2010

April 13, 2010Apr 13, 201012

Debora T. had a blood pressure of 180/110 during her routine visit in my internal medicine clinic. She was already on every blood pressure medication I could think of, save one -- amlodipine. I prescribed the medicine and asked her…

Debora T. had a blood pressure of 180/110 during her routine visit in my internal medicine clinic. She was already on every blood pressure medication I could think of, save one — amlodipine. I prescribed the medicine and asked her to follow up in a week. I feared her blood pressure was going to cause a stroke if it went up any higher.

At our next visit, her blood pressure was …

Physician voices

Healthcare workers in the ER hit hard by H1N1

MedPage Today

April 13, 2010Apr 13, 2010

by Michael Smith Healthcare workers in a New York City emergency department had the highest rate of infection among employees of an urban hospital system during the first wave of the H1N1 pandemic flu, researchers said. In a single-institution study…

by Michael Smith

Healthcare workers in a New York City emergency department had the highest rate of infection among employees of an urban hospital system during the first wave of the H1N1 pandemic flu, researchers said.

In a single-institution study using medical and administrative records, the adult emergency department had an H1N1 infection rate of 28.8% during April, May, and June of 2009, according to Robert Bristow, MD, and colleagues at New …

Health technology

Real world meaningful use of health IT for physicians

David C. Kibbe, MD, MBA

April 13, 2010Apr 13, 20106

by David C. Kibbe, MD, MBA An article in the April 10, 2010 New York Times entitled "Doctors and Patients, Lost in Paperwork," brought attention to what may be, in the near term, the Achilles heel of the plan to…

by David C. Kibbe, MD, MBA

An article in the April 10, 2010 New York Times entitled “Doctors and Patients, Lost in Paperwork,” brought attention to what may be, in the near term, the Achilles heel of the plan to incentivize doctors for the “meaningful use of EHR technology.”

The article cited a study published in the Archives of Internal Medicine this past February, which asked a large cohort of physicians in …

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Drugs and prescribing

Neosporin and other OTC drugs to avoid

Edward Pullen, MD

April 12, 2010Apr 12, 201011

Most people use non-prescription medications without giving much thought to the potential side effects or problems that may be associated with their use. Here are 5 popular OTC meds you should avoid, and better alternatives. I bet most of you…

Most people use non-prescription medications without giving much thought to the potential side effects or problems that may be associated with their use.

Here are 5 popular OTC meds you should avoid, and better alternatives. I bet most of you use one or more of these. Neosporin, Topical Vitamin E, Afrin nasal spray (or other short acting nasal decongestant sprays), daily headache medications, and sedating antihistamines.

1. Neosporin: Neosporin in the most …

Read more…

Neosporin and other OTC drugs to avoid

Physician voices

Emergency departments are frequently used by young adults

MedPage Today

April 12, 2010Apr 12, 20105

by Kristina Fiore Twenty-somethings rely on emergency departments (EDs) for care far more than do other age groups, researchers have found. In 2006, nearly a quarter of all young adult healthcare visits -- 22.1% -- took place at an ED,…

by Kristina Fiore

Twenty-somethings rely on emergency departments (EDs) for care far more than do other age groups, researchers have found.

In 2006, nearly a quarter of all young adult healthcare visits — 22.1% — took place at an ED, compared with 12.6% for children and adolescents and 8.3% for patients over 30.

That rate has significantly increased over a 10-year period, Robert J. Fortuna, MD, MPH, of the University of Rochester Medical …

Health technology

iPad review for doctors: A hands on guide for medicine

Iltifat Husain, MD

April 12, 2010Apr 12, 201021

The iPad has finally been released and we’ve got our hands on one so we can provide the medical community a healthcare perspective of the device. Here are my initial impressions. Fits in your white coat The iPad should fit…

The iPad has finally been released and we’ve got our hands on one so we can provide the medical community a healthcare perspective of the device. Here are my initial impressions.

Fits in your white coat

The iPad should fit comfortably your white coat. If you continue on to the rest of the review you’ll see pictures of the device easily settling into …

Health technology

iPhone medical apps may be medical malpractice targets

Satish Misra, MD

April 11, 2010Apr 11, 20105

Medical practice is a big business. Conservative estimates put the total cost of medical malpractice at nearly $35 billion annually and, according to a Kaiser Family Foundation report, nearly $5 billion is paid in claims each year. With an average claims payment of about $300,000 and up to 50% of that going to the lawyers representing the patient, its not surprising that practically every show on cable television has at …

Conditions and diseases

Flu may be associated with seasonal deficiency of vitamin D

MedPage Today

April 11, 2010Apr 11, 20104

by Michael Smith If you look at the world map, the shapes of South America and Africa look as though they should fit together. Maybe they were once together and then drifted apart. That theory was first put forward in…

by Michael Smith

If you look at the world map, the shapes of South America and Africa look as though they should fit together. Maybe they were once together and then drifted apart.

That theory was first put forward in the late 1500s by a Dutch map maker, but it wasn’t until the 1960s that the discovery of plate tectonics finally put the idea on a — well, …

Physician voices

Can house calls be revived under health reform?

John Schumann, MD

April 11, 2010Apr 11, 20109

Beginning in the 1970s, the house call began a slow death. As the medical-industrial complex (MIC) burgeoned, with bigger hospitals and a surfeit of technology, it became incumbent on patients to come see us rather than us going to see…

Yet there are pockets of house calls still left in the U.S.

For the geriatric age group, there has been growth in the care-at-home sector, especially for homebound elders. They can …

Drugs and prescribing

Statistical analysis in medical journals should be unbiased

MedPage Today

April 10, 2010Apr 10, 20104

by Todd Neale Editors of medical journals should unite in requiring independent statistical analyses of industry-sponsored clinical trials, according to the two top editors of the Journal of the American Medical Association. Such a measure would help prevent any inappropriate…

by Todd Neale

Editors of medical journals should unite in requiring independent statistical analyses of industry-sponsored clinical trials, according to the two top editors of the Journal of the American Medical Association.

Such a measure would help prevent any inappropriate influence from the study sponsors on data analysis and reporting, wrote Catherine DeAngelis, MD, MPH, editor-in-chief of JAMA, and Phil Fontanarosa, MD, MBA, executive deputy editor …

Conditions and diseases

Cell phone use and driving requires attention that few have

MedPage Today

April 10, 2010Apr 10, 20104

by Crystal Phend Only one person in 40 has an extraordinary ability to do safely what many take for granted in daily life -- talk on a cell phone while driving. These "supertaskers" excelled on a simulated driving exercise and…

by Crystal Phend

Only one person in 40 has an extraordinary ability to do safely what many take for granted in daily life — talk on a cell phone while driving.

These “supertaskers” excelled on a simulated driving exercise and a demanding, simultaneous test of memory and math skills conducted over the phone without any loss in performance on either, according to Jason M. Watson, PhD, and David L. Strayer, PhD, both …

Health policy

Op-ed: Patient satisfaction doesn’t mean the best medical care

Kevin Pho, MD

April 10, 2010Apr 10, 201016

A version of this op-ed was published on March 15th, 2010 in the USA Today. If you recently saw a doctor, you might subsequently receive a survey in the mail asking whether your physician was friendly, spent enough time with…

A version of this op-ed was published on March 15th, 2010 in the USA Today.

If you recently saw a doctor, you might subsequently receive a survey in the mail asking whether your physician was friendly, spent enough time with you, or showed the appropriate level of concern for your medical issues.

Patient satisfaction surveys are being increasingly used in hospitals nationwide. Press Ganey, a leading organization measuring patient satisfaction, counts more …

Drugs and prescribing

Children who are traumatized need more than medication

Claudia M. Gold, MD

April 9, 2010Apr 9, 2010

In the Academy Award winning film, Precious, the main character’s transformation comes about largely through her ability to tell the story of her trauma, specifically in the form of writing. In this endeavor she is encouraged by a loving teacher.…

In the Academy Award winning film, Precious, the main character’s transformation comes about largely through her ability to tell the story of her trauma, specifically in the form of writing. In this endeavor she is encouraged by a loving teacher.

In the book History Beyond Trauma, two French psychoanalysts argue that symptoms their patients exhibit represent the horrors of war that are not spoken of, sometimes for generations. The patient is …

Patient voices

Patient beliefs and their role in non-adherence

Steve Wilkins, MPH

April 9, 2010Apr 9, 20105

Patient non-adherence is a big problem. Non-adherence among chronic disease patients is associated with higher rates of hospital re-admissions, higher costs and poorer outcomes. Research has identified over 200 possible factors thought to influence patient adherence. According to the experts,…

Patient non-adherence is a big problem. Non-adherence among chronic disease patients is associated with higher rates of hospital re-admissions, higher costs and poorer outcomes.

Research has identified over 200 possible factors thought to influence patient adherence. According to the experts, these factors can be categorized into two groups:

1. unintentional non-adherence
2. intentional non-adherence.

Unintentional non-adherence is related to a patient’s ability and resources to take their medication (e.g., problems with manual …

Physician voices

Retail clinics are starting to do more primary care

MedPage Today

April 9, 2010Apr 9, 201015

by Joyce Frieden Retail clinics aren't just for strep throats any more; they'll also be managing diabetes and other chronic diseases. "It's a new service strategy," Sandra Ryan, CPNP, told attendees at a meeting on retail clinics sponsored by the…

by Joyce Frieden

Retail clinics aren’t just for strep throats any more; they’ll also be managing diabetes and other chronic diseases.

“It’s a new service strategy,” Sandra Ryan, CPNP, told attendees at a meeting on retail clinics sponsored by the Convenient Care Association and the Jefferson School of Population Health.

“We’re evolving our clinic offerings,” said Ryan, chief nurse practitioner officer for Take Care Health Systems, which operates retail clinics inside Walgreens pharmacies, …

Health policy

AMA: Health reform victories for physicians and what still needs to be done

American Medical Association & J. James Rohack, MD

April 8, 2010Apr 8, 201043

A guest column by the American Medical Association, exclusive to KevinMD.com. by J. James Rohack, MD As our country turns the corner on the historic path toward health system reform, many physicians are left with questions as to how this…

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

by J. James Rohack, MD

As our country turns the corner on the historic path toward health system reform, many physicians are left with questions as to how this new law will affect them and their patients.

The AMA has been an active participant in the health reform debate since the beginning and guided by our House of Delegates, …

Medical education

Medicine residency survival tips during pregnancy

Anonymous

April 8, 2010Apr 8, 20105

Q. I just found out last week that I'll be a new mom in November, making me an official mother in medicine! I've been reading the blog for a while, because I love hearing what all of you have to…

Q. I just found out last week that I’ll be a new mom in November, making me an official mother in medicine! I’ve been reading the blog for a while, because I love hearing what all of you have to say about your lives. Here’s my question: What tips would you give for surviving residency while pregnant, especially 30-hour calls (without caffeine)?

— From a future mom and Family Medicine resident …

Patient voices

Advance planning helps families cope with loss

MedPage Today

April 8, 2010Apr 8, 2010

by Crystal Phend Advance planning improves end-of-life care for elderly patients and helps families cope with the loss, researchers found. In a randomized trial, hospitalized patients over age 80 who were formally assisted with documenting their end-of-life treatment wishes and…

by Crystal Phend

Advance planning improves end-of-life care for elderly patients and helps families cope with the loss, researchers found.

In a randomized trial, hospitalized patients over age 80 who were formally assisted with documenting their end-of-life treatment wishes and with designating a surrogate were almost three times more likely to have those wishes followed (86% versus 30% in usual care, P<0.001).

Family members of patients in the advance planning intervention reported significantly …

Physician voices

Preventive medicine may not always help patients

Amy Tuteur, MD

April 8, 2010Apr 8, 201014

If there's one thing everyone agrees on, it's that preventive care is always a good thing. Well, I'm a doctor and I'm afraid of preventive medicine. The theory behind preventive medicine is sound. It is better to treat prevent disease…

If there’s one thing everyone agrees on, it’s that preventive care is always a good thing. Well, I’m a doctor and I’m afraid of preventive medicine.

The theory behind preventive medicine is sound. It is better to treat prevent disease than to treat it. It is better to refrain from smoking and never get lung cancer than it is to treat lung cancer. It is better to refrain from alcohol abuse …

Drugs and prescribing

Psychiatry benefits when psychologists prescribe drugs

Daniel J. Carlat, MD

April 7, 2010Apr 7, 201030

I want to touch on what is probably the hottest topic in psychiatry: whether psychologists should obtain prescription privileges. This is topical because Oregon just overwhelmingly passed a law authorizing prescriptive privileges for psychologists, although it is unclear whether the…

I endorse psychologists prescribing, and here’s why: it would be the single best thing that could happen to psychiatry.

Yes, I know it sounds ridiculous, but …

2010

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Fits in your white coat

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