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 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....
