Patients

Issues surrounding videotaping surgeries in the operating room

Physician
December 23, 2009

The rapid advance in digital video and still camera technology has found its way into the operating room.

There is the potential to capture and record just about every minute of every surgical procedure in some way. The newest endoscopic camera systems and operating microscopes have integrated systems to record video footage. Storing all that data is just the press of a button away.

The advantages for surgeons are obvious, like the …

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12 most important medical advances of the decade

Physician
December 16, 2009

As the first decade of the 21st century comes to an end, it is interesting to look back and reflect on the most significant medical advances we’ve seen. I’d like to present 12 medical advances that I consider to have been the most important over the past decade, and I’d like to ask you, the wider world, to contribute in two ways:

– Add your nomination in the comment field regarding …

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Should health care workers go to jail for medical errors?

Physician
December 11, 2009

Two years ago, I wrote about the case of Julie Thao, the Wisconsin nurse sent to prison for a medication error. I argued then that – although Julie bypassed some safety rules – she most certainly did not deserve jail time.

Along comes another case involving jail time for a medical mistake, this one featuring an Ohio pharmacist named Eric Cropp. I became aware of Eric’s case through the efforts of …

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Seeing floaters or flashing lights can be caused by posterior vitreous or retinal detachment

Conditions
December 2, 2009

Originally posted in Insidermedicine

The eye is very similar to a camera. Both are optical systems that have lenses in the front to focus light rays onto a film. The retina is the eye’s film. It is a tissue that consists of 10 layers and is about 500 microns thick—or, half a millimeter. The main function of the retina is to trap light rays, convert them into electrical impulses, and send …

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The joys of practicing rural emergency medicine

Physician
November 25, 2009

I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.” It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest. The natural beauty is breathtaking. Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some …

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Op-ed: Humor can be healing for both doctors and patients

Physician
November 21, 2009

A version of this op-ed, co-written with Doug Farrago, was published on October 26th, 2009 in Medscape.

It’s tough to be a doctor these days. Whether it’s listening to the difficulties of our medical colleagues as they try to best care for their patients, or engaging other health professionals about the uncertainties surrounding health reform, we’ve noticed a tense, sometimes gloomy, atmosphere among physicians.

A recent survey from the Annals of Internal …

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Can family doctors do safe first trimester abortions?

Conditions
November 18, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Complications from first trimester abortions performed by family practitioners are rare, and family doctors could help address abortion provider shortages across the U.S., a new study found.

Among more than 2,500 abortions performed by family physicians, abortion was successful without complications in 96.5% of patients using medications (95% CI 95.5% …

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Why doctors are doing so many unnecessary Pap smears

Conditions
November 17, 2009

The Wall Street Journal and other sources reported on a study from the Annals of Internal Medicine that showed that most US doctors don’t know the guidelines of how often women should get a pap smear. More importantly, doctors were doing a lot of pap smears on women who didn’t need them. In all the talk about health care reform, reducing costs by eliminating unnecessary testing has been mentioned multiple …

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Why you should stop taking Vytorin for high cholesterol

Meds
November 16, 2009

At the American Heart Association meeting in Orlando, the results of the ARBITER 6-HALTS study were released. No Vytorin was used in the study, but I am sure that all the headlines will mention Vytorin.

The actual study published ahead of press online in the New England Journal of Medicine. Essentially, they enrolled over 200 patients from Walter Reed and Washington Adventist who had known heart disease or were at …

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Many women report nerve-related persistent pain after breast surgery

Conditions
November 12, 2009

Originally published in Insidermedicine

Nearly half of women who undergo surgery and other treatments for breast cancer report having persistent pain in and around the treatment area a year or more later, probably because of nerve damage, according to research published in the November 10 issue of the Journal of the American Medical Association.

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Should doctors be paid to e-mail their patients?

Physician
October 11, 2009

by Michael Kirsch, MD

This is a less controversial issue than patients ‘friending’ their doctors on Facebook, which I oppose. Although most physicians’ offices are not e-mailing with patients, perhaps they should. There are several obvious advantages.

* Decompress phone lines, which are suffocating nearly every medical practice in America.

* Relieve patients of the cruel and unusual punishment of languishing on ‘hold’ listening to elevator music or dead air.

* Allow office staff …

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Radiologists and communicating mammogram results to patients and their doctors

Conditions
September 24, 2009

by an anonymous radiologist

I recently read the article and comments on this link from this post, concerning radiologists, from Musings of a Dinosaur.

I was disturbed to discover the animosity with which this topic is covered. The tenor of the blog is that radiologists are greedy, self-serving and are out to erode the doctor-patient relationship. The suggestion that radiologists would schedule percutaneous breast biopsies for their financial enhancement is both …

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Do patients really need their complete lab and radiology reports?

Conditions
August 21, 2009

Most prefer the bottom line, sparing them the raw data.

Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.

So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):

lab-valuesRead more…

How soon should patients receive their test results?

Conditions
July 9, 2009

And should you assume that no news is good news?

The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent.

That’s almost a quarter of abnormal test results from that center that patients were never …

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Did Demerol cause Michael Jackson’s cardiac arrest and death?

Conditions
June 26, 2009

Michael Jackson’s death continues to consume the news cycle.

There is currently no clear explanation. Some have speculated that it may be related to the narcotic pain drug, Demerol. According to this report from the UK’s The Sun, “An Emergency Room source at UCLA hospital said Jackson aides told medics he had collapsed after an injection of potent Demerol …

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Steve Jobs received a new liver, and the ethics surrounding his transplant

Conditions
June 22, 2009

Orac, a general surgeon who blogs at Respectful Insolence, writes the most comprehensive entry I’ve seen thus far on Apple’s Steve Jobs’ liver transplant.

For those interested in the medicine behind the transplant, go and read his post in its entirety. I’d like to highlight some of the potentially questionable ethics surrounding the case.

For one, there is the question why Mr. …

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How much time do doctors spend on paperwork?

Physician
May 29, 2009

A common complaint is that doctors these days are spending more time doing clerical tasks.

Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do not need a medical degree to do these tasks.

Bob Doherty points to a study that gives some numbers to back up the claims. Primary care doctors spend about 3.5 …

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Is House M.D. bad for medicine?

Social media
May 17, 2009

A few days ago, we talked about how Scrubs was a relatively accurate portrayal of medical life.

Let’s talk about the other end of the spectrum, namely, Fox’s House M.D.

As an emergency physician notes, the doctors in the House-universe seem super-human. Indeed, “the docs on that show are not only walking encyclopedias of rare diseases, but they are …

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