Editor's note: This post was originally written this past winter.Boston had another blizzard today. I was really worried about this one. It was supposed to snow hard, about three inches an hour from 3 a.m. to 12 p.m. with poor visibility, impassable roads, etc. I've driven home in snow like that, and I find it terrifying. Your car won't do what you want it to, and worse, other people can't ...
June 2011
All Stories
The Golden Moment in medical malpractice
As Kevin Pho pointed out in his piece, "How malpractice hurts doctors and their future patients," physicians who have been through trial are often never quite the same.Physicians who have been sued in medical malpractice case are often referred to as the "Second Victim," a term that says it all. When a mistake is made and a patient is injured, the physician also suffers, often in silence and ...
Why children are getting fatter
Children are getting fatter because they are not allowed to run around and play. This comes from parents wanting to wrap kids in cotton wool -- also known as helicopter parenting.There is a new push to get children to walk to school. This is something which previous generations just did but has largely disappeared over the last 25 years. There are many reasons for this but one of them ...
KevinMD posts of the week, June 12, 2011
Here are the top posts from this past week, based on the number of times they were viewed.1. A doctor’s letter to a patient with newly diagnosed cancer. Nothing in my career in medicine has prepared me for being a friend to someone with such a terrible disease.2. 7 tips to avoid HIPAA violations in social media. There have been a couple of widely-publicized cases recently of physicians ...
How to take care of your health during difficult economic times
Studies show that many people faced with home loss and housing uncertainty can take a tremendous hit to their health. If you’re going through difficult times, and worried you too may lose your home, what can you do to try to buffer or reclaim your health?Here are some tips for ways to counteract some of the toll that constant stress (and the insomnia, distraction and desperation that go with ...
MKSAP: 50-year-old woman with advanced multiple myeloma
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 50-year-old woman with advanced multiple myeloma diagnosed 6 months ago undergoes a follow-up visit. Treatment includes daily oral thalidomide and pulse dexamethasone. The patient now feels well.Laboratory studies indicate a serum monoclonal protein concentration of 3.0 g/dL (30 g/L). Hemoglobin concentration, serum calcium level, ...
Medicare’s high cost end stage renal disease patients
Anyone who thinks America has the best health care system in the world ought to take a look at its miserable record on caring for end stage renal disease patients on dialysis.About one of every five people who go on dialysis dies in the first year here, compared to less than one in seven in Europe and one in sixteen in Japan. Even after adjusting for age, gender, race ...
Securing mobile devices in healthcare
by David TingWith the mobile market exploding, healthcare IT administrators are now faced with physicians and other clinicians requesting to use their personal devices, such as iPads and iPhones, to access patient information from anywhere, anytime.With this ability, clinicians are able to make faster decisions for their patients – improving their overall workflow and patient outcomes. This seductive mobile technology, however, is not ...
ABIM Maintenance of Certification (MOC) internal medicine exam tips
This past spring, I took the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) exam.
7 weeks later, I received my results. Thankfully, I passed.This was not entirely a surprise, as the pass rate for first-time test takers was 88%. But it definitely requires some studying. It's not a gimmie.Considering that I last took my board ...
The unintended consequences of medical marijuana
It was 1978 and I was a third year medical student when my friend was slowly dying of metastatic breast cancer.Her deteriorating cervical spine, riddled with tumor, was stabilized by a metal halo drilled into her skull and attached to a scaffolding-like contraption resting on her shoulders. Vomiting while immobilized in a halo became a form of medieval torture. During her third round of chemotherapy, her nausea was so ...
Students who are the evangelists of family medicine for tomorrow
Recently, I was in a meeting organized by the American Academy of Family Physicians in an effort to understand the lack of student interest in family medicine as well as to encourage brainstorming among those of us charged with facilitating interest on ideas that might work and be transportable.I was with Bill Coleman from Alabama (among others) and was pleased to discover that we were ahead of ...
How shopping for an EHR is like buying a car
So you’ve been hearing all about the recent EHR buzz and decided to give it a try.Whether you are convinced that electronic records are the way to go, or you have reached a point where you are willing to give it a try, the first thing to do is buy one of those EHRs. You may be staring at a glossy brochure or website featuring a distinguished silver-haired doctor ...
How robots will teach us who we are as humans
Recently, I took a Megabus from Philadelphia to Hunter College in New York City to attend Man-Made Minds: Living With Thinking Machines, a World Science Festival program.Rodney Brooks, who until recently was Panasonic Professor of Robotics at MIT and who now is Chief Technology Officer at Heartland Robotics, was the first expert to speak, and he emphasized a very practical approach that was not too concerned with any negative consequences ...
Thoughts after your family doctor retires
My family doctor recently announced he’s retiring from medicine after 37 years, and my husband and I were his patients for more than 18 of those years. We had a lot of one-offs before finding him, but he was worth the wait. I want to explain why he inspired our loyalty.He saved my husband’s mobility. A glass coffee pot separated from its handle and a shard went straight into ...
Baby Boomers are driving the next wave of joint replacements in medicine
by Eric Marcotte, MD Associated Press health writer Marilynn Marchione recently reported on the rapid growth of so-called "fix-me-it is" in orthopedic surgery. Healthier and younger than the typical patients undergoing joint replacement, Baby Boomers are driving the next big wave of joint replacements in medicine.This is definitely welcome news for Zimmer, Biomet, and our other fine biomedical companies here in Indiana. Whether this ...
Why private practice surgeons perform more open breast biopsies
A Florida study assessed the rate of needle versus surgical breast biopsies over a period of five years.What we're talking about here are non-palpable abnormalities that are identified on screening mammography. A mammogram report will come back that assesses the relative risk of an abnormal collection of calcifications harboring an invasive or pre-invasive cancer (staged on a scale from I-V). With such data, one is obligated, as ...
Reasons behind the image mutation of physicians
As far back in history as in the day of Hippocrates of Cos, often referred to as the father of Western medicine, 460 BC - 370 BC, a physician was viewed in a paternalistic manner, one in which a physician's opinion(s) were simply just believed and their recommendation(s) were followed without question. The prevailing culture was definitely one of passive, submissive acceptance.Although there will more likely than not always be ...
Should doctors be blamed for bad decisions by patients?
The Disease Management Care Blog attended a professional hockey game recently and it must say it was quite the spectacle.While the athleticism on the ice was quite remarkable, the real wonderment involved the hometown fans. Questionable referee calls prompted thousands of all ages to chant phrases that the DMCB has not recently read in any medical journals, while the willingness of grown men to display, in stereo fashion, obscene gestures ...
AMA: Revisions, clarity needed before physicians form Medicare ACOs
A guest column by the American Medical Association, exclusive to KevinMD.com.There is said to be an old Chinese curse: May you live in interesting times. As I wrap up my year traveling the country as President of the AMA, I can without a doubt say physicians are living – and practicing medicine – in interesting times. This can be a challenge, but does not need to be a curse.There are ...
Baby monitors abuse the vulnerability of parents for profit
Recently I was interviewed by a reporter about the effects of the newest baby monitors on parent-child relationships. A teddy bear with a camera in its nose hooks up to a TV, allowing parents to watch their baby's every move.One product called an exmobaby is actually worn against the baby's skin and measures heart rate and respirations. A CEO of ...
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....
