| KevinMD.com

People are fallible, but health systems need not be

Physician

January 8, 2013

When I heard in October that Superstorm Sandy was projected to make landfall somewhere in the vicinity of DC and Maryland, I prepared for the worst. I stocked up on non-perishable goods and evacuated to higher ground. (The rest of my family was already coincidentally out of town and harm’s way.)

I put fresh batteries into two flashlights and installed a flashlight app on my smartphone for good measure. Although I …

Medical malpractice: Equating standard of care to best practice

Shadowfax, MD

Physician

January 8, 2013

I review a lot of cases in my professional life. Some of them are just ones that our QA group comes across in our practice. Some are cases related to our liability policy. Some are cases I’m sent for review, or educational cases I present. We see a lot of cases which could have been done better, or in which the …

Why linking patient satisfaction with dollars is misguided

John Mandrola, MD

Health Policy

January 8, 2013

I hope my patients are satisfied. This is everything. Improving the lives of people is why doctors do what they do. How much we help our patients is the metric. It’s the peg we hang our self-esteem on.

So yes, of course, patient satisfaction is really important.

But that doesn’t mean it’s a good idea to link it with dollars.

In fact, on a list of well-meaning but really dumb …

The transition to direct care: Considering the consequences

Rob Lamberts, MD

Physician

January 8, 2013

“This could be big,” he said after I told him about the company who wants me to cover their 100+ employees. I pay him to give me the stark reality of things, but his optimism made me uncomfortable. ”You’ve got to go for this. I know you don’t feel ready for it yet, but this could really be huge for your business, and I don’t think you should pass this …

Balancing honesty and optimism in critical care

Christopher Johnson, MD

Physician

January 8, 2013

A recent little essay entitled “Do patients bond best with doctors who misinform them with optimism” got me thinking about balancing honesty and optimism in practicing any medical specialty in which patients not infrequently die.

Tragic things can happen in the pediatric intensive care unit. Anyone who works there — doctors, nurses, respiratory therapists, and many others — see these …

Holding doctors accountable: The role of teaching hospitals

Ishani Ganguli, MD

Medical Education

January 7, 2013

Fourth year medical students are starting the interview process to match into a residency program – their next and potentially final stage of training.

Over the next few months, these students will rank the programs they visit based on features such as geography, research funding, and hospital affiliations. But there’s another factor to consider – one that gets little attention but that probably matters more for the kind of doctors they’ll become. …

Screening for ovarian cancer: Where’s the outrage?

Peter Ubel, MD

Conditions and Diseases

January 7, 2013

In September the United States Preventive Services Task Force, a panel of medical experts, concluded that tests to screen for ovarian cancer do more harm than good. As a result, insurers will not be required by federal law to pay for such tests.

And the announcement was met with near silence.

Why was this recommendation greeted with such malaise when the same panel’s earlier and similar conclusions about Read more…

Screening for ovarian cancer: Where’s the outrage?

Cut back on screen time for kids

Claire McCarthy, MD

Conditions and Diseases

January 7, 2013

When it comes to getting parents to cut back on their kids’ screen time, we doctors aren’t doing such a great job.

Like most of my colleagues, I talk about screen time at almost all checkups. I talk about how too much screen time makes a kid more likely to be overweight and have behavioral problems. With the parents of babies and …

Read more…

Cut back on screen time for kids

When physicians don’t communicate about their patients

Michael Kirsch, MD

Physician

January 7, 2013

One of the gripes that patients have about the medical profession is that we physicians don’t communicate sufficiently about our patients. In my view, this criticism is spot on.

Patients we see in the office often have several physicians participating in their care. The level of communication among us is variable. While electronic medical records (EMR) has the potential to facilitate communication between physicians’ offices and hospitals, the promise has not …

The recipe for a great hospitalist program

Janice Boughton, MD

Physician

January 7, 2013

Internal medicine is the branch of medicine that deals with diseases of the internal organs in adults. It also involves dermatology, minor surgical procedures, general psychiatry and preventive care of well people. It is an excellent field, full of opportunities to think and feel and connect with people, mysteries to be solved and an endless variety of stuff to be learned. …

The role of alcohol in health costs

Edmund Kwok, MD

Physician

January 6, 2013

Defined as someone “having the faculties impaired by alcohol, those of us who work in an acute healthcare facility are witness to many illustrious examples of drunk patients coming through our doors.

Underaged kids passed out at a house party? Yup. Raging alcoholics who are brought into the ER at least once a week? Sure. Elderly women who secretly binges on wine …

Read more…

The role of alcohol in health costs

It’s time to stop being afraid to study gun violence

Cathleen Collins, MD, PhD

Physician

January 6, 2013

A new message pops up on my phone. I signal to the attending and step out of the OR. I’m on anesthesia rotation at Santa Clara Valley Medical Center, as a pediatrics resident at Lucile Packard Children’s Hospital at Stanford. But because I’m also a mom to a first grader in Cupertino, both my pager and my cell phone are frequently “on call”.

“I want to take this opportunity to update …

The duality that cancer patients face

Andrew Griffith

Patient

January 6, 2013

We are often pulled in different, opposing directions, and take time to find the balance between acceptance and anger, surrender and control, individual and group, being and thinking, living and dying. How we find balance and what that balance is influences our attitude.

Throughout my journey, I was struck by a number of dichotomies, or dualities, as I reflected on my reactions …

Read more…

The duality that cancer patients face

Incremental improvement in medical education is not enough

Michael Moore

Medical Education

January 5, 2013

Going to a new medical school working its way through the accreditation process is, by design, a bit of an experiment. A school wants to establish itself as distinctive, but in the end, it seems that doing anything radical is out of the question. The drive to conform to professional standards and expectations is a good thing. It generally prevents schools from bilking students of grand amounts of money while …

2 ways to help your patients get better sleep

Julia Schlam Edelman, MD

Conditions and Diseases

January 5, 2013

Are you or your patients sleeping well? Mine are not, and I wasn’t either. Do you ask them how they sleep? I never used to ask, and no one asked me. When I was in medical school, we had rigorous instruction in taking detailed medical histories. Sleep quantity and quality were not included.

What changed? Is it the digital age we live …

Protect yourself against fraudulent EHR documentation

Robert Hitchcock, MD

Health Technology

January 5, 2013

As physicians, we know that no matter what care we provide, Medicare and private payers are going to do what they can to reduce payouts. For the health of the nation, healthcare spending simply cannot continue on its current trajectory. Reform measures such as accountable care organizations, bundled payments and penalties for potentially preventable complications and readmissions may help reduce expenditures, …

The increasing stress that radiologists face

Matthew D. Rifkin, MD

Physician

January 5, 2013

In the past, the radiology profession was seen as a very financially successful specialty, but as every businessperson knows, success often has peaks and valleys. Radiology residencies are some of the most competitive to obtain, which is due to the combination of expected financial compensation and the assumed quality of life.

In the early 1990’s, when financial pressures first appeared on the …

How to get the most out of your oncology appointments

Naoto Ueno, MD, PhD

Patient

January 4, 2013

As a patient, you’re entitled to ask your health care providers anything. In that sense, there are no bad questions.

But some questions will help you get more out of your interaction with your health care providers than others. This advice comes from my experience as a medical oncologist and a cancer survivor.

Before asking your questions, remember that you’re dealing with a …

Will doctors recommend health apps to patients?

Jeff Livingston, MD

Health Technology

January 4, 2013

There has been an explosion in health apps. Patients are using them for weight loss, calorie counting, exercise monitoring, ovulation calculation and for many other health needs. But to truly integrate the concept of health apps in the health care system healthcare providers will need to get involved. There is discussion in the health IT world lately regarding physician adoption of …

The critical factors driving up American health costs

Samuel Metz, MD

Health Policy

January 4, 2013

The Bipartisan Policy Report titled “What is Driving US Health Care Spending? America’s Unsustainable Health Care Cost Growth” issued in September lists seven factors increasing American health care costs. The “fiscal cliff” debates include many of these arguments.

While these factors do indeed play roles in American health care, almost all are at work in other industrialized countries, all of whom provide better care to more people for half what we …

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts