Lack of sexual interest is the most common sexual complaint in women.The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), which defines psychiatric disorders, defines Hypoactive Sexual Desire Disorder (HSDD) as ‘‘persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity’’ that causes ‘‘marked distress or interpersonal difficulty.’’ Epidemiologic surveys have suggested that from 25 to 50 percent of women report prolonged periods ...
February 2011
All Stories
Fewer physicians are taking call in rural emergency rooms
My partners and I have long struggled with the lack of specialty back-up at our hospital. Semi-rural hospitals, out of the way facilities, just can’t always attract specialists. So, we’re happy to have cardiologists every night, but understand that we only have an ENT every third night. We’re thankful to have neurologists, even if they don’t admit anyone. We’re glad to have radiologists, even if they don’t read plain films ...
Reference Range, a poem by Veneta Masson [VIDEO]
Veneta Masson, a nurse who wrote in Health Affairs about why she doesn't get mammograms, created a YouTube animation visualizing her poem, Reference Range.Enjoy.(via Gary Schwitzer)
Patients are closing the health gap online
by Jerry LevinFor all of us -- young, old, and those in the middle -- life is simply an interlude between doctors' visits. This perspective, while obvious, perennially stays beneath our consciousness since we are consumed by the daily pursuit of personal identity as if our mind-body-and-spirit were to function without incident and without end. More powerfully of late is the recognition that the explosive neglect of mental ...
Requests for OTC prescriptions for a FSA burdens primary care
As reported by MSNBC, the federal government will no longer allow flexible spending accounts (FSAs) to be used for over the counter medications, without a prescription. FSAs, which are offered by many employers, allow you to use tax free dollars for medical expenses that aren't covered by your insurance. FSAs are a great idea and can be used for things like eye glasses, dentistry, or even nicotine patches ...
Make sure that everyone in your office is vaccinated against influenza
Good news or bad news first?Since you can’t answer me, I’ll choose for you.Here’s the good news first. A National Foundation for Infectious Diseases (NFID) survey unveiled recently at NFID’s annual influenza and pneumococcal news conference reported that more than 90% of physicians will get (or have already gotten) the influenza vaccine this year.If you’re a frequent reader, you know my penchant for chiding health care workers about ...
KevinMD posts of the week, ending February 27, 2011
Here are the top posts from this past week, based on the number of times they were viewed.1. Physicians disgrace the University of Wisconsin with fake doctor notes. Politics should never be allowed to dictate medical decision making, and these physicians should have known better.2. Medical students should not be liable for malpractice. Leave medical students alone, and exempt them from medical malpractice lawsuits.3. How to improve ...
Supermarket tips for preparing nutritious meals
On the subject of shopping for and preparing nutritious meals, one piece of advice that I like to share is that it’s best to stick to the outer walls of the supermarket and avoid the center. So with only a few exceptions, like flour, oil and beans, that’s exactly how I shop. What does it mean to shop at the edges of the supermarket? Let me show you what I ...
Understand the medical economics of a primary care practice
If we are going to make rational decisions about health care reform, it helps to understand the medical economics of a primary care practice.I was ten years out of medical school by the time I joined Narragansett Bay Pediatrics, a group practice in southern Rhode Island, and I was earning a salary of $48,000 for my “part-time” position. I worked in the office 24 hours per week, and covered nights ...
Nurse practitioners and their relationships with pharma
Doctors have been under significant scrutiny over the years regarding their relationships with pharmaceutical companies.Some states have even gone as far as banning events like drug company-sponsored dinners and other pharma-funded educational events. An increasing number of medical schools and hospitals simply won't allow an industry presence.Whether you think it's gone too far is certainly debatable, but let's look at another group which can prescribe medications and examine their relationship ...
Can I be a doctor with bipolar disorder?
"I have bipolar disorder. Can I be a doctor?"It's one of those questions to which there is no real answer. Being a doctor takes a long time, it requires reliability, diligence, and a willingness to learn things you may not want to learn and do things you may not want to do. It requires endurance and passion. You need to be tolerant of many things: arrogant supervisors, irritable colleagues, sick ...
The torture and emptiness of psychological hoarding
Humans are imbued with a competitive spirit. And as a result, we like to count our victories.There are an infinite number of possibilities in human experience. And when the possibility of death looms over us, the sudden fear that we might not have done everything we might have creates immense distress. This "range" or "number" idea rarely has the effect it is supposed to have. Every kind of sex, every ...
Save the Boobs, and whether humor has a role in breast cancer
Last year it was the "Save the Boobs" video. This year it’s the “I (Heart)Boobies” bracelets.Some people were very offended by the video’s slow-motion close-ups that were more reminiscent of a beer commercial. Now, some schools are banning kids from wearing the bracelets. And in a recent post on Salon, Tracy Clark-Flory made the eloquent case that we’re more than the sum of our body parts, and recounted her mom’s battle ...
Sharing information about your health with specialists is difficult
As far as my chemo nurse Olga (not her real name) is concerned, I can do nothing right.She scolded me for sending an e-mail when she thought I should have called and vice versa. She scolded me for going home before my next appointment was scheduled. She scolded me for asking to speak to her personally instead of whichever nurse was available. She scolded me for calling my oncologist directly. ...
When your privacy is violated in the doctor’s office
Few patients enter our health care system prepared for the unexpected and embarrassing circumstances that can routinely happen.Most can accept it when we’re treated with modesty and respect. But not many are prepared for those times when you might be unnecessarily exposed or treated rudely. The possibilities for embarrassment are endless and it is usually unexpected. When avoidable incidents do happen, most patients are not prepared to speak up. Many ...
Defensive medicine accounts for 20 percent of MRI scans and x-rays
In the first, known prospective study, Pennsylvania orthopedic surgeons admitted that almost 20% of the imaging studies they ordered were for defensive purposes.All of the previous data that hinted at the rampant practice of defensive medicine relied on surveys or other forms of retrospective data.In this study,
A total of 72 orthopedic surgeons agreed to participate, submitting information on ...
Gastric bypass is not a short cut to treat obesity
Recently, a female patient saw me in the office for the first time to discuss her chronic digestive issues. Luckily for her, my recommendations did not include probing into her alimentary canal with the endoscopic serpents that we gastroenterologists rely upon.As the visit concluded, she advised me that she intended to have a gastric bypass (GIB) procedure performed, and even used the medical term of bariatric surgery. I suppose that ...
Is alcohol good for me? The data behind drinking and your heart
by Aditya Mattoo, MDNot too long ago, a patient came to my clinic and said (I’m paraphrasing of course), "I never cared for alcohol, doctor, so I haven’t had much to drink since my college days. Maybe champagne or wine on the rare special occasion, but I keep hearing about how wine is good for your heart, so I am thinking I should start drinking ...
New comment policy at KevinMD.com
I appreciate the vigorous discussion that readers bring to KevinMD.com every day. It's not uncommon that the conversation is more interesting than the post itself.As many of you know, seeing patients, writing, editing blog entries and moderating comments stretches my time pretty thin. And with the significant increase in traffic, the number of comments has grown -- often to several hundred a day.So, I'm going to adopt the New York ...
How two different attending physicians approach similar conditions
I recently finished my second month of internal medicine. I had a different attending physician for each month. It is interesting to see how two different attending physicians will approach similar conditions. There is a lot of flexibility in the standard of care. Neither of them is wrong by any stretch of the imagination. Just different.It is also amazing how much of a difference a good, well informed resident can ...
Kevin Pho, MD
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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...
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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...
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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....
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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
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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...
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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...
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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...
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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
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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...
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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...
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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....
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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
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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...
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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...
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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...
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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
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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...
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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...
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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...
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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
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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...
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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...
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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...
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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...
