In Clay Shirky's engaging book Here Comes Everybody, he describes how professionals can be blindsided by disruptive competitors. It got me thinking about medicine.Traditionally, new technologies reached medicine in a top-down direction. The invention of MRI, for example, was first introduced to hospital administrators and department chairs as a potential new diagnostic tool. Once accepted, others further down in the medical hierarchy gained exposure.This technology wasn't disruptive because it didn't ...
December 2011
All Stories
How many parents are failing their children
Our children (and grandchildren) are the future and we are responsible for their growth and development. As responsible parties, we are clearly failing.That is my interpretation of the report issued a few days ago by the Centers for Disease Control (CDC) on seven criteria known to the associate with ideal cardiovascular health as part of the National Health and Nutrition Examinination Survey. They are defined, briefly, as 1) a diet ...
Physicians aren’t taking mobile health seriously
I just returned home from mHealth Summit Meeting in DC which, in my opinion, is still one of the biggest and best mobile health conferences of the year. On the first day of the conference, I discussed the EndoGoddess App as a use case example of mobile health from the practicioner point of view.Sadly, the numbers of physicians in the mobile health entrepreneural space at mHealth Summit were still few and essentially ...
Doctor, why is your hospital better than any other?
I took a deep breath. I had to think carefully. It's not that this was unexpected - Johns Hopkins has been anointed the country's best hospital for 21 years running by US News. But I wanted to tell the patient the truth without alienating them or failing to mention the many admirable aspects of my institution.One truth, however, cannot be denied: to call one hospital the best is not simple.Let's ...
Did hospital politics lead to physician suicide?
What causes a doctor to commit suicide?A story about a radiation oncologist from Springfield, IL brought this strange case to my attention. Dr. Thomas G. Shanahan committed suicide by cutting his throat in November of 2011. He was respected in his field, having published many research papers and traveled the world helping to set up brachytherapy clinics in several countries. He also had been an acting alderman in ...
MKSAP: 38-year-old woman with increasingly frequent headache
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 38-year-old woman is evaluated in the office for a 10-month history of increasingly frequent headache. The headache is often worse in the morning on awakening. She has recently started keeping a headache diary, which reveals episodes on approximately 25 days of each month. The ...
The possibility of zebras in primary care
It is critical for physicians to share unusual patient diagnoses that present to clinic with routine type symptoms. In a hospital setting, these are cases for discussion and debate at Grand Rounds. In a primary care setting, we do case reviews when we can with informal sharing for the purpose of teaching and learning. The bottom line, whether in a formal academic setting, or an informal setting around the lunch ...
The powerful connection of emotions in healthcare
I remember like it was yesterday. My patient was a young blond female with two beautiful Samoan dogs. Her name was Margaret. I was only two years younger than she was. The diagnosis was poor. She was friendly when I introduced myself. And she proceeded to tell me about her health issues, how she was diagnosed and what treatment she was receiving. Marge as she wanted to be called was ...
A medical student meets Donald Berwick
While attending the Institute for Healthcare Improvement Annual Forum recently, my friend, Jared Conley, and I had the good fortune of finding ourselves standing a table away from Don Berwick in a relatively empty conference room. As MD/PhD in Health Policy students, we were interested in asking him a question about ACOs, so we approached him and introduced ourselves, hastily adding, "We know you’re busy, so we just have ...
Why a physician liaison is a short-term career choice
Times are tough for pharmaceutical reps, with many hospitals and physician offices banning their sales visits.But, there's hope for those out of a job. Consider the physician liaison.Faced with budget cutbacks, hospitals are becoming more aggressive growing their market share. They are not only buying physician practices, they want more doctors to admit, refer to and use their ...
The emergency department in an ACO world
In the era of accountable care, you’ll notice that many hospitals and health systems are already driving towards more collaborative workflow. The integrated delivery network (IDN) is changing significantly, and for the better. But in high-acuity care areas, like the emergency department (ED), the challenge of treating patients more holistically in what is already a fast-paced environment is concerning for physicians evaluating the pay-for-performance model.In today’s ED, patients ...
Patient identity fraud in the emergency department
Almost four years ago now, I left my practice as an emergency medicine physician to enter the business world. However, the medical world isn’t easy to escape. I just couldn’t seem to forget some of the problems I used to face in the emergency department. So, when I had the chance to fix one of them, I took it.The most intractable problem for me was fraud, especially as it related ...
Lessons from applying to medical school
I’ve heard applying to medical schools can be a soul crushing process, but I didn’t really quite get it until I got hurled into the process myself. Although I still wouldn’t describe this as "soul crushing," it has certainly brought out a lot of insecurities in me and my accomplishments. Do they not like my stated reasons for pursuing medicine? Do my extracurricular activities seem phony and under-whelming? Is this ...
How medications are like vehicles
I usually cringe when I see a pharmaceutical company ad on TV. I think most pharma commercials do more harm than good. The ads scare patients out of taking medications they need.Actor: Do you have uncontrollable diarrhea? I did, and then my doctor prescribed “No-More-Poop!” Now I feel great and don’t have to worry about embarrassing accidents.Commentator: Clinical studies done at a leading university prove that “No-More-Poop” cures 99% of ...
Solving distracted doctoring from smartphones and tablets
Imagine that your neurosurgeon, during surgery, was talking on his cellphone using a headset.Unthinkable?Well, no. A recent article in the New York Times cites a case where a patient was left paralyzed and the neurosurgeon was sued, in part, for being distracted. He made 10 personal calls during the operation.The proliferation of portable electronic devices, smartphones, tablets, and ...
Taking the knife to doctor-drug company relationships
With health care industry reaching unsustainable lows, media attention is on physician's relationship with the pharmaceutical industry. A Google search will give results that paints doctors as culprits, leading to a prejudiced opinion where doctors are thought of as co-conspirators with drug companies. This article teases this tainted relationship, from a typical doctor's perspective.Pharmaceutical companies have strategies not only to survive, but also to grow with general public investing in ...
KevinMD media mentions, December 2011
I’d like to thank various media outlets for recently citing KevinMD.com.1. Five Reasons Why Physicians Need to Use Social Media. Healthworks Collective. Physician participation in social media is a health care imperative according to Dr. Kevin Pho, a practicing internist and the founder of KevinMD.com, a leading online health portal; however, many physicians remain skeptical about the value of social media.2. Dr. Kevin Pho: Internal Medicine Physician and Social Media ...
Mobile health and the globalization of medicine
The term globalization loosely refers to the increasing unification of order. It has been traditionally applied to the economic sector. As the world is progressively intertwined from financial and cultural perspectives, it is not surprising that it is occurring in the medical arena. There have been international professional medical societies for many decades, and the medical device and pharmaceutical industries have consolidated on a global scale.However, the way medicine is ...
How political correctness interferes with healthcare
Political correctness and sensitivity training are interfering with medicine and healthcare. In a recent article published in the journal, Pediatrics, a group of researchers published their findings regarding parental perceptions of the terminology that doctors use to describe childhood obesity (ages 2 to 18). The researchers found that it was undesirable to use the term "fat," "obese," or "morbidly obese" because they were stigmatizing, blaming, and the least motivating to ...
Health quality requires looking at our caregivers
Sonia struggled to express herself through broken English. Her lively facial expressions and exuberance betrayed by her inability to string the words together fluently. One hand gesticulated widely while the other rested gently on the elderly woman's hair.She somehow managed to coo quietly in her companions ear, calming her, as she continued the conversation with me. Sonia's eyes opened and closed in an exaggerated blinking manner as she questioned me ...
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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Patients will understand an honest mistake if the doctor tells the truth
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned...
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Diagnosing an illness is an art
Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. ...
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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...
Patient
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How will the Baby Boomers age and die?
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in...
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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...
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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Repetition is the curse of the doctor-patient engagement
How many times as a doctor do you ask the same questions over and over again as part of the routine process...
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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...
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....
