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 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...
-
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...
-
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....
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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....
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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
-
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...
-
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...
-
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...
-
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...
