Merry Christmas!I'd like to thank everyone for your continued readership.Doctors, patients and other health care professionals need to be heard, and there's no better place to do so than here, on social media's leading physician voice.This year, KevinMD.com had a regular rotation of 175 guest contributors, and surpassed 1.75 million visits, 2.95 million pageviews, 33,000 followers on Facebook and Twitter, and 40,000 RSS subscribers.I am truly ...
December 2010
All Stories
Successful surgery rotation tips
I recently finished my two months of surgery rotations.I am happy to say that I really enjoyed my surgery rotations. I thought I was going to be intimidated by the OR, but I found it fascinating. I am relieved, since surgery is a big part of OB/GYN.Here are a few things I learned on my surgery rotation:
- Scrub in before the surgeon but after the OR nurse.
- Before you scrub in, introduce ...
Minimize the potentially harmful effects of DTC advertising
Part 3 of a series. Please read part 1, DTC advertising, and its history with the FDA, and part 2, Economic and commercial impact of DTC advertising.In the first two parts of this article, we explored the historical and legal contexts of direct-to-consumer (DTC) advertising, the effects of these ads on prescribing behavior, and the economic incentives to advertise.In this final installment, we will examine what ...
A surge in demand for physicians from newly insured patients
The Affordable Care Act is the most important piece of federal health care legislation since the Social Security Act of 1965 established the Medicare program. It assures that 32 million Americans will have access to health insurance for the first time. But who will care for these people?Our health care system was plagued by a severe and worsening physician shortage even before the new law took effect. In fact, a ...
Say goodbye to your patients the right way
When I realized that I would be moving to a different county within Southern California and would have to change jobs, I knew it would be inevitable that I would have to say goodbye to my patients. I was dreading this. I mean, really dreading it. I don’t like goodbyes. I feel as though I am breaking up, and in a way I am.Like any other relationship, my patient-physician relationships ...
Maximizing enrollment in insurance exchanges is essential
Massachusetts’ Connector, operational since 2006, is the prototype for PPACA’s insurance exchanges. Connector boosters have claimed it is a vital and successful part of Massachusetts’ health care reform; its critics have noted its failure to influence either benefit or administrative costs or to attract significant enrollment. However, whether success or failure, the Connector offers lessons for other states.Low enrollment means failureAs Massachusetts discovered, it’s impossible for the exchange to influence ...
Solve the obesity crisis to ensure our country’s financial stability
If I was Surgeon General, I would follow the lead of our country's first Mom.This is serious folks.We, as an American society, need to solve the obesity crisis. Not just for our physical health, but for our country's financial stability.Reducing the spiraling costs of health care is wanted by all. So far, prevention of the diseases which contribute most to our health care costs, (heart disease, cancer and ...
Physicians need to take responsibility for their actions
As the saying goes, when you’ve got a hammer, everything looks like a nail. Send a patient to a surgeon, and he very well might get surgery. Send a patient to a psychiatrist, and he very well may end up on psychotropic medication.As physicians, we need to take responsibility for our own actions. We should not prescribe or perform procedures unnecessarily. However, even if we are responsible for our own ...
How an iPad is replacing medical textbooks
by Kal ShahKal Shah, a first year medical student at the University of California Irvine who recieved his undergraduate degree from UC Berkeley in Bioengineering, has given iMedicalApps the scoop on how the iPad is being used by himself and classmates.He highlights how medical textbooks are being utilized, along with an app he feels is better at note taking than the popular iAnnotate. ...
Pay close attention to what doctors say to patients
In a report from the Archives of Internal Medicine, it was reported that most hospitalized patients (82%) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted. Of the physicians, 67% thought the patients knew their name and 77% of doctors thought the patients "understood their diagnoses at least somewhat well". ...
Progressive commercialization of American medicine
by Lucas Restrepo, MDThere is only one fundamental problem with American medicine: its progressive commercialization.Every other problem derives from it centrifugally. Medicine, wrote William Osler, is “a calling, not a business.” Patients are not clients, nor physicians businessmen. People do not spend over a decade studying medicine ―living years in poverty or overburdened with debt― merely hoping to get rich. While it ...
Natural lifespan and whether a woman is designed to give birth
Advocates of alternative health attribute all sorts of fantastical properties to the human body. The body supposedly "knows" how to live a long healthy life; the body is supposedly "designed" to work perfectly. The tenets of natural childbirth philosophy also invoke these fantastical properties. The body "knows" how to give birth; a woman's body is "designed" to give birth.On their face these claims are obviously false. The body doesn't "know" ...
Physician barriers to EMR acceptance
Recently, I had my first visit with my new primary care doctor.I picked him based on recommendations (plus he’s one of the few that accepts my insurance), and also because he seemed to be an eager adopter of electronic medical records (EMR). On his website, there was a portal for making appointments on-line, asking questions of the doctor and staff by e-mail and once a registered patient, I could also ...
Health blog posts of the week, ending December 19, 2010
Here are the top posts from this past week, based on the number of times they were viewed.1. Obesity patients are not victims. Call it the McVictim syndrome. Too many pundits, public health experts and politicians are working overtime to find scapegoats for America’s obesity epidemic.2. Favorite ER superstitions. ER docs and nurses (and paramedics) are a superstitious lot. I thought it might be interesting for those ...
Everything about medicine is now big business
Medicine used to be different. Doctors couldn’t do too much for you. They didn’t get paid very much and they were focused more on helping than on managing a business.Hospitals were community-based not-for-profit or public entities. Drugs and devices were not as sophisticated or expensive, and they weren’t marketed directly to consumers. Well Toto, we’re not in Kansas anymore.After witnessing our “healthcare reform” process you must have seen that almost ...
Giving children probiotics
I’m becoming more of a believer in giving children probiotics. Not for everything and not for everyone; I really don’t think we should put them in the water.Probiotics, essentially live “good” bacteria we use to supplement our diet (usually Lactobacillus Acidophilus in the US), are becoming more and more available and recommended by more and more physicians. The role microbes play in our health is a hot topic. ...
Medical school and medical training in Ireland
I recently spent a week in Ireland, taking in the sights and spirits.I was actually there for work too – visiting the University College of Dublin and the Mater Miserecordia Hospital – or the original Mercy Hospital as they refer to it. As the future of primary care, residency work hours, and the healthcare insurance system continue to cause angst in the US, we often find ourselves referencing what our European ...
The art of medicine and mastering relationships
by Kelly, MDThere is a reason why people often say "the art of medicine."It’s not just the fact that so much of what we do is based on culture and habit rather than science, but also the fact that there is a lot of finesse when it comes to relationships as a doctor. Oh sure, we know all about patient-doctor relationships and its importance. There are ...
Comparative effectiveness research (CER) needs honest discussion
Comparative effectiveness research (CER) is suddenly a hot topic at all the health care conferences.How come? Everybody agrees that we have to decrease per-capita cost and increase quality. Why? Government programs like Medicare and Medicaid foot more than 50% of our nation’s health bill, and if everything stays the same these programs will go belly up (bankrupt) in 8 years. Big problem.Health and Human Services (HHS) has defined comparative effectiveness ...
Back to school sometimes means a return to bullying
by Aldebra Schroll, MDBack to school for many children means returning to the environment in which they are bullied.Bullying is a form of abuse, defined as recurrent episodes of physical or psychological intimidation. It can take the form of taunting, name calling, threatening, stealing and physical assault. Other forms of bullying include the spreading of malicious rumors or gossip and the intentional exclusion of ...
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...
