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Neither political party truly represents doctors or their patients

Health Policy

December 13, 2012

When you walked into the voting booth on Tuesday, November 6, did you do so with a feeling of calm certainty that the man who would get your vote for President was unquestionably the best choice, or even the only possible choice? Did you feel confident that your candidate’s political party fully supports your political views as well as your personal values?

For many physicians, I suspect that the answer to …

To the health professionals during hurricane Sandy: Thank you

Jessica Gold

Medical Education

December 12, 2012

It’s 3:30 am and my clock alarm is singing some song that I used to like. I roll over to turn it off all the while thinking to myself: “I am waking up to stand for the next 12 hours straight holding a retractor. No one is going to care that I am there, and if I am even acknowledged …

Stop the stigma and give patients a chance

Randy Roberts

Patient

December 12, 2012

I would like to start out by thanking all the fantastic health care workers. As a recovering person with diagnosed concurrent disorders – having both addictions and mental health issues – I have seen the challenges and abuse often faced by doctors, nurses, counselors and support staff working within the healthcare system. This article is in no way meant to hurt, …

How do you know if you’re a disruptive physician?

Linda Brodsky, MD

Physician

December 12, 2012

Physicians are being attacked in many ways and in many places. It is no longer about how able, available, and affable you are. It is about how well you toe the line when it comes to going along to get along while being watched by an ever increasing line up of watchdogs. Many of whom have sharp teeth.

Here are a few questions that might indicate you are headed for trouble:

Do …

ACP: Practice transformation is more than checking off boxes

Yul Ejnes, MD

Health Policy

December 12, 2012

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

Recently, I was invited to speak at an ACP chapter meeting on the topic of shared vision. In the talk, I used as examples Dr. Martin Luther King Jr., John F. Kennedy, and Steve Jobs, leaders whose visions inspired people and helped them to achieve great things. As I wrote the talk, it occurred to me that …

NPO and be merry

Rena Xu

Physician

December 12, 2012

It is the holiday season, and all through the hospital, patients are being made “NPO.” This is the medical term for “no eating or drinking allowed.”

Mr. T, silver-haired and newly unemployed, is NPO on account of his pancreatitis. “We don’t want to upset your pancreas,” the team tells him when we pass through on morning rounds. It is nearly breakfast time. We hover around his bed in a half circle …

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NPO and be merry

Heroics in medicine involve both a team and an empowered patient

Kevin R. Campbell, MD

Physician

December 11, 2012

Recently, millions of people around the world witnessed a remarkable feat. Daredevil Felix Baumgartner rose to remarkable heights in a capsule tethered to a helium filled balloon. At approximately 128,100 ft (24 miles) and a speed in excess of mach one (faster than sound), he leapt from his capsule and endured a free fall of 119,846 feet. At one point in the dive, he began to spin dangerously …

KevinMD media mentions, December 2012

Admin

Potpourri

December 11, 2012

I’d like to thank various media outlets for recently citing KevinMD.com.

1. Professionalism: Can it be taught? CMAJ.
Though tech-savvy, medical students need to learn what is and isn’t appropriate to do on the Internet, even if their peers in other fields of study haven’t yet grown tired of uploading photos of eye-glazing, face-reddening, vodka-induced debauchery. “They need to be cognizant of online professionalism right from the beginning of their medical training,” …

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KevinMD media mentions, December 2012

When the initial reaction to an unusual test result is happiness

Shara Yurkiewicz

Conditions and Diseases

December 11, 2012

I pull up a test result for my patient, and the senior resident standing behind me lets out an excited squeal.

“I’ve never seen the imaging come back positive for this,” she says. Our two-week-old infant, who already has a rare infection, also has a rare associated structural abnormality. It’s not benign, but it is fixable. The fix usually requires surgery.

As we walk over to the patient’s room to update her …

I do not require perfect health to be happy

Ellen Diamond

Patient

December 11, 2012

Recently, while reading a post in an online chat group for people with chronic lymphocytic leukemia (CLL), I spotted an intriguing comment. At an important conference, a world-renowned hematologist had referred to a “five-year timeline” for a cure.

This took me back fourteen years, to when I’d just been diagnosed with CLL. There was a Gilda’s Club near my workplace; I’d always passed it quickly on my way home. Now I …

Why IT is the core of the healthcare renaissance

James C. Salwitz, MD

Health Technology

December 11, 2012

Warning! I am a practicing doctor who sees real patients using an electronic medical record (EMR). My sole agenda is to provide the best patient care. I have no financial stake in information technology (IT). However, unlike the editorial board at the Wall Street Journal, Mr. Stephen Soumerai of Harvard or Mr. Ross Koppel of the University of Pennsylvania, I have actually …

Mothers who deliver prematurely face serious health risks

Jennifer Gunter, MD

Physician

December 11, 2012

Mothers who deliver prematurely face serious health risks that are often neglected when we talk about prematurity. Today, in honor of Savita Halappanavar’s death from sepsis that was a direct result of her previable premature delivery, I would like to let the world in on the physical perils faced by mothers who deliver prematurely.

Many of us have infections. We rupture our membranes prematurely, and for 40% of …

Delivering mental health care in a more rational fashion

Steve Balt, MD

Physician

December 10, 2012

Consider the following two clinical scenarios:

1. William, a 62 year-old accountant, has been feeling “depressed” since his divorce 5 years ago. His practice, he says, is “falling apart,” as he has lost several high-profile clients and he believes it’s “too late” for his business to recover. His adult son and daughter admire him greatly, but his ex-wife denigrates him and does everything she can to keep their children from seeing …

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Delivering mental health care in a more rational fashion

Why you should avoid the temptation of drug coupons

Kevin Pho, MD

KevinMD

December 10, 2012

A version of this column was published on October 24th, 2012 in USA Today.

As the cost of prescription drugs soar, more patients are turning to online coupons or discount cards from drug companies or promotional offers in magazines. In the past year, it is estimated that 19 million Americans whom took prescription drugs used such incentives to save money. The healthcare industry …

Concierge medicine: Winners and losers

John Schumann, MD

Physician

December 10, 2012

By now you’ve probably heard of the concept of “concierge medicine.”

To me, it’s an idea that’s Win-Win-Lose:

Win: Doctors. Those in concierge practices have chosen to forgo the traditional business model in favor of charging annual fees that range from $1500 to $15,000 per patient. How much you pay depends on the market, exclusivity factors, and amenities, like comprehensive annual physicals with add-ons like a dermatology appraisal and nutrition consultation. Concierge …

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Concierge medicine: Winners and losers

HIV screening and the USPSTF: Better late than never

Paul Sax, MD

Conditions and Diseases

December 10, 2012

A flurry of coverage recently appeared about the U.S. Preventive Services Task Force’s recommendation for one-time HIV screening for all Americans, ages 15-64.

Some might wonder why this is news — um, hasn’t this been recommended now for years? — and I think I’ve figured it out.

Let me start by relaying that every ID/HIV specialists can tell some version of the following sad story, which is still repeated on a regular basis …

DTC genetic tests and the wilds of personal medical information

Tia Powell, MD

Conditions and Diseases

December 10, 2012

The other day I landed on the website of 23andMe. To my surprise, I learned that if I wanted to send the company a sample of my DNA, I’d have to swear under penalty of law neither to collect my sample nor mail it from New York State. That’s because New York State requires a laboratory license and direct interaction with a physician for mail order DNA testing.

New York, it …

Don’t overwhelm patients with unnecessary detail

Peter Ubel, MD

Physician

December 10, 2012

It is not an easy time to be a physician in the United States. Attempt to order an expensive test for a patient and an insurance company is likely to second guess your decision. Try upholding the bottom line for your medical practice and the government will probably start questioning whether you are overcharging for your services. To make matters worse, …

The unintended consequences of boilerplate guidelines

David Mokotoff, MD

Physician

December 9, 2012

I recently saw a 90-year old patient in my cardiology office practice. She was demented, but cooperative with the exam. A devoted daughter, with whom she lives, accompanied her to the appointment. Her dementia was severe enough to make a cogent history from the patient impossible. However, the daughter had something on her mind, and it had nothing to do with her mother’s heart condition.

“My mother’s primary care doctor wants …

Do we really have the world’s best cancer care?

Samuel Metz, MD

Health Policy

December 9, 2012

Those who resist health care reform point to America’s great cancer care – instead, we should protect “the best health care system in the world.” After all, if we’re the best, other countries should change, not us.

Do we really have the world’s best cancer care?

A good indication is the American survival rate for breast cancer, the world’s longest. But …