Part of the KevinMD toolkit series.
A lot of people ask me, “What tools do you use for blogging, speaking, when you’re on the road, seeing patients etc. …” So I decided to start a series that describe what tools I use, and why.
First in this series are tools I use for my social media keynote presentations. My …
I’m involved in a protracted and good-natured (I hope) debate about the merits of robotic surgery with a University of Pittsburgh urologist named Ben Davies. Today he tweeted the following (with translation for the Twitter averse):
“I would love for a $ISRG [stock symbol for Intuitive, makers of the robot] MD hater (like @Skepticscalpel) to actually watch 10 open RRPs [radical retropubic prostatectomies] …
Robotic prostatectomy: A debate with a urologist
The progeny of the iPhone and the iPad will change the shape of your institution — and your balance sheet.
One of the more striking images, to me, out of the online spew in the last few months was from the inauguration. It was a wide view of an inaugural ball. There was the president waltzing with the first lady, and a crowd of several hundred watching them. What was striking …
Medical apps: We are approaching the tipping point
Patricia Wen’s front page story, “Children’s Access to Mental Health Care is Growing,” in which she describes the “co-location” of mental health care services in pediatric practices, brought me back to the summer of 2011 when I attended a meeting of a working group of the Massachusetts Chapter of the American Academy of Pediatrics (MCAAP.) The task of this working group, a subgroup of the MCAAP task force on …
The co-location of mental health care services in pediatric practices
Why do you need a population health management (PHM) IT system? In our last column we discussed the fact that reimbursement tied to outcomes will demand a greater level of patient management. Greater, perhaps, than your EHR can deliver. The early focus of new pay-for-performance and bundled payment systems is on preventive care for top chronic illnesses.
The 15 most expensive health conditions account for 44% of total …
Why you need a population health management IT system
A recent report stating that one in 50 school children carries an autism diagnosis appears to confirm anecdotal evidence that we are experiencing an increase in the autism rate.
But there are a number of things that should be considered in a discussion of these findings — and leading that discussion should be methodology.
These new data from the CDC’s National Center for Health Statistics (NCHS) are culled from a …
Explaining the rise in the autism rate
Dr. Chris Nickson recently asked, if a Martian landed on Earth and looked at how we do medical education, what would she think?
Could it really be true that so many dedicated, brilliant people with the same objectives could be doing exactly the same thing at the same time without sharing their resources? … That they could put so much work put into teaching sessions that so few actually …
4 ways asynchronous learning can benefit medical students
An apology can be a powerful statement that influences how another responds to a perceived wrong. This can be especially true within the context of a doctor-patient relationship. Yet, most physicians have been conditioned to employ a “deny-and-defend” approach to adverse medical outcomes, avoiding apologies because they believe it could imply an admission of guilt or ultimately initiate a lawsuit.
Apology in medicine is neither new or a fringe concept (currently …
Resolving medical liability claims with disclosure, apology and offer
Just as Sherry Gorman describes in her compelling post, being sued for malpractice can launch a complicated mix of often overwhelming emotions so debilitating that personal and professional lives are never the same.
Since so many physicians are sued at some point during their career—some estimates say as many as 9 out of 10 —becoming educated about the malpractice process …
Being sued for malpractice launches a mix of overwhelming emotions
Politicians, financial experts, pundits and main street America would love to predict what’s going to happen to America in the next five years. But we don’t have to dust off the Dow Jones or the S&P, or even wonder what the Feds are going to do about Medicare, taxes, the debt ceiling or Afghanistan.
All we have to is understand the five stages of grief first developed by Dr. Elizabeth Kubler-Ross.
Elizabeth …
America is experiencing a crisis of grief
I inherited motion sickness from my father’s side of the family. I can’t sit in the back seat of a car for more than 10 minutes without becoming sick. I take meclizine before every plane flight.
I inherited asthma from my mother’s side of the family. Exposure to perfume, 90+ degree temps with 90+% humidity, or even a good laugh will all prompt me to cough.
These two maladies of mine have …
Blaming others for their health problems helps no one
When we told the patient and his family that the mass in his lung was highly concerning for cancer, he didn’t say anything. His daughter asked about his symptoms. His son-in-law asked when and how he could get a definitive diagnosis. His wife asked when he could go home. Finally, he spoke.
“I’m sorry for being so much trouble.” The tone was casually apologetic, …
Our medical education system does not tolerate emotional cracks
The more I try to help people in this field of mine, the more I realize that it doesn’t take a village. It takes a huge industrialized city, all its wires and arteries humming with constant activity, just to try and make one woman better. In this case, one smiling woman in her 50s, ethnicity I couldn’t figure and of dubious relevance, who came to our clinic seeking advice about …
Let patients be their own people inside the system of care
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“Physicians care more about their pocketbooks than taking care of patients. They are self-interested and overpaid. They want to control everything. They don’t know what life is like in the real world of patients.”
By now, I am sure that physician readers of this blog can feel their blood boiling, for good reason. Why would I, as the principal staff advocate for internal medicine physicians, put such pernicious, unfair, inaccurate quotes …
Why physicians should sympathize with federal employees
The Boston Globe recently had a front page story on how a neurosurgeon sued a patient’s husband for a blog critical of the physician.
According to the story, the patient underwent a complicated back operation as a result of her bone cancer. She tragically had a stroke post-operatively, and that’s where the situation between the family and doctor deteriorated. On the advice of his psychiatrist, the patient’s husband wrote a …
How a doctor’s online reputation survived a front page newspaper story
Most of us have spent some time thinking about our own deaths. We do it with a sense of dreadful curiosity, but then we push it aside with “well, we’ve all got to go sometime.”
Unlike most people, I probably know the how, the why, and maybe even the when of that event. It is profound information that turns the world upside down for us, our families, friends and caregivers.
I have …
The simple act of truth in the face of incurable cancer
Dear mobile health app developers,
We—patients and caregivers—need your help to reduce the demands of self care. Mobile health (mHealth) apps have enormous potential to lessen our burdens. But our needs are often only loosely related to what clinicians and/or the evidence expect us to do. Most mobile app developers have ignored this fact by designing tools that primarily reflect the imperatives of …
What patients want from mobile apps
As an oncologist who also runs a sexual health clinic for women treated (or under treatment), I am discovering that my perspective on both issues of cancer treatment (and survival) and life after cancer (and quality of life) is somewhat unique. I am conscious of how difficult it is to bring up cancer therapy and survivorship (let alone sexual health) within …
Sexual health in women treated for cancer
Andrews was easily the most anxious patient I took care of that month, a gray Michigan February (is there any other kind?) which I spent in the hospital caring for patients admitted to the general medical ward at the Ann Arbor Veterans Affairs Medical Center. (Andrews is a pseudonym, as are all the patients I blog about, unless otherwise indicated.) He had plenty to be anxious about, too. His leukemia …
I let my hope and optimism interfere with accurate communication
Among others, Gary Taubes has famously argued that calories don’t count. Perhaps the more nuanced version is that the quality of calories, not the quantity, is what counts. Mr. Taubes and I have discussed this, and agreed to disagree. Leaving aside Newton and laws of thermodynamics, there is the Twinkie Diet on my side: evidence that weight can be lost when calories are restricted, no matter how truly dreadful the …
The quality and quantity of calories both count
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