There are few things I enjoy more than talking about the spine and the brain.Therefore, it stands to reason that I enjoyed our state neurosurgical society meeting recently. I don't like big national meetings, being an introvert at heart. Our state meeting, however, is small; this makes for a more intimate atmosphere and more outspoken dialogue. Colleagues from across the state can exchange ideas, new techniques, and opinions. We also ...
April 2011
All Stories
MKSAP: 24-year-old woman is evaluated for irregular menses and infertility
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 24-year-old woman is evaluated for irregular menses and infertility. She reports having had normal puberty but having irregular menses until she started taking an oral contraceptive pill.She has been unable to become pregnant since marrying 1 year ago despite regular intercourse and discontinuing ...
The paradoxical life of a palliative care nurse practitioner who’s an EMT
I am a nurse practitioner committed to expert level end of life care. I a consultant for hospice and palliative care organizations, a clinical educator and a volunteer in my town on the local emergency medical service. My life is paradoxical.It's not a happy partnership having a palliative mind and responding to 911 emergency calls to save lives.It's not ...
KevinMD.com media mentions, April 2011
I’d like to thank various media outlets for recently citing KevinMD.com.The New York Times' Well: Should Your Doctor Be on Facebook?
Dr. Kevin Pho, a primary care doctor in New Hampshire who writes the popular KevinMD blog, maintains both a personal and a professional online presence. His professional Facebook page contains his writing and commentary and can be “liked” by anyone. He limits access to his personal Facebook page to family ...
The war on pubic hair must end
I must have missed the declaration of war on pubic hair.It must have happened sometime in the last decade because the amount of time, energy, money and emotion both genders spend on abolishing every hair from their genitals is astronomical. The genital hair removal industry, including medical professionals who advertise their specialty services to those seeking the "clean and bare" look, is exponentially growing.But why pick on the lowly pubic ...
How the IPAB takes policy and puts it in the hands of health care experts
Everyone knows that the excess growth in health care costs is driving the fiscal crisis in our country.The problem is that while everybody wants to somehow cut the cost of Medicare/Medicaid, in theory, when it comes time to actually make cuts, the courage of our politicians fails in the face of unrelenting public opposition to cuts in Medicare.
Doctors find incentives elusive for meaningful use of electronic records
by Scot Silverstein, MDA reader, Dr. Scott Monteith, a psychiatrist, shared his thoughts on government-mandated 'Meaningful Use' of Electronic Medical Records ('MU') with me after reading a number of my EHR posts, and asked if he could share his thoughts via Health Care Renewal.Dr. Monteith is a graduate of the University of Michigan and Michigan State University where he was chief resident.He is a ...
Tips to prevent heart disease in women
American Heart Month may be officially over, but don’t let the lack of media attention fool you into thinking heart disease isn’t a critical issue.We still need to be mindful of the fact that heart disease is the number one killer of women.There are simple lifestyle choices you can make to help prevent you from heart disease.I hope after reading this post you don’t just move on, but I hope ...
Organizations that link their IT systems to share electronic health records
Glory be. There's good news tonight in American healthcare.It did not come from laws, regulations, or government edict, although there has been much government activity in the field; it did not come from the behemoths of information technology like Google, Microsoft, Oracle or Cisco, although much hard work in IT did precede it; it did not come from the for-profit healthcare industry giants like GE, Big Pharma, United Healthcare, or ...
How a family conference affects the decision for surgery
by Chris Porter, MD"Treat your patients as you would your own loved ones," is advice taught throughout training in health care.Great advice. I use it constantly. Mr. Davis is dying of multiple organ failure in the ICU after exploratory abdominal surgery. His siblings and children trickle in from Florida and Montana.I’m always sorry for the last to arrive, who visits his dying brother’s bedside minutes before ...
How a patient’s organs could live on and be life saving to a recipient
Sam was late and Ella was furious. "Now why isn't that man back by now? He knows it's time to leave for church."The hours began to pass and Ella became frightened. Sam had gone out for his usual two mile run and had simply disappeared. Ella called friends and neighbors but no one had seen him. Panic began to set in so Ella called 911 who connected her to the ...
Why depression continues to go undiagnosed and untreated in primary care
What medical condition is the most costly to employers? I’ll give you a hint. It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians.If you guessed depression you are correct. If you mentioned obesity you get a gold star since that comes in right behind depression for both ...
Social workers can reduce preventable readmissions
I just finished another 2 weeks on service. This time, I had also had a shadower, but one of a different kind. As part of our Institute for Healthcare Improvement (IHI) Open School, we are making an effort to have collaborative learning opportunities for our medicine and health administration program students. Achieving true interprofessional learning is challenging for schools like ours without a pharmacy ...
Alcohol does not discriminate when it destroys the human body
There was a time when Herb was living the American dream in the sunny state of California. He was married with 2 children, a big house in the suburbs, a golden Labrador retriever, and a well-paying job as an executive in a book publishing company.His two sons were stellar athletes and students, both moving on to attend nationally ranked colleges upon graduation from high school. They were the pride and joy ...
Health reform will drive up ER visits, like it did in Massachusetts
Whenever I get asked about how the Affordable Care Act will impact health care, I always say, "look at Massachusetts first."That's because Massachusetts serves as a model for what's coming ahead for the rest of the country.As I wrote in 2009, Massachusetts did not provide the primary care infrastructure for near-universal care, which I predicted would drive up emergency ...
How doctors can use Facebook responsibly
I was quoted recently in the New York Times' Well blog, in a Danielle Ofri piece on Facebook and doctors.There's no question that Facebook has been a minefield of sorts for the medical professions, with infractions ranging from unprofessional conduct by medical students to patient privacy violations by attending physicians.One solution would be for doctors to simply ...
9 websites that savvy medical practices use
It's easy to get caught in the surf on the Web. But plug these URLs into your browser and explore some simple tools that can help not only keep your practice above water but help it ride high.www.digitalassent.comDigital Assent automates the patient intake process with a PatientPad instead of the clipboard and an online tool for advance registration. It does integrate with EMR systems, but it provides another strong operational ...
Health advocacy organizations and the lack of transparency
by Patrick Fitzgerald, MPHHealth advocacy organizations (HAOs) are typically organizations of prominent, trusted stakeholders who conduct campaigns to promote disease awareness, update members to new diagnostic tests and drugs, facilitate physician referrals, deliver health care services, and advocate for policies believed to be in their member’s best interest.They range in size from national organizations with many thousands of members focused on widespread disease to smaller ...
The advance directive is only a part of end of life decision making
On January 1, the White House announced a new policy that would have paid doctors for discussing end-of-life planning during their Medicare patients’ annual wellness visit.Under this policy, physicians would be paid to encourage their patients to establish an advance directive, which would guide medical care if the patient became incapacitated from illness, and could ...
Advances coming in medical science that will have a high impact
There are a series of medical megatrends outlined in my book The Future of Medicine – Megatrends in Healthcare that will profoundly affect health care in the coming five to fifteen years and beyond. Some are due to the explosion of basic understandings of cellular and molecular biology. Others are related to advances in engineering and computer science. Here is a very brief overview.These are the megatrends in medical ...
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....
