shutterstock_161227907 Many people used to believe that Facebook was an extremely defensible business and that it would be almost impossible for another social network to compete. It has grown to an enormous scale with massive troves of data and more than 1.5 billion monthly users. The thinking around their defensibility was that because all of your friends and photos and updates are already stored on Facebook, it ...

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shutterstock_136966010 A lot of people complain about adolescents. They don’t listen. They act out. They talk like they have it all figured out. I disagree. As a pediatrician, this is my favorite group of patients. They have developed cognitively to be aware of the world’s complexities, and yet are still open to guidance as you help them navigate their way through. Adolescence ...

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Recently I completed the Commonwealth Fund’s 2015 International Survey of Primary Care Doctors. They wanted to know what I thought about our health system; if fundamentally it worked or needed to be better. They asked questions about my satisfaction with practicing medicine, the quality of care my patients receive, and my experiences with electronic medical records. (You can click here to read through the 2012 survey, to get an ...

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shutterstock_234499477 In the seven or so years I’ve been blogging, I’ve only written a few posts that prompted controversy in the comments section. Looking back, I notice that these posts have involved chronic illness management, motivation, adherence and/or engagement. In fact, a commentator recently felt my writing was that of an old-fashioned doctor who believes that paternalistic messaging is key to engaging ...

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shutterstock_135157130 acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. Last month, I shared my take on the mess that we find ourselves in with our electronic health records (EHRs) and referred to the recently published ACP position paper on clinical documentation. The paper includes ...

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The whole thing was rather awkward. I have to admit that I was nervous. I perused the records before he walked through the exam room door. These conversations were always difficult and felt out of place in the office. But I had looked at the numbers over and over again. There was a glaring deficiency that had to be corrected. I planned to jump in right away, but we got sidetracked. He ...

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Following the recession, the Obama administration sought shovel-ready projects. One unlikely shovel-wielding aggregate demand was health information technology. The Health Information Technology for Economic and Clinical Health (HITECH) Act passed in 2009 directed 5 percent of the stimulus towards digitizing medical records. Computerization of medical records doesn’t induce the images of public works as building freeways during the Great Depression does, but the freeway is a metaphor for exchange of information between ...

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shutterstock_216800617 I was recently talking to a patient about having some extra help at home when she left the hospital with home nursing services. The elderly lady -- highly intelligent and fiercely independent -- politely declined with the reply: “No, I’m fine thanks Dr Dhand -- all they’ve done before is just come in with their computers, barely talk to me, enter ...

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The progression of science in medicine has been as remarkable as it is relentless. From alchemy, chants, purges, and leeches, medicine has progressed to a deep understanding of human form and function through biology, anatomy, and physiology. Microbiology and pathology revealed details and causes of diseases while chemistry and pharmacology opened the doors for advanced diagnostic testing and a variety of therapies. Physics added more diagnostic capabilities and additional options for ...

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It is with regret that meaningful use legislation has barreled down the path of insanity. As a primary care physician, I don’t see how 700+ pages of rules and proposals mean any bit of relevance to my clinical practice anymore. As the attrition continues regarding eligible providers, it is leading primary care physicians towards the junction point of going off the grid entirely or being enslaved by horrible EHRs forever. I ...

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