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Palliative care physicians can enhance patient decision making

Health Policy

October 7, 2011

Data from the Dartmouth Atlas show patients with chronic illness in their last two years of life account for about 32 percent of total Medicare spending, with much of that expense going toward physician and hospital fees associated with repeated hospitalizations.

Opportunities to reduce medical expenditures during the last 2 years of life are often looked upon as a way to reduce the cost of healthcare while actually improving the …

USPSTF prostate cancer screening guidelines need emotion to resonate

Kevin Pho, MD

KevinMD

October 7, 2011

Prostate cancer screening has always been controversial.

Now, with the USPSTF is recommending against screening for prostate cancer, gas is about to be poured on the proverbial fire.

Recently, the New York Times Magazine published a lengthy piece on the issue, perhaps not coincidentally, perfectly timed with the Task Force’s announcement.

In 2009, advocates for breast cancer screening were up …

5 ways to cut breast cancer risk

Therese B. Bevers, MD

Conditions and Diseases

October 7, 2011

Breast cancer may be the most common cancer among women. But, that doesn’t mean you can’t do something to help prevent it.

Researchers have found certain risk factors that increase a woman’s chances of getting breast cancer. We can’t change some of these factors, like age or race. But we can try to control others, like weight gain and alcohol use.

And, taking responsibility for the things you can control may …

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5 ways to cut breast cancer risk

Is teaching bedside manner a thing of the past?

Jackie Fox

Patient

October 6, 2011

I caught the tail end of a recent #hcsm (health-care social media) tweetchat and it looked to be a good one. I saw a few comments about teaching bedside manner and whether it’s a thing of the past (oh, how I hope not). It occurred to me that sharing a real-life story could be instructive.

I put on a brave face when I got a mastectomy for stage 0 DCIS …

Physicians need to understand data to provide better and safer care

Donald Tex Bryant

Physician

October 6, 2011

Patients expect excellent care from their physicians. Unfortunately, not all receive such care and most of us realize this. Many who do understand the wide variation in patient care probably believe it is due to the clinical knowledge and attitude of the provider—a very knowledgeable physician or nurse who is passionate about his or her job will deliver the best care. Although these ingredients are necessary for excellent patient …

Practical tips for a more comfortable mammogram

Stacey Vitiello, MD

Patient

October 6, 2011

By now you’ve probably seen the internet jokes that compare the mammogram experience to having your breast squashed in a refrigerator door. A few years back, I joined the club of women who have our annual mammograms, and I can’t say that I disagree with the imagery of the jokes. However, the benefits of early detection far outweigh the discomfort, so I’m willing to put up with it.

I’d like to …

Preventing deaths from food allergy

Scott H. Sicherer, MD

Conditions and Diseases

October 6, 2011

Sadly, recent news reports described two food allergy-related deaths in a single week. Although the details are scant, the victims were a 15 year old and a 20 year old, who apparently ingested unsafe foods and were not treated promptly. These preventable tragedies behoove us to learn how to better manage our food-allergic patients and advocate for them as well.

The Centers for Disease Control and Prevention (CDC) estimated that approximately …

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Preventing deaths from food allergy

When to see a doctor if you have a new symptom

Rick Donahue, MD

Patient

October 6, 2011

Patients and friends tell me it’s sometimes difficult to decide exactly what symptoms merit a doctor’s appointment. I find that it helps to think of three basic categories of visits. One category is the all-important annual checkup, which assesses and promotes overall health and can detect signs of early disease. Another category is the follow-up appointment to track chronic conditions or recovery from a major illness.

But the third category …

A doctor cannot be on time and take care of your needs

Stewart Segal, MD

Physician

October 6, 2011

Today’s article addresses a common complaint about physicians.

“Freewheel” responded to a previous article by writing the following, “you will not make me wait more than 10 minutes. My time is important, too.” One of the most common complaints I hear is “I waited over an hour to see you!” Waiting for an appointment, particularly when you are sick, is frustrating. Once you have that appointment, waiting for a doc who …

How Steve Jobs mentored a physician and changed health care

Davis Liu, MD

Health Technology

October 6, 2011

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I’ve been reading A Game Plan for Life: The Power of Mentoring written by famed UCLA basketball coach John Wooden. Wooden spends half of his book thanking the people who had a powerful influence on his life, coaching, philosophy, and outlook on life. Important people included his father, coaches, President Abraham Lincoln, and Mother Theresa.

Yes, President Abraham Lincoln and Mother Theresa.

Though …

Healthcare professionals need to get an annual flu shot

Norman H. Edelman, MD

Conditions and Diseases

October 6, 2011

Whether you are a physician, nurse, physician assistant, pharmacist, or someone else who cares for sick or disabled people, your job as a healthcare professional is an important one. Healthcare professionals are expected to provide services to individuals in need and to do so with quality and care.

One way we can help ensure that we are doing our job the best way possible is to get our annual flu …

The Haiti cholera outbreak is a repeat of history

Christopher Hamlin, PhD

Conditions and Diseases

October 5, 2011

The Cholera outbreak in Haiti reminded us that this is not simply a disease of the distant and unsanitary past. The outbreak was both unique and typical. Caused by a disease that has a long and devastating history, this Haiti outbreak has much in common with the outbreaks of the nineteenth century and twentieth century. History helps us keep in mind five key factors.

1. The role of media coverage …

Depression causes a drop in productivity at work

Dheeraj Raina, MD

Conditions and Diseases

October 5, 2011

According to a recent study, depression causes an 23% drop in productivity at work. The drop is almost 45% for treatment resistant depression, defined in that study as depression that has not responded to 2 adequate trials (i.e. adequate dosage for adequate duration) of antidepressants.

My gut, based on clinical experience, tells me that even when depressed, people devote lot more of their emotional resources to trying to not let …

Calling yourself Doctor and what that now means

Bradley Flansbaum, DO

Physician

October 5, 2011

In New York State, the issue of scope of practice is at the fore. Mainly, what activities can non-physicians (NP’s) engage in, with or without physician supervision? It is a heated subject here where I reside, but not the one I will address below.

The New York Times discusses a similar matter, although altogether more controversial. Many of you are aware nurses are obtaining doctorate degrees and advancing their training.

The divisive …

Cancer screening is plagued by dissonance

Kevin Pho, MD

KevinMD

October 5, 2011

Last year, the USPSTF was poised to meet regarding its prostate cancer screening guidelines.

According the Kenny Lin, a physician who was with the Task Force at the time, the meeting was cancelled for political reasons. He points us to a New York Times story on the dueling narratives of prostate cancer screening.

It’s a topic that often appears here …

The use of a signing bonus as tool for physician recruitment

Bo Claypool

Physician

October 5, 2011

As someone whose livelihood is dependent upon successfully recruiting physicians to various practice opportunities, whenever possible I use the tool of a “signing bonus” and it may not be for the reason you think.

If you have found yourself in the role of recruiter for your practice, you should be open to use of this valuable tool within the physician recruiting process.

Now, I must say, that whenever this is brought …

You may benefit from having a medical student care for you

Vineet Arora, MD

Patient

October 4, 2011

Amid the buzz about whether medical students should be sued and the bill currently debated in Arizona (a state which finds itself in the spotlight more than usual these days), I noticed some commentary from several people who do not think they would like a medical student on their case. Sometimes patients do refuse to be cared for by medical …

The words we choose can have impact on those we interact with

Kate Land, MD

Physician

October 4, 2011

Language matters. The words we choose can have far-reaching impact on those we interact with. This is arguably more true in medicine than in any field.

Ryan Madanick wrote a recent blog post on the use of descriptor terms used by physicians in patient’s charts. He felt that the use of phrases like “is a very pleasant 52 y/o woman” or “is an unfortunate 16 y/o boy” is inappropriate. I …

Patients and families must be tireless in expressing any frustrations

Norman Silverman, MD

Patient

October 4, 2011

I was reading the other day in a magazine the personal account of a woman who had a “perfect example of a mitral valve click” (a type of heart murmur) that was so textbook in sound that she was asked to be a listening post for a class of medical students. She was pleased to help, but was disappointed in how of the 15 examiners no one treated her like …

Keith Ablow on Chaz Bono and the outrage that follows

Ford Vox, MD

Physician

October 4, 2011

Dr. Keith Ablow is an assistant clinical professor at Tufts University School of Medicine. So am I. Ablow has a problem with transgendered people. I do not. I first learned about Ablow’s well publicized stance Wednesday via an email to the Tufts community, signed by the university’s president, the dean of the medical school and the chair of the psychiatry department.

The university reaffirmed its commitment to the complete inclusion …