To everything there is a season and mine comes to an end today. For 720 weeks I attempted to give quality care to my patients. The task was not always easy especially when most of my patients held the unenviable position of having a high risk pregnancy and receiving Medicaid or being uninsured. Babies have a right to be born healthy ...
March 2011
All Stories
A cartoon guide to 10 types of physician blogs
So, doctor bloggers, which category do you fit into?(Click image to enlarge)
(via A Cartoon Guide to Being a Doctor)
Engage employees in healthcare to enhance patient outcomes
It is an axiom of business that employee engagement produces many positive results, no matter what the setting—manufacturing or service. This is true for healthcare as well.Employee engagement produces a better product or service. In healthcare, engaged employees produce enhanced patient outcomes. When employees are engaged there is less turnover, which reduces training costs. Engaged employees are problem solvers.How ...
Hospitals need an engaged social media presence on Facebook and Twitter
How important is it for hospitals to engage in social media platforms, such as Facebook or Twitter?It's essential.Nowhere is that more evident than in the controversy concerning infant Joseph Maraachli. Without getting too involved in the politics or ethics ...
Can family medicine really be defined?
by mdstudent31Going into medicine from a suburban community in the northeast, I never really knew exactly what family medicine was as a specialty. I had heard of it before, but did not see it in action until going to undergraduate school in the middle of Pennsylvania. It was there when I began ...
Why the return on investment in an EHR is poor
I had a déjà vu experience recently when I visited a medical practice that was like so many others I've been to before.This practice just wasn't getting their investment back from their EHR.The practice had been live on the EHR for about five months and was functioning effectively without pulling charts for patient visits. The clinical staff was comfortable with the ...
How a patient support tool works to help patients and doctors
When you go to see the doctor, how do they know (a) if you are due for any preventive health screenings like mammography or (b) if you have a chronic condition, if it is being monitored and managed?And actually, not just if it is being monitored or managed, but are you able to achieve your life goals with good health? And what about ...
How your EHR can help with physician recruiting
by John RossheimWhat’s the latest tool for recruiting the best clinicians to your hospital? Is it the professional pride of being associated with an organization that provides the best care in the region? Is it showing respect for the growing number of clinicians who seek to work hard but protect their personal lives from excessive intrusions in the form of frequent on-call duty or mandatory ...
Being a physician is not just about medicine
by Sunjay Devarajan"Mrs. Adams" slowly ambled into the family medicine clinic on a Wednesday afternoon. I immediately noticed her slight hunch as she made her way into the lobby.“A case of back pain?” I thought to myself. “Perhaps an exacerbation of the scoliosis she’d had since childhood?” I shrugged my shoulders and carried on with my ...
How high blood pressure in the office can be white coat hypertension
"But doc, my blood pressure is always normal at home." I wish I had a dollar for every time I have heard that line and I know it is true.When some patients come to see me, their blood pressure is abnormally high (above 130/90) and this is known as "white coat hypertension." Although it has been thought to be from anxiety about seeing the doctor, even long established patients who ...
How Microsoft Kinect can help in radiology to view a CT or MRI
Radiology has transformed into a core subject of medicine, since imaging procedures are getting more and more crucial to clinical decisions. Whether these developments, be it over-diagnosing or unnecessary radiation on the one hand or a more detailed and enhanced way of diagnostics on the other, are ...
The Institute of Medicine (IOM) is independent and authoritative
On Oct. 14, 1988, I published a Special Communication by Irvine H. Page, one of the founders of the Institute of Medicine (IOM) in JAMA. Dr. Page criticized the IOM at age 18 for failing to live up to the vision of its founders. This was accompanied by a rejoinder and a prospective by then IOM President Samuel O. Thier. My editorial was entitled "Still Needed -- A National ...
Cannabis use and medicine, the debate over benefits and harms
An excerpt from Uses and Abuses of Plant-Derived Smoke: Its Ethnobotany as Hallucinogen, Perfume, Incense, and Medicine.by Marcello Pennacchio, PhDFew plants have generated as much debate and controversy as cannabis (Cannabis sativa).Throughout the ages, it has been labelled both a dangerous drug and potent medicine. Where the former is concerned, law-enforcement agents and governments spend millions ...
How to convince doctors to embrace electronic medical records
Doctors are now incentivized to convert antiquated paper charts to electronic medical records.Despite a few doctors who love their EMR, most readers here at KevinMD.com are skeptical, as the difficulties in transitioning, along with questionable benefits, have been well chronicled.Recently, the Washington ...
What to do with a prescription bottle with the wrong pills inside
Have you ever opened a prescription bottle to find the wrong pills inside? If so, you may have found it to be an expensive mistake.Whatever the reason for the error (and there are numerous possible causes), here is how to best handle the situation.Of course, it is always smart to confirm the medications, quantities and dosages at the pharmacy checkout. A mistake recognized at the time of purchase can be easily ...
Accountable care organizations: The lost art of medicine?
by Sharolyn Rhees Medina, MDIt’s no secret that healthcare’s inevitable move toward accountable care organizations (ACOs) has many physicians feeling a bit …nervous. Admittedly, most physicians are creatures of habit who fiercely defend their individual approach to patient care, focus on cures not cost, and dread the concept of "cookbook medicine."And under the ACO model, physicians ...
Doctors should ask the people what they want for health care
Americans typically rely on elected officials to uphold the will of the people. Now physicians—traditionally confined to exam rooms—are taking direct action to fulfill community needs.In 2004 I decided to meet face to face with citizens in my hometown. I thought, "Why wait for legislation? I'm a board-certified physician. What's stopping me from serving the public?"So I led town hall meetings and invited ordinary citizens to create the clinic of ...
A surgeon on those who understand murderers, rapists and child molesters
(Editor's note: reader discretion advised)Recently I was involved in a discussion with a guy that was explaining how we should understand criminals. The emphasis was on farm murders but we touched on murderers in general, rapists and child molesters. My point of view was that I did not understand them and felt that he was justifying their actions. In the end I was informed that I was smug. Apparently that ...
Family physicians who care for underserved patients
One of the ugliest incidents in my career occurred during my faculty development fellowship year, when I spent two days each week seeing patients at several federally qualified community health centers in inner city Washington, DC. Midway through the year, I was transferred from a health center that served an African-American population to one serving a mostly Spanish-speaking clientele.Nearly all of the permanent Recently, I attended a scientific symposium on addictions.One of the books I picked up at that conference, and read on my flight to Montreal, is A. J. Adams’ Undrunk: A Skeptic’s Guide to AA.While this book is a very quick and highly readable introduction to AA (Alcoholics Anonymous), about which I knew very little, today’s post is not about this book.The definition reads as follows:How obesity is like alcoholism
Alcoholism is a primary chronic disease ...
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....
