Physician

Some hospitals tube feed patients with advanced dementia

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Tube-feeding patients with advanced dementia — a practice whose effectiveness has been questioned by two widely cited literature reviews — is most common in larger hospitals and those run for profit, researchers said.

The odds of a feeding-tube insertion in a hospitalized patient with advanced dementia were about 50% greater …

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Laparoscopic procedures injure the surgeons that perform them

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Four out of five surgeons agree: Laparoscopic procedures cause substantial discomfort and pain for the surgeons who perform them.

More than 80% of surgeons completing an online questionnaire reported pain or stiffness in the hands, neck, back, or legs after performing minimally invasive surgeries, according to Adrian Park, MD, of the …

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Residency programs do not prepare doctors for the real world

According to a recent editorial from Emergency Medicine News, emergency residency programs are doing a poor job preparing their emergency residents for the real world.

The authors note that a typical, large urban academic emergency department comprise less than 5 percent of U.S. ERs, and that “residency programs train physicians in some of the most inefficient EDs in the land. Relative value units of emergency medicine work per hour in …

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Poll: Should doctors be forced to treat patients promptly?

New regulations to reduce wait times for medical care in California are due to take effect next year.

Under the proposal, primary care doctors employed by HMOs are required to see patients within 10 days of the appointment request, and specialists must see patients within 15 days. Telephone calls must be returned within 30 minutes and patients needing urgent care have to be seen within 48 hours.

But will these mandates actually …

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Do part time doctors worsen the primary care shortage?

More graduating doctors are making family and personal life a priority, and opting for part-time work.

But when primary care doctors are needed more than ever, is that contributing to the shortage?

That’s a question that Dr. Gwenn asks over at Better Health. In pediatrics specifically, more “are now opting for part time work right out of the gate, just after training or during, in their 30s. And, that more men …

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Pending lab tests are not in hospitalist discharge summaries

As hospitalist programs become more prevalent, the issue of how best to communicate discharge summaries and instructions to primary care physicians remains.

A recent study suggested that only 16% of pending lab tests were written in hospitalist discharge summaries, which is a staggeringly low number.

Doctors who see hospitalized patients in follow-up need to know what they’re looking for; whether it’s abnormal potassium level or the result of an imaging study …

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How soon should the dead be buried in Haiti?

Originally published in MedPage Today

by Crystal Phend

Aid appears to still be trickling in to Haiti, making little headway against the swelling need for food, water, and medical care after last Tuesday’s earthquake.

With a projected death toll between 100,000 and 200,000, the dead bodies piled in the streets — and reportedly even being incorporated into roadblocks by angry Haitians …

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The difference between regret and apologies in health care

I’ve written recently that “I’m sorry” are the hardest words for doctors to say.

Good piece in The New York Times, observing that the health care industry, in general, has a hard time apologizing. In many cases, hospitals and drug companies simply state they “regret” the situation.

Is there a difference? Of course there is: “The difference between apologizing and simply offering a ‘regret’ may seem semantic. Yet …

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How to stop theft from your medical practice

Originally published in HCPLive.com

by Ed Rabinowitz

There’s a great scene in the movie The Big Chill where the main characters are having a discussion on the topic of rationalizations. One individual comments that he doesn’t know anyone who could get through the day without two or three juicy rationalizations. That may be true. But when a rationalization involves taking things from the office or workplace, and that office just happens to …

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Poll: What should doctors do if patients give a negative online review?

Just like movies, restaurants, and hotels, doctors are being rated on the Internet. Several websites give patients the ability to post what they think of their physicians. But how useful are these sites?

Patient reviews can be manipulated. It’s easy for a doctor or his staff to counter negative reviews by posting numerous positive ones. And how can one be sure that the reviewer is even actually a …

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Teaching doctors the art of negotiation

Originally posted in HCPLive.com

by Jeff Brown, MD

When I am in a civilian situation and someone asks me what I do, if I am feeling whimsical, I sometimes answer “I’m in sales.”

Think about it – almost all of our professional interchanges can be seen as: 1) trying to talk someone out of doing something, like smoking, or 2) trying to talk someone into something, like exercising. Using a broader brush, you …

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