Dr. Kevin Kikta was one of two emergency physicians on duty at St. John’s Regional Medical Center in Joplin, MO on Sunday, May 22, 2011, when an EF-5 tornado struck the hospital.
You never know that it will be the most important day of your life until the day is over. The day started like any other day for me: …
What happened inside the hospital during the Joplin, MO tornado
I went off to medical school thirty-seven years ago.
For the era, I went to what folks regarded as a very progressive place. It had a curriculum that was quite revolutionary for the time. Among other things, we started having interactions with actual patients during our first year, rather than the third year, as was traditional then.
These days many, probably most, medical schools …
Why medical students should be closely observed with patients
In recent weeks, headline news has been reporting on the battle to curb the federal debt. What does this have to do with medical professionalism?
The federal government must borrow forty cents of every dollar it spends. In health care, it needs to borrow from China and other lenders to reimburse doctors, hospitals and other providers who bill federal programs.
The government’s debt totals $14.3 trillion. It is …
What medical professionalism has to do with the federal debt
The transition from paper to EHR is a major policy decision that can have repercussions on patient service, your operations and even your medical professional liability (MPL).
Unfortunately, many practices are not taking the time to analyze their options and responsibilities from a patient care and compliance standpoint. In order to set the correct framework for your effort, you should think …
Questions to ask before moving from a paper chart to an EHR
by Mary McNaughton-Collins, MD, MPH
Aging does not have to be all about appointments, pills, tests, treatments and procedures – instead aging should be about celebrating life and rewarding those older individuals who are “living well” by encouraging pursuits outside of the medical realm.
The current state of our health care system tends to revolve around the idea that “more is better,” however, that is not always true — especially when caring …
Shared decision making in the golden years
In the real world of medicine, “great saves” are rare. Most patients that you expect to die will die, and those who experience a cardiac arrest or code rarely survive. Mr. GR is the closest I’ve seen to an exception to both of these rules, and his story illustrates the best but also the worst of what our health care system achieves.
I first met Mr. GR in the emergency room. As …
In medicine, the greatest save is not having to make a save at all
“The most important thing I learned was that different doctors know different things: I need to ask my internist different questions than I do my oncologist.”
This was not some sweet ingénue recounting the early lessons she learned from a recent encounter with health care. Nope. It was a 62-year-old woman whose husband has been struggling with multiple myeloma for …
Guiding patients through fragmented health care
Medical school should be free.
That’s an argument made by physicians Peter B. Bach and Robert Kocher in the New York Times.
This isn’t a new concept. I’ve discussed whether medical school should be free for students who choose primary care. And, for some in the country, it’s already happening. Like at Case Western Reserve University, for instance. The Cleveland Clinic …
Would free medical school be enough to save primary care?
The psychosocial needs of patients can feel overwhelming for a doctor.
Our rite of passage as medical students, after all, is anatomy, not sociology. Even now, after a family medicine residency specializing in the biopsychosocial approach to medicine, I still brace myself for surprises before asking routine mental health screening questions of the patients in …
Helping with the psychosocial needs of patients
by Setu Mazumdar, MD
Everywhere I go I see unhappy doctors.
All everyone does is complain about rising malpractice premiums, more paperwork, declining pay, and 60 hour workweeks. This includes physicians just graduating from residency and physicians who’ve been practicing medicine for several decades.
All of those complaints are legitimate, but one question I always have in …
Physicians should blame themselves for why they are unhappy in medicine
The VA isn’t perfect, but definitely is better than other health care systems I have worked in so far. It embraces the idea of patient-centered medical home, where a primary care physician coordinates and takes responsibility for a patient’s care … the old-school definition of good medical care that has recently become popular again, …
How the VA looks at population level data to analyze outcomes
My first exposure to KevinMD.com is reading Healthcare costs can be reduced with emerging business models by Joe Flower.
While I am not informed about the medical business models to which he refers, I am experienced in business. I hail from a family of doctors and hospital owners. While I did lose touch with the industry for several years, I have noted several changes which do not make sense. …
The evolution of hospitals and the present state of health policy
I was sitting next to a resident in the preceptor room yesterday. He was calling a patient to discuss lab results, and introduced himself on the phone by his first name and last name … but not with “Doctor.” (e.g., “Hi, this is John Smith from the Family Health Center.”)
I occasionally see the residents’ patients for urgent visits. When I ask them who their regular PCP is at the office, …
Should doctors be addressed by their first name?
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Compliance. I really hate that word! The general impression given throughout the blogosphere is that patients:
A few typical quotes:
It drives me crazy to read accusations such …
Compliance happens when it’s the patient’s treatment plan
A recent survey in the American Journal of Bioethics, indicates that 80 percent of patients expect to see a physician when they come to the emergency department.
Parents were more insistent about their child see a physician or resident for even a minor condition such as a sprained ankle.
Patients indicated a preference for seeing a resident alone for non-urgent conditions (60%) and compared to a physician …
How PAs and NPs impact emergency room care
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 68-year-old man is evaluated during a routine examination. He has a 5 pack-year cigarette smoking history but stopped 12 years ago. He has no history of hypertension, diabetes mellitus, stroke, or transient ischemic attack. He has no claudication. He is being treated for hyperlipidemia. There …
MKSAP: Healthy 68-year-old man with a cigarette smoking history
My wife had just finished meeting with her medical oncologist for her bi-annual check-up at MD Anderson’s Thoracic Clinic.
We were sitting in an area called “the Park” rehashing what her doctor had said when a mother and her daughter sat down at our table. There were lots of empty seats in area but for some reason they decided to sit with us. Call it serendipity. …
Benefits of chance meetings with other cancer patients
by Greg Smith, MD
As a psychiatrist, part of my job is to listen as you tell me about symptoms that bother you every day.
If I can help you put these symptoms into a framework such as a syndrome or a disease, then we can work together on trying to figure out how to treat them. Often times in Read more…
Why cookbook medicine detracts from compassionate care
If you have been at your nursing job for a while, you’ve probably almost forgotten.
Forgotten what it was like to come in to the healthcare system you now work for and realize there are hundreds of new protocols for you to learn and adhere by as a nurse. After years of routine, you now go about your day as if you actually have some choice in the way you give …
How protocols are taking the decisions away from nurses
Stem cells will usher in the era of regenerative medicine, allowing the creation of cells, tissues and organs to treat or cure diseases and injuries. This will be a fundamental alteration in our approach to medical care and a transformational medical megatrend. And it will be very “personalized medicine” to provide the specific individual with custom tailored new cells and tissues for organ repair or …
How stem cells will impact medical care
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