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 ...
March 2011
All Stories
MKSAP: 64-year-old man with a new right-sided headache
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 64-year-old man is evaluated for a new right-sided headache that began 1 day ago. He awoke yesterday with a dull ache over his right forehead that has gradually increased in intensity. He also notes some right eye discomfort, sensitivity to light, and that his ...
Welcome our new (doctor) computer overlords
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
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
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
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
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
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
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
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
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
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
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
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
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
The e-reader battles are clearly heating up, with the Apple iPad, the aggressive marketing of the Kindle
The Strange Powers of the Placebo Effect [VIDEO]
Daniel Keogh, ABC Science Show reporter in Australia, takes us on a visual tour on the strange powers of the placebo effect.
Patients are not to blame for the miscommunication about cardiac stents
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 ...
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....
