Mike Morrison tweets for Massachusetts General Hospital as @MassGeneralNews and for Massachusetts General Hospital for Children as @MGHfC.I met Mike when I tweeted about the Benson-Henry Institute for Mind-Body Medicine including @MassGeneralNews in my tweet and Mike immediately followed me.I contacted him to find out what his strategy is for Twitter use and what the benefits have been.Lisa: Let’s start with the name: ...
March 2011
All Stories
Your laser facial rejuvenation questions answered
Laser facial rejuvenation is one of the most popular but most confusing treatments today.What’s the difference between a lunchtime laser and a fractionated laser? An ablative or a nonablative laser? If many plastic surgeons are confused by the plethora of lasers available, how can the average consumer or patient know what laser is best for removing their wrinkles and tightening their skin?Lasers work by focusing energy on a certain color of the ...
ABIM: Maintenance of Certification (MOC) exams assess clinical judgment
A guest column by the American Board of Internal Medicine, exclusive to KevinMD.com.by Christine Cassel, MD, MACP
KevinMD.com recently posted a blog noting that Watson, the IBM super computer who successfully beat two contestants on Jeopardy, would eventually make board certification exams obsolete. He argues that exams that rely on “memory-based curriculum” focused on recall of facts will become ...
Treatment-resistant depression is a myth
Treatment-resistant depression is one of those clinical terms that has always been a bit unsettling to me.Maybe I’m a pessimist, but when I hear this phrase, it reminds me that despite all the time, energy, and expense we have invested in understanding this all-too-common disease, we still have a long way to go. Perhaps more troubling, the phrase also suggests an air of resignation or abandonment: "We've tried everything, but ...
Are doctors ordering too many tests, or practicing a new standard?
Are medical students and new doctors overly reliant on tests and technology to make diagnoses?
That's an interesting thought I had when reading the latest TIME.com piece from emergency physicians Jesse M. Pines and Dr. Zachary F. Meisel.In their article, they give reasons why doctors order too many tests.Of course, they cite defensive purposes, saying, "once a doctor has ...
Asking a doctor for their opinion on another physician
If one of your patients asked your opinion of another doctor whom you know to be incompetent what would you tell your patient?Incompetence in a physician is a scary thing! Doctors deal with problems of life and death and try to heal you with dangerous tools. A doc that isn’t competent can be seriously dangerous.But how do you know who’s on their game and who’s falling down on the job? ...
Is Medicare the biggest challenge to seeing the doctor of your choice?
Medicare was touted as the social entitlement program that would forever change health care access for our seniors.But is it becoming the biggest challenge to seeing the doctor of your choice?For the first time in the almost 50 years of the program more and more Medicare recipients are facing the challenge of finding a doctor who will take their government sponsored insurance.Sure, there have recently been ...
5 ways I use my iPad at pediatric point of care
I love experimenting with different ways to use technology within my pediatric practice. The iPad has been an amazing device to adapt and use with my families.Here are 5 different ways I use the iPad with my patients at the point-of-care.
- Referring. I have entered my favorite subspecialty providers into Contacts; including their name, address, phone number, and website URL. I list providers by specialty with “pediatric” preceding each listing in ...
Hospitals taking over private practices
A decade and a half ago, when I moved to Memphis, I proudly hung a sign outside an office I shared with another doctor. It had my name followed by an MD. I had started my own small business as a solo practitioner in medicine.Over the years, the practice has grown. I now have several employees and my own office, with the names of several other doctors alongside mine on ...
Mental illness in men, and how physicians can prevent suicide in males
by Sujatha Prabhakaran, MDSuicide is arguably the most preventable cause of death. It is also a tough thing to talk about. But talk we should, because suicide costs Americans a lot. In 2000, self directed violence cost $1 billion in medical costs and $32 billion in lost productivity. Self-directed violence affects men and women of all racial/ethnic groups. However, as highlighted in the 2011 ...
EMR, a patient’s perspective
My oncologist's office implemented a new EMR system when I was in the middle of chemo. Once the nurses learned the system, I saw no difference in the care I got from them.Not quite so with the doctor. My experience with him changed dramatically.Before EMR I would enter the exam room and sit on a chair, play Angry Birds on my iPhone and wait. My doctor would walk in, make ...
Successfully appeal an insurance company reviewer decision
Coverage requests get rejected when the requested service does not fit within an insurance company’s initial guidelines for approval.This happens for a number of reasons, but usually it comes down to poor documentation or inappropriate care, or in some cases care that is appropriate but can’t be supported in the literature. When a denial occurs, the physician or patient has several opportunities to appeal this decision. The first appeal is ...
A primer on brand name drugs and generics
That there are some serious misunderstandings out there about the difference between name-brand drugs and generics, as well as some bizarre assumptions about the merits of newer drugs. So here’s a quick primer on how you (and everyone else) are sometimes not getting accurate information about your pharmaceuticals.As a society, we’re addicted to drugs. Almost all of them are legal, and we’re not abusing them per se, but we want ...
Medical error in a fertility clinic
by Carolyn SavageOur names will be forever connected with one of the most significant medical errors ever made inside a fertility clinic.In February 2009, through a process referred to as a frozen embryo transfer, another couple's embryos were mistakenly transferred into my body. Eight months later, I gave birth to a baby boy who we relinquished to his genetic parents a few minutes after ...
Lifestyle changes to control the symptoms of prostate enlargement
Prostate enlargement, or benign prostate hyperplasia (BPH), is a common, non-cancerous condition affecting nearly 14 million men over the age of 50.The symptoms of prostate gland enlargement include a decrease in the force and caliber of the urinary stream, frequency of urination, urgency, a feeling of not emptying the bladder despite urination and nocturia, or the need to get up at night to urinate. Although lifestyle changes will not cure ...
I see dead people, an excerpt from In Stitches
An excerpt from In Stitches.I see dead people.Eighteen bodies covered with plastic, lying on gurneys. An occasional toe protrudes to verify that beneath the shiny black tarp, a dead person lies.I smell dead people, too.Or at least the thick chemical stench of formaldehyde, tearing at my eyes and packing my nose, enough liquid preservative in here to float a yacht. The smell rises from the bodies and from a ...
Primary care physicians are rebelling against the system
I believe primary care docs are rebelling against the system. The system has made primary care physicians suffer emotionally and financially. The system has taken the greatest form of medical care – that consisting of continuity, comprehensiveness, complexity and completeness – and denigrated it.Now I talk about "the system" in an anthropomorphic sense, but "the system" is virtual. "The system" has no conscious, it is not deliberate, rather it represents ...
Literacy related difficulties in health settings and the written word
by Rima Rudd, ScDWe take the written word for granted.Signs and billboards are everywhere – offering directional information, alerts, warnings, and advertisements. Streets, public squares, buildings, agencies, and institutions are numbered and named. We are surrounded by the written word in public locations and within public and private institutions. Individual entrances and even elevators in some large buildings carry names. The lobby, the inside hallways, ...
KevinMD posts of the week, ending March 6, 2011
Here are the top posts from this past week, based on the number of times they were viewed.1. 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.2. Lack of sexual interest is the most common sexual complaint in women. The discussion calls to mind ...
Entering the golden age of hospice care
Friday in my office is like happy hour for the oldest of the old.They come. 90, 95, 100. Always on Fridays. Some come in wheel chairs. Others walking. Some alone. Others with family. 5,6, 7 sometimes even more in just one short morning. And we talk about life, about their children, about growing old. I apologize that at that age I really have little to offer. After all, they know ...
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....
