Our national health status is in imminent danger from the effects of a condition that most population health experts acknowledge is out of control.I am speaking of obesity -- and, in particular, its increasing prevalence in American adolescents and children.Almost every study that has been done concerning obesity shows a correlation with soda consumption. As a result, some states and municipalities have tried to implement initiatives that make it more ...
January 2011
All Stories
Protecting health care professionals who act based on their conscience
by Child of the OceanI recently came across an interesting article titled “Conscientious Objection Gone Awry — Restoring Selfless Professionalism in Medicine” by Julie D. Cantor, M.D., J.D., in the New England Journal of Medicine.This article argues against a rule, the Provider Refusal Rule, from the United States Department of Health and Human Services (DHHS) that legally protects health care professionals who act based on ...
Nursing turf divisions affect patients in the hospital
While on my way back to the unit after transferring a patient to a medical/surgical floor, I was stopped in the hallway by another patient’s wife. I could hear an IV pump beeping from her husband’s room. “Are you a doctor?” she asked. “No, ma’am,” I replied, “I’m a nurse. Can I help you?” She asked me to come see why the IV pump was beeping.This wasn’t my floor. I ...
Medical care and airlines – should there be a difference?
A recent article by Pauline Chen features a group of primary care physicians at Tufts Medical Center in Boston, who have created a concierge practice that funnels income into the traditional general medical practice that sees less-advantaged patients.Surveys (performed by the medical center itself) found that patients rated the quality of interactions with their doctors similarly regardless of their affiliation. The only significant differences in responses had to ...
An automated call center for your medical practice
Having an answering service is essential for the typical medical practice. But what about your regular call center? Do your front desk personnel answer the phone? Do you have a dedicated receptionist? Or a formal call center?Outsourcing services seem to be on the rise and medical practices are beginning to realize some cost savings just like other businesses.The trade-off of course can be the perception of less personalized service. Some ...
ACP: Clinical decision support – is it time?
A guest column by the American College of Physicians, exclusive to KevinMD.com.by John Tooker, MD, MBA, MACP
The recently enacted American Recovery and Reinvestment Act (ARRA, 2009) and Patient Protection and Affordable Care Act (PPACA, 2010) contain provisions that, if implemented, will fundamentally change the way that medicine will be practiced in the future.As I indicated in a prior ...
Is the media responsible for childhood eating disorders?
I really don’t want my children to be overweight. I know this because I see the consequences every day in my practice, consequences like high blood pressure, impending diabetes, or poor self-esteem.At the same time, I really, really don’t want my children to have an eating disorder. I know this because I had one.In college, I suffered from anorexia nervosa. I’m a little more than 5 feet 9 inches tall, ...
Is more primary care really better?
Proponents of health reform have long claimed that one of the biggest problems with our health care system is an overemphasis on expensive specialists and an underemphasis on primary care physicians -- who, much research shows, produce high quality care at a much lower cost.In essence, the argument is that we're using (and paying for) rocket scientists to fly kites. If we bolster the primary care workforce, suddenly we'll start ...
Permanent makeup risks and dangers
"She just got permanent eye liner and eyebrow augmentation—looks fab," emailed one of my closest friends last month, about her coworker. "I am seriously considering permanent liner/eyelash augmentation. Do you have any interest in doing this with me?"I understood the appeal ... I'd never have to reapply makeup after showering at the gym, save time on my morning routine and enhance features like thinning lashes and brows. Although we had ...
Health blog posts of the week, ending January 2, 2011
Here are the top posts from this past week, based on the number of times they were viewed.1. How American physicians should be paid. How do you think American physicians should be paid? I think many of the current methods are insane.2. Patient complaints do not fit the primary care office visit. Primary care physicians often have to see patients with a litany of issues. Often within ...
What will become of health insurance companies after reform?
The talk around the country among health insurance companies is that their insurance business is dying.What is happening? First, the consolidations in other industries, resulting in large, multistate corporations, already mean that many companies self insure their employees. Even many local firms have large enough work forces that they can be self-contained risk pools. (One source I found says that in 2008, 89 percent of workers employed in ...
Discussing cancer treatment with the terminal patient
For everything, there is a season… - Ecclesiastes“Are you giving up on me?” My patient looks at me severely. “There must be other treatment options! Aren’t there some experimental drugs out there? I have beaten this cancer twice before. Are you saying that I can’t beat it again?”No one can ever know with absolute certainty whether my patient's newly recurrent cancer might miraculously disappear with one more treatment. His recurrence, however, has ...
Kevin Pho, MD
-
Why Priscilla Chan may become the country’s most influential doctor
Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from...
-
Confused about prostate cancer screening? Make a shared decision
In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men. Case closed, right? Hardly. The prostate...
-
When it comes to doctors and social media, hospitals fail miserably
When it comes to medicine and social media, much of the attention is negative. Doctors losing their hospital privileges because of Facebook....
-
Warren Buffett’s prostate cancer choices aren’t right for every man
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
Physician
-
Why test recalls should not be considered cheating
I was appalled recently by the coverage of radiology “test recalls” by CNN, amplified by Dr. Gary Becker of the American Board...
-
Why physicians are susceptible to hardball tactics
I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the...
-
How we deliver bad news is critical to how families deal with grief
As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during...
-
His father’s suffering had already been too great
He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I...
Patient
-
How death can be a beautiful experience
I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law...
-
What meaningful encouragement can be given to someone who is dying?
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
-
Health care journalists have tendencies similar to those of doctors
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
-
Adaptation can be painful, but it can also be a gift
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
Policy
-
What should America’s health care vision be?
America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the...
-
Hospitals around the world aim to remain relevant to patients
"It was the best of times, it was the worst of times ..." So begins a story called A Tale of Two...
-
Repairing the tear in health care’s safety net with social media
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
-
Look to technology to reduce health costs
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
Tech
-
Mobile health apps don’t always follow conventional wisdom
Propaganda and non-truths abound all around the Internet saying that mobile health apps are everything from a threat to Big Pharma to...
-
When patient care becomes secondary to filling out the medical record
The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above...
-
Doctors, use Google to get more patients in less than 7 minutes
Every month, hundreds of thousands of people look for a doctor on Google. As an amazing practitioner, your site deserves to be...
-
The user interface for EHRs should be uniform
The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with...
Social Media
-
We need to see the potential harm of social media
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
-
Why social media may not be worth it for doctors
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
-
Transparency defines social media success for doctors
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
-
How Twitter was used in a potential mass casualty scenario
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
