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What a golf course taught me about patient satisfaction

Physician

August 20, 2014

Over the last year I’ve become rather addicted to golf. Having always been more into cardiovascular sports I’m actually quite surprised with how much I’ve taken to it. Fresh air, outdoors, lots of walking in beautiful nature and spending time with friends — what is there not to like?

Anyway, I’ve frequented several different courses in the Boston area in just the last few months. Last week, we were due to …

A physician reflects on Robin Williams

David L. Katz, MD

Physician

August 20, 2014

I was shocked and deeply saddened when my daughter announced at the dinner table that Robin Williams had died of an apparent suicide. My wife and I and the three of our children home at the time all pretty much gasped audibly in unison, and then for a moment after, you could have heard a pin drop.

For a bit after that, we talked about our shock and sorrow. And then after that, …

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A physician reflects on Robin Williams

Why do some patients go to the doctor in the first place?

Jordan Grumet, MD

Physician

August 20, 2014

William was doing great. His C. Diff was finally gone after a month taper of vancomycin. He was stronger. The nursing home staff reveled in how much progress was being made over such little time. It seemed every one was ecstatic, except for, of course his family. Every step this octogenarian took forward was accompanied by a litany of concerns and complaints from his daughter.

If he was not gaining weight, …

Being a good parent means being unpopular sometimes

Claire McCarthy, MD

Physician

August 20, 2014

I see it again and again in my practice: parents who seem to have forgotten that they are in charge.

“You can say no,” I find myself saying to family after family. Which is kind of an amazing thing to have to say, if you think about it. You’d think that parents would know that they can say no when their child asks for yet another toy, to watch more television, …

Society’s mismanagement of the mentally ill is a disgrace

Allen Frances, MD

Conditions and Diseases

August 20, 2014

We are civilized people in the United States. We don’t set up leper colonies or concentration camps or psychiatric snake pits to banish people with severe mental illness. Instead we send them to jail or prison — almost 400,000 of them, more than 10 times the number receiving care in hospitals. And we also blithely ignore the fact that additional hundreds of thousands live homeless on the streets or in …

Teach the basics of practice management to medical students

Raymond Tsai, MD

Physician

August 20, 2014

For three years before I applied to medical school, I worked in post-Katrina New Orleans helping to rebuild school-based health centers. One of the main challenges, however, was how to create a sustainable safety net for at-risk youth to whom we were hoping to provide much needed health services — key word being “sustainable.”

All too often, there isn’t funding to carry out primary care’s mission of improving the health of communities and …

The dilemma of eating locally-sourced foods

Keith-Thomas Ayoob, EdD, RD

Conditions and Diseases

August 19, 2014

In my pediatric nutrition practice, I often preach about getting more fruits and vegetables into the diets of the children I see. Eating more vegetables is a proven way to fight obesity and promote better health.

Sometimes the question of where and how to find healthy food comes up during my conversations with parents. Many of my clients reside in the Bronx, where sometimes the closest vegetable is the pickle on …

Oncologist pay and chemotherapy: Buy and bill needs to stop

Robert Pearl, MD

Physician

August 19, 2014

Today’s article highlights the lingering problem of physicians buying and selling prescription medications to patients — at a profit.

The medical profession has struggled with this controversial practice for more than 150 years.

In George Eliot’s 1874 novel “Middlemarch,” an idealistic young doctor named Tertius Lydgate questions the ethics of fellow physicians who make handsome profits prescribing and dispensing their own remedies to the townsfolk. His medical colleagues shun him for it.

Around …

A pediatrician’s weight loss journey

Randy Rockney, MD

Physician

August 19, 2014

When I was in medical residency, more than thirty years ago, I ran with a pack of fellow residents, all guys who were fit to varying degrees. Once, on an outing, we discussed the — hopefully — hypothetical question: “If the need arose, which one of us would we eat first?”

“Randy!” my friends gleefully concluded.

“His meat would be the most marbled,” one added.

I’ve never been fat. More accurately, my body …

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A pediatrician’s weight loss journey

Selecting grittier surgeons is harder than you think

Skeptical Scalpel, MD

Medical Education

August 19, 2014

In case you haven’t noticed, a hot new topic in education is “grit.” In order to reduce the long-standing 20% attrition rate of surgical residents, some say we should select applicants who have more grit or conscientiousness.

A recent paper in Surgery reported residents who dropped out of programs had decreased levels of grit as measured by a short-form survey. But due to unexpectedly low attrition rates in the surgical programs …

The ethical dilemma of saving the American Ebola patients

Deep Ramachandran, MD

Conditions and Diseases

August 18, 2014

It was with much fanfare that two American aid workers were airlifted from across the world and brought to Emory University Medical Center where they began experimental treatment for Ebola. We hope for a full and speedy recovery for them and others like them who do God’s work.

But it appears to me that lost in this conversation are myriad others who need help but never get it. Right now, humanitarian work …

Vaginal video games: What to make of mobile Kegel apps

Jennifer Gunter, MD

Health Technology

August 18, 2014

k goal

There are two new high-tech ways that aim to help you with Kegel exercises, both with Kickstarter campaigns. There is the Skea (Smart Kegel Exercise Aid), basically a video game that proposes controlling the avatar with a vaginal probe that uses the pelvic floor muscles and kGoal, a vaginal insert that is meant to connect wirelessly with your smart phone and measures your squeeze …

Marcus Welby won’t survive today

Steve Jacob

Physician

August 18, 2014

An excerpt from So Long, Marcus Welby, M.D.: How Today’s Health Care Is Suffocating Independent Physicians – and How Some Changed to Thrive.

A 30-ish public-relations executive representing a large, modern physician practice was shaking her head in puzzlement.

Her physician client liked to talk about how his practice was not “a …

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Marcus Welby won’t survive today

The Affordable Care Act will face many more Halbigs

Dr. Saurabh Jha

Health Policy

August 18, 2014

“Then you should say what you mean,” the March Hare went on.

“I do,” Alice hastily replied; “at least–at least I mean what I say–that’s the same thing, you know.”

“Not the same thing a bit!” said the Hatter. “You might just as well say that “I see what I eat” is the same thing as “I eat what I see!”

The brilliant Lewis Carroll had a field day with logical fallacies in …

The blonde minority: Sexism is alive in medicine

Elizabeth Horn, MD

Physician

August 18, 2014

While demographic data may suggest otherwise, I still consider myself a minority, albeit a less common one. I am a young woman in medicine, and I am a natural blonde.

I barely qualify for a prescription for eyeglasses, but I have found they give credence to my words and patients seem to take me more seriously. Perhaps three years of residency training …

Does direct primary care improve quality measures?

Stephen C. Schimpff, MD

Physician

August 18, 2014

Part of a series.

In earlier posts, I have described direct primary care (DPC) in its various forms called membership, retainer and concierge. There are some concerns with DPC. Does more doctor-patient time really mean better quality care? Does it really mean lower total costs? It seems logical that closer care means better care, fewer referrals to specialists and fewer hospitalizations. Most DPC physicians will tell you this is the case …

When diagnosing patients, Occam’s razor sometimes fails

Rob Lamberts, MD

Physician

August 17, 2014

I don’t like to brag, but if there is one area of my skills as a doctor about which I am proud, it would be my skill as a diagnostician. I like to play Sherlock Holmes and figure out what’s going on with people, and I think I’m pretty good at it.

So I lied. I do like to brag … a little.

In most people’s mind’s eye, the role of diagnostician …

5 ways mobile apps can impact health care right now

David Lee Scher, MD

Health Technology

August 17, 2014

There is growing healthy skepticism about the past promises of mobile technologies. Issues concerning safety after the release of the FDA guidance of mobile medical apps, privacy and security, and efficacy. Followers of the sector are poised for the rubber finally meeting the road in health care. While most mobile health tools used today are reference apps for health care providers and patients, there are …

The unhealthy behaviors of physicians

Elaine Khoong, MD

Physician

August 17, 2014

As a fourth-year medical student, it was fairly easy to maintain a healthy lifestyle. When you have much leisure time and are relatively stress free, you can eat healthy, stay physically active and maintain quality mental health. However, as I begin the journey called residency, it is clear that the task of maintaining my own health will be much more difficult.

But the importance of this task should not be overlooked. …

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The unhealthy behaviors of physicians

Using technology to improve medication compliance

Kevin R. Campbell, MD

Medications

August 17, 2014

It is clear that patient compliance with prescribed medications is critical to success in the treatment of any chronic disease process. In addition, patient engagement and co-management of their disease has been proven to improve outcomes. A new study from the Annals of Internal Medicine suggests that any changes in the appearance of a medication may result in a decrease in compliance; when a pill looks differently patients often simply …

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