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Don’t ever believe EHR uptake is slow only because it costs too much

Health Technology

October 13, 2012

The latest numbers from the CDC’s National Center for Health Statistics affirm that a majority of small practices do not have an EHR. Why is that?

One big reason is because small practices don’t have the management or technical infrastructure available to prepare for and handle the biggest challenges facing medical practices today.

What are those challenges and what’s that got to do with EHR implementation? According to the Medical …

Why Marissa Mayer deserves our respect

Wendy Sue Swanson, MD

Physician

October 12, 2012

I recently saw a number of tweets from parents and fellow pediatricians on Twitter criticizing Marissa Mayer for announcing that she’d return to work within 1-2 weeks of the delivery of her first child.

First off, I’ll start with my assumptions:

I’m authoring this post in the belief that Ms Mayer has access to quality health care–that is, she has the ear of a board-certified obstetrician, a board-certified pediatrician, and access to a …

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Why Marissa Mayer deserves our respect

What Republicans and Democrats can agree on about Medicare

Bob Doherty

Health Policy

October 12, 2012

Republicans and Democrats don’t agree on much about Medicare, except for getting rid of the fee-for-service system for paying doctors.

“If reducing the growth of Medicare spending to sustainable rates and moving away from fee-for-service are ‘ending Medicare as we know it,’ then both parties have embraced that goal, writes former OMB Budget Director Alice Rivlin in a Daily Beast commentary.

“Paying providers on a fee-for-service basis offers incentives to …

Why hospital pricing practices concern me

Peter Ubel, MD

Health Policy

October 12, 2012

The gynecologist made several incisions and inserted the laparoscope. With the help of her surgical team of nurses, students and anesthesiologists, she removed the patient’s uterus, which had been bleeding uncontrollably for the past six months despite aggressive medical therapy. The price tag of the procedure? Around $6,000.

Meanwhile in a nearby hospital, another gynecologist removes another woman’s uterus, in a procedure no more complicated or time consuming than the first …

A patient is not a dish off the menu

Zackary Berger, MD, PhD

Health Policy

October 12, 2012

Atul Gawande, MD, is a technophile and a believer in the checklist, and he yokes these ideologies to an attractive metaphor in his newest essay for the New Yorker. The article is worth reading in its entirety, but it can be easily paraphrased.

The Cheescake Factory, like other successful restaurant chains, has “brought chain production to complicated sit-down meals.” They’ve done it by far-reaching standardization of the best possible …

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A patient is not a dish off the menu

Stop setting hospital benchmarks at the state average

Ashish Jha, MD, MPH

Health Policy

October 12, 2012

Recently, I discovered the statewide report on quality of stroke care in Massachusetts. It’s a plain document, mostly in black and white, much of what you might expect from a state government report. Yet, this 4-page document is a reminder of how we have come to accept mediocrity as the standard in our healthcare delivery system.

The report is about 1,082 men and women in Massachusetts unfortunate enough to have a stroke …

How our children turn out isn’t really up to us

Claire McCarthy, MD

Physician

October 11, 2012

My two oldest children recently left for semesters abroad: Michaela went to Paris, and Zack to Beijing. I have all sorts of Mommy nervousness about this, but in my heart I know they’ll be fine. They are adults now, at 21 and 20—and not just adults, but capable, responsible, great people.

I don’t know how that happened.

I know that sounds stupid. And it’s not like I have no clue at all. …

5 pieces of advice nobody tells you before starting residency

Deep Ramachandran, MD

Medical Education

October 11, 2012

Since medical school, I’ve gone through an additional 6 years of training, read countless volumes of medical literature, and had the fortune of having some great teachers. Through it all, experience has been the greatest teacher, which I suppose is what training is about. I’ve watched with interest as advice has been hashed out on the web around this time of year to new trainees on all matter of subjects. …

Viagra for women: Prescribe 50 Shades of Grey to your female patients

Sara Stein, MD

Physician

October 11, 2012

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Could “mommy porn” have value in the doctor’s office? Unless you live in a cave (and we physicians sometimes do), you have heard of British author E.L. James’ modern erotic 50 Shades of Grey trilogy, 30-plus million copies sold, overwhelmingly to women. The trilogy is an erotic love story about a naïve college graduate who rescues an abused billionaire – a …

Align employers with doctors, hospitals and insurance companies

Manoj Jain, MD, MPH

Health Policy

October 11, 2012

I once thought that only the federal government in Washington could effect changes that would impact the cost of health care in the United States, especially with so much attention on the recent Supreme Court decision on the 2010 health care reform law. But now I think differently.

Now I believe that emboldened employers in places like Memphis can use their clout. They can influence insurers and work directly with doctors …

What EMRs are doing to our notes, and our brains

Robert Wachter, MD

Health Technology

October 11, 2012

A colleague recently sent me a remarkable video – of Professor Lawrence Weed giving Medical Grand Rounds at Emory University in 1971. It’s fun to watch for many reasons: the packed audience composed mostly of white men in white jackets and narrow ties, the grainy black and white images a nostalgic reminder of Life Before High Def.

But the real treat is …

Chuck Pagano has leukemia: An oncologist discusses his prognosis

John Salter, MD

Conditions and Diseases

October 10, 2012

I’ve been getting a lot of questions about Indianapolis Colts’ Head Coach Chuck Pagano lately, so I thought I would dedicate a blog entry to discussing his disease and prognosis.

Coach Pagano was recently diagnosed with acute myeloid leukemia (AML), a form of blood cancer that typically carries a rather grim long-term prognosis in adults. While early reports were quite sketchy on the details of Pagano’s presenting symptoms, it seems that …

Reform needs more than expanding health care coverage

Steve Balt, MD

Physician

October 10, 2012

Whatever your opinion of the Affordable Care Act, you must admit that it’s good to see the American public talk about reducing health care costs, offering more efficient delivery systems, and expanding health care services to more of our nation’s people. There’s no easy (or cheap) way to provide health care to all Americans, particularly with the inefficiencies and absurdities that characterize our current health care …

10 reasons for physician burnout

Rob Lamberts, MD

Physician

October 10, 2012

It happened again. I was talking to a particularly sick patient recently who related another bad experience with a specialist.

“He came in and started spouting that he was busy saving someone’s life in the ER, and then he didn’t listen to what I had to say,” she told me. ”I know that he’s a good doctor and all, but he was a real jerk!”

This was a specialist that I hold …

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10 reasons for physician burnout

My flirtation with the ER has made me more sympathetic to patients

Leana Wen, MD

Physician

October 10, 2012

As emergency physicians who are trained in acute resuscitation and thrive in high-stress situations, we tend to roll our eyes at the less acute complaints our patients come in with. “Back pain for three months? Headache for a week? Why are they here now?”

Patients, too, complain about this. “Can’t they see it’s not a real emergency and go see their primary care doctor? This must be costing our healthcare system …

How a drug addicted scrub tech changed my life forever

Kate O'Reilley, MD

Physician

October 10, 2012

It was a cold winter day in 2009 when my life changed forever, however, it would be months before I figured that out. On that fateful day, a drug-addicted surgical scrub tech assigned to my operating room stole syringes of fentanyl, a potent intravenous narcotic, from my anesthesia cart. According to news reports, investigative summaries, and the scrub tech’s confession, once she took the syringes, she used them on herself.

It’s …

ACP: Make flu vaccination a team effort

Yul Ejnes, MD

Conditions and Diseases

October 10, 2012

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

Fall is the time of year when the CDC, CMS, insurance companies, and professional societies bombard physicians with reminders to vaccinate their patients against influenza. I will do these groups one better and not only remind you, but also share a couple of ideas for improving …

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ACP: Make flu vaccination a team effort

National Primary Care Week 2012: What makes this year different?

Andrew Morris-Singer, MD

Physician

October 9, 2012

It’s National Primary Care Week, an annual celebration when members of the primary care community come together across the country in events largely organized by trainees to celebrate, promote and advance primary care. So what makes this year different?

Put simply, the momentum for advancing primary care in the US has never been stronger. Those of us who believe that a robust foundation of primary care is essential to the health …

10 tips for new college students with chronic disease

Kitty O'Hare, MD

Physician

October 9, 2012

For some of my patients, going to college is especially nerve-wracking because it will be their first time living away from home with a chronic disease.

I deal with teen health daily. I care for a lot of adolescents and young adults with chronic disease, everything from asthma to diabetes to congenital heart defects. As my patients grow up they have a lot to deal with because of medical issues: taking …

Why Lance Armstrong will always be a hero

J. Leonard Lichtenfeld, MD

Physician

October 9, 2012

Like many of you, I have been reading the various news stories about Lance Armstrong, especially one recently in a major newspaper, which went into great detail about the allegations surrounding Lance Armstrong’s cycling career.