American Medical News published an informative essay by Kevin B. O’Reilly on December 13, 2010, about errors in diagnosis and why doctors make them.According to Gordon Schiff, MD, associate director of the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital, “The problem of diagnostic errors has gotten short shrift in the broader patient safety movement.” The article ...
March 2011
All Stories
How an EMR can be shockingly inconvenient for prescription refills
Let me start by confessing I’m something of a gadget freak. I was an early Palm Pilot adoptor, loved the iPod from the get-go, and need to avoid CNET, Engadget, Gizmodo, and David Pogue’s columns for the New York Times when deadlines loom.Not surprisingly, I embraced the shift to electronic medical records (EMRs) enthusiastically. While I acknowledge that sometimes EMRs ...
How social media will change mental health care
Social media is changing how we communicate and how we define "relationship." I was speaking to someone last week who said to me, "Social media isn’t coming it’s here!" He’s right.And while many voices in our professional communities are wary about social media, I see positive opportunities at every turn. Here are just 5 ways social media will change ...
How primary care will play a central role with health care reform
by Jeffrey L. CohenHealthcare reform used to imply just regulatory change. As time marches on, it also implies market change. Most pundits agree that, whatever happens to the healthcare reform law, whether or not it is found to be unconstitutional, the healthcare business community is unleashed. Change is afoot!If you follow my nahsaying on the ...
Medical professionalism affect how hospitals perform
In my estimation, professionalism has a lot to do with personal values. Thus, when individuals or clinicians are aggregated into groups, their personal values form the base of their organization’s values and culture.It’s not surprising to this sociological-thinking individual when studies show that the differentiating factors between low- and high–performing institutional and ambulatory clinical practices are an organization’s values, ...
Residents assisting with your surgery can save lives, but at a cost
When undergoing surgery, would you want interns and residents present, and perhaps, assisting in the operation?That's a question patients face when going to an academic medical center. Some won't mind the presence of house staff. Some will.A recent study provides some details on the outcomes.In a column by ...
Why medical students should be passionate about health reform
by Chris ChenRecently, I stood in the back of a boisterous, packed auditorium as each of our school’s fourth-years received their match letters and proudly announced in front of friends, family, and classmates where they would be headed for residency.As peers enthusiastically cheered each other, significant ...
Wimpy Parent Syndrome, and allowing your child to get mad and cry
I woke up in the middle of the night last night and I could not fall back asleep. I had a moment of brilliance laying there in bed. I had discovered a new medical disorder, Wimpy Parent Syndrome (WPS).For years I have been seeing it in clinical practice, but have been unable to put my finger on exactly what was taking place. Then the idea of WPS came to me and everything ...
Medical ethics at hospitals and medical schools in China
One of the topics I went to China to discuss was our medical school’s approach to teaching medical ethics.At Wuhan University they have a first-year course, but I was told by both the school administrators and some of the students that the material is dry and not seen of immediate importance, so students often skip the class.Here’s how ...
How much empathy is too much?
If you're sick, you need people to empathize with you, right? Maybe not.
Empathy is one of those words with a wide variety of definitions, especially in academic settings.From Wikipedia: "Empathy ... cover[s] a broad spectrum, ranging from feeling a concern for other people that creates a desire to help them, experiencing emotions that match another person's emotions, knowing what the other person is ...
A boxing fight physician experience
I received a phone call from the Broward Sheriff’s Office Police Athletic League Youth Boxing Program asking if I would help them out and be the fight physician at their upcoming youth boxing tournament.Their usual physician, a member of the Boxing Hall of Fame, had another commitment. However, he was willing to train me in advance and show me the ropes on the day of the event.State law and the ...
Accountable Care Organizations and the need to innovate
There is a lot of buzz over the creation of Accountable Care Organizations (ACOs) under the Patient Protection and Affordable Care Act (PPACA).An ACO is a network of health care providers and hospitals that collaboratively manage patient care and prospective budgets. Perhaps the biggest draw of ACOs is the potential to create innovative ways to improve quality and decrease costs. To ...
Why some EMR programmers think physicians are stupid
Every major industry is now computerized with one glaring exception; health care delivery. Thirty years after Steve Jobs began selling personal computers out of his garage, far less than 50% of physician practices and hospitals have converted to any form of electronic medical record.The vast majority of medical documentation is still done via paper and writing utensil just as it ...
How physician practices can compete with retail clinics
A reader recently wrote to me: "Brandon, in our area, we’ve seen a few retail clinics pop up. What can we do as a practice to let patients know that visiting retail clinics is not in their best interest?"We had along discussion. So I put together a summary of our conversation. Below is a rundown, more of less, of what I ...
What is stuttering, how is it treated, and The King’s Speech
One of the "Crown Jewels" of the 2010 holiday movie season may be The King’s Speech. The film centers on Colin Firth, who plays King George VI of Britain, and Geoffrey Rush as Lionel Logue, the speech therapist who helps the king deal with his stutter.Born Albert Frederick Arthur George, the second son of King George V, he spent most of his early years out of the spotlight, which centered ...
Does empathy mean giving patients what they want?
Recently, KevinMD.com picked up my post on empathy or should I say the lack of it. I received some engaging comments.One comment in particular caught my attention.The contributor for some reason equated “being empathetic” with “giving in” to patient requests presumably during routine office visits. Here’s a direct quote:
Give the patients what they want! Antibiotics are OK for colds. The patients want them. So ...
Why medical education needs to be more affordable
I was talking to a young man who is starting medical school this fall. His tuition at one of South Carolina’s newer schools will be $40,000 per year. That’s admittedly on the high end. On the low end, it runs a paltry $33,000 per year.And this is all after college, of course. He and others like him are taking out loans to the tune of $240,000 to pay for their ...
Implications of the surgical buy in when discussing informed consent
Pauline Chen had a post in the New York Times recently about surgical informed consent. Informed consent is an important part of the surgeon/patient communication transaction.Surgeon reviews the proposed operation, the rationale behind it, and the possible complications. For example--- a patient comes in with biliary colic. We describe the anatomy and pathology. We aver that surgical resection will lead to ...
Treatment for plantar fasciitis is expensive and ineffective
There are nearly 2 million cases of plantar fasciitis in the United States every year. As an orthopaedic surgeon, I’m quite familiar with this issue since nearly 20 percent of my patients come to me about plantar fasciitis.Although there is a surefire way to fix the problem, the current treatments aren’t really addressing the issue, and they are costing millions for those who suffer from the heel pain. Many are ...
Calling in sick serves as a reminder for compassion for this doctor
One of my Facebook updates on my private account was that I "have a love-hate relationship with interleukin-6. Yes, macrophages and T cells, I know you are doing your job, but how many proinflammatory cytokines does it really take to fight this thing? What's that? Be grateful you guys are even working? Oh, all right. I'll shut up and eat my soup now."Yes, I've been sick this week. It started ...
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...
