Rest in peace. These words are a common theme at funerals honoring loved ones. But many people die with no one claiming their bodies. For example, at hospitals there are unclaimed bodies of patients and the unborn. Corpses are found abandoned often in police cases. Mortal remains can go unclaimed due to insufficient funds for burial or cremation, insufficient concern for the deceased, and lack of available or known family ...
August 2011
All Stories
Doctors learn through mistakes during medical school
In most other professions, once you’re halfway through your education, you begin to develop confidence; slowly, but surely, fitting into shoes that once seemed too big for your petite, newbie feet. Not so in medicine.Three years into it, and I still feel unsure - unsure of the answer to a rather simple question asked by an attending and unsure of whether I’m fit to be doing this in the first ...
Social media tips for students applying to medical school
I started my first blog, Chick Lit MD, in December of 2009. By the time I began filling out my medical school applications I had been actively blogging for approximately 7 months. As someone interested in the intersection between medicine and media, the use of social media was integral to my exploration of both fields. As such, I included my adventures in social media in my application ...
Health insurers have come up with the idea of the century
I have come up with the idea of the century. My idea will make your company the richest in the world while attracting millions of new patrons to your credit and debit card services. I don’t know why no one has done it in the past. It has made the insurers of America countless billions of dollars and now you can profit as well. My only request is that you ...
Doctors should learn personal finance during medical school
I read somewhere in the comments here something to the effect of this: "Physicians are only good for one thing: doctoring."That would explain the general ineptitude of many physicians when it comes to skills outside medicine, such as political lobbying, or business and personal finance decisions.The New York Times has written a helpful column that's required reading for any ...
Celebrating 50 years of coronary angiography
When I recommend that a patient needs coronary angiography (synonyms: heart catheterization, coronary angiogram, cardiac catheterization, or simply “cath”) I take a moment to bring up the risks of the procedure—complications that include the rare likelihood of stroke or heart attack (less than one in a thousand), a reaction to the dye, and bleeding at the arterial access site (most often the femoral artery in the ...
A rural medical school to train rural physicians
Are big-city academic institutions really necessary to train excellent clinicians? What irreplaceable benefits do they provide?When I attended medical school a decade ago, there was a group of students comprising about 50% of my classmates that I rarely ever saw. Most of these were students who had come to medical school straight out of college, and still denied that anything important in the world happened before noon. They skipped ...
How health reform is like accident reform
"Do you know how many people died in car crashes in the United States in 2010? 32,000. That’s the lowest number since 1949. That’s impressive, but wait: It’s far more impressive than it sounds at first, because people in the United States drove about 10 times as many vehicle miles in 2010 as they did in 1949. In other words, if you drove a car or truck in 2010, you ...
The effect of therapeutic touch is based on pure chance
There is no "alternative medicine." There is only medicine:
- Medicine that has been tested and found to be safe and effective. Use it; pay for it.
- And, medicine that has been tested and found to be unsafe or ineffective. Don't use it; don't pay for it.
- And, medicine for which there is some plausible reason to believe that it might be safe and effective. Test it and then place it into one ...
Manage malpractice risks with self-diagnosed patients
Search engines and the Internet are impacting patient behavior—eight out of 10 people use the Internet to look for health information, but only 25 percent of those people verify the credibility of their information source before self-diagnosing. It gets even more complicated when patients order drugs directly over the Web.The debate among physicians about the credibility of online information is as old as the Internet itself. As a caregiver, ...
KevinMD posts of the week, August 28, 2011
Here are the top posts from this past week, based on the number of times they were viewed.1. Our country fails to view physicians as humans. When we demoralize these physicians, we show no respect for their hard work, for their lives being given up to take care of sometimes fifty to sixty strangers a day, then we give up on the survival of humanity.2. The entire ...
Why I love community health fairs
There is nothing like a good community health fair. Away from the formal, detached sterility of the office this is an opportunity to meet patients on their turf. No longer adorned with white coat, power outfit and accompanying entourage, physician meets patient as just another member of the community, an equal almost. With a backdrop of blaring music, sweltering heat and flavorful eats people young and old gather, eager to ...
The ethics of being on a pharmaceutical advisory board
While diligently perusing a stack of unread journals, a piece in the July 25, 2011 issue of Modern Healthcare caught my attention.Titled "What's the Agenda?" this special report deftly navigated the murky waters of "physician participation on advisory boards" and managed to present an accurate appraisal of the issues.Here is a brief recap.Back in the days before "medical ethics" issues were commonplace, pharmaceutical and medical device manufacturers were accustomed ...
The trouble with Dr. Google
Things have been a bit tough of late, the bad economy is starting to bite, and you’re feeling the pressure. To top it all, your body has been acting strangely in ways it never has before. Your muscles twitch in funny areas for hours at a time, you tire easily, and you have fleeting pins and needles in your limbs. Over the weeks these symptoms have become worse. The last ...
MKSAP: 58-year-old man is evaluated for increasing fatigue
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 58-year-old man is evaluated for increasing fatigue of 2 months' duration. The patient has hypertension and hyperlipidemia treated with lisinopril and atorvastatin. A sister has hypothyroidism.On physical examination, temperature is normal, blood pressure is 135/80 mm Hg, pulse rate is 72/min, and respiration ...
Intuition saved this patient from a potentially fatal diagnosis
I was working in a rural health clinic when I went into to see a new patient. Amy was 18 years old, with her 6 day old newborn son by her side.I introduced myself and then asked, "what brings you into the clinic?"Amy responded, "Shortly after giving birth, I started having problems with shortness of breath, ankle swelling, and high blood pressure. I told the OB residents and they brushed ...
Your consumer powers when choosing a hospital
An excerpt from Doctor, Your Patient Will See You Now: Gaining the Upper Hand in Your Medical Care (Rowman & Littlefield).The casual attitude people demonstrate when choosing doctors incurs a steep price. Let's direct our attention to your consumer powers when choosing a hospital.The imperative ‘caveat emptor’ (let the buyer beware) carries the most consequence when you purchase health care. When it comes to hiring a hospital's services, it's more ...
Work hour restrictions seem painful now, but are a gift
When I completed my overnight shift and left the medical ICU the morning of July 1, I raised my arms victoriously. I uttered, "Finally, internship is done!" I may have been one of the last to speak such words.As of July 1, 2011, intern year forever changed. In the world of medicine the first year of residency, or intern year, is when doctors earn their stripes. Traditionally it is ...
Fair balance gives natural pills and supplements an advantage
The reality is that my job constantly challenges my sanity. Sometimes, I just want to scream.Patient: "Doc, I don’t want to put any poisons in my body! Isn’t there a 'natural' remedy I can take?"Doc: "No, I want you to take my poison! I haven’t poisoned my quota of patients this month and need to reach my goal."Poisoning patients really isn’t good for business. Why would a patient believe that ...
Why patients flock to alternative medicine providers
As medical practitioners, we are trained to fight disease, becoming familiar with all the metaphors of war, victory, failure, and the Cartesian views of deductive reasoning and mind being separate from body. Through said reasoning, we come to believe in a passive view of health; that health is an absence of something, in this case dis-ease. From that vantage point, it is no wonder medical practitioners have such high rates of burnout, ...
Kevin Pho, MD
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How patient satisfaction can kill
Patient satisfaction is all the rage. Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country...
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How I approach ovarian cancer screening with patients
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
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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....
Physician
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The analogy between baseball hierarchy and medical systems
From age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but...
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Saving patients from Internet health information
Lately, I get the feeling that I’m doing something wrong. I’m supposed to form a partnership with my patients. My patients are...
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Understanding what patient centered care really means
There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He...
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A letter of thanks to my organ donor
I have tried to write a letter of thanks but don't know what to say or even how to begin. I don't...
Patient
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Why patient engagement is reciprocal
It is said that "turn around is fair play." So if providers (physicians, hospitals and other health care professionals) expect patients to...
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Question the price of drugs and medical procedures
Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure...
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In love there is a life giving force
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
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How to get ready for death
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
Policy
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America has a medical care system not a health care system
As Americans we believe we have the best healthcare system in the world. But think again, it’s really not the truth. We...
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Reading between the lines of breast cancer treatment studies
Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently,...
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Why are labor and deliveries closing?
Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no...
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America has a health care paradox
We have a real paradox in American healthcare. On the one hand we have exceptionally well educated and well trained providers who...
Tech
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Why physicians don’t want patients to have their cardiac device data
There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers....
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Impersonal communication on the Internet fuels cyberbullying
In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over...
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Health IT and doctors: A framework for successful partnerships
We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology. We have firsthand...
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Break out of the prison of the American health care delivery system
Speaker after speaker at the recent Care Innovations Summit in Washington, DC concluded that increasing the quality and decreasing the per-capita cost...
Social Media
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Why doctors should embrace Google+
Lots of pressure out there for you to be on Facebook and Twitter, right? The ultimate question, though, is how are you...
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Using Twitter to deliver health improvement messages
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
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Addressing comments on your medical practice’s Facebook page
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
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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...
