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How to get ready for death
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
Policy
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America has a medical care system not a health care system
As Americans we believe we have the best healthcare system in the world. But think again, it’s really not the truth. We...
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Reading between the lines of breast cancer treatment studies
Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently,...
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Why are labor and deliveries closing?
Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no...
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America has a health care paradox
We have a real paradox in American healthcare. On the one hand we have exceptionally well educated and well trained providers who...
Tech
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Why physicians don’t want patients to have their cardiac device data
There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers....
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Impersonal communication on the Internet fuels cyberbullying
In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over...
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Health IT and doctors: A framework for successful partnerships
We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology. We have firsthand...
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Break out of the prison of the American health care delivery system
Speaker after speaker at the recent Care Innovations Summit in Washington, DC concluded that increasing the quality and decreasing the per-capita cost...
Social Media
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Why doctors should embrace Google+
Lots of pressure out there for you to be on Facebook and Twitter, right? The ultimate question, though, is how are you...
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Using Twitter to deliver health improvement messages
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
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Addressing comments on your medical practice’s Facebook page
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
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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...
