Health insurance is very complicated. At our practice, we deal with health insurance all the time and even for us, it gets to be very complicated sometimes. So it is natural that patients have a hard time understanding it as well.Therefore, I decided to summarize a conversation I had with a patient in an effort to help other patients understand, at the very least, a portion of how medical health ...
December 2011
All Stories
MKSAP: 55-year-old man to undergo coronary artery bypass graft surgery
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 55-year-old man with a history of coronary artery disease and diabetes mellitus will undergo elective coronary artery bypass graft surgery. His last hemoglobin A1c value was 7.8%, and his plasma glucose level 2 hours prior to scheduled surgery was 238 mg/dL (13.2 mmol/L). Hemoglobin ...
A complete guide to planning a social media presence for healthcare
The world of healthcare is inherently siloed, tethered, fragmented and prone to poor communication and collaboration. Today, healthcare workers solve their problems via traditional methods that are often costly, inefficient, nor timely. Increasingly, more savvy healthcare workers are looking outside the system to digital media and communities for answers, but are challenged with uncertainty over concepts of usefulness, practicality, bandwidth issues, "ROI" and privacy concerns.Establishing a digital presence is rapidly ...
If you want to know how well the medicine works, ask the patient
It was an invitation that made no sense. I was asked to be a special guest of the South Korean Ministry of Tourism and KMI International, a company that markets medical tourism. Why me, I wondered? As I re-read the invitation, I remembered another strange offer I received in the 1970’s during a tense period in Israeli-Arab relations."Hello Dr. Goldberg," an official from the Jordan Ministry of Education had said. ...
Why doctors need Hollywood
Sex sells. US Weekly and People fly off the shelves with the latest reality star drama. Unfortunately, the same does not apply to the diseases running rampant in today’s society. Is there an answer? I would like to say yes, but the ultimate answer remains to be seen. After my four years of undergraduate work and four more years of medical school, I am confident that there are a myriad ...
MKSAP: 52-year-old man with perineal and suprapubic pain
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 52-year-old man is evaluated for a 3-month history of perineal and suprapubic pain. He has experienced urinary frequency and dysuria for 4 to 6 weeks. The patient reports fatigue, insomnia, and low mood for the past 6 months. He has hypertension. Current medications are ...
The day our hospital lost its heart
In about 1985, as I remember it, my training hospital underwent a pivotal change. In Cape Town, at the southern tip of Africa, Groote Schuur Hospital was world famous for being the place where in 1967 an arrogant, brash and brilliant surgeon by the name of Christiaan Barnard stunned the world by performing the world’s first heart transplant. Nearly twenty years later, Groote Schuur (Dutch for "Big Barn") still retained ...
Why rheumatology is sexy
Although as a medical student rheumatology was always associated with an air of mystery and complexity to me - factors which might have aroused a younger me had they been associated with a member of the opposite sex – the specialty didn’t catch my eye at all as an undergraduate. To a medical student cruising for medical action in the 1980′s, rheumatology wouldn’t have got as far as a first ...
Rigid regulation can become detrimental to patient care
The last four days have provided a sharp glimpse into the future that awaits those of us in the health care profession, physicians in particular. Over the last few years physicians have been burdened with mountains of paperwork, most of which contributes little to patient care, but does take time away that could be better utilized caring for our patients. However, the last four days have demonstrated that the administrative ...
Nutrition needs to be taught in medical school
The study of medicine can be overwhelming. We’ve simply discovered too much for one person to master completely. This is the challenge medical educators are tasked with – what’s so important that it must be allotted time in the brief 2 years of dedicated book learning doctors-to-be receive?Students face a similar time-management challenge – first, we must decide what’s important enough to focus on, but the real question I think ...
Explaining Propofol to patients after Michael Jackson and Conrad Murray
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.Since the passing of Michael Jackson and the recent trial of his physician, Dr. Conrad Murray, I have been frequently asked by patients whether they will receive the drug that killed the singer. As have many of my anesthesiologist colleagues, I have taken this opportunity ...
Impersonal care from the new generation of physicians
Historically, American physicians and surgeons were fiercely independent practitioners, who owned their own practices, worked long days and maybe longer nights, made a good income, but saw little of their families. They trained in a male-dominated world in "residency," so named originally because their extended 120 hour/week work schedule demanded them living in dormitory type residence adjacent to the hospital.They developed long-standing professional commitment to their patients that superceded time ...
I eat lunch with drug company representatives and I’m proud of it
Today, I want to review another article I wrote in last year. That article started with a confession: "I confessed that I ate lunch with a representative of a pharmaceutical company."I must now confess that I often eat lunch with representatives of pharmaceutical companies and I’m proud of it. At this stage of my career, I can well afford my own lunch. I could sit quietly and relax over a ...
Kevin Pho, MD
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Why Priscilla Chan may become the country’s most influential doctor
Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from...
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Confused about prostate cancer screening? Make a shared decision
In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men. Case closed, right? Hardly. The prostate...
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When it comes to doctors and social media, hospitals fail miserably
When it comes to medicine and social media, much of the attention is negative. Doctors losing their hospital privileges because of Facebook....
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Warren Buffett’s prostate cancer choices aren’t right for every man
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
Physician
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Why test recalls should not be considered cheating
I was appalled recently by the coverage of radiology “test recalls” by CNN, amplified by Dr. Gary Becker of the American Board...
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Why physicians are susceptible to hardball tactics
I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the...
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How we deliver bad news is critical to how families deal with grief
As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during...
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His father’s suffering had already been too great
He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I...
Patient
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How death can be a beautiful experience
I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law...
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What meaningful encouragement can be given to someone who is dying?
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
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Health care journalists have tendencies similar to those of doctors
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
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Adaptation can be painful, but it can also be a gift
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
Policy
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What should America’s health care vision be?
America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the...
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Hospitals around the world aim to remain relevant to patients
"It was the best of times, it was the worst of times ..." So begins a story called A Tale of Two...
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Repairing the tear in health care’s safety net with social media
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
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Look to technology to reduce health costs
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
Tech
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Mobile health apps don’t always follow conventional wisdom
Propaganda and non-truths abound all around the Internet saying that mobile health apps are everything from a threat to Big Pharma to...
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When patient care becomes secondary to filling out the medical record
The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above...
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Doctors, use Google to get more patients in less than 7 minutes
Every month, hundreds of thousands of people look for a doctor on Google. As an amazing practitioner, your site deserves to be...
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The user interface for EHRs should be uniform
The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with...
Social Media
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We need to see the potential harm of social media
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
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Why social media may not be worth it for doctors
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
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Transparency defines social media success for doctors
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
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How Twitter was used in a potential mass casualty scenario
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
