by Mike Cadogan, MB ChBCrossing multiple time zones can produce a constellation of symptoms known as jet lag.Jet lag is most noticeable in the first 24-48 hours following travel and can last for up to 5 days before individuals return to normal functioning. Symptoms are closely affected by both the length and direction of travel. Symptoms include: reduced alertness, night-time insomnia, loss of appetite, depressed mood, poor ...
June 2011
All Stories
Unrealistic optimism in early phase new drug studies
In a thoughtful posting in the New York Times, Dr. Pauline Chen, a well respected observer of the doctor-patient relationship, points out an ethical dilemma that faces cancer researchers working in drug development conducting early phase (I) new drug studies. Ethicists have identified that patients in these studies often have unrealistic optimism about their personal outcomes despite ...
Health reform’s prejudice against specialist physicians
Have you noticed the recent trend against specialty physicians? Policy experts have determined that primary care needs incentives to attract medical students away from those "highly lucrative" specialties such as plastic surgery, orthopedic surgery, interventional cardiology, and neurosurgery.Our federal government believes in equal opportunity -- if you wish to become a family doctor. There are incentives sponsored ...
Stem cells will bring us closer to personalized medicine
Stem cell therapies promise to be one of those scientific breakthroughs that will have an enormous impact on health care in the future.Stem cells will bring us closer to the goal of personalized medicine, just as genomics is doing. The course of a disease will change once we have the technology to develop and then insert stem ...
Nurses who work in the cardiac catheterization lab
Ready to learn more about nurses who work beyond the bedside? Nurses who work in the Cardiac Catheterization Lab (CCL) play an important role in cardiac care. Amy Sellers, RN blogs at Nursing Influence and graciously agreed to give us a peek at what a nurse is responsible for doing in the CCL.Amy has worked in the Cath Lab for about 6 months now. She previously worked in ...
Talking patients out of doing tests takes effort and time
I find that it takes more effort for me to talk patients out of doing tests than it takes to get them to submit. It doesn't seem like it should be that way:
I need you to undergo a test where you fast for 12 hours, show up to the hospital 3 hours before the sun comes up, strip down and slide into a breezy hospital ...
A moral obligation to help patients decipher online health information
I believe that the most important reason for healthcare professionals to engage in social media is to take advantage of its tremendous inherent ability to help facilitate in providing all patients with trusted, accurate, meaningful and useable healthcare information.Most healthcare practice consultants and social media experts more often than not highlight the beneficial effects that the use of social media can have on the marketing efforts of healthcare practices, ...
Why cognitive doctors need to be paid more
Everybody has a theory of what’s wrong with American health care and why costs are high.I have my own theory – talk is cheap. By this, I mean Americans and third party payers are unwilling to pay more for what mere talk is worth.They do not want to pay more for a visit to the family doctor, ...
How a dispute with an insurance company can affect patients
8,000 patients will no longer be able to receive care from UNC Hospitals and their affiliated physician practices because of a dispute between UNC and the insurance company Aetna.The bottom line is that Aetna does not want to pay as much for care provided by UNC as UNC wants to be paid for providing this care. No surprise there, as the interests of the two parties (health care ...
Why are sore throats cultured, and why are antibiotics administered?
Why do physicians order laboratory tests? Reasons include: to make a diagnosis, to confirm a clinical opinion, insecurity, patient and family pressure, concern for liability, to guide therapy, habit.Case in point. Throat culture.Sore throat is one of the most common human illnesses. Most are caused by viruses. Fewer than 10% seem to be caused by Streptococcus. But around 10 to 20% of clinically well children, when cultured, have Streptococci ...
Cancer in the gross anatomy lab
"I just want to learn the abdomen and the pelvis", I thought to myself, while staring at our donor's metastasized body. Nothing looked normal, tumor was everywhere, and for the 4th lab my group looked at each other, looked at the lab steps, and concluded it was going to be "just another day where we just ... found what we could find and did ... ...
How Twitter helped me find a New York Times column topic
Occasionally, I'm given the opportunity to write for the New York Times' Room for Debate blog.For those who aren't familiar with the site, every day Room for Debate addresses one question, with various experts chiming in with 300-word op-ed style pieces. Writers normally have overnight to submit their columns.The recent question asked, "What items and procedures should Medicare stop paying for now, even if patients and their families object?"Of ...
How primary care physicians can improve health and lower costs
Ok, I confess. I have contributed to the $2.3 trillion that our country spends on health care every year. As a patient I want the best possible care for my family and me. As a physician I am the gatekeeper to expensive procedures, medications, and diagnostic tests. However, by several indices including life expectancy, infant mortality rate, and satisfaction with the health care system, we are not getting our money's ...
How paying doctors for patient satisfaction is racist
Part two of the three-part series, Let’s Pay Popular People More!Take a moment to ask yourself whether any of these categories describe you or someone you love:
- Never had cancer
- Psychologically distressed
- No regular health care provider
- No health insurance
- Lack confidence in self care
- Avoid doctors
- Minority race
5 easy steps to become a better medical student
I recently had quite a long conversation with a college senior that was just accepted into medical school for this coming fall.As a rising fourth year medical student myself, I would like to think that I have navigated the waters of academia and figured out both efficient paths to success and avoidance of roadblocks and setbacks. ...
Work should be about optimizing your productivity and health
Do you spend 8 hours in front of a screen at work? Do you then spend your free time watching TV or poking around the internet when you get home? How much time are you spending cooking healthy meals to eat with friends and family? How much time are you doing physical activities that make you happy?A recent study in the Journal of the American College of Cardiology entitled, Screen-Based ...
Pain control in a patient with rib fractures and a spinal cord transsection
When I was called to see the patient after a motorcycle accident I expected the worst. The patient sustained a thoracic spine injury with cord transsection at T5 level as well as significant chest wall injury on the right side.Multiple ribs were broken; some with a significant displacement. Managing patients with a significant chest wall trauma could be a nightmare. Pain control is only one of the challenges.
Practical advice for medical students starting clinical rotations
Here's some advice to think about before starting clinical rotations during the third year of medical school.Don’t sit in the back of the planeThe basic sciences are important to learn the vocabulary and grammar of medicine. Clinical rotations are different – it’s where you actually learn to be a physician. If you use the analogy of learning to fly, ...
The legal issues of doctors and chiropractors working together
by Jeffrey L. Cohen and Albert R. MeyerChiropractors and medical doctors (or D.O.s) have had a long and somewhat complex relationship.Though they approach healthcare issues differently, there are many instances where they share care or even work together. Such "M.D./D.C." relationships are legally complex, but often prove to be rewarding in many respects. Properly constructing the arrangements is critical, especially since government regulators and payers tend ...
When communication is broken, the quality of care is diminished
by Alison McKnightI have been in and out of the doctor’s office ever since I was little, and I have had my share of good and bad experiences during this time.These experiences can shape the expectations of both the physician and the patient, in both negative and positive ways. While the perfect relationship between ...
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....
