Physician

Residency programs do not prepare doctors for the real world

Physician
February 18, 2010

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?

Physician
February 15, 2010

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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Doctors are responsible for a minority of medical mistakes in radiation therapy

Physician
February 11, 2010

The New York Times recently featured a disturbing expose of serious medical errors associated with the newest forms of high tech radiation treatment, entitled, Radiation Offers New Cures, and Ways to Do Harm. The piece is an example of excellent medical journalism, compelling stories of two individuals who sustained truly horrifying injuries as the result of treatment errors framed a detailed investigation of similar errors that have occurred in New …

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How will the earthquake affect the future of the Haitian American community?

Physician
February 10, 2010

Marleine Bastien is the founder and executive director of Fanm Ayisyen Nan Miyami–Haitian Women of Miami–www.fanm.org, which advocates for the rights of Haitian women. She is also a congressional candidate for U.S. House District 17, representing Little Haiti and other neighborhoods in Miami. Erin N. Marcus spoke with Bastien on Jan. 22 about the Haiti earthquake.

What has FANM been doing since the earthquake?

As soon as we heard about it, …

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Do part time doctors worsen the primary care shortage?

Physician
February 9, 2010

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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When doctors are at greatest risk of making a mistake

Physician
February 5, 2010

Early in my training as a glider pilot my instructor showed me an excellent but simple analogy for ensuring my safe performance as a pilot. I have always remembered this lesson, which he called the ‘accident slope’, and have tried to apply it to my method of practicing medicine, as well as the other ‘dangerous’ activities for which I have an affinity.

“Accidents and mistakes are seldom the result of one …

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Pending lab tests are not in hospitalist discharge summaries

Physician
February 4, 2010

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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Why primary care doctors need to practice insurance free medicine

Physician
February 3, 2010

I never thought I would be in academic medicine for so long.

When I was hired about 12 year ago, I figured I would stay in academics for a few years and then join a private practice Internal Medicine group. Now, I can’t even fathom that idea. One of the reasons I have stayed at my institution for so long is that I love teaching and the academic environment.

However, a second …

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How soon should the dead be buried in Haiti?

Physician
February 3, 2010

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

Physician
January 28, 2010

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

Physician
January 27, 2010

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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How should patients decide which hospitals are best for them?

Physician
January 26, 2010

Johns Hopkins Hospital is consistently named one of the best in the country. I can’t disagree with that; after all, I just started working there as an internist in September. Coincidentally, in the midst of the raging debate around health care reform, the past few months have seen increasing discussion of a small but crucial question: why do some of the best hospitals spend more money than others? If other …

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

Physician
January 25, 2010

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

Physician
January 22, 2010

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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Primary care needs a face lift, and a better agent

Physician
January 21, 2010

General medicine is not sexy. Less than a fourth of the doctors in the United States are currently primary care providers like Pediatricians, Ob/Gyns, and Internists. According to a recent study published by the Journal of the American Medical Association, only 2% of medical students intend on pursuing a career in general internal medicine. So when health-care reform becomes a reality, and the 46 million uninsured men, women, and children …

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Were hospitals responsible for patient deaths during Hurricane Katrina?

Physician
January 21, 2010

A jury is about to decide how far hospitals have to go to protect themselves against natural disasters.

It all starts in New Orleans, during the Hurricane Katrina disaster. Hospital generators were not protected against floods, and predictably, that contributed to the loss of power during the category 5 hurricane. If all hospitals were to protect their generators appropriately, it’s estimated that it would cost millions to do …

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How carriers of Staphylococcus aureus do worse in the hospital

Physician
January 20, 2010

Originally published in Insidermedicine

Infections with a type of bacteria known as Staphylococcus aureus, or S. aureus, can be diminished by identifying and treating those who carry it in their nasal passages, according to research published in the New England Journal of Medicine.

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Why scaring patients to quit smoking may not be effective

Physician
January 20, 2010

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Telling people about the benefits of quitting is more likely to help smokers break the habit than scaring them with the dangers of continuing, researchers found.

Callers to a tobacco quitline were nearly twice as likely to stop in the short term when they got positive messages rather than …

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How doctors suffer during medical malpractice litigation

Physician
January 20, 2010

There are no winners in medical malpractice cases.

Patients, of course, suffer the most. But doctors aren’t spared either. It’s been written previously that doctors suffer significant emotional turmoil after being sued, and in fact, a good percentage even contemplate suicide.

In a recent New York Times essay, physician Joan Savitsky talks about her own ordeal. She discusses how being sued affected not only her, but other …

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A doctor writes about his first day in Haiti

Physician
January 19, 2010

by Jonathan Crocker, MD

From Cange, Central Plateau
Haiti
01-18-10

We arrived at Cange, in the Central Plateau, the heart of operations for Partners In Health/Zamni Lasante, yesterday. As we expected, things are incredibly busy. People are still arriving from Port au Prince. Those who have been fortunate enough to survive their injuries this long are now running into complications of wound infections, some of which have turned septic, and venous blood clots (from …

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