by Zakari Tata, MDInformed consent has continued to generate a lot of interest in medicine worldwide.The reason is because patients in medicine and subjects in clinical trials need protection from the multitude of injuries and harms that have been caused by intentional or accidental actions. The controversies generated by various lapses of informed consent, in my opinion, have not been addressed and more safeguards need to be put in place ...
February 2011
All Stories
Physicians who are able to feel compassion
Here’s a true story from the operating room:
Surgeon: Intern, what is the story behind this patient?Resident Intern: Patient is a 51 year old female with breast lump on the left side, and 17 out of 20 lymph nodes positive for cancer.Surgeon (speaking in a rather ‘as a matter of fact’ tone): Oh, she’s F_ _ _’d.Resident Intern: shocked, frozen and unable to respond."How do some physicians become so stoic?" I ...
Physicians disgrace the University of Wisconsin with fake doctor notes
One of the stories circulating regarding the demonstrations in Wisconsin is the authenticity of the doctor work notes.Squarely in the cross-hairs are physicians from the University of Wisconsin's Department of Family Medicine.According to this excellent piece in The Atlantic by physician-writer Ford Vox,
In videos breathlessly presented throughout the conservative mediasphere this weekend, doctor after doctor is videotaped writing patently fraudulent sick notes so that the protesting teachers (whose contracts ...
How important is a doctor’s skill in the physical exam of a patient?
How important is a doctor's skill in the physical examination of a patient?To the lay person, a doctor's examination might seem really important. "Of course it is, Dr M ... Come on."But is it so? Or, perhaps, is the examination a charade, a show, a necessity to complete the medical record.It turns out that many in the profession think doctors may be losing the skill of palpating and listening. At ...
How medical loss ratios impact mini-med policies
It’s amazing how much trouble a couple of hundred inexpensive health insurance policies can cause.Up until recently, few people were aware of the existence of so-called mini-med policies. Marketed primarily by for-profit insurers Aetna and Cigna, they are designed to provide bare-bones coverage to employees of low-wage low-margin service companies. Unlike other approaches to affordable insurance that emphasize catastrophic coverage, mini-meds typically keep premiums affordable (some as low as $15 ...
Evolution of tablet devices for the hospital
When working in the hospital, I intentionally minimize the time I spend on my iPhone because I don’t want people to assume that I’m just checking Facebook or playing Angry Birds.Even though medical apps and the vast depths of the internet are at my fingertips, it’s just too easy to appear distracted. This represents a subtle, yet meaningful, glimpse of just one reason why I eagerly await the continued evolution ...
Revenue cycle management for your physician practice
Revenue Cycle Management. What does it mean? In a nutshell, it means taking steps to assure that you get paid for what you do and that you get paid in a timely fashion.The revenue cycle starts when the patient calls your office for an appointment and your staff captures the patient's name, phone number, and maybe the name of their insurance company.The cycle ends when the balance on their account ...
When should psychiatrists give advice to patients?
This post was inspired by Dinah, a psychiatrist over at Shrink Rap.She recently described how a psychiatrist friend of hers has been going through some phase-of-life changes. Recently he has regretted some of the advice that he previously had given to patients who were going through the same life changes he’s now going through himself. He realizes that he was not nearly so qualified to give the advice ...
How patients and doctors can improve the primary care office visit
Consumer Reports recently released a survey of both patients and primary care doctors, regarding their perceptions of each other.Some interesting findings, as summarized by the WSJ's Health Blog:
On the issue of respect and appreciation, 70% of doctors said they were getting less of it from patients than when they started practicing. For patients, meantime, the more they reported being treated respectfully and listened to, the more satisfied they ...
How to improve doctor patient communication
When I was a medical student on my first clinical rotation, obstetrics, I was criticized for not using enough medical jargon when I spoke to the patients.I took that criticism as a compliment and have always attempted to speak clearly and without too much "inflation" of my terms. In my opinion, the more clearly we physicians communicate, the better will be our patients' understanding of their ailments.The important topic of doctor-patient communication led a ...
Why alternative care seems to work
People sort of want to try alternative care. They’re working up to it, but then they read more about it; they read about the theory and they say, "No I don’t believe that theory. That can’t possibly work. There’s nothing to it. I’m not going to do it." But, the problem is that the theory of why something works or the explanation is not necessary related to the effect of ...
Why more primary care may not improve health care quality
by Maggie MaharThe emphasis on primary care as the “key” to lifting the quality of U.S. healthcare may be exaggerated according to a report by Dartmouth’s Institute for Health Policy & Clinical Practice."Primary care forms the bedrock of a well-functioning, effective health care system," the researchers observe. But-- and this is an important caveat- "simply increasing access to primary care, either by boosting the number ...
ACP: High value, cost conscious care
A guest column by the American College of Physicians, exclusive to KevinMD.com.by John Tooker, MD, MBA, MACP
There were two reports from the recent 2011 International Stroke Conference that got my attention.One report noted the sharp increase in the incidence of strokes in children and young adults. The second, in the Los Angeles Times (“Mild strokes may ...
AOL News op-ed: How the Web and social networks will benefit patients
My op-ed was published today in AOL News: Docs Need to Get with the Internet Program.
Here's an excerpt:
... patients should be vigilant about checking the source of what they read on the Web. Ensure it comes from a reputable institution -- such as a hospital, medical school or government agency.The Internet has fundamentally changed the doctor-patient relationship ...
Online reputation can have career implications for physicians
While we have seen a continued increase of online activity in the healthcare space over the past few years, I don’t think we are even scratching the surface of what’s to come.Aside from consumer driven trends on the web, cloud computing is having a dramatic impact on the business enterprise environment and healthcare is next. All this points in one direction for doctors: your online reputation may become as or ...
Medical students should not be liable for malpractice
Should medical students receive immunity from malpractice liability?That's an interesting question that's raised in a bill from Arizona.According to the Arizona Daily Sun,
State lawmakers are moving to keep patients injured by medical students from being able to sue them.But proponents said that won't leave victims without recourse.SB1429, awaiting full Senate action, would spell out that students are not liable for malpractice if they are under the supervision of a ...
How powerful a few words can be in the exam room
Recently, I was reminded of the power of wellness. From the other side. And it came wrapped up in sound. Five words, to be precise.I was instantly reminded how powerful a few words can be in the exam room.We all want to feel wellness. The freeing kind, as in the way you feel when towered over by big objects. You know what I mean, the wide open wellness you feel ...
The biggest problem faced by pilots and obstetricians alike is nature
It's a bit ironic that pilots, the people who spend the most time traveling above the magnificent landscape that is our planet earth, spend very little time appreciating the scenery.That's because they are trained to always be on guard for unexpected emergencies. While the passenger in a jumbo jet traversing the continent can admire the majesty of the Rocky Mountains, the desolation of the Great Salt Lake or the endless ...
Every patient is an immigrant in the doctor’s office
One of my favorite conferences is The Conference on Practice Improvement hosted by the Society of Teachers of Family Medicine (STFM) and American Academy of Family Physicians (AAFP).For all the upset and negativity there seems to be toward doctors, these family docs are in it -- each and every one that I’ve met -- for the good of their patients. And that is why I think every one of them ...
Exercise to prevent cancer
by Karen Basen-Engquist, PhDThe next time you’re on your couch contemplating whether to watch your favorite sitcom or get up and exercise, remind yourself that being active for at least 30 minutes every day can help reduce your chances of getting certain types of cancer.Physical activity fights cancer because it reduces body fat, and lowers hormone levels that raise breast and endometrial cancer risks. It also keeps the digestive system ...
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...
