Just the other day, I saw a 52 year old man in my office for what I thought was a routine prostate issue. I walked in the exam room, introduced myself and immediately knew his prostate was fine. His eye contact was non-existent. He was nervous and his handshake was clammy and brief. I see these patients everyday. Their prostates are just fine. It's their love life that's the issue. ...
Posts tagged Specialist
There is a patient attached to that implantable defibrillator
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going to talk about what your physician looks for when a device is interrogated. Many times this happens in silence or with few words, and some pushes of a button, when done in the office, and when done with remote patient management, is accomplished either automatically or with ...
Why physicians may not buy into ACOs
I’m sure Ezekiel Emanuel hates being referred to as Rahm Emanuel’s brother, so I won’t describe him as such. After working as one of Obama’s main health care advisors, he’s now at U-Penn in a job spanning medicine, economics, and ethics. He’s also been writing engaging essays in JAMA about health care reform and economic change, that give us an augur into where health care reform might lead us.Here, ...
A doctor reflects on his TED talk
I had performed this procedure dozens of times before. It was routine. I stand under the bright lights, I take a deep breath, I wait for my hands to stop shaking, and then, I begin.This time was different, though. The lights were blinding, there were lots of people watching, and there were TV cameras. Oh, and the guy performing before me was a Grammy winner. This was one ...
Why patients with implantable defibrillators deserve their data
The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009.The objective of Measure 12/15 of Meaningful Use regulations of the HITECH act which refer to electronic health records, states that eligible professionals “provide patients with an electronic copy of their health information (including diagnostic test results, problem lists, medication ...
The sense of loss extends beyond the death of a patient
At the end of the year, I find myself thinking about patients usually—and especially those that have passed away. I wonder how their families are coping, how their children are, and whether each day has gotten easier. I think about how my patients died—and whether or not I did enough to ensure that they did not suffer.It's an odd thing ...
Patients will understand an honest mistake if the doctor tells the truth
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned to a rotation in pathology where my job was to process specimens taken at surgery, dictate a gross description of the specimen and then place the specimens into the cassettes that would be used to make the permanent sections. I was transferring a prostate biopsy, approximately 0.5mm x ...
Reclaim your life from urinary incontinence
“I laughed so hard, tears ran down my leg.”That was a quote from a sign I saw on vacation last summer. While we read it and laugh, we all know what it means. “How’s your bladder working?” is a common question that I ask patients in the office. The responses I get include, “fine, except when I ____”, or, I’m fine as long as I know where the bathrooms are. ...
Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever before. In fact, the rate almost doubled in the 10-year period between 1999 and 2009.This drives up the cost of care, as specialist consults tend to be more expensive than primary care visits. Furthermore, specialists tend ...
A 2012 forecast for anesthesiology
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.2012 will be an important year for the health care profession. With a growing aging population, physicians will be needed more than ever to care for patients. In particular, the number of patients who undergo surgical procedures will increase, along with the demand for physicians such as ...
Paperwork causes unintended distractions for physicians and nurses
I admittedly snorted out loud when I read a New York Times article recently regarding increased physician distraction due to electronic devices, especially with the advent of the smartphone with its emails, text messages, calls, and other alerts that ping intermittently throughout a typical work day.There is no question that electronic devices distract physicians as the article pointed out. But that's like complaining about a leaky faucet when there's a flooded basement ...
An oncologist’s deal with fate
Recently, a very dear friend learned that her breast cancer (diagnosed in 2010) had spread to her brain. Despite my many years as an oncologist, having faced questions from my own patients about "Why me?", "What did I do to deserve this?"—questions I am fully aware have no answer—I found myself asking the same questions, expressing the same anguish: "Why ...
Meaningful treatments in the battle against coronary disease
I saw a patient in my office this week who had received a stent from one of my partners last month. The man was highly satisfied with his experience—the procedure was tolerable, the recovery short, and the nurses were pretty (he specifically made a point of this, presumably because the post-hospitalization customer surveys don’t include what seemed to him to be the most important feedback metric)—but his wife had a ...
Each patient has something special that they can share with us
It was January 12, 2007 during rush hour traffic in the metro station in Washington, DC. A nondescript man wearing a baseball cap and khakis began to play the violin. He played six Bach pieces for about 45 minutes. During that time, since it was rush hour, it was calculated that at least a thousand people went through the station, most of them on their way to work. Nearly everyone ...
Twitter Is my third office location
The physician’s decision to first dive into social media can be stress-inducing. Issues of time management, maintaining professionalism, and determining a return on the personal investment can limit our use of the various platforms.Twitter offers me a unique platform that I may use to connect with patients. I use it as a virtual office location. While making personal connections with potential patients sounds daunting, it is actually a very natural ...
Motivate physicians through technology
In the modern medical environment of unpaid insurance claims, malpractice lawsuits and rushed patient encounters, many doctors feel unmotivated and unhappy.Could the use of improved healthcare technology make doctors feel motivated and fulfilled again?The hierarchy of needsMotivating others is always difficult task. But according to Dan Heath, author of Made to Stick, all employers need to do to effectively motivate employees is get out of the basement – Maslow’s basement ...
Do you really know how to choose a good doctor?
So you need a new doctor. You go online and the list is seemingly endless. You browse your insurance provider’s list and the information all looks the same. With so many options, how can you really choose the best doctor for you?Although this topic has been written about before, many people still find it difficult to determine a good fit. And when they do, this fit often comes simply by ...
Cost denies an undocumented immigrant a kidney transplant
You’re in your 30s. You work hard. You strive to master your craft. You support your extended family. You are liked by both your co-workers and boss.Problem: You unexpectedly become unhealthy–you find out your kidneys are failing.Solution: Regular kidney dialysis can keep you alive, by filtering toxins out of your blood.Problem: Dialysis is time consuming (>3 hours/session, 3 sessions/week) and leaves you feeling tired and weak.Solution: Your brother, who is ...
Why I miss practicing medicine
I recently left medical practice in order to pursue a career in mobile health technologies, for which I have had a passion for many years. I had wanted to become a physician since I was very young. The intellectual challenge and curiosities of the natural science and the human body stirred my intellect like nothing else.What I will surely miss most are the priceless personal interactions I experienced on a ...
Physicians need to wake up to the importance of a good night’s sleep
Studies in the past have shown that when someone complains about not being able to sleep to a doctor, more often than not, a sleeping pill is prescribed. The reason is that young doctors are taught in training that pharmaceuticals like Zolpidem (Ambien) stimulates GABA receptors in the brain, promoting sleep. There’s essentially no mention that cognitive behavioral therapy for insomnia works just as well for insomnia in the short ...
