As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going to talk about what your physician looks for when a device is interrogated. Many times this happens in silence or with few words, and some pushes of a button, when done in the office, and when done with remote patient management, is accomplished either automatically or with ...
It's amazing how quickly you can lose track of time as you power through the books. Once everything is setup -- coffee to the left, pens and highlighters to the right, Grooveshark playlist perfectly tuned -- you can suddenly look up and realize that three weeks have flown by and there are 123 multiple choice questions to be answered in the morning.Over the past year and a half I've learned ...
I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by the passing of Patrick Swayze from pancreatic cancer and Elizabeth Edwards from metastatic breast cancer. There’s a reason I am a surgeon, and not a medical oncologist. Death has this bleak sadness about it, that eternal optimists ...
The orders came indirectly from the government.Reduce hospital re-admissions. Cut costs.So, the hospital contacted the local hospice-palliative care center and asked for help. Of course, overwhelmed with work and understaffed, the project was handed off to me.My task sounded simple. Create a palliative care program at the nursing home. But as I gathered for the first meeting with the administrator, social worker, and clinical staff, I knew there would be ...
This series is brought to you by MedPage Today.1. Fighters Need Padded Gear to Cut Head Injury. Rotational head injuries in fighting sports can be minimized if participants wear padded boxing gloves and headgear rather lighter protective gear or no protection at all.2. Heart Failure, Fractures Linked. Heart failure appears to be associated with a greater risk of major osteoporotic fractures, independent ...
I’m reluctant to write a post about ADHD. It just seems like treacherous ground. Judging by comments I’ve read online and in magazines, and my own personal experience, expressing an opinion about this diagnosis—or just about anything in child psychiatry—will be met with criticism from one side or another. But after reading L. Alan Sroufe’s article (“Ritalin Gone Wild”) in the New York Times, I feel compelled to write.If ...
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate enormous amounts of time, at great personal sacrifice, to represent the interests of our members and their patients.One of the things that I like least is when an ACP member (or non-member physician) caustically dismisses their efforts, usually because they disagree with some aspects of ACP policy. It ...
I recently wrote that "diagnosis is job number one." In sports, there are times when two teams share the number one position. Each team competes to make it to the championship; and, ultimately, one team has to lose its top ranking.In medicine, care and diagnosis share the number one spot, working together toward a common goal: to promote health. Some would say that, without care, the diagnosis is worthless. Certainly, ...
I hate running late. I prefer to arrive five minutes early for any meeting. I was that compulsive student who always turned in papers before they were due. Now I turn in conference abstracts, grant applications, and even poetry contest submissions, well before their deadlines. Unfortunately, timing is not always in my control.I particularly hate running late in clinic. I want to see all my patients on time. It is ...
This series is brought to you by MedPage Today.1. Aspirin, Plavix Not Good Stroke Prevention Combo. Combining clopidogrel (Plavix) with aspirin did not prevent recurrent stroke deep in the brain, and even increased the risk of bleeding and death.2. Wii Helps Arms, Heart in Stroke Patients. A short but intense Wii-based program not only improved physical function in stroke patients, but added ...
Julie Gralow, an oncologist at the Fred Hutchinson Cancer Center in Seattle, recently prescribed an exciting new therapy for a 60-year-old woman with metastatic breast cancer. Three-and-a-half years into her battle against the disease, the patient had already exhausted three different anti-estrogen therapies, each of which only put a temporary check on the spreading tumors.The newly prescribed drug, Novartis’ Afinitor, is one of the recently approved targeted therapies that have ...
I don’t like selecting colleagues through the Match. The process was established to allow students to get the best opportunity available and I feel that our program (and our patients who rely on our trainees to provide care) is in jeopardy every year. It always turns out better than I anticipate, so I shouldn’t complain. However, we have to interview 60 prospective residents to fill our six slots so ...
Over the last four weeks I have written about new technologies and their coming impact on medical care. We generally think of new technologies (and new, branded drugs) as pushing up the cost of healthcare. There is truth to this contention, of course, but often the real problem from a cost perspective is inappropriate use. And this happens all to often in medical practice today because the physician does not ...
Ovarian cancer screening clearly touches a nerve.No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease is at an advanced stage. Tests to look for the disease, such as the transvaginal ultrasound or the CA-125 blood test, are not specific enough. That leads to false positive tests that necessitate more studies that may not ...
As a third year medical student, I spent one afternoon each week at a health clinic at a community hospital affiliated with my medical school. This health clinic was focused on primary care for patients with HIV, and many of our patients were poor, homeless, immigrants, or uninsured. Many were also living with their diagnosis in secrecy and had to hide their medications and medical bills from family members.One of ...
This series is brought to you by MedPage Today.1. Spanking No Help in Child-Rearing. Physical punishment of children, such as spanking, is increasingly linked with long-term adverse consequences.2. Physical Child Abuse Sends Thousands to Hospitals. Nearly 4,600 children were admitted to a U.S. hospital in 2006 as a result of physical abuse and 300 died because of the abuse.3. Hubbies ...
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively offer their patients the option to communicate with each other through email. Unlike other professionals in the United States, doctors have generally resisted the adoption of email into their practices. But according to the WSJ article, email can result in many benefits to both the doctor and patient. ...
“I wouldn’t hesitate to sue you.”I’m sorry, what?That is what I heard from the mother of one of my patients. I was evaluating a high school athlete who had recurrent stingers (nerve injury that affects an upper limb, usually resolves with time) and a possible episode of transient quadriparesis (affecting all limbs this time). I wasn’t on the sidelines for these injuries, so I had to go on the reports ...
I’m sure Ezekiel Emanuel hates being referred to as Rahm Emanuel’s brother, so I won’t describe him as such. After working as one of Obama’s main health care advisors, he’s now at U-Penn in a job spanning medicine, economics, and ethics. He’s also been writing engaging essays in JAMA about health care reform and economic change, that give us an augur into where health care reform might lead us.Here, ...
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives. Whether your visit is to be in the person’s home, a hospice or a hospital, there are a few rules of thumb to guide your time together so that it can be mutually satisfying.This post introduces some of the basics.1. Call ahead. Find out what prime visiting times ...
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
I've only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case...
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to...
One of the things I love about family medicine is that I get to care for people of all ages. I almost...
I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by...
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an...
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives....
I found a recent Associated Press article on an aspect of the new health care law that many of us may have...
A guest column by the American Medical Association, exclusive to KevinMD.com. This week, I’m joining hundreds of physicians and medical students in Washington, DC...
Everyone in the world is talking about “value-driven health care.” Or so it might seem if you pick up a medical journal...
CNN recently posted an article titled "Doctors Going Broke." It described several cases of independent physicians who are near bankruptcy although they once...
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate...
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going...
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively...
Paul Conslato, MD, director of clinical affairs for Lancaster General Medical Group, recently was quoted in the PAMED Better Health Network eZine...
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and...
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
