by Brian McMichael, MDThe NEJM recently published an interesting case in the ongoing series: " A Request for Retrieval of Oocytes from a 36-year old Woman with Anoxic Brain Injury." Usually these cases are diagnostic dilemmas. This one focused on an ethical dilemma at end-of-life.The CaseA 36-year-old woman, in overall good health taking oral contraceptive pills (OCPs), was on a prolonged international flight, and ...
October 2010
All Stories
Are social networks competitive or compatible with the medical blogosphere?
I'm back from my whirlwind trip to Las Vegas, and I want to think those who followed our panel at BlogWorld 2010.I was joined by Bryan Vartabedian of 33 Charts, and Kerri Morrone Sparling of six until me in a panel moderated by Kim McAllister of Emergiblog.A few thoughts from my end.
Is healthcare is a right? A balanced opinion
Chris Mathews had Ron Paul on his show, Hardball, earlier this year to discuss Social Security and the new health care bill.Mr. Mathews pointed out that people get old and no longer have an adequate income source to take care of their basic needs, and pointed to this as a reason to force working Americans to save for our retirement through a government program as a sort of ...
How drug reps increase drug sales by influencing physicians
An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc.It may be hard for people to imagine that drug reps can get us to prescribe a particular drug by simply giving us a meal or being nice to us. The process is subtle, but ...
Breast cancer and understanding your breast type
What does your breast type say about your cancer risk? Quite a bit, actually.Whether you have large, small or lumpy breasts, self-awareness is very important. Getting to know how your breasts look and feel can help you recognize possible red flags.Large vs. small breastsWhen it comes to cancer risk, size really doesn’t matter. But, size can affect your mammogram and clinical breast exam.For example, women with large breasts ...
Protecting kids in the world of social media, a Cybersafe excerpt
An excerpt from CyberSafe: Protecting and Empowering Digital Kids in the World of Texting, Gaming and Social Media.by Gwenn Schurgin O’Keeffe, MD, FAAPScreen Time and Childhood Have you ever tried to go “screen-less”? I often tell the story of taking my girls to New York City on an April vacation, looking forward to Turnoff Week. This is a semiannual event that encourages families to flip off ...
Challenges facing patients adopting personal health records
by Kristina FioreThey're still there. Rows upon rows of number- and color-tagged manila charts, packed in so closely together that Fiore sometimes sticks to Fiori, or hides behind it.None of my physicians has yet converted to electronic health records. I dream of the day when my PCP can pull up my chart on her iPad, accessing all of the important information (allergies, family history) before ...
Tips for questioning costs in today’s health care system
by Joanna FiefAbout two years ago in the wee hours of the morning, I found myself in a local emergency room with severe stomach pain, incessant vomiting and dehydration. It wasn’t pretty, and I was desperate for something – anything – to ease my pain and stop my vomiting.Gratefully, within minutes of receiving an IV with medications for pain and nausea, my symptoms subsided. After a couple of blood tests ...
Social Health track at BlogWorld 2010 today
Today, I'm in Las Vegas participating in BlogWorld 2010’s Social Health track.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 the following issue -- Social Networks and the Medical Blogosphere: Compatible or Competitive?It will be held at 1:30pm PST in Tradewinds A & B / 10 ...
One physician’s journey on social media
Wendy Sue Swanson, also known as Seattle Mama Doc, is a pediatrician in Seattle who recently gave a keynote at the Swedish Medical Center as part of their 2010 Health Care Symposium.I was following it on Twitter, where it received rave reviews. The video is now up, and the accolades were truly well deserved. A gifted speaker, Dr. Swanson's presentation should be required viewing for physicians and ...
Finasteride, fruit, and the matter of prostate health
by Arnon Krongrad, MDThe noose was loose on its neck. At first I worried, but then I relaxed. This was a bottle of pomegranate juice, the antioxidant superpower. As the billboard implied, it could cheat death. Perhaps if I consumed pomegranate juice, I could cheat death.Last week, the Federal Trade Commission charged POM Wonderful, LLC, makers of pomegranate products, with deceptive advertising. What ...
What makes an e-Doctor?
The rise of the e-Patient movement has the potential to change the practice of medicine, in my opinion, for the better. e-Patients demand to be taken seriously, to be “equipped, enabled, empowered, engaged, equals, and emancipated.”My recent post on KevinMD.com suggested the need for e-Doctors as well, in response to the growth of the e-Patient movement.So how do you become an e-Doctor? I believe you, and I, need to be equally ...
Selecting health insurance requires free choice for individuals
by William BayerBuying health insurance across state lines and health savings accounts are good - but they do not resolve the core issue.The core issue is that the employer is making the main choice for the employees, leaving them essentially with a choice between small, medium or large. That may satisfy the most important needs, but it does not encourage competition because the ...
Why a lab test is more than a numerical result
A couple of centuries ago, when I was a graduate student in biochemistry and later a med tech, we thought about a lab test as a CBC or a blood sugar that produces a numerical result. Period.Later, I learned and wrote that there were at least nine separate vital steps in the performance of a laboratory test and that the analysis that produces a result was important but that so ...
HIV sufferers benefit from the FDA’s unapproved drugs initiative
by Gary Puckrein, PhDUnapproved drugs have never been tested by the Food and Drugs Administration for safety and efficacy. Prescribed by the million every year in the United States, these products pose a potential danger to all patients, but HIV/AIDS patients who suffer weakened immune systems are at an even higher risk as they are more vulnerable to injury due to their disease.That's why we ...
Narcotic use is rampant in workers compensation
Just in case you thought the problems with abuse of powerful prescription drugs have been overstated, here's a wake-up call.
The CDC's Director is taking this very seriously, saying: "Overdose with prescription drugs is one of the most serious and fastest-growing problems in this country."The problem is showing up in a doubling of emergency room admissions due to prescription drug abuse, driven primarily by oxycodone, methadone, and hydrocodone.Narcotic use ...
Making health care better, faster, and cheaper with collective innovations
The country seems to have shifted in less than 18 months from a slogan of “Yes We Can!” to “Oh, well…” and a shrug, then back to “Cool! I think. What was that, really?”Hopes for a true rebirth of health care turned into the Year of Screaming Inanely, then took that long slide from what we might hope for to what we might settle for. Yet suddenly it seems like ...
Does being a lawyer or journalist stack up with being a physician?
I don’t think there is anything nobler than being a physician. In it’s most prime form it is service to life’s most basic needs.Certainly there are professions and lives with similar dedication. But lawyers and journalist I can’t reasonably place amongst them. This from someone who favors liberty and transparency in society above most else; certainly things that lawyers and journalists can help foster.And yet, for all the respect thrown ...
Too much data can overwhelm physicians and harm patients
One of the supposed strengths of electronic medical records is better tracking of test data.In theory, when using more sophisticated digital systems, doctors can better follow the mountains of test results that they encounter daily.But a recent study, as written in the WSJ Health Blog, says otherwise.Apparently, a study performed in 2007 found,
VA doctors failed to acknowledge receipt of 368 electronically transmitted alerts about abnormal imaging tests, or one third ...
How medical practice operations impacts productivity and profitability
"How many staffers should we have per doctor?" was the opening question in a recent column . We looked at the impact of staff on provider productivity and ultimately practice profitability as an approach to address that question.In that piece, we focused primarily on clinical staff, but in this column, we'll dig even deeper into medical practice operations, looking at the way a practice utilizes nonclinical support staff for ...
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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Improve patient safety to improve healthcare quality
It has taken 13 years for us to revisit the issues in To Err Is Human, the 1999 landmark government report that...
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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...
Tech
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New classes of devices to diet and exercise
For many celebrities, their livelihoods depend on their physical appearance and they rely on armies of personal assistants, schedulers, stylists, trainers and...
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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...
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....
