I’ve received several inquiries from women living in various regions of the country, asking how they should choose where to go for their mammogram, and if it really matters. I cannot emphasize this enough: It matters! Here are a few tips to help your search:The most basic requirement is whether a facility is accredited under the MQSA (Mammography Quality Standards Act). The accrediting body for most states is the ACR ...
A guest column by the American Medical Association, exclusive to KevinMD.com.Continuing our efforts to move medicine forward while prioritizing patient care and minimizing administrative and financial burdens for physician practices, the American Medical Association (AMA) along with 100 state and specialty medical societies submitted a detailed comment letter to the Centers for Medicare & Medicaid Services (CMS). We urged CMS ...
This series is brought to you by MedPage Today.1. Study Confirms Marijuana Helps in MS. Smoking marijuana cuts spasticity and pain that's resistant to conventional therapy in multiple sclerosis (MS), although with some cognitive effects.2. Stress Echo After PCI, CABG Questioned. Repeat coronary revascularization did not improve outcomes in asymptomatic patients with high-risk exercise echocardiography findings after an initial revascularization procedure.3.
The FDA is deciding whether to allow patients to purchase prescription medications over the counter for many common ailments.This idea is controversial.On one hand, deregulation would remove one of the largest barriers to receiving treatment for some conditions – the doctor’s visit. If no doctor’s visit is necessary to receive necessary blood pressure medications or diabetes medications, then patients don’t have to wait for an appointment and the patient/government ...
The trouble with many significant advances in medicine is that that they take us out of our moral depth. They may raise quite different problems from the ones we are used to and, if we are not careful, we may inadvertently undermine the wonderful potential of new technologies by forcing them into existing legal, ethical and institutional frameworks.Transplantation is a case in point. Transplants save and transform lives; but the ...
Recently I was asked, “How can I improve my Press Ganey scores?” Presently this question applies mostly to hospitals as CMS is requiring hospitals to use the HCAHPS as a part of their quality reporting. Press Ganey can manage the HCAHPS for hospitals. Few physicians or physician groups presently survey patients for satisfaction; they should begin thinking about doing so in the near future as it seems likely that CMS ...
Healthcare IT News recently asked, “Do doctors have to be typists to get MU incentives?”That question reminded me that given the many hours of unreimbursed labor performing EMR data entry at end of day, a significant chunk of a clinician’s workday is spent performing medical secretary services. Let me set the record straight, I am a good typist. But EMR data entry interfaces are often unnecessarily cumbersome, so clinicians put ...
This series is brought to you by MedPage Today.1. Age May No Longer Be a Barrier in Kidney Donation. The overhauled United Network for Organ Sharing (UNOS) kidney transplant allocation guidelines will likely remove a controversial age-matching component from its algorithm.2. 'Heart Team' Pairs PCI and Robotic CABG. A surgical robot allows cardiologists and surgeons to work on the same patient with ...
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert. I wasn't in a "backless gown," rolling my IV pole down the hall of some hospital's cardiac care unit. I wore an official lanyard and badge and mixed among health care journalists, yet I felt more like a dugout mom than savvy reporter.My goal was to present the ...
A version of this column was published on April 24, 2012 in USA Today.There has been a recent uptick of elderly men in my primary care clinic asking about prostate cancer, perhaps because they heard of Warren Buffett’s recent prostate cancer diagnosis and his proposed treatment.Patients are wondering if they should also be screened. Other patients who already have ...
This morning started off like any other. I parked my car, walked into Starbucks and pulled up my iPhone app while waiting in line. The usual suspects were already there -- the elderly fellow that always flirts with the baristas, the business man with his freshly pressed suit and the tired-looking mother. As I approached the counter, I ordered my usual summer morning beverage and went through the motions to ...
As a teenager in the mid-late 1990s, my father, an engineering educator, and I would talk about the ills of the healthcare system and how physicians lost control of healthcare: primarily because they concentrated on medicine rather than the forces changing healthcare delivery. I realized this was due to an outdated medical education system and reforming it might actually improve healthcare in this country. That was my Sputnik Moment.Since graduating ...
Facebook recently announced on Good Morning America that users in the U.S. and the U.K. can enroll as organ donors through links to official registries, making it easier for people who want to donate their organs to sign up. They're working with Donate Life America, a nonprofit alliance of national organizations and state teams across the United States committed to increasing organ, eye and tissue donation.But deciding to become an ...
He had yellow nails, leather neck, stained teeth and a deep cough. He wheezed slightly, breathed too quickly and occasionally sprinkled the white handkerchief red. No surprise his ticket to my office was a lung mass to match. We talked about tests, treatment and prognosis. About the future, probably short. Devastated, he was not surprised. He was reaping the reward of 30 smoking years. He sadly admitted, “I knew better, ...
An excerpt from The Truth About Statins.Like all physicians, I’ve had interactions with pharmaceutical companies. Shortly after I went into private practice in Rhode Island in 1977, I received a telephone call from a drug company representative. He offered me an all-expense-paid weeklong trip to Germany to attend a medical conference. I was taken aback, knowing that the cost of such a trip would run to thousands of dollars. I ...
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 22-year-old man comes for a routine evaluation. He has a history of type 1 diabetes mellitus and began taking insulin glargine and insulin lispro 8 years ago. Two days ago, he participated in a marathon race.On physical examination, temperature is 36.4 °C (97.5 °F), ...
Nothing will force you to live life on your own terms faster than almost losing it.In 2008, I was on fire. My husband and I had just moved, bought a house, adopted a dog – and I started my own consulting business while continuing to write and act in my spare time. Life was crazy because I was trying to live all of my dreams – at the same time.While ...
“You are too smart to do primary care.”I have heard this far too many times, directed at me and at others seeking career advice. There are many reasons for the shortage of primary care doctors in the U.S., but at least part of it is this. Smart, capable, successful trainees are discouraged from choosing primary care. It is perceived as a less prestigious pathway than specializing.The knowledge base of primary ...
On my way to the hospital last week, I heard a 26-year-old woman describe her experience of becoming deathly ill. When she first realized that the many bruises appearing spontaneously across her body were unusual, she was working as coffee shop to pay off school loans. With the urging of a friend, she went to see a physician. The diagnosis was acute leukemia.Her job did not provide health insurance and ...
The more I talk to new physicians who are transitioning into practice, the more I realize how many substantial life and career shifts occur post-residency.I experienced these changes myself several years ago, but it’s taken me a while to fully process them and realize how they’ve affected my life.In fact, it would be safe to say that I experienced a complete 180 after graduating from residency. I know other new ...
Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from...
In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men. Case closed, right? Hardly. The prostate...
When it comes to medicine and social media, much of the attention is negative. Doctors losing their hospital privileges because of Facebook....
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
I was appalled recently by the coverage of radiology “test recalls” by CNN, amplified by Dr. Gary Becker of the American Board...
I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the...
As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during...
He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I...
I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law...
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the...
"It was the best of times, it was the worst of times ..." So begins a story called A Tale of Two...
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
Propaganda and non-truths abound all around the Internet saying that mobile health apps are everything from a threat to Big Pharma to...
The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above...
Every month, hundreds of thousands of people look for a doctor on Google. As an amazing practitioner, your site deserves to be...
The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with...
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
