After playing around with Google+ today, I've come away on a more positive note than my speculative post on Google's social network recently.Before experiencing Google+, I asked whether doctors can separate their personal and professional relationships, and how the Google Circles feature would help.Well, if Google+ ever takes off for physicians, it will be because of Circles.Tech ...
June 2011
All Stories
Sometimes the treatment is worse than the disease
To do nothing is sometimes a good remedy. -HippocratesEdna Frost is 88 years old, a slender, slow-talking woman with a dry sense of humor and a blood pressure that’s all over the place. At best, she runs ten points higher than any of her previous doctors wanted to put up with. At worst, she flirts with systolics over 200, but that doesn’t seem to be a common occurrence.Edna has been my ...
The first brain a medical student sees in anatomy lab
Arriving in anatomy lab there was an obvious discontent in the air. People were slower to arrive than usual and then they were even slower to get changed in the locker room. Girls would start casual conversation, or would wait for 15 minutes for others to move from in front of their locker, just in the hopes that they would get 5 more minutes ...
A monetary value on each life saved
by Benjamin P. Geisler, MD, MPHA recent New York Times article on how to value a life drew almost two-hundred heavy-handed comments. It discussed how different governmental agencies such as the Food and Drug Administration (FDA), the Environmental Protection Agency (EPA) or the Department of Transportation (DoT) place a monetary value on each life saved.In many public policy areas, cost-benefit Analysis (CBA) is being used to assess whether an investment ...
When you close an abdomen after a failed rescue, the OR is silent
I didn't know her name until it was over, much too late.What I knew was she was thirteen and that on this winter day someone in her family had been pulling her behind their car, on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl -- probably screaming (fear? delight?) -- held onto the sled as ...
Summer palpitations
It was early Saturday morning, I was making my plans for the day, crossing-off a few items that seemed unreasonable with others that had been accomplished. As I moved toward the kitchen, a voice from the living room bellowed "the coffee is ready."Turning my head I could see bright rays of sunshine making a visible path through the open front door. My morning greeting followed ...
Online physician access is key to future patient communications
Imagine using Skype to contact your physician for a consult.In the midst of this rapidly progressing technologic era, our delivery of medical services is being transformed by health information technology (HIT), electronic medical records (EMR), and advanced telecommunications. In meeting criteria for "meaningful use," physicians are driven to use these technologies to empower patients with communication through electronic medical records. A primary goal is to allow patients to ...
Pharmacies selling prescription information to data mining companies
Walgreens is being sued by customers who are not happy that their prescription information – even though it has been de-identified – is being sold by Walgreens to data-mining companies.The data privacy and security concerns surrounding the transfer of de-identified data are significant. To "de-identify" what is otherwise protected health information under HIPAA, some outfits will simply strip data of 18 types of identifiers listed in federal ...
The decision point psychiatrists faced with psychotherapy
There's been plenty of buzz about a recent New York Times story, "Talk Doesn't Pay, So Psychiatry Turns Instead to Drug Therapy" by Gardiner Harris. The story is essentially a profile of Dr. Donald Levin, a 68 year old psychiatrist who has a private practice in Doylestown, Pa.It is a poignant example of a common situation in psychiatry. Older psychiatrists were trained during a time when there ...
Burning your short white coat after medical school graduation
Eastern Virginia Medical School held it’s "White Coat Retirement Ceremony" recently. In photos from the event, graduating medical students are shown throwing their short white coats into a fire. I thought to myself, "what in the world is going on?"When I was presented with my short white coat at the start of my first year of medical school, I was told that ...
Using gender as sole determinant for a choice of doctor
It happened 25 years ago and I never forgot it. I’d been in the forefront of women’s consciousness-raising; I recognized that women had been professionally downtrodden for years (in certain fields), and hoping to do my part to balance the inequity, I opted for female doctors whenever possible.But using gender as sole determinant for my choice of doctor would prove to be a huge mistake … as I’d learn.At ...
How autism affects social interaction
One of the problems with understanding the natural history of autism is the lack of well-designed outcome studies in the disorder. Outcome studies tend to be expensive and grant agencies commonly do not fund studies longer than a few years. However, given the increased interest and funding in autism, I suspect there will be more research in this area.An example of how outcome studies help in understanding the natural ...
Google Health failed because consumers did not see the value of a PHR
To measure is to know.-Lord KelvinIf you can not measure it, you can not improve it. -Lord KelvinVersus:Asking science to explain life and vital matters is equivalent to asking a grammarian to explain poetry. -Nassim Nicholas TalebTechnology is at its best when it is invisible. -Nassim Nicholas TalebHow can technology help us live healthier lives? Why did Google Health fail? Why are Klout and Twitter Grader publicly issuing a number to me ...
Reverse our attitudes and values to control health costs
by John KaegiWe all complain about the cost of health care and health insurance. Ours is by far the most expensive health care system in the world. And for the money, our health isn’t so hot either. On the world stage, the U.S. ranks 37th in health care efficiency (a measure of health outcomes such as infant mortality, incidence of chronic disease, etc.) as reported by the World Health Organization. ...
Google+ for doctors, and why physicians should be careful
Google has announced its social networking product, Google+.I haven't received an invite yet, so I don't have first-hand experience with the service. But reading the major tech blogs' take from Engadget, TechCrunch and Mashable, you have a pretty good idea of what to expect.What should doctors know about about Google+?Obviously, this is Google's last, best ...
Patients are often intimidated and confused by the medical experience
As a recently minted physician, I am often on the receiving end of the gripes and grouses about the medical profession.Often I get complaints of office visits that are too short, doctors who seem too preoccupied to hear their patients' complaints, medical bills that are too high and medications that do nothing but cause adverse effects. On the other hand, I can't count the number of times I have ...
Examining medicine through the lens of women’s rights
I’ve always had a hard time identifying myself as a feminist.I work for healthcare equality and human rights. Women’s rights seemed to me a part of human rights work (and as Hilary Clinton and others have said, woman’s rights are human rights). Tying myself to the feminist movement then seemed to be looking backwards – clinging to a term that was anachronistic, divisive and too narrowly defined in what activism ...
How ordering tests sometimes have consequences for patients
Sometimes, you just can’t win! In medicine, sometimes is way too often. "Doc, do I need that test?" reviewed the issues surrounding screening colonoscopy exams. The dilemma is always the same. Do I order a test or don’t I?If I order a test, there are consequences. Some are obvious; some are not. Tests cost money and money is in short supply. One consequence of ordering ...
Why doctors shouldn’t leave their emotions behind
Part of the reason I became a physician was because I got tired of watching those close to me as they suffered through illness and eventually died, while I stood helplessly by, unable to do a thing.Throughout my training I watched as my mentors interacted with their patients, displaying a political correctness matched with just enough outward emotion so that there was no telling the difference between the good news and the bad.“Don’t ...
Avoiding confrontations and the difficulty of standing up for yourself
When I was 8, my mom went to a parent-teacher night at school. When she sat down with my teacher, the teacher smiled and said: "So how are Susan’s swimming lessons going?"My mom frowned, confused. "Susan isn’t taking swimming lessons - perhaps you’ve confused her with someone else?""No, I’m sure," my teacher insisted. "Susan told me that she has to leave at 3 o’clock every afternoon, right when the bell ...
Kevin Pho, MD
-
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...
-
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....
-
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...
-
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
-
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....
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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....
