| KevinMD.com

How academic physicians are being used as live bait for journalists

Physician

April 3, 2011

Here’s something little known outside of the small circle of industry marketers, academic docs, PR flacks, and medical journalists: pharmaceutical and device companies (or their PR agencies) regularly offer to arrange interviews with well-known academic physicians to talk about new trials, drug approvals, and other items of obvious interest to the companies involved.

I receive these sort of invitations all …

Can ACOs curb health costs and improve quality of care?

Robert Rowley, MD

Health Policy

April 2, 2011

Accountable Care Organizations (ACOs) have received considerable attention recently, and are the new “hot topic” in healthcare delivery policy circles. They are the latest response to the need to do something to stem the runaway inflation of healthcare costs, while maintaining or improving measurable health care quality.

According to a …

MKSAP: 28 year old woman with easy bruising and bleeding gums

mksap

Conditions and Diseases

April 2, 2011

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

A 28-year-old woman has a 3-month history of easy bruising and bleeding gums. She feels otherwise well. Medical and family histories are unremarkable, and she takes no medications.

On physical examination, temperature is normal, blood pressure is 110/70 mm Hg, pulse rate is 64/min, and respiration rate …

The futility of prolonging life and the benefit to patients

ER Stories, MD

Physician

April 2, 2011

In case you have not heard about it, there is a very gut wrenching court case St Louis Park, MN. A doctor in the hospital system is going to court to replace a patient’s wife, Lana Barnes, with a substitute decision maker, claiming that she is making futile and reckless decisions to prolong her near-vegetative husband’s life.

He has …

Debt prevents health insurance from providing more health care access

WhiteCoat, MD

Health Policy

April 1, 2011

I read an article in the New York Times that underscores my argument that health care insurance does not and never will equal health care access.

Our federal and state governments are being crushed by debt. There are many reasons for that debt, and addressing the reasons for the debt are a necessary aspect of decreasing the debt. For example, if a family household had overdrawn its checking account by …

Dangers of strict adherence to clinical guidelines

Douglas Perednia, MD

Physician

April 1, 2011

Medical guidelines are well on their way to becoming the Law of the Land. Dr. Rich over at The Covert Rationing Blog featured a recent post that highlighted this point.

When a study published in the Journal of the American Medical Association showed that nearly 23% of patients receiving implantable cardioverter-defibrillators (ICDs) received them under circumstances that did not match up with the recommended “guidelines” for doing so, this breach of …

Why medical education needs to evolve away from memorization

Josh Herigon, MPH

Medical Education

April 1, 2011

Skeptical Scalpel writing at KevinMD.com in a post giving some advice to second year medical students nails the problem with medical education on the head:

Rather than forcing [medical students] to memorize information, we should be teaching you how analyze and synthesize it as it relates to your patient.

Our increasingly sophisticated and robust understanding of the pathophysiology of human disease processes coupled with the growth in diagnostic testing power …

Artificial intelligence and capturing quality information into your EHR

Kevin

Health Technology

April 1, 2011

by Janet Dillione

Are we ready to deliberate on how artificial intelligence will be used in healthcare? While the future role of innovation as part of healthcare is certain, it’s critical that we first focus on achieving what is possible and absolutely necessary today.

There’s been tremendous attention on IBM’s work with Nuance to bring Watson (supercomputer) to healthcare, and rightfully so, it’s a fascinating application of technology. However, …

The relationship between parents and pediatricians

Yolanda Wong, MD

Physician

April 1, 2011

It’s strange being on the other side for a change. I remember bringing my son to his first doctor’s appointment. A new mom. No stethoscope around my neck. No patient schedule, replaced instead by the constant grind of breastfeeding.

I knew it was just another routine newborn check for our pediatrician, but every maternal fiber in me believed that my son must be the cutest baby that ever walked through that clinic. …

Diagnostic errors and their role in patient safety

Charles A. Pilcher, MD

Physician

March 31, 2011

American Medical News published an informative essay by Kevin B. O’Reilly on December 13, 2010, about errors in diagnosis and why doctors make them.

According to Gordon Schiff, MD, associate director of the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital, “The problem of diagnostic errors has gotten short shrift in the broader patient safety movement.” The article focused on …

How an EMR can be shockingly inconvenient for prescription refills

Paul Sax, MD

Health Technology

March 31, 2011

Let me start by confessing I’m something of a gadget freak. I was an early Palm Pilot adopter, loved the iPod from the get-go, and need to avoid CNET, Engadget, Gizmodo, and David Pogue’s columns for the New York Times when deadlines loom.

Not surprisingly, I embraced the shift to electronic medical records (EMRs) enthusiastically. While I acknowledge that sometimes EMRs …

How primary care will play a central role with health care reform

Kevin

Health Policy

March 31, 2011

by Jeffrey L. Cohen

Healthcare reform used to imply just regulatory change. As time marches on, it also implies market change. Most pundits agree that, whatever happens to the healthcare reform law, whether or not it is found to be unconstitutional, the healthcare business community is unleashed. Change is afoot!

If you follow my naysaying on the …

Why medical students should be passionate about health reform

Kevin

Health Policy

March 30, 2011

by Chris Chen

Recently, I stood in the back of a boisterous, packed auditorium as each of our school’s fourth-years received their match letters and proudly announced in front of friends, family, and classmates where they would be headed for residency.

As peers enthusiastically cheered each other, significant …

Wimpy Parent Syndrome, and allowing your child to get mad and cry

Michael Gonzalez, MD

Patient

March 30, 2011

I woke up in the middle of the night last night and I could not fall back asleep. I had a moment of brilliance laying there in bed. I had discovered a new medical disorder, Wimpy Parent Syndrome (WPS).

For years I have been seeing it in clinical practice, but have been unable to put my finger on exactly what was taking place. Then the idea of WPS came to me and everything …

Medical ethics at hospitals and medical schools in China

John Schumann, MD

Physician

March 30, 2011

One of the topics I went to China to discuss was our medical school’s approach to teaching medical ethics.

At Wuhan University they have a first-year course, but I was told by both the school administrators and some of the students that the material is dry and not seen of immediate importance, so students often skip the class.

Here’s how …

How much empathy is too much?

Wendy S. Harpham, MD

Patient

March 30, 2011

If you’re sick, you need people to empathize with you, right? Maybe not.

Empathy is one of those words with a wide variety of definitions, especially in academic settings.

From Wikipedia: “Empathy … cover[s] a broad spectrum, ranging from feeling a concern for other people that creates a desire to help them, experiencing emotions that match another person’s emotions, knowing what the other person is …

Read more…

How much empathy is too much?

A boxing fight physician experience

Steven Reznick, MD

Physician

March 30, 2011

I received a phone call from the Broward Sheriff’s Office Police Athletic League Youth Boxing Program asking if I would help them out and be the fight physician at their upcoming youth boxing tournament.

Their usual physician, a member of the Boxing Hall of Fame, had another commitment. However, he was willing to train me in advance and show me the ropes on the day of the event.

State law and the …

Read more…

A boxing fight physician experience

Accountable Care Organizations and the need to innovate

Kunmi Sobowale, MD

Health Policy

March 30, 2011

There is a lot of buzz over the creation of Accountable Care Organizations (ACOs) under the Patient Protection and Affordable Care Act (PPACA).

An ACO is a network of health care providers and hospitals that collaboratively manage patient care and prospective budgets. Perhaps the biggest draw of ACOs is the potential to create innovative ways to improve quality and decrease costs. To …

Why some EMR programmers think physicians are stupid

Chris Rangel, MD

Health Technology

March 29, 2011

Every major industry is now computerized with one glaring exception; health care delivery. Thirty years after Steve Jobs began selling personal computers out of his garage, far less than 50% of physician practices and hospitals have converted to any form of electronic medical record.

The vast majority of medical documentation is still done via paper and writing utensil just as it …