March 2011

All Stories

How the mobile internet can transform healthcare

by | in Tech | 3 responses

Our colleague Susannah Fox of the Pew Internet & American Life Project has done much research about trends in mobile, particularly about health.In contrast, Meeker focuses on overall big trends. She sees aspects I’ve never noticed, like what-all constitutes mobile: when I hear the term, I think handheld phones (iPhone, Droid, Blackberry), but she makes the case that mobile web access (and other wireless) is much more than phones.As we ...

Welcome our new (doctor) computer overlords

by | in Tech | 10 responses

In February, IBM supercomputer Watson won Jeopardy! against its two human opponents, Ken Jennings and Brad Rutter.Watson’s victory rests on its power in speech recognition and the ability to understand colloquial human language used in game shows like Jeopardy!. The most interesting development of this story is that after Watson’s celebrated win on national television, IBM will partner with Nuance Communications to explore how Watson could help with medical diagnosis ...

How to hire an IT director for your medical practice

by | in Tech | 5 responses

About 8 years ago or so, our practice decided to move from paper records to electronic records. The decision was helped along by the fact that we were literally running out of space for our paper charts. I had been looking at electronic medical records systems (EMRs) for years prior to this but could not justify the cost to my partners – apart from the “gee-whiz” factor – until we ...

Free health screening: A service to our community’s health

by | in Patient | 2 responses

Last weekend I had the privilege of supervising University of Miami Miller School of Medicine students at a free public health screening in Pompano Beach, Florida.  The screening was sponsored by the medical school, with the assistance of community leaders, and held in a local public school. The program organization, recruitment of student and faculty volunteers and management of the program was undertaken and implemented by the students. It is ...

Repeal of reform won’t fix our health system

by | in Policy | 40 responses

The system we had before health reform became law was simply not working. I think we can all agree on that. A significant number of people oppose "Obamacare." I can understand that. But repeal doesn't really solve the problem. Sure, if you think that health reform has or will actually make our system worse than it was before, it seems prudent to undo the legislation, but that brings us back ...

Forever grateful to the doctors and nurses who saved my son

in Patient | 6 responses

by Kate GrayI call William my spirited child. Like many 3 year-olds, he loves to run and jump, and does it without the slightest sense of fear. His boundless energy has always been one of his most endearing features, but in a split second, it also almost took him from us forever.A few days before Christmas, my husband Mark and I had some last minute holiday ...

10 health dangers that your teen may face

by | in Patient | one response

It's not easy being a parent of teens these days. Previously rational children transform into moody, unreasonable creatures whose need to shock is only surpassed by their efforts to fit in.Add a measure of impulsiveness and experimentalism, and it's no wonder risky behavior skyrockets during these years. What a parent can do is to keep the lines of communication open, stay informed of the health dangers of some of the ...

Surgical error: The difference between mistake and complication

by | in Physician | 18 responses

One of the benefits, or aberrations, depending on your point of view, of the fee-for-service model is that we surgeons are remunerated for correcting our mistakes and complications.At first glance this seems wrong. But perspectives differ, and when a doctor has to deal with serious, undeserved complications and is self-employed he deserves to be compensated adequately.   So what really is the difference between the two?A complication may be described as ...

Understanding patient violence against health care workers

by | in Pho | 37 responses

The following op-ed was published on February 2, 2011 in USA Today.Last fall, a surgeon at Johns Hopkins Hospital was shot by the distraught son of a patient for whom he was caring. The man later killed his mother, then himself. A week earlier, a patient in a Long Island, N.Y., hospital beat his nurse with a leg from a broken chair, causing serious injuries. The following month, a psychiatric ...

Proton beam therapy and the medical arms race

by | in Physician | 5 responses

Proton beam therapy is an effective modality for killing certain types of cancer cells. New England and the Northeast are fortunate to have a proton beam machine at Massachusetts General Hospital, where it has been in use for some time effectively treating patients. This is a valuable resource, serving the entire region and beyond.But what happens when everyone wants one? Well, we see the medical arms race at work again.These ...

Learning to love primary care via an emergency department rotation

in Education | 5 responses

by Stella SafoIt is Saturday night at an Emergency Department (ED) in Boston, MA and I am faced with a medical student’s dream dilemma: which one of the many interesting cases should I observe? Should I watch trauma surgeons operate on the 17-year-old gunshot victim or work with the ED docs to assess whether a 59-year-old woman is having an acute stroke?That is exactly what ...

How to fix primary care in 3 steps

by | in Policy | 18 responses

Primary care physicians, including pediatricians, are usually really nice people. But old baseball fans will remember that Leo Durocher famously said, "nice guys finish last."How true. And, as one result, the American healthcare system and the American people are the real losers.A deliberate radical change in the behavior of American primary care physicians and their representative organizations could go a long way toward fixing our broken healthcare system.Primary care physicians ...

Viewing physicians source of care, rather than a barrier to care

by | in Physician | 2 responses

Clinician. Diagnostician. Prognostician. Healer.A physician has many jobs to perform, all critical to the appropriate management of what ails our patients. Without astute physical exam skills or a keen ability to sort through a medical history to uncover salient data, the physician is no better at diagnosing a patient than a Google search (and we're quite a lot better, in case anyone was wondering). Without a proper understanding of physiology ...

The physical exam of the head and neck is both simple and challenging

by | in Physician | 2 responses

No great artist ever sees things as they are. If he did, he would cease to be an artist. -Oscar WildeThe physical exam of the head and neck is both simple and challenging. Simple, in that even children are familiar with the shape of the face, the sheen of the eye, the curve of the ear, and the texture of the tongue. Challenging, because when complicated, interlacing structures malfunction, they send ...

Apple iPad, Amazon Kindle, or the Nook for medical students

by | in Tech | 9 responses

The e-reader battles are clearly heating up, with the Apple iPad, the aggressive marketing of the KindleApple iPad, Amazon Kindle, or the Nook for medical students and the Nook trying to sneak its way into the conversation. What does this mean for medical students? Should iPadsApple iPad, Amazon Kindle, or the Nook for medical students be mandatory in medical school?Joseph Kim of Mobile Health Computing argues that it certainly should be, but I think ...

Patients are not to blame for the miscommunication about cardiac stents

by | in Patient | 10 responses

When I had a heart attack two years ago, I was taken immediately from the E.R. to the O.R. for emergency treatment, including cardiac catheterization and a stainless steel stent implanted in a major coronary artery that was 99% blocked. But, overwhelmed and terrified, I knew nothing about what was about to happen, even though I have a vague memory of the cardiologist explaining something to me before I was whisked ...

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