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Triage pathways make patients feel disconnected from their doctors

Physician

September 17, 2010

There are things we (the providers) do to health care that are hurtful. We make protocols and rules that divide us from our patients. Protocols that sometimes make patients feel alone, distant, and disconnected from their doctors. I don’t mean algorithms of care (safe, standardized ways of how and why to treat pneumonia, for example), I mean clinic rules for helping patients schedule and get in to see doctors appropriately.

Triage …

There is no alternative medicine, only unproven medicine

George Lundberg, MD

Conditions and Diseases

September 17, 2010

There is no Alternative Medicine.

Thus sprach Phil Fontanarosa and me in a 1998 JAMA editorial in the famous theme issue dedicated to Complementary and Alternative Medicine.

So I went to Mr. Google in 2010 and entered … Alternative Medicine … and clicked — 41,200,000 results; entered Complementary and Alternative Medicine, click — 3,210,000 results; entered CAM, click — 191,000,000 results, but that’s not fair; CAM can stand for many unrelated topics.

Let’s …

Chronic prostatitis is a public health problem

Arnon Krongrad, MD

Conditions and Diseases

September 17, 2010

by Arnon Krongrad, MD

David was afraid. After years of peregrinations with pain, he had exhausted all the options. David knew he wasn’t crazy. The problem was the doctors: They had no more treatments for chronic prostatitis. The doctors did not want to see him.

Chronic prostatitis is a public health problem. Contrasted with fibromyalgia, autism, and breast cancer, however, nobody talks about it. President Obama declared …

AMA: Ensuring medical education best prepares future physicians

Kevin

Medical Education

September 16, 2010

A guest column by the American Medical Association, exclusive to KevinMD.com.

by J. James Rohack, MD

This year marks the 100th anniversary of the landmark Flexner Report that standardized medical education in North America. Now, during this historic time of health system change, medical education reforms on the scale of those enacted a century ago are needed …

Powerful examples of using the iPad on the wards

Vineet Arora, MD

Health Technology

September 16, 2010

I recently completed a two week tour of duty on the wards in July with new residents, interns, and students.

Attending (serving as the supervising doctor for the team of residents, interns and students) in July can be challenging, but also one of the most rewarding clinical experiences as a faculty member. The interns and residents are eager to learn and your teaching may have a more lasting impact as the residents …

Goals when starting medicine and how some have been disillusioned

Gizabeth Shyder, MD

Physician

September 16, 2010

When I went into medicine, I had clear goals in mind. Helping people. A stable income to provide for a family. I grew up under the spotlight of my father, who is a neonatologist, and lived in awe of his work. I remember being in restaurants with my dad – people would come up to him reverently and sing his praises (to his obvious embarrassment).

Talk about their son or daughter …

Business reasons to get compliant with HIPAA

Rosemarie Nelson

Physician

September 16, 2010

In addition to providing those incentive dollars for meaningful use of a certified EHR, the Health Information Technology for Economic and Clinical Health Act (HITECH) significantly strengthened aspects of the HIPAA security rule, including the penalties imposed under HHS and the Office of Civil Rights.

If you are a “Covered Entity” (CE) or “Business Associate” (BA) it’s time to get serious, the deadline to be fully compliant with these final HIPAA …

Can scientific knowledge overcome uncontrollable food behavior?

Susan Biali Haas, MD

Conditions and Diseases

September 16, 2010

I’ve struggled almost my whole life with food. During my late teens I was obsessed with dieting and calorie-counting, which turned into compulsive eating and a powerful addiction to sugary, fatty foods in my 20’s and 30’s – even though I had both a medical degree and a degree in dietetics (human nutrition).

Obviously, having scientific knowledge about food and health isn’t enough to help someone control their uncontrollable behavior around …

Physicians love their work but are frustrated

Aldebra Schroll, MD

Physician

September 15, 2010

I recently finished reading In Their Own Words: 12,000 Physicians Reveal their Thoughts on Medical Practice in America. It is a summary of a 2008 survey from the Physicians Foundation. I vaguely remember filling out this survey. I was interested to see what my colleagues had to say.

Many physicians describe themselves as at the breaking point.

“I am so mired in this mess that I can’t see clearly enough to give …

Physicians must be aware of what they know they don’t know

Kent Bottles, MD

Physician

September 15, 2010

St. Augustine: “Fallor ergo sum”

When I was in charge of the medical residency programs in Grand Rapids, Michigan, David Leach introduced me to the expanded Dreyfus Model of how physicians can progress from beginners to masters.

I was always struck by how master physicians freely admitted their mistakes and used them as a teaching tool. As a young surgical and cytopathologist, my sanity was saved more than once by University of …

Health decisions are not entirely based on evidence based data

Kathy Kastner

Conditions and Diseases

September 15, 2010

“Science tells us nothing about the individual.”

So said Dr. Susan Pinker, psychologist and author. This perfectly articulated truth puts into perspective popular thinking: To make a decision, the most important thing is evidence-based information: all you need is science. To this I say, that’s a bunch of hooey. Science tells us nothing about the individual. Thank you Dr. Pinker.

Creating the expectation that health decisions are entirely based on evidence-based information …

Emergency department utilization and its impact on health care reform

Kevin

Health Policy

September 15, 2010

by James P. Davison, DO

Emergency department utilization and its impact on health care reform legislation has been a hot topic of conversation in healthcare journals and the blogosphere. It is a tenet of the currant legislation that ER visits and cost growth will go down, contributing to a decreased health cost growth curve.

Opponents state the newly insured will flock to the nation’s emergency rooms. Proponents …

How CPOE violated medical ethics

Kevin

Health Technology

September 14, 2010

by MedInformaticsMD

As a result of my mother’s health IT-related cerebral hemorrhage and resultant multi-month hospitalization, with transfers to nursing homes then back to acute care due to setbacks, I recently had the chance to observe her care in a small community hospital.

This was a hospital that, in her last several days there before going back to a nursing home …

Read more…

How CPOE violated medical ethics

Does the DSM-5 medicalize normal behavior?

MedPage Today

Conditions and Diseases

September 14, 2010

by John Gever

Just about everyone catches colds, and just about everyone who gets one is able to go to work and cook their meals, and they nearly always recover within a few days whether or not they take anything for it. That’s normal.

So, is the advice to take aspirin “medicalizing normal behavior”? Are drug companies that market decongestants and fever reducers “medicalizing normal behavior”?

The answer …

Talk to your own doctor when hearing advice on the radio

Kevin

Patient

September 14, 2010

by Adam Linker

A doctor at Sloan-Kettering Cancer Center recently advised that I submit to genetic testing without ever having met me. It turns out I may harbor a gene that increases my risk of developing prostate cancer.

This unsolicited advice was delivered via National Public Radio after a story on the JAMA study of preventive breast and ovarian surgery in women with BRCA1 or BRCA2 genes. Dr. …

Social science requirements for pre-medical students

Robert Wachter, MD

Medical Education

September 13, 2010

I thought I was an oddball in college. I’ve only recently learned that I was avant garde.

Right before beginning college in 1975, I decided I wanted to be a doctor. Being the first-born son – with decent SATs – of an upwardly mobile Long Island Jewish family, I had relatively little choice in the matter. Notwithstanding this predestiny, I felt confident that medicine was a good fit for my interests …

Is health care shifting towards convenient retail clinics?

David Williams

Physician

September 13, 2010

Mark Perry provides an interesting inference from two news stories: a WSJ article that suggests consumers are using less health care and another that reports a big jump in MinuteClinic volumes.

Consumers aren’t necessarily consuming less health care like the WSJ suggests; rather, they are shifting their demand for health care away from expensive, conventional physician offices with limited hours to affordable and convenient retail clinics. Especially …

A primary care physician who knows history and can relate to people

Kevin

Patient

September 13, 2010

by Marianne Mattera

Recently, a press release from Mount Sinai School of Medicine in New York City landed in my e-mail inbox. “Students with Humanities Background Equally Successful in Medical School as Traditional Students”, the headline read.

The press release summarized the findings of a study published in the August issue of Academic Medicine. David Muller, MD, and Nathan Kase, MD, reviewed data on the Mount Sinai …

All patients will soon become e-patients

Kevin

Patient

September 13, 2010

by Daphne Swancutt

I’m having a weird, visceral reaction to all of the recent brouhaha surrounding the term “e-patient.”

For some reason, semantically speaking, the term is slipping in to derogatorium. Up there with “cyberchondriac,” which definitely is derogatory. It’s kind of like research—one day, omigod, it’s Mecca; the next day, it’s the scab on a rotting wound.

Whatever.

I have a chronic condition—I’m not dying, it’s not …