I was reading the other day in a magazine the personal account of a woman who had a "perfect example of a mitral valve click" (a type of heart murmur) that was so textbook in sound that she was asked to be a listening post for a class of medical students. She was pleased to help, but was disappointed in how of the 15 examiners no one treated her like ...
October 2011
All Stories
Keith Ablow on Chaz Bono and the outrage that follows
Dr. Keith Ablow is an assistant clinical professor at Tufts University School of Medicine. So am I. Ablow has a problem with transgendered people. I do not. I first learned about Ablow's well publicized stance Wednesday via an email to the Tufts community, signed by the university's president, the dean of the medical school and the chair of the psychiatry department.The university reaffirmed its commitment to the complete inclusion ...
Health related questions about plastic
Susan Freinkel is the author of the new book, Plastic: A Toxic Love Story.She was kind enough to answer some health related questions about plastic based on her research for her book.Is all plastic toxic?There are lots of different kinds of plastic and some may pose more of a health hazard than others. The two experts are most worried about are:Polycarbonate, a hard, clear plastic ...
Disease treatment progress will continue to be slow and painful
Recently, a friend sent me a text message with a rather conservative back-of-
Personal statement tips for medical school
As you all know, the personal statement is one of the most important components of the medical school application process. It is one of the first opportunities you have to explain to an admissions committee exactly who you are and what you bring to the table. Don’t show up empty handed.Here are some tips I learned while writing my personal statement.1. The personal statement on the AMCAS does not have ...
Obese Americans don’t actually realize they are obese
What if you passed a regulation, and nobody cared? Obesity is quickly emerging as a major policy issue, with related health costs consuming 10 cents on every health dollar – and rising. Policymakers, then, are eager for ideas. Top of the list: regulations to force chain restaurants to post calorie counts on their menus. This past Friday, the FDA released proposed regulations to force restaurants to do exactly that.New York ...
Considering patient advocacy as a career
Several questions have come my way recently about what kinds of job opportunities might exist for patient advocates. I refer people to an article I’ve written elsewhere, but the real answer is – to be a true advocate, you must analyze who is paying for your services, and what your responsibility will be to them.Finding an employerIn 2011, most of the job possibilities for patient advocates are ...
The cumulative effect of viruses in day care
Tracy has a good question: "My 4 year old is not in day care – he stays with Granny. I heard that once you get a cold, you never get that cold again, and I am worried he isn’t exposed to enough germs now to keep him healthy later. Should we be trying to infect him with more colds now that he has the luxury of staying in PJs all ...
A day in the life of a hospice professional
I know of few students who aspire to serve in end of life care. I sure didn’t. If anyone had told me that I would spend the first decade of my professional life serving the dying and their families as well as thinking, writing and talking about death and I dying, I would have thought that person to be morbid, strange, and sad. Most of society does not think ...
Genetically informed therapy and technical innovations in cardiology
I want to give an overview of cardiac care advances – the first two themes are discussed here. I want to thank Dr. Mandeep Mehra, chief of cardiology at the University of Maryland for conceptualizing these themes for me.First is genetically informed therapy. Pharmacogenomics is having an impact in the use of warfarin (Coumadin) and clopidogrel (Plavix). Warfarin dosage can now be titrated in part based on a person’s genomic makeup. In ...
Universal board certification can solve the Doctor Nurse controversy
I'm going take on the Doctor Nurse controversy.This isn't a new issue, as the doctorate in nursing degree has been around for awhile. But a recent piece in the New York Times gave it new life.The topic is a ripe invitation to "doctor bash," with the predictable arguments about physicians protecting their turf, elitism, and the like.Yawn.To sample ...
Protecting health apps on the web from the evils of the Internet
The Internet can be a swamp of hackers, crackers, and hucksters attacking your systems for fun, profit and fraud. Defending your data and applications against this onslaught is a cold war, requiring constant escalation of new techniques against an ever increasing offense.Clinicians are mobile people. They work in ambulatory offices, hospitals, skilled nursing facilities, on the road, and at home. They have desktops, laptops, tablets, iPhones and iPads. Ideally ...
Lawsuits are more of an emotional issue than a financial one
Doctors love to talk about tort reform – states passing laws to put limits on awards such as non-economic damages for harms such as pain and suffering, and on the legal process of suing a doctor for malpractice. They speak of defensive medicine – the practice of ordering extra tests, treatments, and days in a hospital to cover their medical-legal butts.Texas passed a comprehensive tort reform law in 2003 ...
Forget the mommy wars, offer support instead
I was just thinking the other day how much I need my mom friends. The ones I'm fortunate enough to have in real life and the ones (you) who come here, read, offer support, share your stories, and commiserate at times.All of you moms are incredibly important to me. It doesn't matter to me whether you've breastfed or bottle fed, whether you are a champion of sleep training or prefer co-sleeping, ...
Patients have a part to play in their own medical care
Medicine has changed so much over the past years, I look back even to when I finished my program and in the mere 20 years since I finished, medicine has changed dramatically. I can remember when I was a student, seeing a patient with rheumatoid arthritis and advising her that the best treatment we could give her was a DMARD. Now we have multiple monoclonal antibodies that not only ...
7 ways to make patients like you
Patients want to be cared for by doctors who show an interest in them as individuals. It has been a well-known statistic that the average doctor interrupts a patient within 16 seconds after the doctor-patient interview begins. You know full well that few patients can learn to develop an emotional attachment in 16 seconds. This article will discuss 7 steps to develop rapport that will make patients like you, will make them ...
Sometimes cyber-medicine is fraught with danger
I’m worried about the future. Everyone I know is stressed. Patients fail to follow up as directed. They fail to take their medications as directed. They have too much to do. Their priority lists are in shambles.With all the responsibilities that today’s multitasking society thrust on my patients, they don’t even have the time to pick up the phone and call each other; instead, they text, IM, SMS, and email. ...
Use a beginner’s mind in your medical practice
As a mom and first-time parent, I marveled at my tiny daughter's curiosity about and interest in the world. Her quest for knowledge was insatiable and her ability to sit absorbed in what she was doing and the moment enviable. Now that she's 8 (“8 and a quarter, mom!”, said with a sigh and an attitude), she seems to have morphed into a smart, verging-on-sassy pre-tween who's beginning to think ...
I concentrated to distill all that I had learned about death
The recycling container was already full. But I had two more bags to stow before lugging the bin through the gate and into the front yard for pick up. My button down shirt untidy and bulging out from the waist. My long khaki pants felt like a fur coat in the ninety plus Chicago humidity. It was 4pm and I had just arrived home from work, dropped my computer in ...
The decision to pursue a rare illness
Patricia Daly, FACP, of Warren Memorial Hospital in Front Royal, Va., told us about the case of a 49-year-old man who presented with marked weight loss. A year prior, the patient had weighed about 220 pounds and intentionally put himself on a diet, but after losing 45 pounds, he developed poor appetite and early satiety.He continued to lose weight to a nadir of 143 pounds. He found it increasingly difficult ...
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....
