The iPad has been a mind-blowing success, and we’ve been regularly covering the excitement about the potential it offers to doctors and hospitals.
However, it’s important to continue innovating, and I propose that a 7 or 8 inch iPad Mini (Or Nano, if you prefer) would be the next logical step for Apple, as it offers an ideal blend of screen real estate and portability that both the iPhone and …
Is the iPad too big for medicine?
Google+ has launched in beta stages and social networking for physicians has the potential for significant evolution. The challenge for physicians of balancing personal and professional online is not easy to solve. The dual citizenship approach provides recommendations for physicians to manage their profiles online. It is suggested that separate personal and professional profiles are created, with the hope that the latter will rank higher in searches. They also recommend …
Google+: Physicians can optimize their online footprint
Much has been made of the downside of the increasing use of EMR systems by physicians. But I am not going to dwell on those pervasive complaints concerning the cost and complexity of setting up the systems. Nor shall I rehash the well known issue of what I call “doc blocking” … wherein a computer (or other entity) stands between the patient and physician, slowing the exchange of information to however many words can be typed per …
The loss of eloquence in EMR notes
If you’re a physician or hospital that relies on Medicare payments, grim times are ahead. Yes, even worse than the scheduled 29% payment cut that’s scheduled to go into effect in 2013. Emergency physician Shadowfax calls the debt deal “a terrible deal for health care providers.”
Under the contentious debt ceiling agreement, significant cuts in Medicare dollars will be made. …
Why the debt ceiling deal is a horrific outcome for physicians
This is Lokin. Every morning as I enter the hospital, Lokin sits in the same spot. Last week he was covered in gasoline and set aflame by a man in his village — a dispute over gambling debts.
For the past five days I’ve walked silently past this man, torn apart by not knowing what to do. I could tell him all …
Showing me how much medicine I’ve never even known existed
For those who have been following the back and forth over the Less is More blog I posted last week, here’s the poster that upset some cardiologists when it was up on the Parsemus Foundation’s site.
Over the top? Of course it is — it’s satire! And like all good satire, it contains a few grains of truth mixed with a hefty dose of exaggeration.
Still, it’s only fair to point …
Decision aids need to be used for angioplasty and stents
Medically speaking, what’s a guy to do when there is no right answer? My patient’s solution is often to ask me what I would do given his particular circumstance. He isn’t happy when I respond with, “I truthfully don’t know.”
In reality, I always know what I would do. I’d gather knowledge, see consultants, and explore every possible option to its fullest. Then, most probably, I would still not be …
With cancer, sometimes there is no right answer
One of my readers astutely pointed out in the comments section of my blog that “nurses will make your life a living hell” if you treat them badly. Some will make your life a living hell, no matter what. As in every profession, there are nurses with a chip on the shoulder, as well as those who are simply counting down to retirement. But for the most part, nurses …
Improving the relationship between intern and nurse
For years, I supervised residents. They would come in each week and tell me about a patient in crisis. If no one was in crisis, they’d say all their patients were fine and they didn’t know what to talk about, even though I had told them to pick a patient they saw weekly and either audio-record the sessions or take detailed process notes. Psychotherapy, I would say, is a …
Psychiatry residents need to learn psychotherapy
Medical ethics has properly gained a foothold in the public square. There is a national conversation about euthanasia, stem cell research, fertilization and embryo implantation techniques, end-of-life care, prenatal diagnosis of serious diseases, defining death to facilitate organ donation, cloning and financial conflicts of interest. Nearly every day, we read (or click) on a headline highlighting one of these or similar ethical controversies. These great issues hover over us.
We …
Medical ethics in the office should not be a private matter
I hate the bouncy houses. I mean, I really hate them; I get a sick, nervous stomach when the boys are inside them. And it’s created a parenting perplexity for me. See the photo? I bet my HR is about 160 and my BP 150/90 (translation: high). I’m not kidding, I have a visceral and then flight-type response when the boys jump … it’s one of those instinctive parenting responses …
Why this pediatrician hates bouncy houses
There was news of yet another high profile death from an uncertain cause in a star with addiction history. Media accounts included reference to the “27 club” — a lengthy list of famous artists who have perished by their own hand, often unintentionally, at the age of twenty seven.
The reality is that too many fatal overdoses responsible for the deaths of the famous and not-so-famous are from medications …
Who to blame in fatal medication overdoses
Recently, we expressed concern about the effects on the accuracy of the diagnostic process of the increasing numbers of well and worried well entering the medical care system.
One of the consequences of this influx of well people (and the concomitant reduction in disease prevalence) is the generation of more false positive test results and false diagnoses of nonexistent diseases.
The medical literature is filled with studies on the accuracy of …
How prevalent are false diagnoses of disease?
ADVERTISEMENT
The following op-ed was published on June 5, 2011 in USA Today.
A patient recently asked me if I had heard about the new “wonder drugs” used to treat skin cancer. Indeed, I had. In a widely reported story in early June, two novel cancer drugs were found to benefit patients with advanced melanoma, a devastating form of skin cancer. These …
Advances in cancer treatment are hyped by headlines
Most pregnancies are completely straightforward. A woman gets pregnant, she has a normal pregnancy that lasts nine months, she delivers a healthy baby, and she takes her baby home. End of story. But not all pregnancies are so straightforward. Complications develop. Challenges arise. Doctors guide their patients through unknown experiences, and parents make choices they couldn’t have dreamed possible before embarking on the road to parenthood.
Complications of pregnancy occur anywhere …
Complications of pregnancy and the conspiracy of silence
I like Iceland. It is a really neat place; great people; terrific scenery; lively nightlife; surprisingly temperate climate, considering the latitude, thanks to the Gulf Stream.
Of course, it is true that some of the Iceland bankers, poorly regulated and without scruples, were even more predatory than many of the American Wall Street investment bankers, taking the money and running to lead a pack of nations into international fiscal calamity, a …
Tobacco cigarettes should be sold only in pharmacies to people with a permit
One of the great myths of healthcare is that there is an actual “system” in the United States. If such a system exists, I have yet to become familiarized with it. What we have are mountains of paper that slavishly tie the patient, doctor, hospital and insurance carrier alike to a system of coding interpreted by individuals with no sense of what the codes mean or the labor and …
We need a single payment system instead of single payer
Not only is Social Security on the chopping block in order to respond to Republican extortion. So is Medicare.
But Medicare isn’t the nation’s budgetary problems. It’s the solution. The real problem is the soaring costs of health care that lie beneath Medicare. They’re costs all of us are bearing in the form of soaring premiums, co-payments, and deductibles.
Medicare offers a means of reducing these costs — if Washington would let …
Why Medicare is the solution to the soaring costs of health care
Over the past several decades, there has been a shift in the kinds of patients seeking medical care.
The progression has been from sick to early sick to well to worried well to worried sick.
The reasons are beyond the scope of this article. There is a subtle and hidden, but potentially very damaging, factor operating in the diagnostic process when large numbers of well people seek medical attention in a …
When well people seek medical attention in a system designed to care for the sick
“I don’t have the time … I don’t get reimbursed for that.” This is an all too common refrain from primary care physicians and practice managers when ever the subject of improving physician-patient communications comes up.
I get it. Primary care physicians in particular are under tremendous pressure to produce. Just imagine, physicians in small primary care practices spend about 3.5 hours per week just on dealing with insurance-related paperwork. Then …
Why doctors can sometimes be their own worst enemies
Get free updates delivered free to your inbox.
