It may seem strange that a gastroenterologist like me does not prescribe pain medicines. Let me rephrase that. I don’t prescribe opioids or narcotics. I write prescriptions for so few controlled substances that I do not even know my own DEA number. You might think that a gastroenterologist who cares for thousands of patients with abdominal pains would have a heavy foot on the opioid accelerator. But, I don’t. Here’s why. I ...

Read more...

There was her 28-year-old daughter lifeless in an ICU bed. Her name was Tricia, and she had dabbled with drugs since she was 15. As a child, she was artistic, adventurous, and always found excitement with other kids who tended to do risky things. She'd justify their behavior and say they were more fun and had better personalities. Eventually, her mom and dad moved to a small town thinking it would be ...

Read more...

As of July 1, pharmacies in Maine cannot honor paper or telephone prescriptions for controlled substances, from OxyContin down to Valium, Lyrica, and Tylenol with codeine. EPCS, or electronic prescribing of controlled substances, is a double security step in the prescription process built into EMRs, electronic medical records. It involves another password entry and the use of one-time passwords from a small number generator issued to each prescriber. It has been said ...

Read more...

The New York Times says nonadherence to prescribed medications is “an out-of-control epidemic” in the U.S. and quotes a review in Annals of Internal Medicine, which found “20-30% of medication prescriptions are never filled, and approximately 50% of medications for chronic illness are not taken as prescribed.” For example, “a third of kidney transplant patients don’t take their anti-rejection medications, 41% of heart attack patients don’t take ...

Read more...

It is surprisingly easy to sell snake oil. I know, because I’ve done it. In 2014, I helped create and sell The Right Detox. This was a bogus detoxification program that purported to improve anyone’s well-being and perhaps, cure disease. I was the face of the scam. I launched The Right Detox at a spring-time women’s health expo in Tucson, Arizona. I kicked off my sales-pitch in front of a small ...

Read more...

This April, my turn to take the medical board exam rolled back around, necessary every ten years for maintenance of certification. I studied diligently for the better part of three months preceding the test (and I think I did well). It was actually pleasurable to go back over details that I had forgotten and to catch up on newer developments in the field. I realized that I don’t do nearly ...

Read more...

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Alleviating pain has been a primary focus of my career as a physician anesthesiologist. Just as there are physicians who specialize in treating conditions such as cancer, heart disease or allergies, there are specialists in treating pain. These physicians complete four years of ...

Read more...

A 10-year analysis of medical malpractice cases indicates that medication errors continue to represent a significant risk to patients and health care providers, despite myriad efforts to eliminate that risk. For events that occurred beginning in 2003 (12 percent) to those from 2012 (12 percent) the proportion of cases alleging a medication error was, essentially, unchanged. Raised awareness, advances in technology, and millions of dollars directed at improving the medication ...

Read more...

Medical school prepares physicians to prescribe medications for prevention and treatment of disease, but little to no time is spent teaching something just as important: de-prescribing. In our current system of auto-refills, e-prescriptions, and mindless “checkbox” EMR medication reconciliation, patients may continue taking medications years after their original prescriber intended them to stop. There is no doubt that many Americans are over-medicated, and the problem
Read more...

At what point, we have to ask ourselves, does a medical error that we do over and over again cease to be an error, and simply become business as usual? At one of the patient safety conferences this week, where we reviewed sentinel events that occurred in the hospital and in the outpatient setting, one of the cases was about a patient who developed an abnormal cardiac rhythm as a result ...

Read more...

Most Popular

Get KevinMD's 5 most popular stories.