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An inside look at the FDA drug approval process

Medications

May 23, 2012

Behind the headlines “FDA Panel Unanimously Rejects…” and “Arthritis Pill From Pfizer Wins Support…” was, for me, over 600 pages of reading and two days at the FDA as the Consumer Representative to the Arthritis Advisory Committee (AAC).

These were my first meetings following an almost yearlong process that started with a nomination by Diane Aronson, the Consumer Representative whose term was ending, and culminated with my four year …

How medical school changed me

Matthew Gibson, MD

Medical Education

May 22, 2012

I have been thinking a lot over the last few weeks about all the many ways that the experience of medical school has changed me.

The most obvious is knowledge. I’ve drunk from the proverbial “firehose” of information that we experience in medical school, and apparently enough of the facts stuck with me to pass all my exams, and secure myself a residency program back in my home state of California. …

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How medical school changed me

Mobile health apps don’t always follow conventional wisdom

Richard Meyer

Health Technology

May 22, 2012

Propaganda and non-truths abound all around the Internet saying that mobile health apps are everything from a threat to Big Pharma to a way to save billions of dollars in healthcare costs. There may be a future for mobile apps but a lot of work is yet to be done.

Last year I led some market research into mobile apps across all demographic segments and several disease conditions. While we did …

Why Priscilla Chan may become the country’s most influential doctor

Kevin Pho, MD

KevinMD

May 22, 2012

Who has the potential to be the most influential physician of our generation?

It’s Priscilla Chan, who not only recently graduated from medical school, but also married Facebook founder Mark Zuckerberg.

When I brought this up on Twitter, someone responded that it was “disappointing at the same time. I’m certain her own merits and studies would have made waves alone.”

But her influence …

Confused about prostate cancer screening? Make a shared decision

Kevin Pho, MD

KevinMD

May 22, 2012

In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men.

Case closed, right?

Hardly.

The prostate cancer screening debate has been raging for the past decade. Increasing amounts of evidence show that screening does not save lives, and increase the risk of complications like impotence and urinary incontinence that stem from invasive diagnostic tests and treatments.

Regular …

When patient care becomes secondary to filling out the medical record

Jordan Grumet, MD

Health Technology

May 22, 2012

The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above the limit. I lamented the forced, measured pace as the road lazily formed a long straight path. The clock refused to slow for my new found law abiding citizenry.

A sports car motored around a curve and flew past us unaware. The cop switched on his lights and tried …

Take on the problem of obesity with dignity and respect

Katherine Ellington

Conditions and Diseases

May 21, 2012

At a time when 2 out of 3 Americans are overweight, a story about black women and fat has gone viral. Perceptions about what women see in the mirror, feel about their bodies and others tell them about beauty is not sufficient for health. The opinion that “many black women are fat because we want to be” may nurture bias that can hinder health care for those who are …

Why physicians are susceptible to hardball tactics

Bradley Evans, MD

Physician

May 21, 2012

I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the meeting. The topic was healthcare reform and its effect on hospitals and physicians. Included were discussions on patient-centered medical homes, accountable care organizations, bundled payments and physician integration and alignment with hospitals.

The course director made it crystal clear that there will be no place in the future for …

When it comes to doctors and social media, hospitals fail miserably

Kevin Pho, MD

KevinMD

May 21, 2012

When it comes to medicine and social media, much of the attention is negative.

Doctors losing their hospital privileges because of Facebook.

Or other health care workers taking pictures of patients and posting them on the web.

It’s no wonder that many hospitals are taking a heavy handed approach when it comes to their doctors and social media.

Consider this story, Doctors warned …

What should America’s health care vision be?

Stephen C. Schimpff, MD

Health Policy

May 21, 2012

America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the same time has a dysfunctional care delivery system. A new vision is needed.

Vision is a leadership concept that presents an idea, garners support and then develops the coalitions to bring it to fruition. America needs to envision what its care delivery system should be and then determine, as …

Struggling with the idea of leaving for medical school

Imraan Allarakhia

Medical Education

May 21, 2012

The lines of text on my laptop screen blurred together as I lost focus. I knew there was at least one error on my medical school re-application I would regret later on. My eyes scanned the familiar body of words but failed to connect the information to my brain. Frustrated, I closed the application and shut my computer off.

My bedroom door abruptly swung open, revealing my mother with the phone …

What if stress management was actually ridiculously easy?

Susan Biali Haas, MD

Conditions and Diseases

May 20, 2012

I keynoted at a conference a few weeks ago. As usual, as the date approached I felt the pressure intensify. It’s much better than when I first started public speaking years ago. For my very first paid speech, which was in front of several hundred people, I shook for the three months leading up to it – some days when I got really worked up it was actually a challenge …

How we deliver bad news is critical to how families deal with grief

Kevin R. Campbell, MD

Physician

May 20, 2012

As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during my career. How a physician goes about this process can make an enormous impact in the lives of those affected by the news that must be delivered.

Precious little time is devoted to teaching this essential communication skill in the training of physicians today. I can remember back to …

His father’s suffering had already been too great

Monica Williams-Murphy, MD

Physician

May 20, 2012

He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I thought the patient was dead. He was nearly the same color as the pale sheet covering his thin frame. His cheeks were sunken in and his eyes were gazing upward, in what I sometimes call the “death stare.” Then, surprisingly, he moved his arm upward to push his …

A Life After Residency Alliance to ease the transition to practice

Adriana Tobar, MD

Medical Education

May 19, 2012

I recently wrote about the ways in which residents’ lives change dramatically during the transition to practice. For many, this transition feels like a complete 180.

I’m going to devote today’s post to introducing the concept of a “Life After Residency Alliance,” which is a group of people you can rely on for support, guidance and direction as you transition to practice.

The concept is taken from Napoleon Hill’s Mastermind Alliance, …

Diversity provides color to the tapestry of human experience

Anees Chagpar, MD

Physician

May 19, 2012

I was recently appointed the Assistant Director of the Yale Cancer Center with the portfolio of Diversity/Disparities. While I’m not sure I’m the most qualified for this, it has gotten me thinking a lot about diversity, disparities, and what it means to achieve health equity. Too often, I think, we are plagued by narrow thinking … the impression that our …

Necessary is a word best defined when looking back in time

Stewart Segal, MD

Physician

May 19, 2012

How do you define a “good” doc? I was reading the patient responses to an article here on KevinMD.com and was saddened by how many of the patients were angry with their docs. Anger is an unhealthy emotion! One of the respondents was particularly angry about the “unnecessary” tests her doc performed on her and her family.

I have written about the vagaries of the term “unnecessary” in the past. What …

Medicine involves a tension between isolation and connection

Reflex Hammer

Medical Education

May 19, 2012

I was skeptical when a doctor casually mentioned that 2% of all pregnancies are ectopic pregnancies (in which the fertilized egg is implanted somewhere other than the uterus, usually the fallopian tube). Without treatment, a common outcome is fallopian tube rupture, which jeopardizes the life of the mother. It is a serious medical concern. I shot a confused look at a fellow first-year medical student. Two percent? It seemed way …

The user interface for EHRs should be uniform

Roheet Kakaday

Health Technology

May 18, 2012

The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with names and organized alphabetically. There were three of these cabinets, taking up the entire length of the back wall, filled with hundreds upon hundreds of patients’ records.

“I see you still have paper records. Do you plan on implementing an EHR anytime soon?” I inquired.

The doctor paused for a …

Medical school and residency aren’t places for human growth

Paul E. Smith, MD

Physician

May 18, 2012

The end of my residency and beginning of my practice was the most wrenching experience of my life. I was woefully prepared for the transition. Full disclaimer: I was trained many years ago when residencies were acknowledged brutal demeaning processes. Things have changed considerably, but the psychological passage I endured still holds.

I think my process of becoming a surgeon was fairly typical, with the exception that there was no one …