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Will resident autonomy disappear completely in the future?

Paul Bergl, MD

Medical Education

February 18, 2014

Recently, our residency program had the excellent fortune of hosting Dr. Bob Wachter as a visiting speaker. Dr. Wachter is considered a pioneer in the hospitalist movement and has built his career around inpatient quality and safety. During lunch with Dr. Wachter, some of our residents, and hospitalist faculty, we discussed the topic of resident autonomy in the hospital.

In the glory days of residency, I imagine that house officers …

The high cost of “free,” unnecessary medical equipment

Yul Ejnes, MD

Physician

February 18, 2014

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

A couple of weeks ago, a television commercial caught my attention. It was an official-sounding announcement, a “national healthcare alert” that if you have Medicare, you might qualify for a knee brace “at little or no cost to you.” I found it interesting because a week earlier, a durable …

Analyzing the Katie Couric effect on the vaccine conversation

Natasha Burgert, MD

Social Media in Medicine

February 18, 2014

On December 4th, 2013, Katie Couric gave the HPV vaccine center stage during a segment on her talk show, Katie. The segment, entitled “The HPV Controversy,” was 20 minutes long, but ignited a digital firestorm between pro- and anti-vaccine voices that raged for days after the stage lights went dark.

In partnership with Global Prairie, the entire online conversation surrounding this Katie segment was digitally captured using …

Why doctors commit suicide

Pamela Wible, MD

Conditions and Diseases

February 18, 2014

PAMELA-WIBLE

I’ve been a doctor for twenty years. I’ve not lost a single patient to suicide.

I’ve lost only colleagues, friends, lovers — all male physicians — to suicide.

Why?

Here’s what I know:

A physician’s greatest joy is the patient relationship.

Assembly-line medicine undermines the patient-physician relationship.

Most doctors are burned out, overworked, or exhausted.

Many doctors spend little time with their families.

Workaholics are admired in medicine.

Medicine values …

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Why doctors commit suicide

Where is the safest place to have a baby?

Roy Benaroch, MD

Conditions and Diseases

February 18, 2014

Two big studies have been published in the last few weeks, both of which have confirmed previous data: home birth is not as safe as hospital birth. These studies show that having a baby at home increases the risk of your baby dying by about 4 times. That really is a big increased risk — especially considering that most home births are supposedly low-risk pregnancies. Those babies …

CVS stops selling tobacco: Let’s keep it in perspective

Wendy Sue Swanson, MD

Physician

February 17, 2014

Doctors are tough critics — as well they should be. The news that CVS Caremark pharmacies will no longer sell tobacco brought about quite a bit of rapid online dialogue. Even President Obama chimed-in with praise, a response that some in the business world say is worth billions for CVS. Having a good reputation, particularly when you’re in the business of delivering health care and lending health advice, seems essential. In my …

Reentry physicians are an invisible minority in American medicine

Christine Stone, MD

Physician

February 17, 2014

Are you a practicing primary care physician, board-certified in either family medicine or internal medicine, and in good standing with your state licensing board? Do you have concerns about the relative lack of primary care professionals, especially now that 40 million new patients have been added to the U.S. health care system this year?

What if I told you that you, simply by carrying on with your usual daily …

Do we really need more physicians?

Robert Pearl, MD

Health Policy

February 17, 2014

The goal of the Affordable Care Act is to make affordable, quality health care coverage available to more Americans. But how many physicians will America need to satisfy this new demand?

The debate over doctor supply rages on with very little conclusive evidence to prove one case or the other.

Those experts who see a shortage point to America’s aging population — and their growing medical needs — as evidence of a …

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Do we really need more physicians?

Alzheimer’s disease is the uninvited guest

Natalie Wilcox

Conditions and Diseases

February 17, 2014

Alzheimer’s disease is the uninvited guest that crashes all of my family gatherings. It relentlessly pursues my grandfather’s brain, unraveling more threads from the tapestry of his memory each year. Although it causes him no physical pain, it sows guilt, sorrow, frustration, and a sense of deep loss in all of us.

Like all diseases, this one seems entirely unfair. My grandfather was a sharp attorney, a witty, silly champion of …

Why is there a shortage of primary care physicians?

Stephen C. Schimpff, MD

Health Policy

February 17, 2014

Next in a series.

Primary care physicians (PCPs) are becoming extinct. It’s true. Not many medical students choose primary care as their career path. Older PCPs are retiring early. Many others are closing their practices or seeking employment at the local hospital. And there has always been a shortage of primary care physicians in rural and urban poor areas. Today only 30% of all physicians practice primary care (compared to …

The data behind the medical home: High costs without a benefit?

Jan Gurley, MD

Health Policy

February 17, 2014

As the patient-centered medical homes (PCMHs) train charges forward along with implementation of the Affordable Care Act, dollars are taken directly out of our health care system to certify providers in a method with no proven benefit. And, while there is a marked shortage of primary care providers nationwide, funds that could be used toward providing the direct provision of, or access to, health care are instead devoted to accreditation, …

Entering the exam room without the weight of the computer

Christine A. Sinsky, MD

Physician

February 16, 2014

It started with a dead laptop. For the first time in more than 3 years I felt like a doctor again. I had forgotten what it was like.

Having neglected to plug in my laptop the night before, it was without power. (Without power!) An opportunity for an uprising, of consciousness if not full revolt.

For the first 1½ hours of clinic I entered each exam room without the weight of the …

When patients abuse emergency department workers

Jonathon Savage, DO

Conditions and Diseases

February 16, 2014

There are few professional careers centered around protecting and caring for others that garner so much verbal and physical abuse than a career in emergency medicine. Mental health workers, police, fire, and EMS personnel are the other fields that come to mind when I think of a service that “helps” people yet gets abuse dished upon them on nearly a daily basis.

A 2006 survey of emergency nurses showed that 25% …

Why I am grateful for Match Day

Catherine Spaulding, MD

Medical Education

February 16, 2014

In the past 84 days, I have traveled to eleven different cities, been left stranded in two unfamiliar airports by cancelled flights, met approximately 124 new people and briefly recited the more interesting parts of my life story far too many times to count — all for the purpose of matching to a residency program in March. Exhausting doesn’t come close to summing it up.

And yet, this process has also …

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Why I am grateful for Match Day

Banning cigarettes is a start but CVS still has a long way to go

Rhea Boyd, MD

Physician

February 16, 2014

Recently, CVS Caremark announced that starting October 1, they will no longer be selling tobacco products, including cigarettes, in their CVS stores. Taking a bold and unexpected stance on the issue, CVS’s CEO Larry Merlo reasoned to ABC News that “We’ve come to the conclusion that cigarettes have no place in a setting where health care is being delivered.”

What does he mean by that?

Here, he is referring to CVS’s robust market of …

What Uber can teach health care delivery

Ali Khan, MD, Tasce Bongiovanni, MD, and Ali Ansary

Health Technology

February 16, 2014

Let’s get the disclaimer out of the way: We love Uber.

As physicians with roots in the Bay Area, we use Uber all the time. The service is convenient, (usually) swift and consistently pleasant. With a few taps of a smartphone, we know where and when we’ll be picked up — and we can see the Uber driver coming to get us in real time. When the vagaries of San Francisco …

The best thing a doctor ever did to me

Duncan Cross

Patient

February 16, 2014

In fall of 1994, I was sixteen years old and sick. I had lost a lot of weight, reduced my diet to BRAT and roast chicken, filled a half-dozen stool samples, even tried a few prescriptions — and nothing seemed to help.

By that point I was seeing a gastroenterologist, Dr. C. After a pointless barium enema and follow-through, Dr. C performed a colonoscopy. From that, he gave me a definitive …

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The best thing a doctor ever did to me

The joy of creating smiles

Bhupesh Vasisht, MD

Conditions and Diseases

February 16, 2014

As I finished surgery on a beautiful 10-year-old girl from a local orphanage with a secondary cleft lip deformity, I did not realize how this tiny little Filipino girl was about to humanize me and my entire team involved in her care. When I met her the day before with her caretaker from the orphanage, it was obvious that she had …

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The joy of creating smiles

Electronic medical records obstruct patient interaction

Kevin Pho, MD

KevinMD

February 15, 2014

A version of column was published in USA Today on January 19, 2014.

Over half of physicians today use electronic medical records, thanks to the federal government spending more than $22 billion dollars incentivizing providers to transition away from paper charts. Supporters of digital records, including President Obama, say they improve patient care and reduce health costs. Having navigated a transition from paper charts to electronic records in my own practice, …

10 things to know about anesthesia and heart surgery

Kent B. Berg, MD, MBA and Gregory M. Janelle, MD

Conditions and Diseases

February 15, 2014

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

February is American Heart Month. Unfortunately, heart disease is a major problem in the United States that can result in surgery. In addition to discussing your procedure with your surgeon, you want to be sure to discuss your anesthesia care with your physician anesthesiologist.

Here are …

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