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Our patients live with the fallout of a device recall

Conditions and Diseases

April 28, 2012

In the last several weeks there has been much discussion concerning the St. Jude Medical Riata lead Class I recall. Prior to the Riata, there was the Medtronic Sprint Fidelis lead recall. Prior to Fidelis, there were multiple recalls involving Guidant (now Boston Scientific) devices. The common thread to all of these recalls is our patients. Our device patients have endured all of these events. How exactly does the recall …

When doctors are forced to accept malpractice case settlements

William Sullivan, DO, JD

Physician

April 27, 2012

Suppose your malpractice insurance company wants to settle a medical malpractice case against you – even though the case has no merit.

In many cases, insurance policy language may allow the insurance company to do just that.

In the 2011 case of Mohan Papudesu, MD v. Medical Malpractice Joint Underwriting Assn. of Rhode Island, the Rhode Island Supreme Court allowed an insurer to settle a case on behalf of the defendant physician …

While doctors disagree, every physician wants to fix health care

Kohar Jones, MD

Health Policy

April 27, 2012

Three out of four dentists recommend this tooth brightening toothpaste — make your smile sparkle like never before! Six out of seven plumbers recommend this drain opening de-clogger — make your bathtub drain like never before! Nine out of ten doctors recommend improving the medical system in the United States — make your health care system heal like never before!

But how do we do that?

Do doctors think the Affordable Care Act is the soothing balm …

On the day we cure cancer

James C. Salwitz, MD

Physician

April 27, 2012

On the day we cure cancer I will rise in morning dark. I will stand in last night cold, and watch stars fade. The light will come and a following breeze blow. On that incredible dawn, there will be brilliance. I will make sunrise rounds on the day we cure cancer.

I will stay late and breakfast with my wife. We will talk about flowers, kids and books. I will stand …

Read more…

On the day we cure cancer

Why academic medical centers need a stress test

Michael Weitekamp, MD

Physician

April 27, 2012

A group of nine medical specialty societies recently announced the “Choose Wisely” campaign, targeting 45 commonly performed medical procedures and tests that offer little or no value in improving health. These interventions waste precious health care resources, lead to erroneous conclusions and/or false security, spur unwarranted additional interventions, and cause patient harm. Among the appropriately indicted procedures was cardiac stress testing of asymptomatic, low-risk patients. There is an old …

Heroic measures cannot cure how people want to live their lives

angienadia, MD

Physician

April 26, 2012

I was working in the Intensive Care Unit (ICU) the other day and as I counted, I found that more than half of the patients there, for lack of a better term, brought the condition upon themselves.

I sound harsh, but there was no better way to put it. I was taking care of Mrs. B, a 60-year-old lady with COPD who called EMS for shortness of breath. As EMS readied …

When do I stop being someone’s oncologist?

Don S. Dizon, MD

Physician

April 26, 2012

I recently talked about wondering how those I had met through my own patients were doing, especially after my patients had passed on. I wondered if they were all right and whether they were able to move on. Well, I’ve been thinking about it again, though this time in the context of cancer survivorship.

The Office of Cancer Survivorship of …

Many medical decisions require shared decision making

Kevin Pho, MD

KevinMD

April 26, 2012

The following column was published on April 1, 2012 in USA Today.

I recently saw a middle-age man in my primary care clinic who asked whether he should continue his cholesterol medication. He was reacting to new Food and Drug Administration warnings on statins, a class of drugs taken by more than 20 million Americans to lower their cholesterol. Though generally safe, …

Why the physician shortage is worse than you think

Karen S. Sibert, MD

Physician

April 26, 2012

Only a generation ago, medical students thought about what specialty to choose simply in terms of what interested them most. All doctors made a comfortable income; money wasn’t a primary motivator. There was a sense that cardiac surgeons or neurosurgeons could make more than most other physicians, but in fairness their training was much harder and longer. Internal medicine was held up to us as the most prestigious and intellectually …

Death arrives in many different packages

Monica Williams-Murphy, MD

Physician

April 25, 2012

The sage doctor who stood at the bedside as I held my dying grandmother said, “We seem to die one organ at a time.” I, however, have come to believe that we are too focused on the failing of the organs to rightly perceive the dying of the person.

Death comes in many different ways, in many different packages. Sometimes it arrives wrapped thoughtlessly in advanced dementia, other times the package …

Lack of health care coordination benefits physicians

John Toussaint, MD

Health Policy

April 25, 2012

An excerpt from Potent Medicine The Collaborative Cure for Healthcare.

It was mid-summer 2010 when the full scope of everything that Nancy D’Agostino did not know hit home. Still raw from surgery and missing parts of her body, she thought that all the hard choices were behind her. Then here was a new face, a radiation oncologist, outlining side effects of treatment and asking her to choose. And then a medical …

Lessons learned when a doctor sues an attorney

Neil Baum, MD

Physician

April 25, 2012

Several years ago I was hired by a plaintiff’s attorney as an expert witness on a personal injury case. He paid the fee in advance but the night before the trial, his co-counsel called me to review the case. It was clear that she did not have a thorough understanding of the case and I spent two hours with her on the phone trying to bring her up to speed. …

Thinking differently about treating neuropathic pain

Corey W. Hunter, MD

Conditions and Diseases

April 25, 2012

Pain, in any form, can present a difficult challenge for even the most astute pain physician. The complexity of treating neuropathic or nerve pain stems from a variety of reasons, ranging from the lack of an obvious source of the pain to the inability of the patients to explain what ails them, to a arduous history that was poorly managed with the wrong medications, allowing the pain to progress to …

The coming changes in health care delivery

Stephen C. Schimpff, MD

Health Policy

April 24, 2012

There will be some very disruptive and some transformational changes in the way health care is delivered, not as a result of reform, but as a result of the drivers of change described in a previous post on KevinMD.com. They included an aging population, an obese society, shortages of doctors, and emerging consumerism, among others.

I interviewed in depth about 150 medical leaders from across the United States to collect …

The emotional effects of device recalls on patients

Kevin R. Campbell, MD

Physician

April 24, 2012

As most of the electrophysiology (EP) community is aware, device and lead recalls are a reality in today’s EP practice. In the last 5 years, both Medtronic and St. Jude Medical have had significant lead failure issues. The public responses to these recalls have been varied and quite different. As physicians who care for device patients, we must learn to quickly sort through the rhetoric put forth in the New …

5 key trends to look for in the emergency department

Wesley Curry, MD

Health Policy

April 24, 2012

Patients have been arriving at the doors of emergency departments in increasing numbers over the past decade, and this trend will only grow in the future. I believe there are five key factors that suggest every ED should brace itself for a never-ending rush hour.

As the CEO of a physician group that provides medical care to over 4 million patients per year, I have the opportunity to study in great …

Making more drugs non-prescription is bad for patients

Matthew Mintz, MD

Medications

April 24, 2012

In our world of 24/7 media, where we seem to hear about the next big cure, important dietary change or very dangerous drug virtually every day, it is hard to believe that the news people, tweeters and bloggers could miss anything that is going on in health care today. However, it appears most everyone missed a big one. This might be one of the most important stories in health care today, that no one …

Should every case of domestic violence be reported?

MomTFH, DO

Physician

April 23, 2012

I am on my last rotation for medical school. It is a “rural selective”, which is a required elective at a rural or underserved location. I am fulfilling it at a local community health center in the women’s health department. Fun!

I am taking part in a day long orientation today. In one of the presentations, the speaker had a point on one of the slides about mandatory reporting, and included …

Medical residents are abused more than Chinese factory workers

Anonymous

Physician

April 23, 2012

Medical residents have fewer labor protections than Chinese factory workers. While labor abuses at Apple’s factories make headlines, few people are as concerned about the lack of protections for doctors and medical students here in the United States. As a resident, I was subject to some of the worst abuses – intentionally misreported time sheets and gender-based discrimination – and after I complained, I was fired, so I sued the …

Patients deserve a medical malpractice early offer

Kevin Pho, MD

KevinMD

April 23, 2012

The following column was published on March 25, 2012 in the Nashua Telegraph.

Medical malpractice historically has been a contentious issue. Doctors have argued that the system is broken, promotes multi-million dollar awards disproportionate to the injuries suffered, and encourages the ordering of unnecessary tests to avoid being sued, a practice known as defensive medicine. Trial attorneys, on the other hand, …

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