| KevinMD.com

Medical practice career choices commonly become medical business failures

Kevin

Physician

June 21, 2011

by Curt Graham, MD

Never in the history of medicine have doctors faced such a ruthless gauntlet of threats, financial debts, and practice restrictions than they do today. These factors, among others just as crucial, don’t begin to tell the story about why 40% of medical doctors readily admit to intense frustration in their practices, in addition to the percentage of doctors quitting medical practice completely.

They’re not retiring. They’re adapting. Extended …

How physicians should deal with angry patients

Steve Wilkins, MPH

Physician

June 21, 2011

I highly recommend you take a look at “10 Dumb things you do at the doc’s office.” Be sure to scan the article, but what you really need to look at is the comments, all 700+ of them.

While by no means a representative sample of how we think about physicians, there is a clear pattern to the comments. A lot of people feel disrespected by their doctors, …

Shifting procedural work to midlevel providers

Janice Boughton, MD

Physician

June 21, 2011

It is entirely clear that too few medical graduates go into primary care.

Although the number of family physicians is increasing modestly, there are very few internal medicine residents becoming primary care doctors. This year there will be only about 200 new internal medicine doctors entering the workforce from training programs, which will not even begin to cover the attrition of older and more efficient physicians, and due to improvements …

Why the AMA is in decline, and should doctors care?

Kevin Pho, MD

KevinMD

June 20, 2011

The American Medical Association recently released its membership numbers, and they’re declining.

According to MedPage Today, the AMA “saw another steep drop in its membership in 2010 — this time losing about 12,000 members or 5% of its total membership.”

It’s been well publicized that the AMA only represents a minority percentage of physicians, depending on what you read, it’s between 20 and 30%. But it seems many physicians have little …

A good history is integral to practicing good medicine

Linda Pourmassina, MD

Physician

June 20, 2011

Have you ever gone to the doctor’s office and forgotten what you were going to say or felt like you didn’t have the answers to any of the doc’s questions? Have you ever gone in to an appointment thinking, “I have pain and I am sure an MRI will show the cause,” but your doctor seems to insist on asking you a million questions about your symptoms and doesn’t Read more…

A good history is integral to practicing good medicine

A medical school dean plagiarized Atul Gawande in his commencement speech

Brian Goldman, MD

Medical Education

June 20, 2011

Recently, Dr. Philip Baker, Dean of the University of Alberta’s Faculty of Medicine, gave a speech to the graduating class at the convocation banquet held in Edmonton. Now, there are accusations that Dean Baker lifted much of his June 10 speech from a commencement address given by famed physician and essayist Dr. Atul Gawande at Stanford’s School of Medicine in June 2010.

As Baker gave his address last Friday, medical students …

Hospitals that ban physicians from social media are long term losers

Kevin Pho, MD

KevinMD

June 20, 2011

I’ve heard that a few academic medical centers, the identities which I will keep anonymous, are advising incoming medical residents to stay off social media. Meaning, they have to close their blogs, and shutter their Twitter or Facebook accounts.

As hospitals and doctors try to best use social media, and prevent damage from its improper use, taking the extreme measure of forbidding doctors in training from utilizing social is …

Evidence versus experience based medicine for patients

Dennis Grace

Patient

June 20, 2011

by Dennis Grace

The Internet’s been rife, lately, with discussions of evidence-based medicine (EBM) and its alternative, experience-based medicine (which, to avoid conclusion, I’ll call XBM).

Look up either phrase on Google if you want more details, but be warned, it’s like trying to get a sip from Niagara Falls. Ideally, though, EBM is guided by information generated by studies conducted as rigorous, double-blind, randomized, …

The best diagnostic medical device is right in your own home

George Lundberg, MD

Patient

June 20, 2011

What is the year 2011’s best diagnostic and therapeutic medical device?

Is it the PET scan with special bells and whistles to detect early Alzheimer’s?

Is it the robotic surgery that reams out the worst prostate cancers remotely?

Is it the Total Genomic Analysis that predicts what your genetic future holds?

Is it the GI endoscope that checks out your innards from stem to stern?

Is it the latest drug-eluting stent that promises to …

How Medicaid is under political attack

Rishi Manchanda, MD, MPH

Health Policy

June 20, 2011

by Rishi Manchanda, MD, MPH

Mr. M walked into the community clinic where I work with a portable oxygen tank in tow. At 62, he’s gaunt and winded, battling a disease that is progressively scarring his lungs. Every breath is a fight. Instead of the clear flow of air, I hear the sound of velcro ripping when I place my stethoscope on his chest. In medicine, his …

Read more…

How Medicaid is under political attack

Doctor Kevorkian dead, but not by suicide

Christina Girgis, MD

Physician

June 20, 2011

Recently it was announced that Dr. Jack Kevorkian (also known as Dr. Death) died — ironically, not by suicide.

As a psychiatrist, one of the things I consider part of my job description is suicide prevention. Although many consider Dr. Kevorkian a civil rights activist for assisted suicide, I believe that there was a severe lack of ethics in his medical practice.

From everything I’ve read in the media (and I …

What to say if you suspect child abuse in the ER

ER Stories, MD

Physician

June 19, 2011

I don’t know anyone that works in health care that does not dread suspected child abuse.

On all levels it is horrible. Horrible that someone would do such a thing to a child, horrible for the logistical nightmares it can cause in treating the patient, horrible going though the whole mandated reporting process. It just sucks. Now, if it is obvious and you are totally sure it’s going on, you …

The difference between an ambulatory and hospital EHR

Robert Rowley, MD

Health Technology

June 19, 2011

What difference is there between an inpatient EHR and an ambulatory EHR?

The difference is quite significant, actually. Let’s start by looking a little deeper into hospital IT issues, and the evolution of tools that try to address them.

The hospital EHR environment

Traditionally, from an IT perspective, a hospital is not really a single system – it is a collection of systems in various departments.

Over the past few decades, each …

A surgeon makes it a point to directly communicate with the patient

bongi, MD

Physician

June 18, 2011

If nothing else, this post illustrates that surgeons are not that great with the whole bedside manner thing. I would like to think I’m an exception … but I still am a surgeon.

I make a point of communication with my patient. Obviously if he is a child, I use the same measure of effort in communicating with the parents. But few things irritate me more than some …

MKSAP: 61-year-old man with progressive weakness

mksap

Conditions and Diseases

June 18, 2011

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 61-year-old man is evaluated in the office for a 6-month history of progressive weakness of the lower extremities. He says he has difficulty rising from a seated position and walking up stairs and also has episodes of dry eyes, dry mouth, and erectile dysfunction. The …

How physicians not adhering to clinical guidelines may be punished

Douglas Perednia, MD

Physician

June 18, 2011

The Justice Department decided to weigh in on the topic of clinical guidelines.

As if to underscore Dr. Rich’s assertion that “guidelines are no longer guidelines,” the Federal government has raised the prospect of fining your doctor and/or sending her to prison for the crime of not strictly following guidelines of care.

As reported by MedPage Today:

“Federal prosecutors are looking into physicians’ prescribing practices relating to implantable cardioverter defibrillators …

Read more…

How physicians not adhering to clinical guidelines may be punished

How far should hospitals go to treat obese patients?

WhiteCoat, MD

Physician

June 17, 2011

Boston Emergency Medical Services recently debuted an ambulance with a mini-crane and reinforced stretcher to transport patients weighing up to 850 pounds. It cost $12,000 to retrofit the ambulance.

My problem is this: I think we need to do our best to provide medical care to all patients. But patients need to take some basal level of responsibility for their own health. If you’re saying that you …

Considering a single payer model for health reform

Aldebra Schroll, MD

Health Policy

June 17, 2011

The Patient Protection and Affordable Care Act is in the process of being rolled out, however many questions remain.

Will it guarantee universal coverage? Will it stand up to the many court challenges? The private insurance industry will receive an estimated 400 billion in taxpayer money to subsidize the purchase of these plans. Is this the best way to spend our money?

Many of us in the health field remain skeptical …

Let’s stop the war between breastfeeding and formula feeding

Yolanda Wong, MD

Patient

June 17, 2011

I am all for breastfeeding. Without doubt, breast milk is incredible stuff. And it’s free. Who complains about free?

Nevertheless, somewhere along the way, the campaign for breastfeeding has spun out of control. The topic has morphed into yet another competition in the arena of parenthood. Mothers boast about breastfeeding. Mothers compare how long they nurse. Mothers compare how much milk can be pumped in one sitting. Mothers are made …

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts