Female genital cutting complications

Conditions and Diseases
May 19, 2010

by Todd Neale

Clinicians should actively persuade families not to participate in the ritual cutting of female genitalia, the American Academy of Pediatrics urged.

However, the organization suggested that legislatures and doctors might ultimately consider legalizing ritual “nicks” to satisfy cultural or religious demands without more serious and problematic cutting.

The centuries-old practice, which is illegal in the U.S. and several other developed countries, carries with it a host of physical and psychological …

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Female genital cutting complications

Defensive medicine starts early in residency training

Physician
May 19, 2010

Part of a resident’s job is to learn the ropes in preparing for independent practice. While you’re a resident, you get the benefit of having someone looking over your shoulder to critique you as you determine how you are going to manage patients.

I frequently tell residents that different attending physicians practice medicine in different ways. Some practice defensive medicine more than others, some prescribe antibiotics more than others and some …

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Defensive medicine starts early in residency training

ACP: Can medical societies interact ethically with commercial entities?

Health Policy
May 18, 2010

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

by Steven Weinberger, MD, FACP

acp-logoThe Council of Medical Specialty Societies (CMSS) recently developed its “Code for Interactions with Companies,” which outlined the principles that should guide relationships between medical societies and commercial entities, including pharmaceutical companies and medical device manufacturers. Although a subsequent editorial in the New …

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ACP: Can medical societies interact ethically with commercial entities?

Why primary care doesn’t appeal to this medical student

Medical Education
May 18, 2010

I try to read as much as I can of everything floating around the medical blogosphere. I think the most recurrent topic I come across is why current medical students aren’t choosing to go into primary care.

It’s a great topic that relates to health care reform, making it ripe for medical bloggers to comment on relentlessly. Probably the most often cited reason is low reimbursement for primary care (read: primary …

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Why primary care doesn’t appeal to this medical student

Children with DNR orders and the liability risk for schools

Patient
May 18, 2010

by Crystal Phend

When children with complex chronic diseases have do-not-attempt-resuscitation orders in place, schools should honor them, the American Academy of Pediatrics urged.

More children with diseases that may involve sudden and potentially fatal attacks are attending school due to legal and societal trends over the past decade, according to a statement in the May issue of Pediatrics.

While these requests are honored in hospitals and nursing homes, schools may find it …

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Children with DNR orders and the liability risk for schools

Burnout is common to teaching violin and practicing medicine

Medical Education
May 18, 2010

I went to medical school and know something about what it’s like to work in clinical environments.

I’ve recently started reading blogs and articles about “physician burnout” and I can’t help but notice that there’s a lot of blame being placed on “the system”. Doesn’t this kind of storytelling just reinforce that physicians are victims? I’d like to see physicians adopt a way of thinking that will enable them to create …

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Burnout is common to teaching violin and practicing medicine

Blood tests in hospitals may be unnecessary

Physician
May 17, 2010

I’ve just finished a month “on-service” as a teaching attending for a general medicine team here at GlassHospital. This means I served as the physician of record for every patient admitted to the team.

You might find it interesting to know that patients admitted to the hospital’s general medicine service get assigned to their teams by random assortment. Since there are five teams, one team takes call every fifth day. …

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Blood tests in hospitals may be unnecessary

Doctors may be forced to accept Medicare rates to stay licensed

Health Policy
May 17, 2010

Massachusetts has a problem.

In April 2007, they became the first state to require residents to have health insurance. Reportedly this has resulted in 300,000 newly insured patients and lowered the uninsured population to 5%. But of course, given the relatively poor reimbursement rates for primary care providers, especially when it comes to government insurance, the state is facing a growing shortage of primary care providers.

Without an adequate supply of primary …

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Doctors may be forced to accept Medicare rates to stay licensed

Physician assistant not associate: Reasons against a name change

Health Policy
May 17, 2010

In reference to the seemingly “simple” name change being proposed for Physician Assistants to Physician Associates, I take great exception to the commentary offered by Dr. Zilberberg in her recent article entitled, Physician assistant name change rubs doctors the wrong way.

She states: “Physicians have been only too successful at becoming the final word in health, at the exclusion of all others.”

Physicians are the highest and most extensively trained group …

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Physician assistant not associate: Reasons against a name change

Body mass index (BMI) may not measure obesity accurately

Conditions and Diseases
May 17, 2010

by Kristina Fiore

The scale of the obesity epidemic may be much worse than currently believed, because the usual measure, body mass index (BMI), is a very insensitive measure of excess body fat, researchers said.

In a single-center study, 66% of patients classified as obese on the basis of DEXA scanning had BMI values in the nonobese range, according to Eric Braverman, MD, of New York Presbyterian Hospital/Weill Cornell Medical Center.

Among more …

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Body mass index (BMI) may not measure obesity accurately

Patient wants an apology, not money, after medical malpractice

Physician
May 16, 2010

by Tricia Pil, MD

This is the true story of a hospitalization as told from three points of view: first, the recollections of the patient (who happens to be a physician); second, events as recorded in the medical charts by doctors and nurses; and third, the version put forth by the hospital.

FRIDAY

Patient:
It is fall 2005, and I am nine months pregnant. A healthy 33-year-old pediatrician, I am a longtime patient of …

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Patient wants an apology, not money, after medical malpractice

Pediatricians have a role in reporting domestic violence

Conditions and Diseases
May 16, 2010

by Crystal Phend

One of the most effective ways to prevent child abuse may be for pediatricians to identify domestic violence against a child’s caregiver, according to a report from the American Academy of Pediatrics.

Intimate partner violence in the home has a profound effect on kids, Jonathan D. Thackeray, MD, of Columbus Children’s Hospital in Columbus, Ohio, and colleagues wrote in the May issue of Pediatrics.

They pointed to elevated risk of …

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Pediatricians have a role in reporting domestic violence

Crucial public health issues facing legalizing marijuana

Medications
May 16, 2010

So what do I know about this issue? As the physician and City public health administrator tasked with the initial implementation of Proposition 215 (legalizing medical marijuana) – I learned a lot.

On the data side, I compiled every bit of published research about marijuana (positive and negative) from the previous thirty years, researching every conceivable symptom and/or adverse event. The results were published and widely cited. I also …

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Crucial public health issues facing legalizing marijuana

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EHR notes and the cut and paste documentation problem

Health Technology
May 15, 2010

“Detritus.”

Not only was that a chance for the Disease Management Care Blog to refamiliarize itself with an underused noun (and, er, its spelling), that was the telling term used today by a DMCB colleague to describe the output from a local health system’s electronic health record (EHR).

He had received a copy of a lengthy consultant-physician’s documentation involving one of his patients and was astonished by the blob of past …

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EHR notes and the cut and paste documentation problem

Brainstorming other income opportunities for doctors

Physician
May 15, 2010

Once you’ve decided that you want to explore other income opportunities, then it’s time to do some preliminary brainstorming.

The goal here is to create a list of business ideas that you would find success in and be happy with. As a physician, you have a distinct advantage if your business plan involves the medical field. However, you do not need to limit yourself to this field as there are enumerable …

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Brainstorming other income opportunities for doctors

Endocrinologists may improve surgical care in diabetic patients

Physician
May 15, 2010

by Kristina Fiore

Shorter hospital stays and lower costs were the result when surgical patients with diabetes and dysglycemia received endocrinology consults, researchers said.

Adding endocrinologists to surgical care teams for patients with abnormal blood glucose readings cut total length of stay among patients in a single center by 1,342 days and saved the hospital $1.15 million, according to Arthur Chernoff, MD, of Albert Einstein Medical Center in Philadelphia.

Chernoff presented his findings …

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Endocrinologists may improve surgical care in diabetic patients

Pediatricians need to wonder when dealing with behavior problems

Conditions and Diseases
May 15, 2010

Last week, I again had the privilege of teaching pediatricians in training. These students were very bright, challenging and asked excellent questions. They all agreed about the limit of the pediatric model of “giving advice.” One resident, who had young children of her own, spoke of new mothers using blogs for emotional support. Many of these mothers speak less than kindly about their pediatricians, who they perceive as “not getting …

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Pediatricians need to wonder when dealing with behavior problems

How doctors can reduce unnecessary tests and treatments

Health Policy
May 14, 2010

Several years ago, when my wife directed the third-year Family Medicine clinical clerkship at a highly ranked medical school, she developed a popular workshop on the cost of health care that presented students with scenarios of patients who were either uninsured or underinsured and challenged them to provide cost-conscious health care by selecting medications and tests that were clinically appropriate and financially affordable.

Many students remarked that it was the only …

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How doctors can reduce unnecessary tests and treatments

Doctors are focusing on lifestyle when practicing medicine

Health Policy
May 14, 2010

An interview with Elizabeth Chase, MD, obstetrician-gynecologist in Dover, New Hampshire

Elizabeth Chase, better known as Betsy, is a close and enduring college friend of my son, Spencer. She is a solid, pragmatic, hard working obstetrician-gynecologist, with two sons, and an architect husband, who spends his time caring for their children and their house in Dover, New Hampshire. She represents many of changes that occur when women become full-time physicians. The …

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Doctors are focusing on lifestyle when practicing medicine

Fight against salt needs consumer help

Medications
May 14, 2010

by Cole Petrochko

As a person who has handled salt in cooking, is prone to headaches from sodium, and has written an article on legislating salt content in prepared and packaged foods, let me tell you about salt, because I know a thing or two.

Well, it would be hard to not know much about salt after the recent string of attention paid to the “white shaken one” — eat too …

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Fight against salt needs consumer help

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