2010

October 26, 2010Oct 26, 201024

by 911Doc, MD American medicine will die or be reborn in the next ten years. Correction, it will either continue an accelerated slide into banal mediocrity, or be reborn. The battle is finally joined, and it has been joined by…

by 911Doc, MD

American medicine will die or be reborn in the next ten years. Correction, it will either continue an accelerated slide into banal mediocrity, or be reborn. The battle is finally joined, and it has been joined by the specialists. Thank you, doctors, for drawing the line in the sand. I hope you win. Honest.

I am cheering against my own college here because they have …

Physician finance

Specialist and primary care pay per hour

Kevin Pho, MD

October 26, 2010Oct 26, 20109

Authors of a recent study from the Archives of Internal Medicine are unlikely to endear themselves to specialists. As reported by Reuters, and provocatively titled, Do specialist doctors make too much money?, the study gives a per-hour breakdown of how…

Authors of a recent study from the Archives of Internal Medicine are unlikely to endear themselves to specialists.

As reported by Reuters, and provocatively titled, Do specialist doctors make too much money?, the study gives a per-hour breakdown of how much doctors make.

I think this is a good approach, since annual salary figures do not account for the number of hours doctors work — and in the case of primary …

Physician voices

Technology empowered direct pay primary care

Anar Mikailov

October 26, 2010Oct 26, 201018

By now it is common knowledge that primary care is an undesirable field for newly graduating medical students. Additionally, many current primary care physicians are closing shop and either enter early retirement or seek non-clinical professions. According to the American…

By now it is common knowledge that primary care is an undesirable field for newly graduating medical students.

Additionally, many current primary care physicians are closing shop and either enter early retirement or seek non-clinical professions. According to the American Academy of Family Physicians, the 2010 Residency Match showed that 1,184 U.S. medical grads chose Family Medicine, less than half of the available positions ( …

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Patient voices

Post traumatic stress disorder after the Haitian earthquake

Erin Marcus, MD

October 25, 2010Oct 25, 2010

In the months since the Haitian earthquake, psychologists from around the world have been traveling to the island, hoping to help a population in shock and at risk for post-traumatic stress disorder. Many are veterans of crises such as Hurricane…

But Dr. Guerda Nicolas, a Haitian-born researcher who has conducted landmark studies examining how Haitians experience depression and cope with disasters, has a …

Patient voices

How to command respect in any medical setting

Trisha Torrey

October 25, 2010Oct 25, 20103

It’s a simple question, but it has stirred some controversy. It’s the word “friendly.” Colleague and fellow passionate advocate Bart Windrum got (as my mother would say) his blood in a bubble after reading an article about engaging a patient…

It’s a simple question, but it has stirred some controversy. It’s the word “friendly.”

Colleague and fellow passionate advocate Bart Windrum got (as my mother would say) his blood in a bubble after reading an article about engaging a patient advocate to help you navigate your healthcare, published in a Tampa newspaper.

In a list of tips about how to advocate for someone else, one tip said, “In hospitals ask, …

Physician voices

Senior leaders need to periodically reflect on their role

John Halamka, MD

October 25, 2010Oct 25, 2010

Leaders often think about succession plans for their direct reports, but what about themselves? What if I had a serious health problem or accident that impaired my ability to lead my IT organizations? Here's my brief analysis. Beth Israel-Deaconess Medical…

Leaders often think about succession plans for their direct reports, but what about themselves?

What if I had a serious health problem or accident that impaired my ability to lead my IT organizations? Here’s my brief analysis.

Beth Israel-Deaconess Medical Center

My role at BIDMC is to document the strategies prioritized by our governance groups, ensure our organizational chart structure is optimized for executing the strategies, …

Physician voices

ACP: Doctors as leaders – the value of civility

American College of Physicians

October 25, 2010Oct 25, 20104

A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP The campaigning for the mid-term elections reminds us once again of the state of civility – or lack of civility - in…

A guest column by the American College of Physicians, exclusive to KevinMD.com.

by John Tooker, MD, MBA, MACP

The campaigning for the mid-term elections reminds us once again of the state of civility – or lack of civility – in American politics. By civility, I mean showing regard for others. We are beset by campaign attack ads that are often factually wrong and designed to …

Health policy

Will the accountable care organization (ACO) be a durable part of reform?

Jim Sabin, MD

October 25, 2010Oct 25, 20103

Magic bullets come and go in the world of health policy, but the accountable care organization (ACO) is likely to be a durable reform. Except for group practices like Geisinger, Harvard Vanguard, Kaiser Permanente, systems like the VA, and local communities in which independent practitioners have established cooperative collaborations, health care has been grotesquely uncoordinated in the U.S. ACOs speak to that structural lesion.

Title III of the Patient Protection and …

Physician voices

Physicians need to consider a digital resume

Philippa Kennealy, MD, MPH

October 24, 2010Oct 24, 2010

As a physician coach to doctor clients making the transition from clinical practice and seeking out new careers, I latched onto a recent article in the Los Angeles Times business section. Titled "Revive your Resume" by Emily Hughey Quinn, it…

As a physician coach to doctor clients making the transition from clinical practice and seeking out new careers, I latched onto a recent article in the Los Angeles Times business section.

Titled “Revive your Resume” by Emily Hughey Quinn, it hints at the death of the traditional paper resume. In its place is the digital resume you create on sites such as LinkedIn and VisualCV.

Take special note – if you’re a …

Health policy

Why the Florida Medical Association (FMA) is angry with the AMA

Brian Klepper, PhD & David C. Kibbe, MD, MBA

October 24, 2010Oct 24, 201011

At an Orlando meeting recently, Florida Medical Association (FMA) members fumed that their parent, the AMA, isn’t adequately representing Florida’s private practice doctors. After talk of secession and forming a new group, they settled for writing a stern letter urging…

The FMA dustup began with a resolution written by Douglas Stevens MD, a Fort Myers cosmetic surgeon – you can’t make this stuff up – complaining …

Physician voices

Will a higher demand for generalist doctors save primary care?

Ali Khan, MD

October 24, 2010Oct 24, 201010

by Ali Khan, MD “So, why didn’t I take the ROAD again?” It’s a question that I regularly hear from many of my co-residents in internal medicine – and no, we’re not questioning our travel routes to the hospital. We…

by Ali Khan, MD

“So, why didn’t I take the ROAD again?”

It’s a question that I regularly hear from many of my co-residents in internal medicine – and no, we’re not questioning our travel routes to the hospital.

We all know why we chose internal medicine: the intellectual challenges inherent in treating across organ systems, the excitement of primary scientific investigation and diagnosis and the like. As we …

Health technology

EMR ROI depends on workflow improvements

Mike Koriwchak, MD

October 23, 2010Oct 23, 201011

Some of the toughest obstacles to EMR are the physician doubters. These people say, “My charts are going to be on a computer. So what? All I know for sure is that it will take longer for me to finish…

Some of the toughest obstacles to EMR are the physician doubters.

These people say, “My charts are going to be on a computer. So what? All I know for sure is that it will take longer for me to finish my charts every day and we will have another component in fixed overhead. Why this is a good idea?”

The concerns are valid. When my practice chose to get EMR 6 years …

Conditions and diseases

Few health benefits from genomic discovery

Kevin

October 23, 2010Oct 23, 20103

by W. Gregory Feero, MD, PhD Recent high-profile articles in the lay press have criticized the lack of immediately tangible health benefits from genomics research investment. Expectations for immediate clinical benefit from genomic discovery, fueled by both scientists and the…

by W. Gregory Feero, MD, PhD

Recent high-profile articles in the lay press have criticized the lack of immediately tangible health benefits from genomics research investment.

Expectations for immediate clinical benefit from genomic discovery, fueled by both scientists and the media, have outstripped even the blistering pace of genomic discovery. The gap between discovery and application is particularly notable in general medical practice, where only a …

Patient voices

Religious coping in dying patients

Richard Barager, MD

October 23, 2010Oct 23, 20105

In downtown Los Angeles recently, two very different celebrations went on within walking distance of each other. On West Temple Street, at the beautiful and contemporary Cathedral of Our Lady of the Angels—a structure with no right angles in its…

In downtown Los Angeles recently, two very different celebrations went on within walking distance of each other.

On West Temple Street, at the beautiful and contemporary Cathedral of Our Lady of the Angels—a structure with no right angles in its adobe-colored walls—Catholic Mass was offered throughout the morning, in both English and Spanish. Five blocks south, at the stunningly refurbished Millennium Biltmore Hotel on Grand Avenue, the Council for Secular Humanism, …

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Religious coping in dying patients

Patient voices

Continuity of care starts with caring

Hans Duvefelt, MD

October 22, 2010Oct 22, 20102

We often speak of the importance of continuity of care, but there is confusion about what this really means. When I first joined our small clinic twenty-five years ago, continuity was the reason every medical group in the five town…

We often speak of the importance of continuity of care, but there is confusion about what this really means.

When I first joined our small clinic twenty-five years ago, continuity was the reason every medical group in the five town area had its own night-call roster. This way, patients who called after hours could reach a doctor from their own doctor’s office. Even if the covering physician didn’t know the patient, …

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Continuity of care starts with caring

Drugs and prescribing

Arimidex price markup at major pharmacy chains

Leslie Ramirez, MD

October 22, 2010Oct 22, 20108

The commonly prescribed breast cancer drug, Arimidex, was released as a generic in June 2010. The generic name is anastrozole. I called several local pharmacies last week to find out how much this medicine would cost for a one-month supply.…

Costco: $27

Walgreens (with Saver Card): $325 (without Card): $380

CVS: $361

Walmart: $347

Target: $340

These are not typos. Costco is selling a one-month supply of generic Arimidex for $27, …

Physician voices

Doctors need to be aware of their office staff behavior

June Parker Beck

October 22, 2010Oct 22, 20105

by June Parker Beck At age 73 I have definitely seen the evolution of the whole "doctor" experience, from Ob/Gyn, to pediatrician (have 5 children) to specialist, to internist. I've learned to accept the fact that in this high tech…

by June Parker Beck

At age 73 I have definitely seen the evolution of the whole “doctor” experience, from Ob/Gyn, to pediatrician (have 5 children) to specialist, to internist.

I’ve learned to accept the fact that in this high tech age, we aren’t going to be chatting with our doctor about the grade school bake sale. The biggest lesson learned, however, was that if you are treated …

Medical education

Medical resident superstition and black clouds

Elizabeth Breuer, MD

October 22, 2010Oct 22, 20103

This month of my intern year, I am covering night float for the private hospital. Compared to the massive county hospital teeming with laboring patients, churning at all hours of the day and night, the private practice pace is meant…

This week however, has been nothing less than hell. One night, I was …

Patient voices

Using the internet for health information is not the exception

Susannah Fox

October 21, 2010Oct 21, 201010

New concepts need gimmicks. Proven concepts do not. The phenomenon of using the internet to gather and share health information is now mainstream. It’s time to change how we talk about it, revising and maybe even retiring certain terms. Some…

New concepts need gimmicks. Proven concepts do not.

The phenomenon of using the internet to gather and share health information is now mainstream. It’s time to change how we talk about it, revising and maybe even retiring certain terms.

Some history to build our case:

In 1998, only about one-third of American adults had access to the internet. Harris Interactive published pioneering research about how internet users gather health information online, dubbing these …

2010

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