From helping you wake up rested to getting couch potatoes ready for a 5K, there really is an app for everything.But when it comes to health apps, many don’t get the job done.Companies are often in such a hurry to sell their app that they don’t conduct a study to see if users will adopt real, lasting change. And, app stores don’t have medical reviewers who make sure health ...
August 2011
All Stories
The problem with I Heart Boobies bracelets worn by middle school students
Many of you know that a judge in Pennsylvania has determined that the popular "I Heart Boobies" bracelets worn by middle school students are a form of free speech intended to raise awareness of breast cancer and cannot be restricted by schools.As much as I love a good double-entrendre, I find the entire situation to be sad, particularly the misinformed comments I've seen made by parents of ...
Health reform and the iron triangle of health care
When I was in medical school, we had a class on health economics taught by William Kissick. I didn’t pay as close attention as I should have (especially given what I do now). But I remember one thing he stressed. It involved the iron triangle of health care.There are three aspects of health care systems that are essential: quality, cost, and access (thus the triangle). The problem ...
Fever in children: 5 facts you must know
A recent issue of Pediatrics includes a new report detailing the need for doctors to improve patient teaching about fever and fever-reducing drugs.Many parents fear their child getting a fever, or have "fever phobia." I certainly can understand why. Kids can do crazy things when they get fevers. They don’t sleep well, eat poorly, and behave strangely. Some children can even have seizures due to a quick ...
Why work hour restrictions won’t improve patient safety
Darshak Sanghavi recently wrote an excellent piece in the New York Times summarizing the controversy over resident work hours.The topic has been discussed here frequently, with ramifications ranging from the fact that errors arising from patient handoffs negate any benefit gained from restricting work hours, to surgeons not accumulating enough experience during their work hour-restricted training.I've ...
Google gave up on electronic personal health records, but we shouldn’t
Which will improve a person’s health more? Running around the block for 20 minutes or sitting at a computer entering their cholesterol and blood pressure readings?The answer is one reason why Google’s decision to end its electronic personal health record (PHR) service offers important lessons about health IT and will affect the way patients get their health information and the way physicians communicate with their patients. A recent survey ...
Explaining an abnormal pap smear is no longer simple
As I look back over my 10 year career in obstetrics and gynecology, I am sometimes struck at how many things have been discovered in this time period.When I started the origin of pre-eclampsia was unknown, and now we know that it likely originates in an overabundance of a molecule called Soluble FMS-Like Tyrosine Kinase, a competitive inhibitor to natural angiogenesis in the placenta. Ten years ago the origins of ...
Why the third year is the greatest year of medical school
This post is dedicated to the many 3rd year students whom I have had the privilege to teach over the past 35 years. They continue to inspire me to help them become great physicians. They care.The third year of medical school is wonderful, but it is a year of great change. Those readers who are physicians will completely understand, and I will try to explain to the non-physicians.During the ...
Why don’t simple messages convince people to take action?
It’s hard to find anyone who would argue against keeping things "plain and simple." Or would they?Is it possible that the imperative to create simple health information has over-promised – hasn’t lived up to its billing? What if the complexity of health, science and technology information in the first half of the 21st century requires more than simple simplicity?Think back to swine flu.Dateline November 2009: We were awash in ...
Every new scientific finding to be nothing more than a first draft
A recurring theme on e_Patients.net is the need for empowered, engaged patients to understand what they read about science. It’s true when researching treatments for one’s condition, it’s true when considering government policy proposals, it’s true when reading advice based on statistics. If you take any journal article at face value, you may get severely misled; you need to think critically.Sometimes there’s corruption (e.g. the fraudulent vaccine/autism data reported ...
What the death penalty has to do with medical errors
A fascinating, beautifully-written article on a death penalty granted to a most likely innocent man, with interesting details on fire dynamics and the history of the judicial system pertaining to the death penalty.Reading about the system in place that should prevent an innocent man from being wrongfully executed reminds me of the supposed system that prevents medical errors from occurring - both are imperfect, with innocent victims falling through ...
Why you would want a younger doctor in the hospital
Recently, the American Journal of Medicine published a study with the unexpected conclusion that hospitalized patients were more likely to die or stay long in the care of an experienced physician than in the care of a recent graduate from residency: "When doctors weren't very busy, they kept patients in the hospital for roughly the same average time no matter how many years of experience they had. But when they did have a lot ...
The problem of hospice in nursing homes
As I point out in The Medical Profession Is Dead and the Doctor Is "Critically Ill!", more factions are able to charge for and be reimbursed for healthcare delivery than ever before. This has come about through creating boutique health care niches. The demand for boutique care is being driven by entrepreneurial interests, and, once brought to fruition, then being managed with corporation business tactics -- i.e., for profit.One of the ...
Doctors face difficult choices to save Medicare
So, here we are, between a Medicare rock and budget hard place.Costs are clearly a problem. Our healthcare system is the most expensive in the world. Take a look at the 2003 figures from the Kaiser Family Foundation. Per capita costs, in 2003, in the US were $3,394 above those of the UK.
We need to work on the costs. ...
Being a doctor takes a toll
It takes its toll on me, being a doctor.I think as I wait in the Indian restaurant buffet. My son is curled on my lap. Uncharacteristically tired. Later he will develop a fever and I will realize why he is so warn out.It takes it toll on me. I wouldn't say I am a stressed out person but I certainly live with stress. Most of it is self inflicted.It's ...
Wireless devices will dramatically change how medicine is practiced
I interviewed about 150 medical leaders just a few years ago for my book The Future of Medicine – Megatrends in Healthcare. Not one mentioned wireless devices as a coming megatrend. How fast the world changes! Nowadays everyone has a cell phone and we rarely stop to think that just two decades ago almost no one had them. We have a laptop or tablet computer that can access information from the web ...
Unintended consequences of patient portals
There seems to be an inverse relationship between the amount of spin one hears about "the next big thing" and reality. First it was EMRs and virtual e-visits, then social media, and now patient portals seem poised to be next big thing. The drumbeat of vendors and pundits is unmistakable: physician that don’t adapt will be toast. It can all sound pretty convincing until you ask to see the evidence. ...
What to consider when adding the Apple iPad to your medical practice
The variety of new technology coming into the market can sometime make one’s head spin. Physicians are especially vulnerable to the call of the latest, greatest gadget. The Apple iPad certainly fits the bill when it comes to the consumer – entertainment, apps, great design. But can that translate to the environment of the medical practice? A lot of experts seem to think so, ...
The public’s values of fairness in health inequalities
There are two camps in America: those who think that health care is a right and those who think that it's a privilege. Well, perhaps that's a bit of an oversimplification, but bear with me. Given these two respective positions, what are we to make of the health inequalities that are well documented in the United States? First, we must acknowledge that health is the product of multiple factors ...
Women are now choosing safer options for beauty
Women have a long history of risking health for beauty. But several developments over the past few months suggest they might be starting to choose safer options.1. Temporary tattoos. The latest trend on the runway and in the beauty isle is temporary tattoos, according to the advertising firm JWT. Chanel now offers limited-edition skin art, and Beyoncé has signed up to help sell Temptu’s product. Permanent tattoos not only cost ...
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....
