The latest Kaiser Family Foundation poll, conducted in August, shows public support for health care reform falling. After two monthly polls in which reform was viewed increasingly favorably, the new poll shows a sharp decline in public backing for the new law. Kaiser polls in the first couple of months after enactment of Patient Protection and Affordable Care Act (PPACA) showed more confusion than clear support or opposition, but by June favorable ...

Read more...

Have you ever had a cold beer after a mountain bike ride? Oh my! But does such indulgence put one at risk for an arrhythmia? Does alcohol exacerbate an existing arrhythmia? How much, if any, alcohol is acceptable? These are questions I am asked frequently.  And for those asking, they are very important questions. I wish the answer was straightforward.  But it is not. Undoubtedly, excessive alcohol can precipitate an abnormal rhythm.  Look no farther ...

Read more...

Lung cancer screening has been an area of considerable controversy.  Before today, there had been no evidence that screening patients for lung cancer, either with a CT scan or chest x-ray, saved lives. For years, doctors have been waiting for the results of the large, randomized National Lung Screening Trial (NLST), conducted by the National Cancer Institute. This morning, it was announced that the trial was stopped early, with a ...

Read more...

The psychiatrist knocks on the door of the patient’s hospital room. Patient: “Come in.” Psychiatrist: “Good afternoon, Mrs. Jones. I’m Dr. Moodbetter, one of the psychiatrists here. Your doctor asked me to see you. Did he say anything about this?” Patient: “No, he didn’t! You know, I’m not nuts. I didn’t think he believed me. Great. Now he just thinks it’s all in my head.” Psychiatrist: “Well, I don’t think he meant to imply ...

Read more...

Hospitals nationwide are racing against the clock to ensure their health IT systems meet meaningful use guidelines. The incentive?  Money, of course. Systems that meet certain criteria make doctors eligible for up to $44,000 in bonus money from the government. As mentioned on this blog previously, implementing an electronic health system is difficult. The usability of the current generation of EHRs is still relatively primitive, especially when compared to other industries, and ...

Read more...

Doctors and nurses are leaders in health care.  Being a great leader means having a clear vision, mission or goal.  It means being committed, and knowing how to listen and communicate, but it involves much more.  It’s about having heart, empathy, and an uplifting spirit. I value and respect a well written post by Thomas Goetz, author of The Decision Tree: Taking Control of Your Health in the New Era of ...

Read more...

I’m both interested in and disturbed by what some doctors have said to patients at the first consultation for tinnitus,  an annoying perception of sound that comes from somewhere within their heads.  Not many of these patients are referred to me – most come of their own accord for a second opinion.  What they tell me their doctor said is a lesson in how not to communicate with patients, and ...

Read more...

Who ever said you have to stay with the same doctor? I am always disappointed when I hear the stories that some people relate about how they sat and told their doctor this and that and that he/she didn't listen, didn't know what to do, didn't care, etc. Makes me sad of course, because I know how easy it is to just listen and look people in the eyes when they ...

Read more...

Travel is frequently required for non-clinical jobs. The big question is: how much travel? When a job description indicates 30% travel, do you know what that really means? What if you had to travel 30% each week? 30% each month? If there are 5 working days each week and 4 weeks each month, then there are approximately 20 working days each month. Are you willing to be gone 6 days each ...

Read more...

What does it cost to improve operational efficiency using technologies and outsourced services? For some physicians, the first reaction to every new service or technology is that it's going to "cost too much." And you get pitches for plenty of new services: * Your clearinghouse vendor or your billing manager wants you to push all your claims, even the claims you can file directly at no cost, through the clearinghouse for efficiencies. * Your ...

Read more...

shutterstock_162044975 Dr. Ryan Flesher was working his usual shift in the emergency department that night in July of 2006.  The hospital was short-staffed, per usual, and patients continued streaming through the revolving doors.  Neither the people at the front desk nor the nurses saw Dr. Flesher slip quietly down the hall that night. The following is a true story that occurred well before healthcare ...

Read more...

Who constitutes your market? The obvious answer is "patients". We provide services and in some instances products for patients. We receive compensation for doing this. It's instructive to ponder the source of these patients. How do they get to us? What other people and institutions play a role in this process. Existing satisfied customers? Other physicians? Hospitals? Health plans? Other institutions? Tracing the sources is a critical exercise if we are ...

Read more...

If conservatives manage to kill health care reform legislation, what will happen next? I really don’t want to go there. First, I’m convinced that conservatives won’t be able to repeal the Affordable Care Act (ACA).  Democrats will hold onto the Senate, and President Obama still has a veto. If necessary, he will use it to protect the bill. Meanwhile, the majority of the public either favors the legislation or want to “wait ...

Read more...

It seems rather obvious that medical procedures should be reserved for medical indications. Why? Because almost every medical procedure, even some of the simplest, have small but real risks of complications. And risking complications can only be justified if the medical benefit outweighs the risk. That rule applies to labor inductions, although many obstetricians have forgotten it. Induction of labor for non-medical reasons, primarily convenience, is attractive, but labor induction is ...

Read more...

by Toni Bigby Lately there has been a lot of conversation around patient empowerment – an ambiguous term, but one that is fodder for many conversations across the health care industry. Patient empowerment – to put it simply – is about providing the necessary tools and information to a patient so that he or she can take a more active and involved position in his or her health ...

Read more...

How are we going to solve the drug problem? The answer is we aren't. Psychoactive drug abuse is as old as recorded history. As long as drugs are available and humans are frail, there will be drug abuse and drug abusers. The main point for medicine is to follow Hippocrates. First, do no harm. So many of our drug laws, intended to do good, actually do more harm than good. Witness marijuana. Will California ...

Read more...

by Lucas Restrepo, MD Recently, the fire department of a small town in Tennessee called South Fulton ignored the call of a man who needed help quelling a fire near his house. The firefighters declined lending a hand because the caller neglected to pay a $75 bill, the prerequisite for deserving assistance. The caller tried to put down the fire with a garden hose, but after two ...

Read more...

Something recently stopped me in my tracks. A study published in Pediatrics recently found that 65% of parents to 3 year-olds said they had spanked their child within the last month. Sixty five percent? The number surprised me. If you’d asked me to guess, I would have said 20-25%. Talk about way off. Another reminder of how much I have to learn. The study evaluated risk factors, including domestic violence ...

Read more...

Though I’ve spoken about breast cancer for Susan G. Komen for the Cure (emphasizing the importance of early screening and detection), until recently I had never had a mammogram. In my training I’d been taught that mammograms weren’t that accurate or useful in women under 40 (our health system’s protocols reflect that), so I got regularly checked by my physician whenever I had a physical and otherwise was waiting until ...

Read more...

I am teaching a new course entitled “Turning your Clinical Cases into Scholarly Work.” I hope to draw on my own experiences through the years mentoring students and residents in writing up several clinical cases, but also in making diagnoses.  In preparing for this course, I have also learned quite a bit about the controversy surrounding case reports and the challenges that they face in today’s healthcare system. Unfortunately, case reports have ...

Read more...

Most Popular

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories