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Google Glass is the tip of the iceberg for wearable technologies

Health Technology

July 5, 2014

As an early Google Glass explorer, I see many ways this and other wearable technologies will soon enhance patient care.

Google Glass is “smart” eyewear that offers features similar to a “smart” phone: It can take photographs, video, make phone calls, display Internet-based information. The data is transposed onto the glass lens in the wearer’s field of vision. The device is activated by voice command or a touch to the tiny …

5 things health care can learn from running a marathon

Brad Stulberg

Health Policy

July 5, 2014

Health behavior change is hard; if it were easy, everyone would be doing it. But running a marathon is also hard, and lately it seems that just about everyone is doing it. The health care industry could learn a lot from the increasing popularity of the marathon about how to design programs that help people make positive health behavior changes.

At its core, running 26.2 miles has much in common with the process of health …

What to know about children’s enuresis and nighttime wetting

Katie Gawerecki, APN

Conditions and Diseases

July 5, 2014

Toilet training can sometimes be a stressful process. This is particularly the case for children who achieve daytime dryness but continue to wet themselves, and the bed, overnight. It may leave you wondering what’s normal and what you can do to help your child.

Nighttime wetting is one of the most common urologic conditions in childhood. The vast majority of cases are not related to a physical cause. Most commonly, nighttime …

Shinseki’s resignation: Rearranging Titanic deck chairs at the VA

Brian C. Joondeph, MD

Health Policy

July 5, 2014

As the VA scandal unfolds, with continued revelations of secret waitlists and delayed or denied medical care, calls have been building Veterans Affairs Secretary Eric Shinseki to resign. He did just that, resigning because, “He had become a distraction as the department struggles.”

President Obama, eager to show America that he was being proactive about the scandal, regretfully accepted the General’s resignation. But other than allowing the president to show that he is doing something about …

When school boards fancy themselves health care providers

Dan Flanders, MD

Physician

July 5, 2014

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I met Madelyn for the first time last month in clinic. Six months prior, she was an otherwise healthy 14-year-old girl. One afternoon, Madelyn’s phys ed teacher led a gym class aimed at completing fitness and health assessments on all of the children in the grade. One at a time, each child was asked to step up and onto a scale …

MKSAP: 38-year-old man with a 1-year history of cough

mksap

Conditions and Diseases

July 5, 2014

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 38-year-old man is evaluated for a 1-year history of cough with mucoid sputum and a 6-month history of mildly progressive dyspnea. He has a 12-pack-year history of smoking. He has no history of asthma, allergies, skin disease, or liver disease.

On physical examination, vital signs are normal. Pulmonary examination discloses decreased breath …

The troubling deficiencies in our mental health system

Emily Newhook

Health Policy

July 4, 2014

Mental health patients and their families already pay a hefty price with the stigma of mental illness and the emotional roller coaster they often face dealing with symptoms. But insufficient mental health resources across the United States also means that they must pay a financial price as well in the form of lost productivity, out-of-pocket costs for treatment and sometimes periods of unemployment. A recent USA Today special report estimates …

Health care for the poor: A race to the bottom

Margalit Gur-Arie

Health Policy

July 4, 2014

There are over 16,000,000 American children (21.8%) who live in official poverty and double that number who are just poor. This is not happening in an obscure country, in a continent far away. It is happening right here, across the street from you. For those enjoying a good episode of Duck Dynasty, these are not children of illegal immigrants, and the vast majority is white kids.

Over 44,000,000 American children (more than 1 …

5 sensible ways to decrease medical school debt

Joanne Conroy, MD

Medical Education

July 4, 2014

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There is a tremendous amount of handwringing among students, workforce researchers, and medical school deans about the record amount of debt that medical students incur — more than $175,000, according to the Association of American Medical Colleges. This has unintended consequences, including student selection of more lucrative specialties and placing medical education beyond the reach of low-income and minority students. The average …

Inequality in medicine: Be thoughtful about the way we educate our trainees

Rhea Boyd, MD

Medical Education

July 4, 2014

Earlier this year, I started teaching a course to first year pediatric residents at Stanford. In it, I challenge the trainees to identify the structural contexts in which patients and families make choices that may impact their health and well-being. Termed structural competency, the goal is to enable young physicians to understand and confront stigma and inequality as key determinants of health. We …

Social media advocacy matters: The case of the Ellen DeGeneres Show

Sherry Pagoto, PhD

Conditions and Diseases

July 4, 2014

The Ellen DeGeneres Show has repeatedly put out a call for viewers to send in their funny sunburn pictures and stories. The following was posted on the website:

Summer is here and everyone is hitting the beach or pool. Just don’t forget the sunscreen! If you did, and you have the bad sunburn to prove it, we want to see the funny photos. Be sure to tell us the story behind …

Read more…

Social media advocacy matters: The case of the Ellen DeGeneres Show

Conflicting state versus federal incentives confuse doctors

P. J. Parmar, MD

Health Policy

July 4, 2014

I get paid by Medicaid to see patients. How much?

Exactly $52.28 if it is an easy patient issue, like a cold, and $78.54 for a harder one, like a kidney stone. Who decides when the issue is easy and when it is hard? I do. But I have to follow some complex rules when deciding whether to bill a 99213 …

Patients need education about their role in care

Martine Ehrenclou, MA

Patient

July 3, 2014

According to the recent Wall Street Journal article patients are encouraged to engage in care, keep track of their medical data, seek preventive care, and to manage their conditions. Studies show that if patients are actively involved in care and partner with providers, that they experience better health outcomes and lower costs.

But for patients to be active participants in care they must acquire knowledge about their diagnoses and treatment plans, …

The importance of recognizing immunodeficiency

Purvi Parikh, MD

Conditions and Diseases

July 3, 2014

On a cold, blustery Cleveland day when I was a resident, a forty-year-old man walked into our infectious disease clinic at the Cleveland Clinic. The patient was undergoing routine visits in preparation for a kidney transplant. This poor man had been hospitalized six months earlier at another hospital where he caught a terrible infection and was readmitted in septic shock and multi-organ failure. Luckily he survived, but in the process …

Chemotherapy: Giving a man one more day of good life

Kenneth D. Bishop, MD, PhD

Physician

July 3, 2014

There’s no good age to die.

Way too many of the patients I’ve seen over the past two years are harrowingly close to my own age. I think it’s less startling to hear that an older person has cancer than when a young person is diagnosed, but I have yet to identify the age when this transition happens.

Maybe it’s an unspoken understanding that older people die and younger people shouldn’t, but …

Why premedical students need the liberal arts

Armaan Rowther

Medical Education

July 3, 2014

In his commencement address at Sarah Lawrence College, international affairs journalist and author Fareed Zakaria defended the value of a liberal arts education. “At its essence,” explained Zakaria, “a liberal education is an education to free the mind from dogma, from controls, from constraints. It is an exercise in freedom.” His speech, I imagine, was well received and much appreciated by the over 400 graduates earning liberal arts degrees that day …

Applying translational research to real world scenarios

Paul Marantz, MD, MPH

Medical Education

July 3, 2014

An intriguing article was recently published in the Proceedings of the National Academy of Sciences — one of the most prestigious (more on “prestige” later) journals around — with the provocative title, “Rescuing U.S. Biomedical Research from Its Systemic Flaws.” That this was written by some of our country’s most well-respected scientists provides credibility to this challenging and thought-provoking critique. The …

What to do when a patient says thank you

Dike Drummond, MD

Physician

July 3, 2014

Let me show you four simple steps, requiring just 15 seconds, that will turn a patient thank you into a two-way healing encounter of the highest order.

It is incredibly easy for a thank you from a patient to slip by during a busy day in the office. We can get so caught up in the blizzard of clinical tasks we fail to hear what the patient is trying to communicate. We don’t …

Preventing nightmares: A guide for medical students and residents

Alberto Hazan, MD

Physician

July 2, 2014

Nobody likes waking up in the middle of the night gasping for air. When you make a mistake in the emergency department, that’s exactly what happens.

They come in all sorts of shapes and colors:

The sixty-year-old man diagnosed with a strained lower back muscle who comes back with a ruptured abdominal aortic aneurysm.
The fifty-four-year-old Hispanic female with generalized malaise who goes into cardiac arrest from a missed myocardial infarction.
The two-year-old with …
Read more…

Preventing nightmares: A guide for medical students and residents

Navigating the prescription drug abuse epidemic

Chiduzie Madubata, MD

Medications

July 2, 2014

Over the past few months, more attention has been paid to the prescription drug epidemic, with increasing rates of accidental deaths noted across the country. Legislatures in different states are currently considering laws to provide first responders access to reversal agents, such as naloxone, to treat people found on the scene who have likely overdosed on these medications. With increasing media coverage, the public is becoming more aware about the …

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