As I walked up the stairs I thought about the history of the building I was about to enter. Although the foundation was the same, almost everything else had changed. The hallways were updated. The patient rooms decked out with comfortable furniture and fancy televisions. I even marveled at the bathroom as I answered nature's calling. I could have been in a fancy hotel.Yes. Things were different than when I ...
November 2011
All Stories
Useful tips when looking for a new doctor
These days, it is not uncommon for people to need to find a new doctor. The most common reasons include a) moving to a new city, b) dissatisfaction with your former doctor, c) your old doctor no longer accepts your new or old insurance, or d) you were diagnosed with a new medical condition and need specialized treatment.Often, people go to their insurance company website or provider book, search for ...
Running a marathon when pregnant
The fact that Amber Miller did not fall or faint or develop complications while running in the Chicago Marathon is nothing short of a miracle. An ounce of prevention is worth a pound of cure. What on earth was her physician thinking when she was given the green light to half-run half-walk a 26.2 mile marathon? Miller was not your usual runner; she was approximately 39 weeks pregnant.Although pregnant ...
Unsupervised anesthesia care by a nurse anesthetist is a threat to patient safety
No matter how quickly you tried to switch the television channel lately, you probably couldn’t escape the trial of Dr. Conrad Murray or avoid hearing about propofol, an anesthesia drug that can be fatally easy to use.What you may not have heard is that the American people just dodged a serious threat to their anesthesia care, and most don’t know how near a miss it was.The Centers for Medicare and ...
Immunization before radiation to avoid complication
Radiation oncologists offer curative cancer treatment to many. Despite irradiating the spleen for over 50 years, why don’t we routinely offer pneumococcal vaccination to avoid complications after treatment? Since we just had World Pneumonia Day to raise awareness for children, I want to do the same for cancer patients.A healthy spleen helps fight off pneumonia, sepsis and meningitis. Publications on infection from spleen radiation date back at least thirty years, but were ...
The hesitation before shaking a patient’s hand in the hospital
Today, during my psychiatry rotation, a very grateful patient confronted my attending and thanked him profusely for saving him. The patient had been severely depressed and was at his wit's end before they met. The doctor listened to him, analyzed his situation, and came up with a plan to help which included involving the patient' family as well as using proper medication. The patient had a great response to this ...
A cancer survivor’s perspective on wounded warriors
I was at the Walter Reed National Medical Center where I get medical care as a retired naval officer, and decided to use my time between medical appointments to get a much needed haircut. I walked into the barber shop, took a number, and sat down to await my turn. The three chairs were occupied by young men getting haircuts. Their chests and lower bodies were covered with long blue aprons to protect them from the ...
Your worst days can bring out your best resiliency skills
I’ve been talking via email with my stepsister, Lori, whose teenage daughter has Asperger’s Syndrome. Our online conversation was mostly about the highs and lows of raising her neuro-diverse daughter and she shared with me many of the gifts that come along with having a special needs child.Then, one day, this was the message in my inbox: "Today is a day in the trenches! It's a battle and I'm bawling ...
AMA: Health insurance monopolies hurt patients and physicians
A guest column by the American Medical Association, exclusive to KevinMD.com.Anyone making a major purchase wants to maximize value by exploring their options. Shopping for the best option drives market competition and promotes innovation and efficiency. Shopping for competitive health insurance options can be difficult when a market is controlled by one or two large commercial insurers. The lack a competitive ...
How to talk with your teen about marijuana
Adolescence is filled with challenges - at school, at home, with friends, on stage and in sports. Even their own body betrays them from time to time. Acne, hair, changing bodies and voices, parents, siblings and friends are all possible sources of gut-wrenching shame for a normal teen. Parents of teens have challenges too - and high on the list is the challenge of talking about important topics like sex, ...
A few more minutes with Andy Rooney
"I died last week, just a month after I said goodbye to you all from this very desk. I had a long and happy life - well, as happy as a cranky old guy could ever be. 92. Not bad. And gotta say, seeing my Margie, and Walter, and all my old friends again is great.But then I read what killed me: 'serious complications following minor surgery.'Now what the heck ...
What patients with heart disease need to learn from cancer patients
Cardiologist Dr. Richard Fogoros has issued this blunt warning to those at risk for developing heart disease: "You need to change your life. If you don’t, you will suffer the consequences – possibly decades earlier than is necessary."In his Heart Health Center column, he observed that most high-risk people end up making only half-hearted efforts to modify their heart attack risk. And he blamed doctors for enabling this ...
The risks of exercise injury can increase health care utilization
The health benefits of exercise are well-established. A recent study published in the Journal of the American College of Cardiology showed that one’s fitness level, as measured a person’s one mile run speed, compared to other cardiovascular risk factors, was the best single predictor of heart attack risk and life span. Studies have shown that regular exercise reduces one’s risk of obesity, diabetes, and hypertension. Exercise has been ...
The stigma of HIV continues today
Firefighters are heroes because they run into a burning building. They run towards a fire, risking their lives to save others. No one would doubt that they are heroic, but most will wonder how this is even possible. How is it that some people can ignore our innate drives to survive to instead, help others do just that?Doctors are not typically equated with this type of heroic measure, we give ...
Why we must Occupy Healthcare
Why do we need to occupy healthcare? Why are we here, on this website, calling for change? We are so often told that America has the best healthcare system in the world. If that were so, then there would be no need to change anything. We could continue running things as we currently are, and all would be well ...Except that we do not have the best healthcare system in ...
Medicine introduces us to loss early in life
I recently sat by a man whose young wife was dying. Her cancer was taking her away from her husband and toddler. She was sleeping intermittently as the pain medication we administered did its work. Her husband’s eyes were red from crying and he could barely suppress a sob. He touched her and looked at me. I barely kept my own composure.I wanted to avoid that room and that patient. ...
Give meaningful use value for physicians
Before I took over one of the classes that now teach at the medical school, I asked students why the value of that class was so low. One of the reasons they gave was that it was so hard to do well in the class, and there were so many other things to study, students only put in enough effort to pass. In other words, incentives are only good if ...
Can vaccine recommendations be based solely on individual and public health?
Have you heard the parable about the blind men and the elephant? Each is holding a different part of the animal and comes to a different conclusion about what he’s dealing with. The man holding the tail is sure it’s a rope; the one with the trunk fears a snake; the one holding the tusk is certain he has a spear. It’s all in their perspective. They’ll need to share ...
The problem with healthy fats
Frankly, it rankles me when people use the term "healthy fats." We don't make a distinction like that when we're talking about carbohydrates, although there are certainly carbs that are nutritious and carbs that are not.Consider the Atkins diet. I like to believe that Dr. Atkins was on the right track, but that he had some of the details wrong. Clearly, he realized that there was something about carbohydrate in ...
Simple tips to improve your blood pressure checks
A recent study confirmed that the doctor’s office may be one of the worst places to determine if your blood pressure is under control. The automatic rise in tension many people experience when they are being scrutinized contributes to artificially high blood pressure readings. Although many times the only way improve one’s blood pressure is through treatment (such as medication, a low salt diet, and weight loss), other times ...
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....
