It has been three months since I closed the door on my primary care office for the last time. It was with a heavy heart that I said goodbye to the many patients I cared for over the last six years. I am the fourth physician to leave the practice in as many years.
As the economy faltered, I found my private office practice had simply become unsustainable. With the popularity …
Primary care doctors are saying farewell
by Rick Bendinger, MD
I am a rural health provider in Abbeville, Alabama and have been here almost 30 years. I originally went to school on a public health scholarship and took the private practice option. This was a program that existed in the 1980s that paid for tuition and a stipend with the obligation to go either to a prison, rural area, or Indian reservation.
Sadly the program no longer exists. …
Rural medicine won’t be helped by health reform
by Joyce Frieden
Most patients who visit the emergency department (ED) four or more times a year have health insurance and a primary care physician, a review of the literature found.
“The uninsured represent only 15% of frequent users and are no more likely to be frequent users than they are to be occasional ED users (<4 visits/year),” Eduardo LaCalle, MD, MPH and Elaine Rabin, MD, of the Mount Sinai School of …
Patients who visit the emergency department have insurance
“On the Internet, nobody knows you’re a dog” was the caption of the famous cartoon by Peter Steiner in the July 5, 1993 issue of The New Yorker. The same is true of patient stories on health Web sites: nobody knows who really wrote them.
In the case of Lifestyle Lift, the company agreed to pay a $300,000 settlement last year to New York State because their patient stories were employee-generated.
Patient …
Patient stories on the web may not be real
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 …
Price transparency will improve patient care
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 …
Healthcare workers in the ER hit hard by H1N1
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 …
Real world meaningful use of health IT for physicians
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 …
Neosporin and other OTC drugs to avoid
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 …
Emergency departments are frequently used by young adults
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.
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 …
iPad review for doctors: A hands on guide for medicine
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 …
iPhone medical apps may be medical malpractice targets
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, …
Flu may be associated with seasonal deficiency of vitamin D
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 you.
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 …
Can house calls be revived under health reform?
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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 …
Statistical analysis in medical journals should be unbiased
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 …
Cell phone use and driving requires attention that few have
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 …
Op-ed: Patient satisfaction doesn’t mean the best medical care
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 …
Children who are traumatized need more than medication
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 …
Patient beliefs and their role in non-adherence
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, …
Retail clinics are starting to do more primary care
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 …
AMA: Health reform victories for physicians and what still needs to be done
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