As an infectious diseases physician with a special interest in head and neck infections, I had extensive experience in otolaryngological illnesses. However, when I was exposed to new, different, and challenging experiences as a neck cancer patient, I had to deal with these as a patient --- not as a physician. I endured the consequences of radiation, repeated surgeries, and prolonged hospitalizations. I confronted medical errors in my care, discrimination ...
January 2011
All Stories
Who benefits from computerization of patient-specific clinical information?
Electronic health record (EHR) systems are big news (and big money) these days.Our government is pushing adoption and “meaningful use” of EHR systems because computerizing patient-specific clinical information can benefit our nation’s health care system. The primary focus has been on the benefit to the care of individual patients, but computerizing patient-specific clinical information can also benefit other parties in the health care system.I believe that there are 6 major ...
Fight multiple sclerosis using YouTube and other social media tools
“Facebook is for the living, not the dying” – Regina Holliday
It finally happened. The day my Facebook feed included information about a friend’s illness. This is the photograph my friend Matt posted to his feed. Normally I don’t play that close attention to everything in there, but this caught my eye immediately.When we talked on the phone, I understood that this ...
How to improve patient satisfaction with electronic records
by John RossheimTo many physicians, it may appear self-evident that electronic records will improve the patient experience. After all, the doctor has speedier access to notes, labs and other patient data, and that’s got to increase the patient’s confidence in the doctor’s understanding of his health status.But whether patient records are confined to a private-practice EMR or live in an EHR system, the usefulness of ...
A historical perspective of alternative medicine
by Roberta BivinsAs a historian who writes about the controversial topic of ‘alternative medicine’, I get a lot of questions about whether this or that therapy ‘works’. Sometimes, these questions are a test of my objectivity as a researcher. My questioners want to know whether I am ‘believer’, or a fan of alternative medicine, or have any stake in promoting or disdaining a given medical ...
Your doctor isn’t superhuman and is allowed to call in sick
I mentioned having a migraine this past weekend, and was somewhat surprised by how many people commented and wrote to me, surprised that a doctor, let alone a neurlogist, would actually get migraines.What's up with that?I know this may be hard to believe, but we get health problems too.I see this odd view surprisingly often. People who somehow expect us to be beyond the health concerns of non-doctors.We may be ...
Is red wine really good for your heart and your brain?
An excerpt from Beautiful Brain, Beautiful You. Published by Hyperion. Copyright(c)2011.by Marie Pasinski, MDAlthough much has been written about how red wine in moderation can be good for your heart and your brain, I would like you to reconsider. It’s important to understand that the studies supporting this claim are “observational.” This means they were conducted through self-reported questionnaires inquiring into the drinking habits of a large group of ...
Your surgeon may be contemplating suicide
I wrote last year in USA Today about the impact of physician burnout. Not only do doctors suffer, but so do their patients.Burnout starts early in residency, with entering interns having a depression rate of 4%, similar to the general public. But after the first year of residency, that number balloons to 25%.Now, another study adds fuel to this disturbing trend.A paper published in the Archives of General Surgery ...
Your blood test and the need for better designed results
Either as a patient or as a physician there’s a very high chance that you’ve ever got your hands on a simple blood test.These range from very basic ones to complex ones with multiple pages and are substantial to any cinlical evaluation. Blood tests are probably one of the most performed tests in a clinical environment with direct patient contact. Also, if you’ve ever seen a typical blood test from ...
How often to see your doctor when feeling well
How often do you see your doctor? Once a year? Every 6 months? Never? Most of you are pretty healthy and only show up for screening physical exams or aches and pains. Some of you may have more health problems and come more frequently.What if you had diabetes, coronary disease, hypertension, high cholesterol, and sleep apnea, but no symptoms to indicate any ...
Individual health beliefs play a role in medical decisions
As a family physician, I've found that patients' individual health beliefs often play a big role in important decisions such as starting a new medication or undergoing an invasive test or procedure.Some patients were more willing to endure potentially risky procedures in order to learn their diagnosis quicker, for example, while others preferred "watchful waiting," or monitoring symptoms that were unlikely to be a sign of anything serious. Unfortunately, in ...
Quora in health and medicine, what doctors and nurses need to know
by Phil Baumann, RNWhat assets do physicians nurse practitioners have which they can share online? It’s knowledge.With today’s technologies, medicine and nursing care online are obviously limited – perhaps in the future we’ll have technologies which more robustly extend traditional care.When patients seek information online, they’re usually looking for answers to questions. Now they may be seeking answers from different sources, but if they could find ...
AMA: Help physicians across the world gain access to stethoscopes
A guest column by the American Medical Association, exclusive to KevinMD.com.As physicians in the United States of America, most of us take stethoscopes for granted. A stethoscope is among the most basic and essential of all medical instruments, but in many parts of the world access to stethoscopes is severely limited.WorldScopes is a global, philanthropic initiative of the American Medical Association Foundation that works with leading humanitarian organizations to ...
Should obesity prevention be a personal matter?
Obesity is now increasingly recognized as the "natural" consequence of societal changes that have occurred over the past decades to foster an increasingly obesogenic environment.Yet, rather than focus on the root causes of these societal drivers of obesity, governments apparently prefer to make obesity prevention a personal matter, with a strong emphasis on trying to get individuals to change their lifestyles.It is clearly far easier to simply tell people to ...
Fetal ultrasound and our image oriented society
An excerpt from Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank published by W. W. Norton & Company, 2010 (paperback January 2011).by Randi Hutter Epstein, MDOn eBay, you can buy a fetal ultrasound scrapbook that has a poem on the first page that begins, “I loved you from the start.” It comes with Care Bear stickers. One ...
Save time and money with your visit with healthcare providers
Have you ever been frustrated by an unproductive or inopportune visit with your doctor that wasted your time and money?Here are a few tips to keep that from happening again.The problem Many visits with healthcare providers are poorly timed and less productive than they could be. Why? Because nobody is looking out for you between visits. It’s not that your doctor doesn’t care. He or she is simply too busy with ...
Are malpractice lawsuits really responsible for the rise in C-sections?
by Louise Marie Roth, PhDAbout one third of all births in the contemporary United States occur via c-section. Physicians and the public at large often attribute this to a "malpractice crisis," whereby obstetricians perform c-sections routinely to avoid malpractice litigation. Over the last couple of years, I have been conducting research on obstetric practices and malpractice.One of the things that I have learned ...
How cocaine can be used in sinus surgery
Many people are already aware that marijuana is now legal in some states in the US with a medical prescription.What many people may not realize is that cocaine is also used in medical care, especially in the ENT world.Cocaine is one of the most potent anesthetic and vasoconstrictor. These two characteristics make it an ideal medication for use during sinus surgery as well as any nasal procedure where bleeding and ...
States dropping Medicaid and the impact on patients
by James Baker, MDLawmakers in over a dozen states are considering getting out of Medicaid altogether as a way of dealing with the impact of the new healthcare law on already-bad state budget deficits.I can understand the frustration with federal intrusion into state policymaking that would lead some Texas lawmakers to suggest that approach. In doing so, you’d be freed of all of the federal ...
KevinMD posts of the week, ending January 16, 2011
Here are the top posts from this past week, based on the number of times they were viewed.1. A cartoon guide to learning in medical school, residency and fellowship.2. Can a doctor dodging a question help the patient? Sometimes patients don’t need factual answers. Doctor D had hundreds of questions tumbling around in his over-educated head.3. How much we should try to help patients who do not ...
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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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...
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I learned the value of listening to the patient
William Osler famously said (among other things): “Listen to the patient. He is telling you the diagnosis.” I was doing my obstetrical...
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Repeated experiences of shaming are not good for a young child
The little boy, who looked to be about two, darted away in a fit of giggles. His young mother, who seemed thoroughly...
Patient
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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...
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How I became a hospice volunteer
People often ask me how I became a hospice volunteer. For the record, nobody is more surprised than I am. You know...
Policy
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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...
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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
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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...
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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...
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Robotics can revolutionize the delivery of medical care
Robotics has the potential to revolutionize the delivery of healthcare. It can help extend the delivery of information, expertise and clinical care...
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....
