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
A 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 board certified psychiatrist, clinical assistant professor in the departments ...
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 Priscilla Chan may become the country’s most influential doctor
Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from...
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Confused about prostate cancer screening? Make a shared decision
In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men. Case closed, right? Hardly. The prostate...
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When it comes to doctors and social media, hospitals fail miserably
When it comes to medicine and social media, much of the attention is negative. Doctors losing their hospital privileges because of Facebook....
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Warren Buffett’s prostate cancer choices aren’t right for every man
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
Physician
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Why test recalls should not be considered cheating
I was appalled recently by the coverage of radiology “test recalls” by CNN, amplified by Dr. Gary Becker of the American Board...
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Why physicians are susceptible to hardball tactics
I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the...
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How we deliver bad news is critical to how families deal with grief
As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during...
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His father’s suffering had already been too great
He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I...
Patient
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How death can be a beautiful experience
I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law...
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What meaningful encouragement can be given to someone who is dying?
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
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Health care journalists have tendencies similar to those of doctors
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
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Adaptation can be painful, but it can also be a gift
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
Policy
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What should America’s health care vision be?
America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the...
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Hospitals around the world aim to remain relevant to patients
"It was the best of times, it was the worst of times ..." So begins a story called A Tale of Two...
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Repairing the tear in health care’s safety net with social media
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
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Look to technology to reduce health costs
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
Tech
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Mobile health apps don’t always follow conventional wisdom
Propaganda and non-truths abound all around the Internet saying that mobile health apps are everything from a threat to Big Pharma to...
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When patient care becomes secondary to filling out the medical record
The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above...
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Doctors, use Google to get more patients in less than 7 minutes
Every month, hundreds of thousands of people look for a doctor on Google. As an amazing practitioner, your site deserves to be...
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The user interface for EHRs should be uniform
The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with...
Social Media
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We need to see the potential harm of social media
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
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Why social media may not be worth it for doctors
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
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Transparency defines social media success for doctors
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
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How Twitter was used in a potential mass casualty scenario
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
