"See me, feel me."Yes, that’s right, the title of a song played at Woodstock by The Who—at sunrise of the third day, no less—is the title of my post. The song begins with those very words sung in dramatic refrain, followed by four more: Touch Me/Heal Me.The same four imperatives succinctly describe the essence of what patients want from their doctors. But in the age of the EHR ( Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.MKSAP: 63-year-old woman with a 4 week history of fatigue
A 63-year-old woman is evaluated during a follow-up visit for a 4-week history of fatigue; pain in the proximal interphalangeal joints, knees, and hips; and low-grade fever.She has not had joint swelling, chest pain, or shortness of breath. Over the past 4 years, she ...
April 2011
All Stories
Is health care ready for the iPad and other new technology?
I think I may have a problem, but it’s not clear exactly what it is, or if it even truly is a concern.I’m not a “techie” so to speak. I have trouble figuring out how to enter the code for my garage door opener without making some fundamental mistake, due to a deficit embedded in my cerebral cortex at some level. But that is not coupled with an associated lack ...
Judicious use of complex medical procedures
by Shanti Bansal, MDIn the cardiac catheterization lab one Tuesday morning, I encountered a situation that made me reflect on a bit of 18th-century British history.At that time, the British government was overburdened with prisoners. A plan was hatched for sea captains to transport many of them to Australia. Due to poor conditions, up to one third died on the voyage. Politicians and clergy members ...
Where an adult can get low cost vaccines
At LesliesList.org we get many emails asking where an adult can get low cost vaccines.It appears the answer is... nowhere. They don't exist-- unless you are an established patient in one of the county-funded or low-cost clinics in your metropolitan area. However, you can save a little money by comparison shopping. I think your best bet is to try one of ...
Should older doctors be allowed to opt out of EMR?
A fair amount has been written on EMR for the individual physician facing retirement.But I have come across a more complicated variation of the question. What if a multi-physician group has one physician approaching retirement who is the "lone hold-out," opposing EMR while the rest of the docs in the group are ready to take the plunge?The older physician has a ...
Can doctors learn surgical skills on YouTube and Facebook?
I am a self-taught bass guitarist in a church band, and, to be honest, it sometimes shows. I know I need to improve my skills, but time commitments make formal lessons difficult. So two days ago I opened up YouTube and entered "bass guitar lessons" into the search box.19,000 hits registered. I selected a few that looked good on ...
True Grit and sharing decisions on health care with our doctors
In the recent Coen brothers' remake of the 1969 movie True Grit, Mattie Ross, an intrepid 14-year-old, is determined to hunt down and kill the man who murdered her father.To accomplish this, she hires U.S. Marshal Rooster Cogburn, (played by a mumbling Jeff Bridges) a rough, one-eyed veteran of many such quests - then announces that she plans to come along. She figures she is prepared.After all, she and her ...
Natural forces within us are the true healers of disease
In my forays into the history of medicine I came across these six little words by Hippocrates.They seem strangely modern, almost like something you might find on a Hallmark-card for today’s medical school graduates. I don’t know how old the translation is and I couldn’t understand the original text if I tried – but these simple words really touched me when I ...
AMA: Getting the best value for our health care dollars
A guest column by the American Medical Association, exclusive to KevinMD.com.As physicians, many of us realize on some level that our practices contribute to our state and national economies - we just lacked the empirical evidence to understand how much.That changed last month, when the American Medical Association released a report that studied the economic impact of office-based physicians. While a handful of states have previously studied the economic ...
Using social networks to help patients quit smoking
David C. Kibbe and Joseph C. Kvedar’s article, "Building a Research Agenda for Participatory Medicine" highlighted two of their "ready-to-go" research questions:
- What is the role of coaching in sparking and supporting increased participation over time?
- What can we learn from research on how social norms shape behavior—with the idea of developing hypotheses on whether social networks could serve as a coaching tool?
How to sabotage a doctor’s appointment
by Diana E. LeeNone of us really wants to sabotage a doctor's appointment through our own behavior. But it's easy to do just that by not paying attention to the factors within our control that affect the quality of our appointments.These are some behaviors to avoid at all costs:1. Show up late for appointments. It's an unfortunate ...
A healthy plan for dining out
by Sally Scroggs, RDAbout 130 million Americans will eat out on any given day this year. While dining out shouldn’t mean "pigging out," picking a salad over cheese fries can sometimes be difficult.According to the American Cancer Society, making healthy food choices is one of the most important things you can do to reduce your cancer risks. But nutritional experts say many of us don’t make ...
How an ACO will affect physicians and Medicare patients
by Benjamin P. Geisler, MD, MPHEverybody is talking about Accountable Care Organizations or ACOs these days.The reason being that the Centers for Medicare and Medicaid Services or CMS has released the rules for shared savings between ACOs and CMS.The complete proposed rule is 429 pages long and they're seeking comments on it now until early June.What is an ACO?ACOs will take care of ...
Sixteen stab wounds, seriously delivered
She was a Korean woman, spoke passable English. We always exchanged pleasantries, and she called me "doctor" when I picked up my laundry. This time she was notably quiet, distant.I didn't figure it out until I got home and hung up my jacket, on the inside of which I noticed she'd pinned an envelope. It contained a photo I'd taken months ago, left and forgotten in one of my pockets. ...
What happens when two hockey teams and a defibrillator cross paths?
I’ve played over a thousand ice hockey games in my life, but I had no idea that yesterday’s adult men’s league game in Cleveland would be the most memorable.I grew up in Canada, three blocks from Wayne Gretzky, the greatest hockey player ever, but I wouldn’t be surprised if my game last night was more important than any game that my former neighbor played. Tonight’s game was literally a matter ...
Policies prohibiting collaboration between physicians and industry
As the number of restrictions on physicians working with industry continue to grow, and the places where policies prohibit physicians from collaborating with industry expand, close examination of the reasons supporting these policies is necessary.The current trend of academic medical centers (AMCs), professional organizations, and States that have begun adopting policies that restrict permissible interactions and activities between industry and ...
Should the FDA have rejected Contrave?
Recently, the FDA has rejected another anti-obesity drug, Contrave, because of concerns that it might cause heart attacks in patients who take it for years.FDA's excessive caution was motivated by its experience having been burned by the Fen-Phen fiasco. This was a weight loss drug widely prescribed in the 90s that was pulled from the market after studies showed it caused fatal ...
Why do medical students find primary care so boring?
There was a New York Times piece recently about a young doctor from northeastern Pennsylvania, not far from my hometown.Dr. Kate Dewar speaks with the NY Times about her decision to not join the primary care practice of her father and grandfather. I don’t have an issue with her choice to enter emergency medicine instead ...
USA Today op-ed on end of life care and advance directives
My latest column was published this morning in USA Today: Politics mustn't silence end-of-life talks.
It coincides with National Healthcare Decisions Day this Saturday, April 16th, an initiative to encourage patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes.Here is an excerpt:
Rationing care, cost control, and the fictitious concept of government-sponsored ...
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....
