| KevinMD.com

Newtown, CT will not be the last time tragedy strikes

Physician

December 16, 2012

I will say this up front: Newtown, Connecticut will not be the last time tragedy strikes. For good or bad, in this age of social media including twitter, it is easier to track the coverage of this story and people’s opinions about it. I have been thinking about this constantly today, and talking with my friends and neighbors about what happened this morning.

Outlining the problems setting up this tragedy …

Take back some of the richness that life can offer

Matthew Gibson, MD

Physician

December 16, 2012

As I was driving to work this morning, I was thinking about how I wish I had time to exercise more. It’s my 7th week as an intern, and I have only gone on a run once in that time (a 2.5 mile run last week in 25:30 — pitiful considering that two months ago I was running 8-10 miles at least once a week). I got to thinking about …

How can we as a society honor the dead children?

Claudia M. Gold, MD

Physician

December 16, 2012

For the families who lost children, their world as they knew it has effectively ended. Yet somehow the sun rises again and the next day is here. For the rest of us grieving along with these families, the only way to move forward is to take what President Obama called “meaningful action.” I interpret this to be action that is radical and significant enough that it will somehow give meaning …

Locum tenens prepared me to volunteer in undeveloped countries

Renée Volny, DO, MBA

Physician

December 16, 2012

For the majority of physicians in the U.S., taking their skills abroad and providing care via medical missions in undeveloped countries is usually not an option. For me, that was always an option. I am an OB-GYN who works as a locum tenens, a traveling physician who temporarily fulfills the duties of another. This has provided me the flexibility to have …

It is almost midnight: Can this day be over soon?

Miranda Fielding, MD

Physician

December 16, 2012

“As flies to wanton boys, are we to the gods. They kill us for their sport.”
-King Lear, Act IV

There are certain days that everyone will always remember. People of my generation uniformly remember where they were and what they were doing the day that John F. Kennedy was shot. My children’s generation will never forget 9-11. For my parent’s generation, images of Pearl Harbor, D-Day, Hiroshima and Nagasaki were burned …

MKSAP: 65-year-old man with headaches and blurred vision

mksap

Conditions and Diseases

December 16, 2012

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

A 65-year-old man is evaluated for a 1-month history of headaches and blurred vision, early satiety, and itching that occurs after showering. He has a 90-pack-year smoking history. He has no history of cardiopulmonary or sleep disorders, no other medical problems, and he takes no medications.

On physical examination, temperature is normal, blood pressure is …

Medical homes need ready access to good data

Timothy Johnson, MD, MPH

Health Policy

December 15, 2012

Recently, “60 Minutes” (in my view the last bastion of great traditional network news investigative reporting) described a for-profit hospital system that apparently uses percent targets (allegedly 20%) to encourage high admission rates by their ER doctors.

In setting up this report, the reporter commented that as much as 10% of healthcare expenditures in this country were “unnecessary.”

Actually, most health experts I have read and consulted would put that number much …

Motivating employees to meet their wellness goals

Sreedhar Potarazu, MD, MBA

Health Policy

December 15, 2012

A lot of us get health benefits through our workplace, and employers are increasingly turning to wellness programs as a means of reducing costs and improving productivity.

In the coming year, as aspects of the Affordable Care Act take effect, many employers will provide even greater incentives for participation in programs that require the employee to achieve certain wellness goals, such as smoking cessation or weight loss.

What this means for the …

Shopping for items in the operating room

Catherine deVries, MD

Physician

December 15, 2012

You may have noticed that stores everywhere, and restaurants, too, are getting mobile — as in mobile technology. In a store like Nordstrom, where thousands of items in many departments must be inventoried and managed, it saves a lot of time, personnel, and therefore money, at least for the store. From last season’s belts to the spring’s platform shoes, it is in the system, on the iPod and available for …

MKSAP: 62-year-old man is evaluated during a routine examination

mksap

Conditions and Diseases

December 15, 2012

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

A 62-year-old man is evaluated during a routine examination. Medical history is significant for a myocardial infarction 3 years ago, dyslipidemia, hypertension, tobacco use, and drinking two alcoholic drinks per day. Medications are an ACE inhibitor, a statin, a β-blocker, and aspirin. He participates in cardiac rehabilitation, exercising four to five times per week.

On …

Mobile health technology adoption depends on insurers

David Lee Scher, MD

Health Technology

December 14, 2012

Insurers will also play a pivotal role in the development and adoption of patient-focused mobile health (mHealth) technology adoption for wellness as well as for the management of chronic diseases.

1. Payers hold the purse strings. Insurers will be the ones paying for the use of mHealth for chronic disease management for the vast majority of patients. They have a vested interest …

Don’t be afraid to ask your radiologist for help

Paul Dorio, MD

Physician

December 14, 2012

It used to be that radiologists mainly helped out your doctor so that they could figure out what was ailing you. Such is no longer the case.

Nowadays, with the easy access to almost any doctor of any specialty, you can visit your radiologist, obtain a needed study (or procedure, in the case of an interventional radiologist), and never even see your …

How my ER rotation turned me into a primary care doctor

Stella Safo, MD, MPH

Medical Education

December 14, 2012

It’s Saturday night at an emergency department (ED) in Boston, MA, and I am faced with a medical student’s dream dilemma: which one of the many interesting cases should I observe? Should I watch trauma surgeons operate on the 17-year-old gunshot victim or work with the ED docs to assess whether a 59-year-old woman is having an acute stroke? That is exactly what I adored about emergency medicine as a …

AMA: Patients are vulnerable to health plan monopoly power

Jeremy Lazarus, MD

Health Policy

December 14, 2012

A guest column by the American Medical Association, exclusive to KevinMD.com.

When health plans have merged, they’ve said that a bigger insurance company would drive down premiums. The casual acceptance of this economic fallacy led to more than a decade of unchecked megamergers that helped health plans cement dominant market positions across the country.

It’s now clear that when health insurers talk …

Tips to examine the eardrum of the squirming, angry child

Roy Benaroch, MD

Conditions and Diseases

December 14, 2012

Let me tell you a secret. Examining eardrums in a squirming, angry child is really difficult—if not impossible. If the doc in your screaming, struggling child’s ear for a half-second, it’s unlikely that anything useful was seen.

Sometimes, it is just impossible to get a decent exam. But there are ways that parents (and doctors!) can help at least increase the chance …

When there was no hope, I used my imagination to create it

Clarissa Schilstra

Patient

December 13, 2012

On November 17th, I celebrated the three-year anniversary of the end of my leukemia relapse treatment. In going through the day, I thought a lot about what I went through. I thought a lot about how I ever survived it all. I remember so vividly those hopeless moments, hours, days, months of nausea, pain, and so many forms of discomfort. What stands out to me was the hopelessness and …

Tiny threads hold a marriage together

Bruce Campbell, MD

Physician

December 13, 2012

Chains do not hold a marriage together. It is threads, hundreds of tiny threads which sew people together through the years.
– Simone Signoret

Allen’s cancer has continued to grow quickly. He raises his chin so I can see. I check my notes from a month ago and pull out my ruler and make new measurements. I jot down my findings and turn to look him in the eye. We both know this …

Read more…

Tiny threads hold a marriage together

I work at clarifying obscurity about the human condition daily

Emily Gibson, MD

Physician

December 13, 2012

Be obscure clearly.
-E. B. White

As a family doctor, I work at clarifying obscurity about the human condition daily, dependent on my patients to communicate the information I need to make a sound diagnosis and treatment recommendation. To begin with, there is much that is still unknown and difficult to understand about psychology, physiology and anatomy. Then throw in a disease process …