You may have heard of the “Dean’s Lie“, the artificial padding of numbers allowing medical schools to claim ever-increasing percentages of their graduates are going into primary care medicine. This is accomplished by counting everyone going into internal medicine, pediatrics, and med-peds, in addition to family medicine as “primary care.” It makes their schools sound more attractive by seeming more progressive, but it does nothing to enhance the supply ...

Read more...

A reader recently wrote:

My [spouse] and I are 63 and childless. We are thinking of spending $99 to get genetic screening on the theory that it could help us plan a little better for our old age. Just as a random example, if I knew my chances for getting Alzheimer’s disease were high, I might want to move into assisted living sooner rather than later. We have many questions. Is ...

Read more...

Surprise! It turns out that if every woman in the US got a mammogram every year, almost exactly the same number of them would still die of breast cancer. Why? Watch this video. Read this by TBTAM. Bottom line: mammograms don’t find aggressive cancers soon enough (by definition, you can’t), while too many of the cancers they do find were never going to be fatal anyway. This is what “over-diagnosis” ...

Read more...

“Doctor’s office; please hold.” You’ll never hear that when you call me. Never. You’ll also never get an automated answering system (I’m just referring to office hours, of course. Evenings and weekends the phone goes to Google Voice. More on that below.) We are also in the middle of a communication revolution. There are now so many other ways patients ...

Read more...

My esteemed colleague Dr. Bob Centor is enamored of an interesting essay from which he quotes:"Only you can educate you—and you can’t do it by memorizing. You have to find out who you are by experience and by risk-­taking, then pursue your own nature intensely. School routines are set up to discourage you from self-discovery. People who know who they are make trouble for schools." Personally, I found it ...

Read more...

After all the hullabaloo generated by my passing on the accurate but controversial information that exercise will not help you lose weight, I thought I should give equal time to the other side, and discuss several things that appear to help enhance efforts at weight loss. Sleep Although I’m not aware of any formal studies documenting this, I can report from personal and professional experience that the value of sufficient ...

Read more...

Medicine has gone down Alice in Wonderland’s rabbit hole. Looking at the size of practices today, it seems like some of them have taken red pills and the rest have taken blue ones: most of them are getting bigger and bigger and bigger, while some are getting smaller and smaller. As the giant practices gobble up their competition to become ever more gargantuan, others are shrinking down into micropractices. Everyone has ...

Read more...

Dear NP student who rotated through here back over the winter: You probably don’t remember seeing this particular woman. I sent you in to do a well-woman exam on her; everything was completely normal. There was nothing particularly memorable about her, either clinically or personally. Just another nice lady coming through the office; just another physical. You asked her a question, though: “How are things in the bedroom?” She was too shocked ...

Read more...

I love my new EMR, which I’ve been using for about 18 months now. I love having all my patients’ information at my fingertips in and out of the office. I don’t miss the piles of paper charts all over the place at all! In short, there’s really nothing about it I don’t like. My staff, on the other hand, hates it. Now that they’re not jumping up and down all the ...

Read more...

One single, deceptively simple idea that would vastly improve medical care in this country by immediately streamlining all medical communication. Design a standardized form for all medical reporting. Scope of the problem: Despite my exclusive use of an electronic medical record, I still receive dozens of medical communications on paper every day. So be it. Until we get to the utopian ideal of a nationally interactive medical record system, we’re stuck with ...

Read more...

Join 145,000+ subscribers

Get the best of KevinMD in your inbox

Sign me up! It's free. 
close-link
✓ Join 145,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.
close-image