Not all cancer screening saves lives.I alluded to this recently in a New York Times' Room for Debate piece, discussing why Medicare shouldn't pay for prostate cancer screening in men over the age of 75.And, when it comes to ovarian cancer screening, a recent study showed that annual CA-125 antigen testing and transvaginal ultrasound did not save lives. ...
June 2011
All Stories
Implications of the placebo effect for physicians
The placebo effect is somewhat of a mystery in modern medicine. Wikipedia calls a placebo "a sham or simulated medical intervention." Commonly, when we refer to a placebo we mean dummy-drugs, but the placebo effect has further applications in medicine, such as sham surgery or false information.Now, a great video produced by an Australian journalist from the ABC Science Show has compiled ...
Emotionally supporting physicians sued for malpractice
A physician or nurse who receives a Summons and Complaint regarding a medical malpractice suit also receives pointers about whom to talk to, what to say, what not to say, and whom not to talk to. Despite some emphatic precautions, the appropriate advice to those malpractice defendants is not strictly "shut up and lawyer up."To help defendant clinicians cope, the answer ...
How Susan G. Komen for the Cure affects other cancer non-profits
by Gayle A. Sulik, PhDIn response to increased publicity surrounding Susan G. Komen for the Cure’s questionable trademark and marketing activities, the organization published an official statement on its website, titled: “Susan G. Komen for the Cure® Sees Trademark Protection as Responsible Stewardship of Donor Funds.”According to the statement, Susan G. Komen for the Cure® has never sued other charities or put other non-profits out of business, and ...
Closing communication gaps between providers
by Diane Shannon, MD, MPHErrors in communication are widely recognized as an important cause of adverse events in health care. In 2010, communication problems were the most commonly cited root cause of sentinel events, according to data reported to the Joint Commission.In fact, communication issues were identified as a root cause of two thirds of all the sentinel ...
Respect the potential wrath of a drug
I should be hard at work right now seeing patients in the office, and I would be if it weren’t for one little pill.Have you ever been frustrated by a physician refusing to give you an antibiotic? That very scenario occurs daily in primary care."It is only a virus."The arguments against taking an antibiotic (cost, side effects, allergic reaction) can seem less ...
Finding out the gender of your baby during pregnancy, or not
Are you having a boy or girl? This is one of the standard questions people ask a pregnant lady. Everyone asks. It has become a kind of conversation starter. It's not that the stranger in the grocery store really cares, but it just seems like natural thing to say. It's part of the standard questions we ask pregnant women. How far along are you? Is there just one? When are ...
What will be your legacy as a physician?
by Francine Gaillour, MDI’ve heard some physicians wonder out loud if they’re career has been "wasted" – either because they were on a path that wasn’t a good fit, or they spent years focusing on accumulating and worrying, rather than on contributing and enjoying. The question is one of personal value: Am I measuring up? And by whose metrics?How do you measure the value of your physician ...
7 tips to avoid HIPAA violations in social media
by Dave EkremThere have been a couple of widely-publicized cases recently of physicians divulging patient information in social media. I’m sure the doctors involved did not intend to violate patient privacy.While there are several excellent guidelines and policies on this topic, there isn’t a whole lot of practical advice, so here are my tips to help you avoid privacy violations (I hope this is ...
Why popularity based payment for doctors is not the answer
Part three of the three-part series, Let’s Pay Popular People More!Perhaps you remember Sam, the chronic inebriate whose story I shared to discuss the pitfalls of basing doctor pay on patient satisfaction surveys.Looking at his discharge papers, I wondered who helped Sam fill his survey out, and how much their "help" affected the results.After all, millions upon millions of dollars are already now at stake for hospitals. And ...
Medicine needs a social revolution led by America’s doctors
Enjoy year-round sunshine with a month paid vacation. Earn 300k plus production bonus. No state tax! No call! Daily I’m bombarded with glossy postcards promising the good life.With so many options, why are physicians fleeing medicine? Some leave for teaching, waitressing, even homemaking. Others escape into administration, insurance or pharmaceutical positions. Many simply retire in despair.Robert Centor, MD, writes about our quiet rebellion: “This rebellion has no Glenn ...
Helping acute care patients find the right care in the correct setting
The number of patients with acute care problems visiting the emergency rooms is steadily climbing.According to the article Hospitals Work to Reduce ER Wait Times posted on the ASQ website the rate is increasing at a 3% annual rate. This leads to several problems, including longer waiting time. An analysis of the growth reveals several trends in the demographics ...
How to minimize the costs of surgery
Surgery is expensive, there are no doubts about that. However, there are a few things a patient without insurance who desires surgery can do to minimize the costs as much as possible. Before going into cost-cutting measures, you first need to understand where the costs come from.In rank order, the costs of surgery come from (highest to lowest):
- Hospital Charges ...
KevinMD posts of the week, June 5, 2011
Here are the top posts from this past week, based on the number of times they were viewed.1. What happened inside the hospital during the Joplin, MO tornado. Dr. Kevin Kikta was one of two emergency physicians on duty at St. John’s Regional Medical Center in Joplin, MO on Sunday, May 22 when an EF-5 tornado struck the hospital.2. Should doctors be addressed by their first name? Unlike ...
What the physician hiring process can learn from the NFL draft
As I was getting my daily fix of ESPN recently, something a bit different than the routine scores and highlights came across my TV.Two very talented men, both potentially bound for NFL stardom, were showcasing their talents for scouts, coaches, recruiters, and reporters – a panel of judges if you will. Although these players have certainly proved their talents in the past, these workouts will likely determine which player an ...
Vermont’s version of the Independent Payment Advisory Board (IPAB)
by J. Walden Retan MDBegin with what everyone knows. Healthcare costs and health insurance costs are climbing more than twice as fast as the cost of living, and have been for years. There is no need for numbers to prove the point. Just ask anyone who buys health insurance on their own, any employer trying to take care of his employees, any employee whose wages ...
Will paying for outcomes improve healthcare quality and efficiency?
With the expected cutbacks in healthcare funding and the increasingly dismal outlook for "new" money in the healthcare pot, "value" has quickly become a key watchword.In the past decade, we've seen many public and private payers implement value-based, pay-for-performance (P4P) programs as a means of spurring healthcare providers to improve the quality of services they provide and, tangentially, reduce the ...
Themes explaining why people are obese
In my interactions with patients, I always ask them to tell me when their weight problems began and what they believe contributed to their weight gain.Broadly speaking, there are two categories: people, who were big (or were considered big by others) as long as they can remember and those, who can often clearly pinpoint when their weight ...
Examining the evidence behind a community health screening
The following deceptive advertisement appeared in my church's bulletin yesterday:
Life Line Screening, the nation's leading provider of preventive health screenings, will offer their affordable, non-invasive, painless health screenings [in the church cafeteria] on April 9th. Five screenings will be offered that scan for potential health problems related to: blocked arteries, which is a leading cause of stroke; abdominal aortic aneurysms, which can lead to a ruptured aorta; hardening of the ...
Niaspan and how comparative effectiveness research was done well
by Harlan M. Krumholz, MDComparative effectiveness research — investigations that determine which treatments are best — has attracted attention in the health care debate. Critics charge that these studies are designed to restrict choice. The Center for Medicine in the Public Interest released a report that suggested that they would stifle innovation. Often they are framed as ...
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....
