"Musta been the ham sandwich," he said as he leaned onto the operating table and belched a couple of times. We were half-way through a thyroid operation and Doug, my partner, didn't look all that good. I'd been in practice for all of a year, and Doug, ten years my senior, was my guardian angel, my guide through the vagaries of the world of private practice, and the best surgeon ...
February 2011
All Stories
How to check your scientific paper for plagiarism
We were taught in grammar school that plagiarism is wrong. It is stealing someone else's property.Imagine in high school asking your mother to buy you "Cliff Notes" so you can copy it word for word. Mother would not have liked that, and it wouldn't have been right.To write an essay today, you'll probably start with a search engine. Instantly, Mr. Google delivers many intelligent commentaries on anything, probably better than ...
Online tools to help shop for the most affordable health care
by Ray CarlsonTwo recent articles posted here at KevinMD.com regarding the inclusion of discussions about the cost of health care services between doctor and patient highlighted the growing emphasis on not only the quality of care but the cost of that care to the patient as well. The first article was written by Dr. Leslie Ramirez, who advocated for a more proactive stance by doctors regarding the subject ...
Do stroke centers improve patient outcomes?
by Harlan M. Krumholz, MD, SM
Another good paper for a journal club recently appeared in JAMA. What makes this one worth discussing is the research question the investigators posed and how they addressed it. Although this is not focused on cardiac care, the issues are germane to literature in our field and cardiac care certification is also spreading.The article, titled “Association Between Stroke Center Hospitalization for ...
Integrating doctors and hospitals may worsen cost control in health reform
Health reformers propose the proliferation of integrated health systems, like the Mayo Clinic or Kaiser Permanente, which, according to the Dartmouth Atlas, lead to better patient care and improved cost control.To that end, Accountable Care Organizations have been a major part of health reform, changing the way health care is delivered.Never mind that patients may not be receptive to the new model, but the creation of these large, integrated ...
Physicians love a CIO who lets them focus on patients, not technology
by Donald Burt, MDMany hospital CIOs face an uphill battle winning the hearts, minds and fingers of physicians. It’s not because doctors are technology phobic. Quite the opposite: physicians are some of the most ravenous consumers of new information technology. Smartphones and tablets are becoming as ubiquitous as stethoscopes at many hospitals.The truth is doctors are happy to make screen touches, mouse clicks and keyboard strokes if the application is ...
The AIDS crisis in Zambia
Wednesday, December 1st was World AIDS Day — a day to raise awareness for the ongoing AIDS pandemic around the world and to remember the past. As a trainee intern I spent 3 months in Zambia, a time that really opened my eyes up to what AIDS was doing to the world. Much has changed since then, antivirals have arrived in Zambia for instance, yet the disaster continues: 1 in ...
If you’re in medicine, you’re in politics
by Nicholas J. RohrhoffEach generation of physicians has no choice but to take on the responsibility of learning the science of medicine - how best to care for patients. But current circumstances dictate that we must also bear the burden of developing policy that creates the best system in which to provide that care.Creation of a 21st century American healthcare system will require engagement and ...
Why the CME community is lacking in its use of social media
Both the Patient Protection and Affordable Care Act (PPAC), as well as the stimulus bill from last year included funding, which focused on the use of health information technology (HIT) and electronic health records (EHRs). These initiatives are aimed at getting health care providers and entities to begin using information technology to improve the quality, efficiency, and delivery of care to patients.Along the same lines as using HIT, a recent article ...
iPhone medical apps for patients with migraine headaches
by Diana E. LeeSome are free, others are not, but there are some great, off the beaten path apps on this list that are well worth downloading to your iPhone.1. iHeadache (free version, with ads).This app isn't bad, but I did find some features less than ideal. You're limited to their list of symptoms, which may not include all of your symptoms. It didn't include all of mine, ...
Teenage patients are answering medical questions on Yahoo! Answers
by Lorelei ArmstrongDoctors debate whether patients Googling symptoms is a good thing or a bad thing. I bet you haven't thought about something that might be worse: your teenage patients are answering one another's medical questions on Yahoo! Answers.They're not always clear on anatomy and terminology: "How can I tell if I'm circumcised?" and "What's the best way to shave my vagina?" and "Where is the female prostate located?"They are ...
Combat compassion fatigue in caregivers to improve patient care
Six months down. Six to go. I am officially halfway through what people have told me will be one of the most challenging years of my life. I’ve rotated through Cardiology, Primary Care, Gastroenterology, General Medicine, Psychiatry, Palliative Medicine, the Medical Intensive Care Unit (MICU), and Rheumatology. Finally I have reached every resident’s favorite rotation – vacation.Intern year has been hard work, but I’ve enjoyed it and am extremely pleased ...
Discussing smoking habits with patients
I saw two patients recently that really made me scratch my head.The first was a 15-year-old girl who was smoking a pack of cigarettes daily and had been for 3 years; the other was a 26-year-old man who smoked 1.5 packs daily for 10 years and had recurrent oral ulcers and bleeding gums. In sitting and talking with these two patients, it became blatantly obvious that the risks of tobacco ...
KevinMD.com recent media mentions, February 2011
I'll be on Sirius XM's Doctor Radio 8am Eastern tomorrow morning, Monday February 7th. Host Dr. Ira Breite and I will discuss social media and medicine.I’d like to thank various media outlets for recently citing KevinMD.com.CBS News: Male Docs Make WAY More than Females: What's Going On?
Another possibility is that women earn less because they tend to see fewer patients than do their male counterparts.For the most part, doctors ...
ProPublica’s Dollars for Docs: Strengths and weaknesses
The non-profit media organization ProPublica last year announced a new website/database called Dollars for Docs. It lists cash payments made to 17,000 U.S. doctors by seven large drug companies.I’ve been browsing through the database and I have some thoughts about its strengths and weaknesses—and how it might be useful for patients.First, here’s what these journalists did. Rather than waiting for the provisions of the Physician’s Payments Sunshine Act ...
KevinMD posts of the week, ending February 6, 2011
Here are the top posts from this past week, based on the number of times they were viewed.1. Physician blogs, doctors on Twitter and a malpractice trial. You are in the middle of a deposition. Plaintiff’s lawyer asks, “Do you blog or tweet?”2. Patient safety lapses in the hospital. Lack of adequate communication during these transitions led to a delay in changing the patient’s IV and failure to ...
Female physicians make less money than male doctors, here’s why
Female doctors make less than male physicians.That conclusion gained major media traction recently. A recent post on KevinMD.com by medical student Emily Lu had some great conversation discussing some reasons why women make less money in medicine.To recap, the study from Health Affairs concluded that,
newly trained physicians who are women are being paid significantly lower salaries than their male counterparts according to a new study. The authors identify ...
Kernels of humor in a tragic cancer story
I didn't always recognize its importance. I mean when I was younger, I thought that being attractive, slim, athletic, articulate were sure-fire antidotes to one’s suffering a life of mediocrity. I just never recognized the value of something I took for granted, my sense of humor. And then life happened.When I was 36, my husband (who was older by 12 years) was diagnosed with lung cancer. Inoperable, incurable, his type ...
Stressful life events in suicide attempts and completed suicides
The role of stressful life events in suicide attempts and completed suicides has been a key area of study in the epidemiology of mental disorders. Although suicidal behavior often occurs in the context of acute and chronic stressor, this does not prove a causal link. We all could probably report serious life stressors throughout out lives and these could be interpreted as a reason for suicidal behavior. So these associations ...
Finding out the cost of lab tests is a real challenge for patients
In the spring of 2005, the sinus infection returned. I awoke severely congested with a pounding forehead and pain around my eyes that grew worse when I bent to tie my shoes. The feeling was familiar. Two years earlier, I had similar symptoms, but was uninsured and endured a miserable week with nothing but over-the-counter medication. Now they were back.Fortunately, when I started graduate school, my father insisted that I ...
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....
