KevinMD.com

October 2, 2012Oct 2, 2012

Medicine, like politics, sports, and everything else, has gotten sucked into a 24/7 sound bite culture in which the most complex issues are spun into a few provocative words on news sites, TV, and radio shows. Enraged readers and listeners…

But three recent stories involving medicine are worth a closer look, and cooler heads.

First, consider the …

Patient voices

There is no app for patient engagement

Steve Wilkins, MPH

October 2, 2012Oct 2, 20125

Physicians, hospitals and other providers are being misled by industry pundits claiming that more health information technology (as in EMRs, PHRs, smartphone apps, and web portals) is the key to greater patient engagement. It’s not. If health information technology were…

If health information technology were all that was needed to “engage” patients then patient and member adoption rates of provider and payer web portals offering personal health records (PHRs) and electronic health records (EHRs) would not …

Read more…

There is no app for patient engagement

Real physician voices, twice a week

Free, and one click to unsubscribe.

Physician voices

Humility and humanity is required of us to best respect our patients

Meghana Gadgil, MD

October 2, 2012Oct 2, 2012

Several days ago, I had the opportunity to listen to a lecture by a visiting physician who practices narrative medicine, a medical humanist. She is well-known for bringing a voice to the interactions between doctor and patient, the healing relationship, the unparalleled bond formed between these two individuals. In her talk, she spoke of the “turmoil” that ensues when caring for a patient, caused by the interaction of deep concern …

Physician voices

Thank you for setting me on the road to practice medicine

Emily Gibson, MD

October 1, 2012Oct 1, 2012

All of us come to the study and practice of medicine through different pathways: some because of family members who were doctors or patients, some out of our own illness or woundedness, some out of intense drive to achieve and…

I came to medicine because of my grade school classmate Michael.

My grade school represented a grand social experiment of the early 1960’s. It was one of the first schools to …

Physician voices

Doctors are notoriously awful about dealing with death and dying

Miranda Fielding, MD

October 1, 2012Oct 1, 20129

Some things are just so damned hard to write about. People often ask me, "Why do you have so many animals?" The current count is 4 dogs, two horses and a cat. I used to say, "Because it’s good for…

Some things are just so damned hard to write about. People often ask me, “Why do you have so many animals?” The current count is 4 dogs, two horses and a cat. I used to say, “Because it’s good for my children to learn responsibility. Having a dog, whose life is so much shorter than our own, teaches them about love, and about death. They get to practice parenthood, before …

Physician voices

How many times have you done this procedure, doc?

Max Berry, MD, PhD

October 1, 2012Oct 1, 20122

Questions such as this from proactive, increasingly knowledgeable patients place a physician on the horns of an ethical dilemma. Although fellows are closely supervised and trained under a gradually increasing responsibility principle (based upon subjective evaluation), a time will come…

Fact: Someone has to be a physician’s first case of any given type. However, no one really …

Health policy

What happens if Medicaid expansion is undermined

Erin Marcus, MD

October 1, 2012Oct 1, 20123

He was a "frequent flyer" -- a patient with multiple health problems who gets admitted to the hospital repeatedly. It was usually because he hadn't taken his medicine correctly, if at all. When he left the hospital 10 days earlier,…

He was a “frequent flyer” — a patient with multiple health problems who gets admitted to the hospital repeatedly. It was usually because he hadn’t taken his medicine correctly, if at all. When he left the hospital 10 days earlier, he told his physician that he wouldn’t have problems filling his prescriptions, because he had Medicaid. But when he arrived at his local drug store, it wasn’t so easy.

“I was …

Physician voices

Speak the truth, document the truth: To do otherwise is malpractice

Edwin Leap, MD

October 1, 2012Oct 1, 201210

I remember a short lecture I received in my medical officer's course when I joined the Air National Guard around 1988. The room was full of young medical students, physicians, nurses, and other health care folks who were beginning their…

I remember a short lecture I received in my medical officer’s course when I joined the Air National Guard around 1988. The room was full of young medical students, physicians, nurses, and other health care folks who were beginning their service. The topic was appropriate documentation in the medical record.

Among the notable examples of what not to do was this gem, written by a medical officer about another officer’s wife: …

Drugs and prescribing

ADHD medications: Performance enhancing drugs of the mind

Dr. Joe Kosterich

September 30, 2012Sep 30, 201218

There are interesting double standards that we apply to different fields of human endeavor. In sports the use of performance enhancing drugs is forbidden. Whilst that does not necessarily stop athletes using them at least it is not condoned. Efforts…

The rationale behind this is that sporting contests are meant to be about who …

Physician voices

Why doctors need to be better social workers

Arvin Akhavan

September 30, 2012Sep 30, 20124

Doctors are already busy, but do they need to do more in a day? If you think a physician’s job is to take the best possible care of patients, then the answer is a resounding yes. But additional responsibilities do…

It doesn’t take unique insight to understand that doctors, in many ways, act as social workers. They help patients schedule follow-up appointments, …

Drugs and prescribing

Taking medications in the middle of the night can be risky

Barbara Bronson Gray, RN

September 30, 2012Sep 30, 20125

You may have heard that veteran NBC News correspondent Tom Brokaw was hospitalized recently after he reported feeling lightheaded after making an appearance on MSNBC's "Morning Joe." He's fine. Brokaw tweeted, "All is well. Early a.m. I mistakenly took a…

You may have heard that veteran NBC News correspondent Tom Brokaw was hospitalized recently after he reported feeling lightheaded after making an appearance on MSNBC’s “Morning Joe.”

He’s fine. Brokaw tweeted, “All is well. Early a.m. I mistakenly took a half dose of Ambien and made less sense than usual.”

And that’s what you’ve got to be careful not to do.

Any time you get up in the wee hours …

Health policy

The Accountable Care Organization: Think opportunity, not threat

Charles Kennedy, MD

September 30, 2012Sep 30, 20128

Accountable care is here – both as a way of doing business and an approach to providing high quality health care. With accountable care, the potential for reducing overall health care costs, realigning incentives and focusing clinical resources on prevention and disease management is now a real opportunity. Physicians who aren’t ready to transition their practices to operate in a manner required under accountable care models will increasingly find themselves …

Patient voices

Break the cycle of intimate partner violence

Lisa Gualtieri, PhD

September 29, 2012Sep 29, 2012

I was curious why Lahey Clinic, a nonprofit group practice outside of Boston, started asking patients, “Are you safe at home?” during intake. Trying to find this out turned into an exploration of the inconsistent state of intimate partner violence…

“Are you safe at home?”

The first time I was asked “Are you safe at home?” during patient intake at Lahey Clinic, I was surprised that such a …

Drugs and prescribing

I have seen the tragedy of prescription drug abuse

American Society of Anesthesiologists & John Dombrowski, MD

September 29, 2012Sep 29, 20122

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. To say prescription drug abuse is one of the biggest drug problems in the United States today is clearly an understatement. The Partnership at Drug-Free America cites every…

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

To say prescription drug abuse is one of the biggest drug problems in the United States today is clearly an understatement. The Partnership at Drug-Free America cites every day more than 2,000 kids use a prescription drug to get high for the first time. While it’s true a variety of prescribed medications are abused, most …

Physician voices

Help your doctor better help you

Linda Brodsky, MD

September 29, 2012Sep 29, 20129

In my office, every new patient encounter starts the same way. I walk in and say, "Hello." Then I put down my computer (which I take from room to room), wash my hands (which I purposely point out that I…

In my office, every new patient encounter starts the same way. I walk in and say, “Hello.” Then I put down my computer (which I take from room to room), wash my hands (which I purposely point out that I do before I touch anyone or anything else), and then I turn to the family and greet the child first. Depending on the age, I might be squatting and gently …

Read more…

Help your doctor better help you

Physician voices

Why I quit internal medicine for physiatry

Fizzy, MD

September 29, 2012Sep 29, 20122

Some of you may know that I started out in an internal medicine residency and quit for physical medicine and rehabilitation (PM&R). Switching residencies? Not recommended. But entirely doable. I spent most of my first half of internship being really,…

Some of you may know that I started out in an internal medicine residency and quit for physical medicine and rehabilitation (PM&R). Switching residencies? Not recommended. But entirely doable.

I spent most of my first half of internship being really, really miserable. I remember sitting in the call room during my ICU month, talking to my mother about how badly I wanted to quit and what my options would be if …

Health policy

Why is there a primary care shortage?

John Schumann, MD

September 28, 2012Sep 28, 201239

Health care reform is a locomotive barreling down America's tracks. In two years, the Affordable Care Act (ACA) will cover some 30 out of 50 million of us that currently lack health insurance, provided neither the Supreme Court nor a…

Health care reform is a locomotive barreling down America’s tracks. In two years, the Affordable Care Act (ACA) will cover some 30 out of 50 million of us that currently lack health insurance, provided neither the Supreme Court nor a new president overturns the law. Political beliefs aside, it would seem that supplying insurance to protect the health of more people is a societal good. Though the costs of reform …

Read more…

Why is there a primary care shortage?

Health policy

Are insurance companies responsible for increasing health costs?

Stephen C. Schimpff, MD

September 28, 2012Sep 28, 20128

The insurance system for healthcare is perverse. The individual is not the customer of the healthcare company; in most cases it is the employer or the government (i.e., Medicare, Medicaid). They physician works for the insurer who determines for what and for how much the doctor is paid. But are the insurance companies the blame that is often placed on them for our current state of affairs?

This system abrogates the …

Medical education

Medical residents need to be accountable for their own well-being

Brian J. Secemsky, MD

September 28, 2012Sep 28, 20126

I am three months into my medical residency, and I am getting fat. Not the noticeable change-in-pant-size fat, not yet. But I am most certain that what was once muscle is now just “padding,” and I can no longer solely attribute the words “muffin top” to the anatomy of the snacks that I scrounge to stay alive during the long hours in the hospital.

I am three months into my medical …

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular