A guest column by the American Medical Association, exclusive to KevinMD.com.
Physicians filing claims in $350M UnitedHealth Settlement can get help from new AMA guide
by J. James Rohack, MD
In mid-April, the first of 18 million people around the country began receiving legal notices containing details of a record-breaking settlement reached last January in a historic court challenge …
AMA legal battle a victory for fair pay from insurers
Added sugars hit a new low this week. A study published in JAMA found that people who consume higher quantities of added sugars have worse cholesterol profiles than those who consume less.
First of, what are added sugars? Added sugars simply put are sugars that are added into foods (in contrast to naturally-occurring sugars that you find in fruits). The JAMA article writes that added sugars are “defined as caloric sweeteners …
Added sugars worsen cholesterol levels
Although every day can bring surprises in a medical practice, you can develop a clinical team that can optimize the efficiencies of your operation and make it easier for you to see your patients.
There are three key areas that lead to provider frustration in daily operations: preparation and anticipation; the daily dance; and being in the moment. Address these, and your days should go more smoothly.
Preparation and anticipation
Are your charts …
Medical practice success depends on a strong clinical team
Generally, I find my practice works best when I get paid in dollars. They’re convenient. They can be transmitted electronically between bank accounts. Mary and Annie like them. I can spend them by swiping a credit card.
But, in a remarkable effort to win the “Let’s See How Stupid I Can Sound” award, a Nevada candidate for U.S. Senate has proposed ditching the idea of paying doctors in money, and going …
Bartering and whether doctors should be paid with chickens
The role of autopsy in the medical profession is difficult to overestimate. Western medicine takes its roots from comparative studies between patient’s symptoms and the findings on autopsy.
Participation in an autopsy was one of the most valuable lessons from medical school and residency. If you participated in the patient’s care, there is no greater educational tool than witnessing the postmortem exam. It is especially true if the cause of death …
Declining autopsy rate, and how that impacts doctors
When I recently walked into my local Apple store to buy an iPad accessory, I saw a group of about 20 people huddled around a large LCD screen while an Apple employee was giving a workshop.
When I saw the LCD screen full of medical applications, I was shocked. This wasn’t your run of the mill “how to use your iPhone” workshop.
The people gathered for the workshop consisted of healthcare professionals …
Apple Store is demonstrating iPhone EMR apps to physicians
There is a lot of focus on what elders with dementia can’t do. But what about more discussion of what they can do?
When you see a patient with dementia, how do you help family members maintain meaningful interactions with their loved ones? I am sad to admit that I don’t do this nearly as well as I should. After all, this is not the type of thing we are taught …
Activities for family members with dementia
by Michael Smith
When cesarean section rates are lower than expected, adverse maternal or neonatal outcomes are higher, researchers said.
But the converse isn’t true — higher-than-expected C-section rates aren’t associated with a protective effect, according to Sindhu Srinivas, MD, of the University of Pennsylvania, and colleagues.
The finding comes from an attempt to see if the risk-adjusted C-section rate can be used as a marker for the quality of obstetric care, Srinivas …
C-section rates as a marker for obstetric care quality
I have spent most of the past 2 weeks on the road – first at ACP and this week at SGIM. I have talked with many internists, but several conversations have contributed to writing this post. Each of several leaders contributed to these ideas, but I will keep them anonymous so the innocent are protected.
Here are the main assumptions:
1. Internists by training excel in the care of complexity
2. Pursuing the …
Outpatient internal medicine needs a consultant track
Beau Biden, son of Vice President Joe Biden, suffered a stroke today.
He is 41-years old, and is expected to make a full recovery according to the medical director of the Center for Heart and Vascular Surgery at Christiana Care Health System:
Biden has what the doctors “believe to be a mild stroke,” according to Gardner. “[He is] “fully alert, …
Much like many other news items, I came upon the one about the proposed name change for Physician Assistants quite by accident: it came to me as an e-mail notification of a new topic being discussed on one of the physician only discussion boards that I am a part of. Apparently, after 40+ years of the profession’s existence, there is a grassroots effort afoot to upgrade the name, and presumably …
Physician assistant name change rubs doctors the wrong way
An audiobook except from Intern: A Doctor’s Initiation, now available for download on iTunes.
Intern: A Doctor’s Initiation — Click to play audioclip
by Sandeep Jauhar, MD
Chapter one
I had been an intern less than an hour, and already I was running late. The sloping footpath leading up to the hospital was paved with gray cobblestones. My feet ached as my oversize leather …
Intern: A Doctor’s Initiation, an audiobook excerpt
by Joyce Frieden
In one of those “important but little noticed” announcements that government officials are prone to put out, the Department of Health and Human Services recently let the world know – via the Federal Register — that it has created an Office of Consumer Information and Insurance Oversight to assist with implementation of the newly passed health insurance reform law.
This new office has four divisions. Here are a …
Health insurance will be reformed by a little known department
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The heresy of one age becomes the orthodoxy of the next.
-Helen Keller
The patient returned to my clinic several years after her original thyroid cancer surgery. “The cancer blood test never went completely back to zero,” she told me. “We knew there was cancer in there somewhere. Finally, the new ultrasound machine found it! I guess it is time for more surgery!”
I guess. In my patient’s situation, the latest high resolution diagnostic …
Treating cancer needs to be an individual patient decision
A guest column by the American Board of Internal Medicine, exclusive to KevinMD.com.
Imagine a sub-par doctor at a vibrant health system with care delivered and coordinated by skilled teams, using robust EHRs and other vital supports for physicians and patients. Now imagine an extremely talented, knowledgeable doctor at an underfunded community clinic. This clinic has no real computer system, …
ABIM: Quality medical care needs more than strong systems
My friend, the Buckeye Surgeon, has resisted reforms in medical residency training programs, that have eased some of the inhumane exhaustion on young interns and residents.
I have a different view on the subject. This issue generates spirited debate in the blogosphere and in teaching hospitals across the country.
Not all medical education reforms, however, provoke controversy. I learned recently from an Ohio medical student that they are now being taught …
Transparent medical pricing lowers health costs
A patient apologized to me for asking so many questions. There is no need to apologize, I said to the patient; it’s wonderful that you have so many questions concerning your health care. I mentioned to her that she is an “empowered and engaged patient,” and that is a good thing.
It’s no secret that health consumers are turning to the internet for health information.
In a recent article from MediaPost News, …
Social media starts the patient dialogue with doctors and nurses
by John Gever
Up to one-third of children with febrile bacterial infections failed to receive antibiotics in a large emergency department, while 20% of youngsters without such infections received antibiotics unnecessarily, Australian researchers said.
A computer algorithm based on standard test results could do a better job of assigning feverish children to the correct treatment sooner, Jonathan C. Craig, MBChB, PhD, of the University of Sydney, and colleagues reported online in BMJ.
Although …
Children with fever may not receive antibiotics in the ER
One of the biggest emergency room problems is contacting patients after they leave.
Patients sometimes leave false contact information — which makes it difficult for the emergency room staff should problems arise after the visit.
The issue was illustrated in a piece from msnbc.com. Many times, results like blood cultures or x-ray findings take time to return. And if there’s something that needs to be acted upon, contacting the …
False patient contact information worsens emergency care
An excerpt from How to Survive a Medical Malpractice Lawsuit: The Physician’s Roadmap for Success.
by Ilene R. Brenner, MD
The most important part of your case is upon you: the pretrial deposition. If you do a poor job, you can ruin your case and make a defensible lawsuit become indefensible.
So what is a deposition? It is the sworn testimony of a witness taken before trial, in a location …
Medical malpractice deposition survival tips for doctors
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