It may sound obvious. But many years working in and with hospitals has taught me that many health care providers, although they want to treat their patients in a culturally and spiritually sensitive manner, often don’t know how. It seems that every day as our country becomes increasingly diverse, health care clinicians are confronted with someone from a cultural or ethnic group they have never encountered before.At the same ...
August 2011
All Stories
Medical school rotation at a free clinic for the uninsured
My patient had onychomycosis – toenail fungus. Not a devastating disease. The treatment for this fungus is a 12-week course of terbinafine. About $50 for a month’s supply ... $150 for 3 months. Terbinafine’s potential side effects include liver toxicity.During my primary care clerkship at the Bronx VA Hospital, I treated several patients who had onychomycosis and had undergone the antifungal treatment. One patient declined treatment with terbinafine because ...
How can doctors understand the business side of medicine?
What do you regret about your medical training or specialty selection?Anything?One thing I regret is not taking advantage of the Masters degree in Health Administration program at my medical school. At the time, I was focused solely on medicine and on being a doctor. I didn’t think the business side of medicine was all that important. In fact, I didn’t consider the business side of medicine at all.I regret ...
Chronic disease management through mobile health
The conundrum continued behind conference doors at the American Telemedicine Association (ATA) conference in Tampa about the efficacy of mobile phone usage to improve patient health.Lively discussions followed about the ROI for chronic disease management through mobile health and outcomes for remote patient monitoring focusing on whether telemedicine is excluded from meaningful use and reasons why telehealth should be a key component in Accountable Care Organizations (ACO).As the debate ...
What is the truth behind stem cell cosmetic surgery?
You may have seen advertising for stem cell facelifts and breast augmentation. Some cosmetic and plastic surgeons are touting these treatments as cutting edge procedures that promise results far greater than anything we’ve ever seen in plastic surgery. So what is the truth behind stem cell cosmetic surgery?Stem cells are definitely the future of medicine and plastic surgery. But the truth is, the claims of today’s marketing have pushed ...
Will a healthy lifestyle prevent illness?
I am utterly sick of the myth that living a healthy lifestyle will prevent illness.
- Granted, eating a balanced diet of nutritious food is better than grazing on ice cream and bon-bons all day.
- Getting regular exercise has distinct health benefits; moving as little as possible has a detrimental impact on people’s health.
- Is there anyone who isn’t aware of the health ramifications of smoking?
- Excessive alcohol consumption is another no-no.
Accommodate people with hearing loss in the hospital
Hospital care for people with hearing loss can be ineffective when people cannot communicate. Most hard-of-hearing people do not know sign language because they lost hearing later in life and remain in the oral culture. Without effective communication, quality of care is impaired and patient compliance is often reduced. The patient’s bed needs to have proper signage and chart records to alert staff of special communication needs.Ironically, many hard-of-hearing people ...
Why is it so difficult for doctors to stay on time?
"I'm sorry."I said that phrase a lot last night during evening patient hours.With an overfilled schedule, I mostly said it to patients who waited twenty, thirty, even forty-five minutes for me to see them. "I'm sorry for your wait. I appreciate your patience." I say these sentences far more often than I should. Why is it so difficult to stay on time?I could blame my inadequate supply of nursing staff; ...
The physical and emotional costs of non-compliance
There are multiple costs to non-compliance, including financial, both personal and societal, and physical-emotional. When patients fail to comply with treatment protocols, fail to get prescribed tests, or fail to stop destructive behaviors, there is a societal cost.Today, I want to address the physical and emotional costs of non-compliance. I just read a brilliant article by Roxanne Sukol, MD. Dr. Sukol’s article discussed the fact that diabetes starts ...
The majority with diabetes do not lead a disciplined diabetic life
"More than half of all Americans may develop diabetes or pre-diabetes by 2020, unless prevention strategies aimed at weight loss and increased physical activity are widely implemented, according to a new analysis. Diabetes is an epidemic, " according to Denise Mann in WebMD Health News.At 14 months old, the doctor told my parents that the disease would ultimately take my life. The doctor motioned my father into the hallway of ...
Doctors sometimes fail when practicing what they preach
I’ve heard patients say, “How could she smoke and she’s a doctor?” Alarmed and bewildered by the fact that an agent of health could partake in one of the most harmful acts of bodily destruction. In medical school, a sizable number of my classmates smoked and I always found it so counter-intuitive, mind-boggling that they would be learning about smoker’s lung in pathology and on class breaks would huddled outside ...
Medical student research and reading
According to Liaison Committee on Medical Education (LCME) policy, medical education curricula should provide opportunities for and encourage medical student participation in research and scholarly activities. Some med students take the summer between first and second year while others may take elective time or a year-off to pursue more in-depth research experiences.Med students may also choose to become the subject of research by participating in a clinical trials as patients, ...
Taking the time to answer patient questions
I was working in the bone marrow transplant clinic of an internationally known cancer center. When I looked into the patient’s faces, I saw hope as they were being worked up for a possible transplant.I went into see a new patient. She had leukemia and had relapsed after her remission. Her sister would be the donor.Gretchen, age 19 came in with her mom for the appointment. She was tall, youthful ...
Think about mindfulness when seeing a new patient
I had a "wow" experience recently when I accompanied my wife to interview a new doctor for her. As some reader may know she is being seen by specialists at MD Anderson Medical Center in Houston for Stage IV lung cancer. She has not had a local oncologist for the past 6 years, but she does now. And we both love this guy!You need to understand that I have ...
Does the White Coat Ceremony encourage compassion?
An article written by Dr. Sally Satel in The Wall Street Journal, Physician, Humanize Thyself, discusses the origins of the white coat ceremony. In the 1980s, as insurance companies placed increasing pressure on physicians to minimize visit time and maximize patient volume, the medical profession at large became increasingly cynical and disgruntled. A direct result of this was the White Coat Ceremony, whereby each medical student goes up ...
Demystifying anesthesia to put patients at ease
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.As patient safety advocates responsible for monitoring vital signs, managing pain and safeguarding a patient’s overall health through the surgical process, anesthesiologists are committed to informing patients about the anesthesia experience. The American Society of Anesthesiologists (ASA) and the Michigan Society of Anesthesiologists (MSA) have launched a new public education campaign to help patients better prepare and ...
Doctors diagnose, sometimes we dispense, often, we teach
"My grandson has HDHD."This was intriguing. I had just asked her one of my standard psychiatric interview questions about family history of mental illness. Maybe I hadn’t heard right, but it sounded like she was telling me about a new flat screen. Had her grandson just bought a fifty-two inch LED set in time to watch the Final Four this weekend? Had he mounted it on the ...
Tips to care for your child with extra medical or behavioral needs
Lately when I ask my son to make a choice or do anything he considers difficult, he says, "Bus number twenty three. Number twenty three. Bus number seventy nine. Number seventy nine."He memorized not only the words but the exact cadence of how buses are announced at his school and recites this script instead of screaming. If you know David, this avoidance tactic is creative, a little annoying, and downright ...
Nursing is methodical and precise, like military special ops
Another crazy three days at work and I begin to think about the similarities of Seal Team 6 and nurses. Methodical. Precise.Nursing is not a glorious profession. Even though my father thinks I sit at the bedside of the sick and dying and hold their hands all day, the fact of the matter is, I simply do not have the time. We run around attempting to tread water with ...
3 easy ways for doctors to respect patients
One of my professors teaches psychology, but he was hired as a "generalist" meaning that he has no area of specialization when he’s teaching. He ends up with all the 101 classes. And I love that. Trained as a biopsychologist, he’s now known as a clinical psychologist and is one of the best in the area.As I walked into the class the first day and he was going over standard ...
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....
