The Internet was recently atwitter (see what I did there) about the major health care story of Ebola in the United States. However, there was also a interesting rumor announced at the end of last week, to which people should really be paying attention. As reported by Reuters, Facebook is taking aim at health care, your health care: "The company is exploring creating online 'support communities' that would connect Facebook users ...

Read more...

Top stories in health and medicine, October 13, 2014From MedPage Today:

  1. Cashing in on Ebola. What was your reaction when you first realized that Ebola was killing thousands of people in Africa and would probably come ashore in America at some point? Sympathy? Worry? Scientific curiosity? An urge to hop the first plane to Monrovia?
  2. Ebola: Body Fluids Carry the ...

    Read more...

Why do doctors still use pagers? I was on call last night. Don't get me wrong, this is not as bad as it sounds. With over 20 partners sharing evening call, and residents getting the calls first, we do not have it bad at all. And certainly nothing like my obstetrician friends, who seem to go in every time they are on call for labor and delivery and then ...

Read more...

Please don’t call call me a “prescriber.” Yes, I know it’s easier to say “prescriber” than “psychiatric nurse practitioner or psychiatrist.” The word “prescriber,” however, puts severe limits on what I can do and how I can help. You may believe that, because I have a license to prescribe medications, that’s all I choose to do. In fact, you may believe that’s all I know how to do. Psychiatrists can do a lot more than that. As ...

Read more...

As the birth of our first child loomed on the horizon, I couldn’t help but worry.  As a first time mother and a pediatrician, I found the uncertainly coupled with too much knowledge of all manner of possible problems particularly unsettling. In addition to worrying about my baby’s health, I grew increasingly concerned about how I would handle the balancing act that all working mothers must perform.  Having put motherhood off in order to complete ...

Read more...

Insurance is without a doubt the best business on earth. Every month, insurance companies from many industries collect premiums from thousands of clients, relying on the statistical likelihood the companies themselves will collect more than they pay out. If the company has a poor year, they raise the premiums for the next year. It is a beautiful business model and a way to guarantee consistent profits year after year. Even ...

Read more...

Outpatient anesthesia in elderly patients: What to watch forA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. More than 75 percent of operations in the U.S. occur in an outpatient setting. Outpatient, or ambulatory care, can take place in a number of different settings, including physician offices, outpatient surgery centers, or hospital or non-hospital-based outpatient clinics. With more and more elderly patients undergoing outpatient ...

Read more...

In their current form, most (if not all) EHRs kind of stink. I don’t speak from direct experience, as I’ve held off buying and implementing a system to date. But I’ve never heard any of my colleagues say they love -- or even really like -- their EHRs, and I’ve asked many. The most ardent supporters state that they've gotten used to their systems (usually after years of tribulations) and ...

Read more...

What happens when the federal government and the states have split responsibilities for caring for Medicaid beneficiaries? Not much, other than casting blame on one another or on doctors for not providing the care. Buried on page 26 of the front section of a recent New York Times is a story about Medicaid patients not finding doctors or having to traveling long distances to find one. It says a federal inquiry finds ...

Read more...

Do you want a culturally competent practice? Here are 15 tips. Over the last few years I started a family practice serving refugees, and have seen 10,000 refugee patient visits. With regards to culturally competent medicine, medical schools teach about traditional remedies such as coining, and maybe role play with interpreters, but stop short of practice design ideas. The AAFP provides a checklist of qualities, which I feel could ...

Read more...

The ER demonstrates the inverted priorities of American society We fling open the doors of America’s emergency departments to help those who can’t afford health care.  We have legislated this protection: No person can be turned away for financial reasons.  This is very compassionate, and represents the higher angels of our culture.  Alas, it also is emblematic of the stupider demons of government.  You see, the ER demonstrates the inverted priorities ...

Read more...

The Journal Psychological Science just published a complicated, long, and fascinating study about happiness. The full text is tucked behind a paywall, but it’s great reading if you can get your hands on it. The authors arranged four separate experiments, looking at the effects of getting things versus experiencing things, and how the anticipation of waiting might affect happiness. Some of the studies involved just imagining a future purchase or vacation; ...

Read more...

With the recent discovery of the ShellShock vulnerability affecting a large number of computers, the question comes up again: How secure is medical data? Thanks to the federally mandated push to transfer medical data from paper charts to computer databases, most if not all of this data is now fertile ground for hackers. As pointed out in this article medical data is more valuable to hackers than stolen credit cards. ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 48-year-old man is evaluated during a follow-up visit for urinary frequency. He reports no hesitancy, urgency, dysuria, or change in urine color. He has not experienced fevers, chills, sweats, nausea, vomiting, diarrhea, or other gastrointestinal symptoms. He feels thirsty very often; drinking water and using lemon drops seem to help. He ...

Read more...

It used to be that the greatest cost at a doctor’s visit was paying for the visit itself. Nowadays, the office visit is just a drop in the bucket compared to what medications cost. Medication costs were already starting to rise, but have risen to unprecedented levels since Medicare Part D became law about a decade ago and with the latest government attempt to help with the un-Affordable Care Act. In the last few ...

Read more...

A thick green glob landed on my scrub top at the same time that the first drop of sweat rolled down the small of my back. I tried not to grimace and discretely walked over to the hand sanitizer dispenser. But like every other hand sanitizer I had tried, this one was empty. Yesterday I had also discovered that the only bathroom in the hospital had no toilet paper. It ...

Read more...

To put this post in perspective the pain of childbirth is said to be equivalent of amputating a finger. The joint statement of the American Congress of OB/GYN and the American Society of Anesthesiologists sums pain control during labor and delivery quite nicely: “There is no other circumstance where it is considered acceptable for an individual to experience untreated severe pain, amenable to safe intervention, while under a physician’s care. In ...

Read more...

Proton beam therapy: We need more than informed hope on social mediaI had an interesting day this past week. Sadly, it left me wondering why the same "hope and hype" directed at cancer patients and their families decades ago when I started my oncology career was still alive and well today. But then, maybe I am the naïve one to think that anything should have really changed. In the morning ...

Read more...

Many of our patients are besieged with unsolicited Internet advertisements offering them unbelievable solutions and cures to most of mankind’s medical maladies.  Patients come to and ask for advice about these promises to magically restore their health. Since I receive so many requests from patients to evaluate these offerings, I have put together five questions that patients should ask themselves before proceeding to buy from websites offering outlandish claims, including restoring ...

Read more...

Its time to talk trade offs in health care An advantage of being a foreigner, or a recent immigrant to be precise, is that it allows one to view events with a certain detachment. To analyze without the burden of love, hate or indifference for the Kennedys, the Clintons or the Bushes. To observe with both eyes open, rather than one eye looking at the events and the other looking ...

Read more...

Most Popular