Our kindergarten teachers and Hippocrates taught us to share. But after school, capitalism takes over among American medical researchers.Eric Campbell writes in "Data Withholding in Academic Genetics" that it was frequent for investigators to be denied access to data. The reasons for denials include "too much effort" and protecting potential publications of students and themselves.The respondents expressed only a little worry about protecting the commercial value of results: ...
October 2011
All Stories
Psychiatry should not be a tool for social justice
A doctor’s primary responsibility is to heal, and all of our efforts and resources should be devoted to that goal. At times, it is impossible to restore a patient to perfect health and he or she must unfortunately deal with some degree of chronic disability. Still other times, though, the line between "perfect health" and "disability" is blurred, and nowhere is this more problematic than in psychiatry.To illustrate, consider ...
Palliative care physicians can enhance patient decision making
Data from the Dartmouth Atlas show patients with chronic illness in their last two years of life account for about 32 percent of total Medicare spending, with much of that expense going toward physician and hospital fees associated with repeated hospitalizations.Opportunities to reduce medical expenditures during the last 2 years of life are often looked upon as a way to reduce the cost of healthcare while actually improving the ...
USPSTF prostate cancer screening guidelines need emotion to resonate
Prostate cancer screening has always been controversial.Now, with the USPSTF is recommending against screening for prostate cancer, gas is about to be poured on the proverbial fire.Recently, the New York Times Magazine published a lengthy piece on the issue, perhaps not coincidentally, perfectly timed with the Task Force's announcement.In 2009, advocates for breast cancer screening were ...
5 ways to cut breast cancer risk
Breast cancer may be the most common cancer among women. But, that doesn’t mean you can’t do something to help prevent it.Researchers have found certain risk factors that increase a woman’s chances of getting breast cancer. We can’t change some of these factors, like age or race. But we can try to control others, like weight gain and alcohol use.And, taking responsibility for the things you can control may ...
Is teaching bedside manner a thing of the past?
I caught the tail end of a recent #hcsm (health-care social media) tweetchat and it looked to be a good one. I saw a few comments about teaching bedside manner and whether it’s a thing of the past (oh, how I hope not). It occurred to me that sharing a real-life story could be instructive.I put on a brave face when I got a mastectomy for stage 0 DCIS ...
Physicians need to understand data to provide better and safer care
Patients expect excellent care from their physicians. Unfortunately, not all receive such care and most of us realize this. Many who do understand the wide variation in patient care probably believe it is due to the clinical knowledge and attitude of the provider—a very knowledgeable physician or nurse who is passionate about his or her job will deliver the best care. Although these ingredients are necessary for excellent patient ...
Practical tips for a more comfortable mammogram
By now you’ve probably seen the internet jokes that compare the mammogram experience to having your breast squashed in a refrigerator door. A few years back, I joined the club of women who have our annual mammograms, and I can’t say that I disagree with the imagery of the jokes. However, the benefits of early detection far outweigh the discomfort, so I’m willing to put up with it.I’d like to ...
Preventing deaths from food allergy
Sadly, recent news reports described two food allergy-related deaths in a single week. Although the details are scant, the victims were a 15 year old and a 20 year old, who apparently ingested unsafe foods and were not treated promptly. These preventable tragedies behoove us to learn how to better manage our food-allergic patients and advocate for them as well.The Centers for Disease Control and Prevention (CDC) estimated that approximately ...
When to see a doctor if you have a new symptom
Patients and friends tell me it’s sometimes difficult to decide exactly what symptoms merit a doctor’s appointment. I find that it helps to think of three basic categories of visits. One category is the all-important annual checkup, which assesses and promotes overall health and can detect signs of early disease. Another category is the follow-up appointment to track chronic conditions or recovery from a major illness.But the third category ...
A doctor cannot be on time and take care of your needs
Today’s article addresses a common complaint about physicians.“Freewheel” responded to a previous article by writing the following, “you will not make me wait more than 10 minutes. My time is important, too.” One of the most common complaints I hear is “I waited over an hour to see you!” Waiting for an appointment, particularly when you are sick, is frustrating. Once you have that appointment, waiting for a doc who ...
How Steve Jobs mentored a physician and changed health care
I've been reading A Game Plan for Life: The Power of Mentoring written by famed UCLA basketball coach John Wooden. Wooden spends half of his book thanking the people who had a powerful influence on his life, coaching, philosophy, and outlook on life. Important people included his father, coaches, President Abraham Lincoln, and Mother Theresa.Yes, President Abraham Lincoln and Mother ...
Healthcare professionals need to get an annual flu shot
Whether you are a physician, nurse, physician assistant, pharmacist, or someone else who cares for sick or disabled people, your job as a healthcare professional is an important one. Healthcare professionals are expected to provide services to individuals in need and to do so with quality and care.One way we can help ensure that we are doing our job the best way possible is to get our annual flu ...
The Haiti cholera outbreak is a repeat of history
The Cholera outbreak in Haiti reminded us that this is not simply a disease of the distant and unsanitary past. The outbreak was both unique and typical. Caused by a disease that has a long and devastating history, this Haiti outbreak has much in common with the outbreaks of the nineteenth century and twentieth century. History helps us keep in mind five key factors.1. The role of media coverage ...
Depression causes a drop in productivity at work
According to a recent study, depression causes an 23% drop in productivity at work. The drop is almost 45% for treatment resistant depression, defined in that study as depression that has not responded to 2 adequate trials (i.e. adequate dosage for adequate duration) of antidepressants.My gut, based on clinical experience, tells me that even when depressed, people devote lot more of their emotional resources to trying to not let ...
Calling yourself Doctor and what that now means
In New York State, the issue of scope of practice is at the fore. Mainly, what activities can non-physicians (NP’s) engage in, with or without physician supervision? It is a heated subject here where I reside, but not the one I will address below.The New York Times discusses a similar matter, although altogether more controversial. Many of you are aware nurses are obtaining doctorate degrees and advancing their training.The divisive ...
Cancer screening is plagued by dissonance
Last year, the USPSTF was poised to meet regarding its prostate cancer screening guidelines.According the Kenny Lin, a physician who was with the Task Force at the time, the meeting was cancelled for political reasons. He points us to a New York Times story on the dueling narratives of prostate cancer screening.It's a topic that often appears ...
The use of a signing bonus as tool for physician recruitment
As someone whose livelihood is dependent upon successfully recruiting physicians to various practice opportunities, whenever possible I use the tool of a "signing bonus" and it may not be for the reason you think.If you have found yourself in the role of recruiter for your practice, you should be open to use of this valuable tool within the physician recruiting process.Now, I must say, that whenever this is brought ...
You may benefit from having a medical student care for you
Amid the buzz about whether medical students should be sued and the bill currently debated in Arizona (a state which finds itself in the spotlight more than usual these days), I noticed some commentary from several people who do not think they would like a medical student on their case. Sometimes patients do refuse to be cared for by medical students, often due to overestimating the involvement they will ...
The words we choose can have impact on those we interact with
Language matters. The words we choose can have far-reaching impact on those we interact with. This is arguably more true in medicine than in any field.Ryan Madanick wrote a recent blog post on the use of descriptor terms used by physicians in patient’s charts. He felt that the use of phrases like “is a very pleasant 52 y/o woman” or “is an unfortunate 16 y/o boy” is inappropriate. I agree. ...
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....
