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Are the doctors of tomorrow going to sink or swim?

Medical Education

April 18, 2012

We finally broke down and bought floaties. The kids played for a few days in the shallows, but since neither of them are yet proficient swimmers, they dared not wander into deeper waters. Each day they watched as younger kids scooted around the pool wearing wing like contraptions colored with cartoon characters.

I never liked the idea of floaties. Much better, I thought, to let them struggle and build on the …

How can doctors curb digital distractions?

Robert Wachter, MD

Health Technology

April 18, 2012

It’s been said that losing weight is much harder than kicking cigarettes or alcohol. After all, because one doesn’t need to smoke or drink, the offending substances can simply be kept out of sight (if not out of mind). Dieting, on the other hands, involves changing the way a person does something we all must do everyday.

It’s no surprise, then, that reports of problematic doctor interactions with social media are …

Why patients should be paid for good health

Stewart Segal, MD

Physician

April 18, 2012

Over the past few years, insurers and Medicare officials have fostered the idea that physicians should be reimbursed on a pay for performance (P4P) basis. Many articles, both pro and con, have been written regarding P4P. I have been strongly opposed to P4P, believing that the sole purpose of the performance indicators designed by the government and insurers is to reduce payments to docs and hospitals. I also believe that …

When doctors are incorrect in their prognosis of terminal illness

Manoj Jain, MD, MPH

Physician

April 18, 2012

In January, when my close friend’s lymph node biopsy came back as a rare form of T-cell lymphoma, I scoured the scientific literature. What was his prognosis?He was 56, a little overweight but otherwise healthy. He had helped us move into our home more than a decade ago, and I was like an uncle to his son and daughter.

In the literature I found jagged graphs plunging downward, indicating that my …

Tips for successful home blood pressure monitoring

Erin Marcus, MD

Conditions and Diseases

April 18, 2012

Sometimes, the simplest tools in medicine are the ones that give us the most useful information.

Take the humble blood pressure machine, for example. It’s been around for years, and it’s cheap, compared with a lot of other medical devices. It’s simple to use, and it doesn’t require a medical or a nursing degree to operate. But the numbers it reports are valuable in helping predict a person’s risk of a …

Why doctors should drive health reform

Kohar Jones, MD

Health Policy

April 17, 2012

Who better knows how to fix a leak than a plumber?
Who better knows how to repair a cracked doorway than a carpenter?
Who better knows how to solve the conundrum of our leaking cracked health care system than a doctor?

Doctors are an important part of public discussions about health care reform. Our prescriptions drive healthcare costs. We are the crucial middlemen between the biomedical industry and patient health. Sharing our first hand experiences in health care …

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Why doctors should drive health reform

A Hindu physician in a Christian hospital

Deep Ramachandran, MD

Physician

April 17, 2012

As I enter the hospital in which I work, I am struck by a number of signs that denote that my place of employment is a Christian hospital, with Christian values, and a Christian “vision” of health care. I don’t have the vaguest clue as to what that means. And I don’t really mind either, it’s not like they’re paying me with Jesus biscuits and Christmas ornaments, nor does it seem …

The unintended cost consequences of patient centered care

Richard Young, MD

Health Policy

April 17, 2012

I’ve just come back from my semi-annual renewal in my belief that family medicine is the foundational solution to make healthcare more affordable in America: the interim session of the Texas Academy of Family Physicians. The most important activity at these meetings is the networking: the chance to bounce ideas and experiences off colleagues from around the state.

The issue of cost came up and two colleagues in private practice told …

Take charge of your healthcare quality and costs

Stephen C. Schimpff, MD

Health Policy

April 17, 2012

Fed up with our health care delivery system? Maybe even angry? What should a person do? What can a person do?

I recently wrote a post on drivers of change in health care delivery such as the aging population, adverse lifestyle behaviors, shortages of physicians and developing consumer expectations. I planned to follow up today with what those drivers will produce as change in the delivery system. But a commentator responded …

Bullies are not born, they are raised

Katie Hurley

Physician

April 17, 2012

People often wonder what causes children to bully. Why is it that some children feel the need to hurt and humiliate other children? What do they really stand to gain from this cruel behavior?

Some studies indicate that some (not all) bullies have naturally aggressive and/or hyperactive personalities from the start. Some. But that doesn’t mean that all “spirited” kids will bully while all “mellow” kids will be perfectly empathic and …

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Bullies are not born, they are raised

The computer had stopped the doctor from communicating

James C. Salwitz, MD

Physician

April 17, 2012

There was no mistake, but a bad thing has happened. Despite the best efforts of the doctors, Bob’s wife is very sick. Due to a rare side effect of treatment, her liver is failing. Bob believes this could have been prevented. He is very mad.

“When we go to see the doctor, he stares at the computer,” says Bob. “He does not look at us. Most of the time, the doctor …

Why the physician path today is far from linear

Philippa Kennealy, MD, MPH

Physician

April 16, 2012

As a child, the only physician I ever knew was our crusty opinionated and entirely trustworthy family doc. His physician career spanned almost five decades, in one unbroken line from his first days as a GP in solo practice until his retirement, which occurred way past the age at which most of us would like to stop working.

His was the typical physician career, representing continuity, professional satisfaction and a lifelong commitment …

Chaos for doctors if the Affordable Care Act is struck down

Bob Doherty

Health Policy

April 16, 2012

Imagine you’re a physician, and you have a full schedule of patients to see the day after the Supreme Court has thrown out the entire Affordable Care Act. Imagine you never liked “Obamacare” in the first place, so you are feeling pretty good about the Supreme Court decision.

Your first patient, an elderly retiree named Mrs. Jones, comes in for her annual Medicare wellness visit—one of the new Medicare preventive benefits …

The residency journey is just getting started

Allison A. Greco

Medical Education

April 16, 2012

Every career has that one question that is notoriously hated by all. For nurses, that question is, “So, why didn’t you want to be a doctor?” For teachers, it’s questions about the age-old adage, “Those who can’t do, teach.” For medical students, that question is, “So, do you know what you want to do?”

It’s not that people who ask medical students about their career plans are ill-intentioned or nosy; in …

CME limitations and how we can improve Continuing Medical Education

Behnood Bikdeli, MD

Medical Education

April 16, 2012

Some people critique Continuing Medical Education (CME) programs as spoon-feeding. As a young physician struggling to learn a lot of material, I actually appreciate a bit of ready-to-consume content that I can learn quickly and effectively. The American College of Cardiology (ACC) and other reputable institutions provide CME programs that, overall, help to keep physicians up on the literature and integrate new findings with existing knowledge. However, despite the basic …

Part time medicine and birth of the new normal

Dike Drummond, MD

Physician

April 16, 2012

One of the most common stressors for physicians is the sheer toxicity of what are considered full time hours. While the rest of the world considers full time to be 40 hours a week, we all know a full time doc starts at 80 plus, if you include all the hours you must be available on call.

In physician surveys, schedule flexibility and the ability to function as a part time …

What to say to a newly diagnosed cancer patient

Salli Camphouse

Patient

April 15, 2012

“So, the doctor told me I have breast cancer. I just wanted to let you know. I’m doing fine right now, but I have some decisions to make regarding my treatment options. I’ll keep you posted.”

This may be a typical email sent to family and friends after receiving a breast cancer diagnosis. Sending emails seems more practical at this point. With so many friends and family to update, unless a …

We need to systematically evaluate digital health technologies

Fard Johnmar

Health Technology

April 15, 2012

An old colleague once told me: “When you assume it makes an ass out of u and me.”

Many of us would consider being an ass a bad thing. If so, why are we making so many assumptions about digital health? Belief in the power of digital technologies to solve a host of pressing problems in health has us poised to devote billions of dollars to their adoption and development. But …

Tips to fight depression during medical residency

Adriana Tobar, MD

Physician

April 15, 2012

Even though I love my job, I’ve been feeling a little burned out lately. I think it comes from being stretched too thin, which is something I’ve coped with off an on ever since med school.

As the saying goes, there are never enough hours in the day, and sometimes that really gets to me. While my practice is incredibly important, I also place a lot of value on my family. …

What does it take to have successful end of life conversations?

Virginia L. Seno, PhD

Physician

April 15, 2012

Everyone suffers when communication fails at the end of life. Though we may “know in our hearts” what to do in difficult situations; anxiety and bias close us down. We lose our ability to say and act on what we know is best.

Physicians and nurses suffer when they “know in their hearts” that they are doing harm performing CPR on people at a natural end of their lives on people …

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