Why would anyone want to become a physician?Good question, given the current atmosphere of doom and gloom amongst my colleagues and peers.Like most folks, when one has worked at the same job for 10, 20, 30, and even 40 years, the human spirit does need replenishment. Many pubic servants (and that is what we are), police, fire department personnel, correction officers have some things very much in common. Stress. ...
August 2011
All Stories
The insensitivity towards kids with food allergies
Dear Members of the Illinois State Board of Education,As a parent of a child attending Illinois Public Schools, a taxpayer, and a board-certified pediatric allergist and immunologist, I was distressed to hear of the irresponsible comments made by Illinois State Board of Education (ISBE) Members Catherine Campbell and Lawrence Gregorash regarding the requirement for Illinois schools to have a food allergy policy in place by 2011.When the parents ...
The achievement culture problem in our country
My friend Nancy went for physical therapy for her back pain the other day, and was really surprised by what she saw there: the place was full of kids."Yeah, it’s like this now," said the therapist when Nancy asked about it. "It’s the sports."It’s not that kids are getting clumsier or having more accidents. The injuries that are sending kids to physical therapy are overuse injuries. Kids these days are ...
My primary care frustration is outweighed by my relationships with patients
I love my job as a primary care doctor, and I enjoy sharing the joy with students who visit me at the community health center where I work. It is terrible to read in the press (and to hear from students) that angst and frustration are the predominant emotions associated with primary care. While there are sources of frustration in what I do, these are overwhelmingly outweighed by the satisfaction ...
Why a neurologist turned down an interesting hospital case
Dr. Grumpy has lost his neurology mojo over time. Actually, I shouldn't say I've lost it, as much as it's been worn down by red tape.Yesterday I turned away a good hospital case, and told them to find someone else. The patient was insured. The patient was interesting. Not some run of the mill chronic back pain case.28-year old guy admitted for abdominal pain and weight loss. Large mass found (possibly lymphoma). ...
Your medical information is not private, and it’s sold routinely
Privacy, is it important to you? Do you believe that your medical and personal information should be kept in strict privacy? Do you expect your doctor to keep your information private? What is the cost of privacy?The computer I am typing this article on is protected by Norton’s Security Suite and by Comcast’s Constant Guard. My friends, family, and patients invest a small fortune every year to keep their ...
ACP: New COPD guideline addresses an important health issue
A guest column by the American College of Physicians, exclusive to KevinMD.com.It is easy to continue practice patterns we establish over the years. In my daily life as a general internist I am more likely to look for more information on a condition I don’t see regularly than on one that I see all the time. While we want ...
Getting insurance to cover a test requires guessing the diagnosis
We had an interesting dilemma in the office. You see, being pulmonologists we treat people with asthma, and one of the more useful drugs we have in the ammunition belt is a medication called omalizumab (Xolair).Among patients in whom it’s indicated, particularly those with severe allergic asthma, the effects can be dramatic and life altering. The problem with this drug is the cost. Actually also the administration. And the anaphylaxis. Not to mention all the ...
Angry Birds: A psychiatrist explains the addicition
Joe Frisch is a staff scientist at the SLAC National Accelerator Laboratory at Stanford University. Dr. Frisch writes: "I wonder when we will start seeing really addictive games banned? I don't know what makes games addictive though. Angry birds is a mystery to me - there is no ongoing story line, you don't really gain any abilities as the game ...
Consider the cost when choosing a medical school
Over the last two weeks, I have been engaged in an email discussion with a young woman who is trying to decide where to attend medical school. I shall call her Ms. X.Ms. X has been accepted to numerous schools and has narrowed her options to two: School 1 is a private school in Boston (not Harvard), and school 2 is a public school in suburban New York City ...
Using RFID tags to track physician movement at conferences
Not everything that counts can be measured. Not everything that can be measured counts. -Albert EinsteinRecently, a disturbing trend of monitoring physician quality and accountability has taken another ominous turn: tracking physician's movements at scientific conferences (so called "tag and release") using RFID tags embedded in attendees name badges at national scientific sessions. Having had personal experience with the American College of Cardiology meeting, this technology was also embedded in the name badges ...
There is no billing code for compassion
Back in 2009, Dr. Amy Ship gave a moving acceptance speech when she received the annual Compassionate Caregiver Award from the Schwartz Center.The most memorable tag line from the speech was, "There is no billing code for compassion." This resonated with so many of us -- patients and providers -- in part because it set forth the proposition that compassionate care should be an inherent aspect ...
A cream to fight obesity is being ignored
Do you, or many of your patients, have a little more belly fat around your and their middle than you and they would like? Me, too.Turns out that there are two decent published studies from reputable places that report that a person may rub a cream on their skin over the fat spots and make the fat go away.Wow, what a deal.The first study addresses fat thighs, with each ...
Dangers of the hospital press release
You may have noticed the rash of medical news spewing from your favorite news outlets with greater frequency. As a medical professional you probably cringe as you envision the calls that are about to flood your office, "Doctor Smith, I heard a report on the news that this drug you prescribed to help me quit smoking is bad for my health!" or, "I want a referral to The Hoffenheimer Institute ...
KevinMD posts of the week, August 7, 2011
Here are the top posts from this past week, based on the number of times they were viewed.1. Why the debt ceiling deal is a horrific outcome for physicians. If you’re a physician or hospital that relies on Medicare payments, grim times are ahead.2. Why this pediatrician hates bouncy houses. I hate the bouncy houses. I mean, I really hate them; I get a sick, nervous stomach when ...
The different types of frail to consider before surgery
"If I’d known I was going to live this long, I would have taken better care of myself." -Eubie BlakeHe leaned forward, energetically listening to my conversation with his daughter. There was more than one cancer treatment option. We reviewed everything and she asked what he could expect with either a major surgery or seven weeks of daily radiation treatments. Soon, both the father and daughter were peppering me with questions about ...
How smog affects the human body
We all know that outdoor aerobic exercises like running and biking are good for your health. But during the hottest days of summer, it’s not just excess heat we have to worry about, but smog, the concentrated air pollution you can often see hovering over the cityscape. During the hot summer months, smog can become a serious health problem in the Boston area. We are often downwind from the Midwest’s ...
Call Day from ZDoggMD
What's it like to be on call? Hospitalist ZDoggMD knows.
During the holidays, our goal should be to provide a holiday for our patients
During Christmas holidays, many medical students, interns, and residents will not be celebrating the holidays with their families. Instead, they will be on call, or night shifts, or just long schedules, taking care of patients.For life and death, sickness and health, do not take holidays, and nor should our compassion for taking care of those who are in trying times. I recall working last year on Christmas Eve at ...
Being a patient is an unforgettable form of medical education
In his online essay, This Won’t Hurt A Bit, cardiologist Dr. Eric Van De Graaff tells his own story of being a hospital patient after surviving a motorcycle accident while he was in med school. His experiences as a patient will sound very familiar to heart patients, and the lessons he learned while on the other end of the stethoscope may very well have made him a far better doctor.A ...
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....
