Today was a rough day at work. My schedule of 10 patients for the afternoon rapidly ballooned into 17. People were sick and miserable. Those who were healthy were frustrated by the long wait. I heard myself apologizing over and over to each family.The day was mostly a chaotic blur. Babies crying, phones ringing, parents reprimanding children on the brink of a meltdown. I don't remember much of it, except ...
September 2011
All Stories
Essential tips for medical journalists
We're five years old. We've been doing the same thing the same way for five years and have analyzed over 1,488 stories using our ten standardized criteria on HealthNewsReview.org.We've recently returned from the annual Association of Health Care Journalists (AHCJ) conference in Philadelphia, where we led a two-hour workshop, and where we received a tremendous amount of gratifying feedback on our work and many terrific suggestions about new ...
Physicians need to be more proactive asking about code status
When I saw my first patient die, I was in shock. You will never forget your first one, that always stays with you.My first patient died during medical school, a young guy around 40. He died of complications from endocarditis. He was fine in the afternoon, talking about his family and what he does, but when I came back in the morning he was gone. I was shocked beyond ...
Can cost accounting save health care?
In the September 2011 issue of Harvard Business Review, Harvard Business School professors Robert Kaplan and Michael Porter argue that a better understanding of the actual cost of care patient-by-patient can have a dramatic impact in the effort to control health care costs. They maintain that actual costs are poorly understood, that there is a mistaken belief that many costs are too complex to allocate accurately, and that ...
Biology and biography: The Two-B Factor of depression
An excerpt from Living with Depression: Why Biology and Biography Matter along the Path to Hope and Healing (Rowman & Littlefield Publishing Group).To be human is to experience an array of different emotions. We can feel upbeat and hopeful, cool and unconcerned or frustrated and fearful in a given day—even in a given moment. The heart of human experience beats with moments of joy and flashes of sorrow, and with ...
Explaining human motivation towards unhealthy behavior
We have all seen people exhibit flagrantly unhealthy behavior. Some of us–though we’d never admit it–derive a certain, smug satisfaction by observing them. At least I don’t do that!Somewhere in the course of our daily lives though, most of us do exhibit behavior that suggests at least some disregard for our health. We don’t change our diet, though we know we should. We don’t floss, take medications as prescribed, or ...
Requiring a prescription for OTC products is a waste of physician time
Most OTC products, excepting some medical equipment like crutches and diabetic supplies, now cannot be purchased with flexible spending account dollars without a physician prescription.One of my partners asked last week how I am dealing with this issue. He has had several patients ask for a long list of prescriptions for OTC products so that they can use their FSP to pay for these things with pre-tax dollars. This puts ...
My iPad and my hip fracture
Dear Apple:I've been a happy iPad2 owner since March 2011, but I never fully appreciated its value until I recently broke my hip in a bad fall and required subsequent hospitalization.I am a physician, so I had already been using my iPad for my work, reading PDFs of medical articles, communicating with my colleagues via e-mail, etc. But when I broke my hip in an accident a few days ago, ...
Who benefits most from psychological therapy?
There is a saying in psychiatry, "even bad therapy is good therapy."I always thought this was a terrible thing to say, but really, there’s some truth to it. The basic tenet of therapy is that a person is able to vent their feelings with an objective third party. Depending on how good the therapist is, he or she will be able to help that person process their feelings in ...
The worst abuse of an embargo this medical journalist has ever seen
In general I support embargoes in medical journalism. Although the current system is far from perfect and contains all sorts of wrinkles and unexpected consequences, I support the system because it allows journalists a bit more time to work on complicated stories and to try to get them right. Recently, though, I came across the single worst abuse of an embargo that I have encountered in the course of my ...
Born premature, my sons have already endured a lifetime of hardship
Thump.There is a strange sound emanating from the hallway. It’s more of a series of sounds, of thuds, punctuated by an odd, louder noise. The hallway is narrow, not much room for a five-year-old to create too much havoc. I close my eyes, and as I try to visualize the corresponding sequence of events the rhythm is interrupted by a much louder sound and the house shakes. A child has fallen ...
New HIPAA rules won’t enhance privacy, but they will burden physicians
Hospitals and physician practices are waiting with bated breath for the final changes to the HIPAA Privacy Rule, which the Department of Health and Human Services (HHS) is expected to release by the end of the year. One of the new rules could require healthcare providers to keep track of the instances in which patients' health information is shared with third parties for reasons including treatment and managing payments. ...
A contract for patient responsibility
I often refer to myself as a fireman pouring water on the flames that are burning my patients. Often, I view my patients as arsonists, pouring gas on the fire I am working to put out. Taking personal responsibility is a critical component of success in any of life’s ventures. While my patients are very responsible business and family men and women, they often take no responsibility for their ...
How elderly patients can be stubborn to their own detriment
The elderly population can be fun to take care of (they have more stories than you have time to hear), or they can be a handful in regards to all of their chronic complaints and numerous medications. But then, there are those senior citizens that come into clinic and tell us, "I don’t need to take medications, I haven’t taken medications my whole life, and look at where it’s ...
When not to use a physician recruiter
As a physician recruiter of prominence, a number of times during any given week I get a fair number of calls from physicians in training who, honestly, should not be calling me whatsoever and I am very frank in telling them this. The call normally starts something like this:"Hi Bo, my name is Dr. Doe. I am finishing up my dermatology residency and I want to be there in ...
9/11 grieving in the social media era
Sunday marks the tenth anniversary of the 9/11 attacks, and our keyboards, monitors and smartphones will likely play a big role as we commemorate the events. Numerous remembrance websites and videos already appear online, and people will undoubtedly take to Facebook and Twitter over the weekend to share their personal stories and express their thoughts on that tragic day.Never before have we been so "plugged in," and I had to ...
KevinMD posts of the week, September 11, 2011
Here are the top posts from this past week, based on the number of times they were viewed.1. How social media impacted a medical student’s career. After learning about the far-reaching effects of social media, I have decided to make these tools a part of my future career.2. 10 ways to make a difference in the lives of your patients. Most of us who write about health believe ...
How Jenny McCarthy became a medical thought leader
The mere mention of Jenny McCarthy gets an immediate eye roll from many physicians. The closer their practice is to autism or immunology, the more likely the eye roll turns into a lecture on why Ms. Playboy should focus on what she knows.The problem is that "Ms. Playboy" is kicking the medical profession’s behind on thought leadership. Jenny McCarthy has become a – if not the – leading voice regarding ...
What to ask a doctor when faced with a difficult diagnosis
We live in an era of medicine in America in which patients want to be involved in their healthcare. This is very satisfying to physicians like me, who prefer to educate and engage patients rather than just telling them what to do. Granted, there are some instances when a patient does need to be told what to do (ex: "You have appendicitis. You need surgery.")However, when faced with a ...
Patients often think doctors do nothing, but they’re wrong
Very often I ask patients about their recent visits to other doctors. While I am taking a history, it’s important for me to know if you’ve recently been seen by another provider for the same or similar complaints and what they did, what they diagnosed you with, what they prescribed, etc. I often get a kind of irritated response such as "Oh, he didn’t do anything" or "he said it ...
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....
