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Healthcare consolidation may bend the cost curve the wrong way

Health Policy

March 16, 2012

Last year, Ann Mathews wrote a brilliant piece in the Wall Street Journal about the future of medical care in the United States. It is an extremely informative study and provides the reader with a very fine 50,000-foot view of the current condition of its subject.

What she did not mention, or truly highlight, is the threatening trend that is taking place with ever increasing rapidity, of hospital conglomerates, both …

Complex, painful and expensive medical procedures at the end of life

Janice Boughton, MD

Physician

March 16, 2012

It isn’t that it was a bad day, because it wasn’t really. There was too much work, yes, and I ended up staying late, but it was mostly made of good interactions and I felt generally competent. So, no, it wasn’t just a bad day. Still, this evening I feel like the best possible future would be one in which there was no technological medical care, where we just worked …

Should doctors be forbidden to complain about money?

Kevin Pho, MD

KevinMD

March 16, 2012

The Patient Centered Medical Home is supposed to be the solution to our primary care woes.

Endorsed by both the American Academy of Family Physicians and the American College of Physicians, this new model of primary care creates a team-based approach to patient care, with a cadre of care managers and nurses assisting physicians to manage patients with chronic disease. If …

Reflections on the Match: Improving the interview process

William Bain

Medical Education

March 16, 2012

We are sorry, you did not match to any position. – NRMP Staff

Despite more than one-quarter-million dollars in tuition and expenses at a top-notch medical school, several of my classmates received that stark e-mail on Monday. Most quickly began the SOAP (the new “scramble”) to find an unfilled position. Although many factors influence whether a medical student finds success in The Match, this week’s results suggest to me that the …

A family bucket list is a reminder to have fun together

Yolanda Wong, MD

Physician

March 16, 2012

Parenthood. It has changed everything.

Snot on my sweater goes unnoticed. Hobbies gather dust in the closet. Kissing away the boo-boos and wiping away tears become daily ritual. Screams, laughter, tantrums, and toys crashing to the floor become the household white noise. All my Facebook status updates are about my kids.

Some people manage to continue their lives with style.

Me? I’m just tired. And I need a haircut. Smartypants would say I need a …

Heed the 4th year medical student spoils

Nonmaleficence

Medical Education

March 16, 2012

Looking back on the first three years of medical school, it’s hard to imagine living through the endless days of studying again. Weekends were spent cooped up in the library and there were countless holidays that I wasn’t able to spend with my family. Instead, they were spent memorizing indecent aspects of the human anatomy and performing DREs on strangers. There are better ways to get to know a person …

Cancer screening stories need to report on the uncertainties

Gary Schwitzer

Conditions and Diseases

March 16, 2012

A Miami Herald story, heralds “Prostate cancer hits younger men.” You know right away how this one is going to play out.

The story begins by profiling a 48-year old man with prostate cancer. It says his “doctor ordered the test as a routine practice for his male patients.” There isn’t any discussion about how such ordering as a routine practice doesn’t demonstrate the kind of shared decision-making model that the …

Improving patient safety requires a commitment to transparency

Paul Levy

Patient

March 15, 2012

An excerpt from Goal Play!: Leadership Lessons from the Soccer Field.

I recently had lunch with one of my soccer alumnae, now aged 28. Tovah said to me, “Do you remember that play I made in the tournament we went to in Connecticut? I mean when I mistakenly headed the ball into our own goal and caused us to lose the game.”

“Well, I was devastated and was sitting on the …

The problem with obesity counseling

Christina Girgis, MD

Conditions and Diseases

March 15, 2012

Recently I have become interested in the obesity epidemic plaguing our country. I’ve actually been interested in obesity and co-morbid psychiatric illness since residency, but recently my interest has been revived. I read that Medicare is going to be reimbursing health care practitioners for obesity counseling and screening. My initial thought was that this is a positive step in the right direction. But the cynic in …

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The problem with obesity counseling

How dare strangers tell me to ditch my doctor

Kris Byrd

Patient

March 15, 2012

It’s always amazing to me how quick folks can be to offer advice. Unwanted advice. Medical advice. Near strangers jump at the chance to give input without a second thought. Isn’t everyone quick to judge a doctor they’ve never met, particularly when the doctor is treating something they’ve never even heard of? What does this say about me? When someone does this to me, they are basically telling me that …

Planned Parenthood can’t accept Medicaid in Texas: Why we should care

Jennifer Gunter, MD

Conditions and Diseases

March 15, 2012

She knew she was supposed to be careful about getting pregnant, although truthfully she didn’t think it could happen because of her blood pressure and kidney problems. The nurses at the county clinic started her on the pill, but her blood pressure went all crazy. They asked her to come back on a Wednesday night when the doctor was there. The doctor asked lots of questions and spent a lot …

Will Peyton Manning ever fully recover from his spinal nerve injury?

Edward Pullen, MD

Conditions and Diseases

March 15, 2012

Does muscle weakness improve after disc surgery?

For an NFL fan arguably the best thing that could happen to your team is to sign Peyton Manning and have him perform at or near his pre-injury level. The corollary is that one of the worst things to happen to your team would be to take a huge salary cap hit to get a Peyton Manning with such weak throwing arm that even …

Doctors need to be better trained to deliver bad news

John Salter, MD

Physician

March 15, 2012

Last week was tough. I had to refer several patients to hospice, and a few more received bad news regarding their disease. This has always been the toughest part of my job, but it’s also the part patients need me to handle best. I have to remind myself that no matter how hard it is for me to give bad news, the patient and their families are the ones receiving …

Why one-third of hospitals will close by 2020

David Houle and Jonathan Fleece

Health Policy

March 14, 2012

For centuries, hospitals have served as a cornerstone of the U.S. health care system. During various touch points in life, Americans connect with a hospital during their most intimate and extraordinary circumstances. Most Americans are born in hospitals. Hospitals provide care after serious injuries and during episodes of severe sickness or disease. Hospitals are predominately where our loved ones go to …

A radiologist disagrees with the breast cancer screening guidelines

Stacey Vitiello, MD

Conditions and Diseases

March 14, 2012

As a veteran of World War II, my grandfather was a GI Bill success story, the first man to go to college from his impoverished neighborhood in Jersey City thanks to government at its finest. A card-carrying member of the state teachers’ union, and a politically active Democrat for most of his life, it came as something of a shock to me when, after a few decades of observing big …

Match Day 2012: Medical students anticipate this Friday

Perelman School of Medicine

Potpourri

March 14, 2012

Match Day marks one of the most important days in a medical student’s career. Match Day is held annually to announce the results of the National Residents Matching Program (NRMP), which places graduating medical students with residency programs throughout the country. On March 16, 2012, the wait will be over for Perelman School of Medicine students who will open their envelopes revealing the location where they will spend …

Changing older adult stereotypes through children and nursing homes

Frances Shani Parker

Patient

March 14, 2012

“What’s considered a sexual risk for an old person? Not wearing a diaper?”

“How about old people just stop having sex?”

These comments from an Internet social media “discussion” group on older adult AIDS prevention reflect blatant eldercare bias. They are just more of many examples of negative stereotypes about them that are embedded in our society. Not only do they affect older adults who are currently victimized by them, they also …

ACP reminds physicians to assess risk, screen for colorectal cancer

Fred Ralston Jr., MD

Conditions and Diseases

March 14, 2012

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

Colorectal cancer is the second leading cause of cancer-related deaths for men and women in the United States. Although the effectiveness of colorectal cancer screening in reducing deaths is supported by the available evidence, only about 60 percent of American adults aged 50 and older get screened.

A new …

Patients are not the customer

Stephen C. Schimpff, MD

Health Policy

March 13, 2012

Ever been put on hold when calling your insurance carrier? Or had so little time with your physician that you could not discuss everything you thought was important?

Our care is generally good in the United States but not as good as it could be nor as good as it should be. There are multiple problems to consider.

First, ours is a medical care system not a health care system. It is …

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Patients are not the customer