Earlier this year, my team presented a list of risks to the Compliance, Audit and Risk Committee at BIDMC. Here's my list of top risks for 2012:1. Old Internet browsers. Many vended clinical applications require specific versions of older browsers such as Internet Explorer 6, which are known to have security flaws. We've worked diligently to eliminate, upgrade or replace applications with browser specificity. At this point we ...
Tonight a 17 year-old boy came to the emergency room complaining of headache. As I entered his room, in my usual hurry to do an assessment as expeditiously as possible, so as to get on to the next case and attempt to avoid the inevitable backup of patients so common in our ER, I was struck by the vulnerable demeanor of the patient before me. The triage nurse’s report assured ...
In the current climate of health care reform, it is important to understand doctors and the work they do. I have found 3 common misconceptions, held even by doctors themselves, concerning the job of being a doctor.The first is the idea that doctors are conservative, resistant to change. Facts show that doctors deal with change all the time. They are familiar with the concept of change for change's sake and ...
In the last several weeks there has been much discussion concerning the St. Jude Medical Riata lead Class I recall. Prior to the Riata , there was the Medtronic Sprint Fidelis lead recall. Prior to Fidelis, there were multiple recalls involving Guidant (now Boston Scientific) devices. The common thread to all of these recalls is our patients. Our device patients have endured all of these events. How exactly does the ...
Suppose your malpractice insurance company wants to settle a medical malpractice case against you - even though the case has no merit.In many cases, insurance policy language may allow the insurance company to do just that.In the 2011 case of Mohan Papudesu, MD v. Medical Malpractice Joint Underwriting Assn. of Rhode Island, the Rhode Island Supreme Court allowed an insurer to settle a case on behalf of the ...
Three out of four dentists recommend this tooth brightening toothpaste -- make your smile sparkle like never before! Six out of seven plumbers recommend this drain opening de-clogger -- make your bathtub drain like never before! Nine out of ten doctors recommend improving the medical system in the United States -- make your health care system heal like never before!But how do we do that?Do doctors think the Affordable Care Act is the soothing balm ...
On the day we cure cancer I will rise in morning dark. I will stand in last night cold, and watch stars fade. The light will come and a following breeze blow. On that incredible dawn, there will be brilliance. I will make sunrise rounds on the day we cure cancer.I will stay late and breakfast with my wife. We will talk about flowers, kids and books. I will stand ...
A group of nine medical specialty societies recently announced the “Choose Wisely” campaign, targeting 45 commonly performed medical procedures and tests that offer little or no value in improving health. These interventions waste precious health care resources, lead to erroneous conclusions and/or false security, spur unwarranted additional interventions, and cause patient harm. Among the appropriately indicted procedures was cardiac stress testing of asymptomatic, low-risk patients. There is an old ...
I was working in the Intensive Care Unit (ICU) the other day and as I counted, I found that more than half of the patients there, for lack of a better term, brought the condition upon themselves.I sound harsh, but there was no better way to put it. I was taking care of Mrs. B, a 60-year-old lady with COPD who called EMS for shortness of breath. As EMS readied ...
I recently talked about wondering how those I had met through my own patients were doing, especially after my patients had passed on. I wondered if they were all right and whether they were able to move on. Well, I've been thinking about it again, though this time in the context of cancer survivorship.The Office of Cancer Survivorship ...
The following column was published on April 1, 2012 in USA Today.I recently saw a middle-age man in my primary care clinic who asked whether he should continue his cholesterol medication. He was reacting to new Food and Drug Administration warnings on statins, a class of drugs taken by more than 20 million Americans to lower their cholesterol. Though generally ...
Only a generation ago, medical students thought about what specialty to choose simply in terms of what interested them most. All doctors made a comfortable income; money wasn’t a primary motivator. There was a sense that cardiac surgeons or neurosurgeons could make more than most other physicians, but in fairness their training was much harder and longer. Internal medicine was held up to us as the most prestigious and intellectually ...
This series is brought to you by MedPage Today.1. WHO Policy Could Have Big Effect on Smoking Rates. Without implementation of a World Health Organization policy package called MPOWER, the number of adult smokers around the world will continue to grow over the next two decades, even as prevalence retreats slightly.2. Feds Analyze, Target Rx Painkiller Abuse. Most people who misuse prescription ...
The sage doctor who stood at the bedside as I held my dying grandmother said, “We seem to die one organ at a time.” I, however, have come to believe that we are too focused on the failing of the organs to rightly perceive the dying of the person.Death comes in many different ways, in many different packages. Sometimes it arrives wrapped thoughtlessly in advanced dementia, other times the package ...
An excerpt from Potent Medicine The Collaborative Cure for Healthcare.It was mid-summer 2010 when the full scope of everything that Nancy D’Agostino did not know hit home. Still raw from surgery and missing parts of her body, she thought that all the hard choices were behind her. Then here was a new face, a radiation oncologist, outlining side effects of treatment and asking her to choose. And then a ...
My latest column was published this morning in USA Today: What's right for Warren Buffett not right for every man.I discuss Warren Buffett's recent prostate cancer diagnosis, and whether he should have been screened in the first place: "Buffett’s coverage should have been an opportunity to educate the country that, for many, more conservative options would not only save ...
Several years ago I was hired by a plaintiff's attorney as an expert witness on a personal injury case. He paid the fee in advance but the night before the trial, his co-counsel called me to review the case. It was clear that she did not have a thorough understanding of the case and I spent two hours with her on the phone trying to bring her up to speed. ...
Pain, in any form, can present a difficult challenge for even the most astute pain physician. The complexity of treating neuropathic or nerve pain stems from a variety of reasons, ranging from the lack of an obvious source of the pain to the inability of the patients to explain what ails them, to a arduous history that was poorly managed with the wrong medications, allowing the pain to progress to ...
This series is brought to you by MedPage Today.1. Smoking Cuts Risk of Benign Brain Tumor. The risk of developing an acoustic neuroma was greatly reduced among male smokers, but not among those who take snuff.2. Medicare Fund Forecast Bleak, but Stable. Funding for Medicare will be exhausted in 2024, according to the annual report from the program's trustees, but federal health ...
There will be some very disruptive and some transformational changes in the way health care is delivered, not as a result of reform, but as a result of the drivers of change described in a previous post on KevinMD.com. They included an aging population, an obese society, shortages of doctors, and emerging consumerism, among others.I interviewed in depth about 150 medical leaders from across the United States to collect ...
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...
