A lot has been written about how awful electronic health record (EHR) systems are. They are overwrought, overengineered, dreadfully dull baroque systems with awkward user interfaces that look like they were designed in the early 1990s. They make it too easy to cut and paste data to meet billing level requirements, documenting patient care that never happened and creating multipage mega-notes, full of words signifying exactly nothing. They have multitudes of ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 66-year-old man is evaluated for vague abdominal pain of several months' duration and a 10-kg (22-lb) weight loss. He drinks alcohol socially but does not smoke. The patient is otherwise well, has good performance status, and takes no medications. On physical examination, vital signs are normal. No lymphadenopathy is noted. Cardiopulmonary examination ...

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Water births, delivering a baby so it is born underwater, are controversial medically because while they are promoted as safe and natural by some midwives and lay midwives they are not recommended by the American Academy of Pediatrics and the American Congress of OB/GYN. (Laboring in a tub in an entirely different thing.) The January 2015 issue of Emerging Infectious Diseases is reporting the death of a newborn from to Legionella acquired during a water ...

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The enormous push continues to reduce readmissions, due in no small part to stiff financial penalties from CMS for the worst performing hospitals. The most commonly cited statistic is that about 1 in 5, or 20 percent, of Medicare patients are readmitted within 30 days. A staggeringly high number when you think about it. Having discharged thousands of patients and seen the characteristics of those patients that are frequently readmitted ...

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shutterstock_145891655 Have you ever eaten a healthy meal, maybe some brown rice and stir-fried veggies, and found yourself ready for another meal just a short while later? Or, more often couldn’t overcome a hankering for a satisfying dessert to top off (and undermine the healthiness of) that meal? As it turns out, this lack of satiety is not merely a function of the ...

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Nurses rock! What would doctors do without them? Watch ZDoggMD's ode to nurses.  Enjoy.

A few years ago, the United States Navy launched a new recruiting and marketing campaign using the slogan: “America’s Navy: A global force for good.” The line was apparently a flop, and the Navy threw it overboard for “protecting America the world over,” but I liked it. I thought it captured a deep truth about the Navy, which is that it is undoubtedly a global force and that the force exists for ...

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It was last summer in July when I became sick. It was a range of not unusual upper respiratory symptoms, but as time progressed and my symptoms didn’t respond to the usual combination of steroids and antibiotics, I became concerned. I’d developed a more distinct pain in my chest and became increasingly mindful about those bad things we see from time to time. It was late after a shift in the ...

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shutterstock_108354956 This year, we celebrated our 25th wedding anniversary. So, last week, one evening, I told my wife about a news story I heard on National Public Radio (NPR) about the microbiology of a kiss. My wife smiled. A group of researchers, I said, looked at the oral bacterial flora of 21 couples to determine how many bacteria were transferred by a kiss. ...

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In the world of medicine, we often feel like we’re swimming upstream without a paddle. Like we’re the only ones having problems out there. With no one to lend a hand. No wonder health care providers suffer from major burnout. You would think when one is away on a great vacation, it’d be easy to rein in that feeling, to appreciate what truly matters. Not always. Until it is presented to you ...

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I recently spent time at the New York eHealth Collaborative's Digital Health conference. The meeting was full of interesting seminars, informational sessions, presentations on innovative technology looming on the horizon, and talk about the future digital face of health care. The hallways outside the conference rooms were full of administrators, legislators, consultants, and representatives of companies building and designing new resources to help transform the health care system as they see it. Over and ...

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shutterstock_115992457 Look here: I am a breastfeeding supporter. I regularly help new moms breastfeed successfully, and I even took a special class to learn how to do a brief procedure to help babies overcome breastfeeding problems caused by tongue-tie. I’ve got a happy breast support sticker, right on my AAP card. But I think honesty is (or should be) the breast policy. Some ...

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Vivek Murthy was recently confirmed to become the surgeon general of the United States. Much of the press in the past few hours have been celebrating the political victory over the GOP objections, particularly the National Rifle Association. But does this mean anything for the health of America? Supporters cite his medical credentials about being educated at the most prestigious institutions in the U.S. People also site his public health credentials, like ...

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Despite the changes around us, the training of physicians has stayed much the same. Sure, there are new work hour limitations and a push to move towards competency-based assessments, but the overall structure of our training remains largely untouched. We spend the vast majority of our time training in hospitals, with the remaining time spent practicing in traditional outpatient clinics. However, health care is being increasingly delivered outside these two arenas. ...

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shutterstock_215658670 Thanks so much for visiting and reading KevinMD.com!  2014 was the busiest year yet. Below are the most popular posts of the year, measured by number of shares on Facebook, Twitter, LinkedIn and Google+.  Enjoy. 1. Frozen in the hospital! Watch medical students sing Let It Go. The University of Chicago Pritzker School of Medicine Class of 2016 sings “Let It Go,” or ...

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Physician–assisted suicide: the collaboration of two through a professional relationship, to cause the death of one. Ever since Socrates took hemlock, suicide has been part of society, sometimes supported, often condemned.  Today, many argue that we have a right to die, sort of an infinite extension of free speech or thought.   Regardless, to actively involve doctors is a unique distortion of the medical arts, as if stopping a beating heart can somehow ...

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shutterstock_44805883 There once was a kind, humble physician who worked for years in an office building across the street from the hospital, toiling day to day to take exceptional care of his patients.  He was open and deliberate, calm and thoughtful.  He himself hired every secretary and medical assistant, every nurse, and biller.  His staff formed a protective family who fiercely advocated ...

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You couldn't invent a worse health care system than the nightmare we have created in the U.S. Our medical costs are almost twice as high per person as they are in most other similar countries but produce only mediocre outcomes. There is massive overtreatment of people who don't need it, while many who desperately do have no coverage at all. The payment incentives for doctors are perversely misaligned to produce the wrong ...

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The issues around race and how it plays out in modern day American society are numerous, deeply personal to many and utterly complex to most. The incidents in Ferguson, Mo., which began in August and erupted late November in nationwide protests, are an example of the many problems with race relations that persist in our country. While I believe we have made significant progress since the civil rights movement began, ...

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Whatever happened to “first, do no harm?” One of the findings included in a Senate investigative committee’s report on the U.S. government’s post-9/11 torture program was that it was designed by two psychologists.  They were paid “$80 million to develop torture tactics that were used against suspected terrorists in the wake of the September 11 attacks on the Pentagon and the World Trade Center” -- including “waterboarding and mock burial on some of ...

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