I just got off the phone with a very upset patient who had just discovered that her pharmacy had been giving her the wrong medication for the past 5 months, substituting a similarly spelled antibiotic for her rheumatoid arthritis med. She was tipped off when she realized how bad she had been feeling of late and decided to check the expiration …
7 ways patients can help reduce medication errors
Only in America can we find a way to scare the bejesus out of a woman with normal breasts and a normal mammogram. Because that’s exactly what happened when New York Times reporter Roni Caryn Rabin read her entirely normal mammogram results letter: “A sentence in the fourth paragraph grabbed me by the throat. ‘Your breast tissue is dense.'”
I can’t really blame Rabin for being afraid. The information about breast density in …
Dense breasts on mammogram? Don’t be afraid.
Given all the complaining I and my colleagues do about the problems with the EMR, I figured I’d take the opportunity to tell you about something good that came from having my practice online.
A patient came to see me last week for a check up and requested a prescription for birth control pills. She’d used them in the past without problems. I wrote the script and sent her on her …
One example where the EMR can really make a difference in outcomes
A recent study has concluded that women with breast cancer who failed to get annual mammograms are more likely to die from their disease than those who had annual mammograms, and argues that more frequent mammograms are warranted in women under age 40. Unfortunately, despite all the media attention this study is getting, I don’t think the researcher’s conclusions are supported by the study results.
The researchers did a retrospective medical record …
Mammograms in younger women: Is the data there?
In an editorial in the New York Times entitled “My Medical Choice,” Anjelina Jolie has come out publicly as a carrier of the BRCA1 gene, which places her at high risk for both breast and ovarian cancer. She has undergone a prophylactic nipple-sparing mastectomy with plans for future removal of her ovaries to prevent ovarian cancer:
I choose not to keep my story private because there are many women …
The BRCA mutation: Screening, breast and ovarian cancer prevention
From ACOG comes five new cautions, part of the American Board of Internal Medicine Foundation’s Choosing Wisely campaign, to eliminate wasteful and unnecessary medical interventions that can actually cause harm. All the recommendations are evidence-based and have broad consensus.
1. Don’t schedule elective, non-medically indicated inductions of labor or cesarean deliveries before 39 weeks 0 days gestational age. Delivery prior to 39 weeks 0 days has been shown to be associated with an increased risk …
An OB/GYN perspective on Choosing Wisely
There’s a big discussion going on in the health tech community about a controversial keynote speech given by Vinod Khosla at the Health Innovation Summit (HIS), in which he stated that 80% of what doctors do could be replaced by machines.
If you’re a doc like me who has no idea who the heck Vinod Khosla is (he’s a venture capitalist and co-founder of Sun Microsystems), why he’d be a keynote speaker at a …
Doctors need to be part of the digital revolution
Once again, legislators are meddling into healthcare. This time, it’s in my own home state, where Governor Cuomo has just signed a bill requiring radiologists to notify women when their normal mammogram also shows that they have dense breasts. In such cases, the following text must be included in the lay summary mammogram report given to the patient:
“Your mammogram shows that your breast tissue is dense. Dense breast tissue is very …
Mandatory breast density notification violates physicians’ free speech
One day, about 5 years into using the electronic medical record in my practice, I came to the realization that I wasn’t having fun anymore. I was sitting throughout most of every office encounter facing a computer screen, my back to the patient on the exam table across the room. The joy of face to face interaction with people, the real reason I went into medicine in the first place, had been replaced with …
How changing patient workflow can make using an EMR fun
Most women in their 40′s believe they should have annual mammograms, regardless of what screening regimen their doctor might recommend.
So say researchers in Massachusetts who surveyed women (primarily white, highly educated) ages 39-49 presenting for annual checkups. They gave the women a fact sheet about the new USPSTF guidelines on mammogram screening in their age group, and asked them to read one of two articles either supporting or Read more…
An informed screening choice for breast cancer
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