A reader recently wrote to me: “Brandon, in our area, we’ve seen a few retail clinics pop up. What can we do as a practice to let patients know that visiting retail clinics is not in their best interest?”
We had along discussion. So I put together a summary of our conversation. Below is a rundown, more of less, of what I …
How physician practices can compete with retail clinics
One of the “Crown Jewels” of the 2010 holiday movie season may be The King’s Speech. The film centers on Colin Firth, who plays King George VI of Britain, and Geoffrey Rush as Lionel Logue, the speech therapist who helps the king deal with his stutter.
Born Albert Frederick Arthur George, the second son of King George V, he spent most of his early years out of the spotlight, which centered …
What is stuttering, how is it treated, and The King’s Speech
Recently, KevinMD.com picked up my post on empathy or should I say the lack of it. I received some engaging comments.
One comment in particular caught my attention.
The contributor for some reason equated “being empathetic” with “giving in” to patient requests presumably during routine office visits. Here’s a direct quote:
Give the patients what they want! Antibiotics are OK for colds. The patients want them. So …
Does empathy mean giving patients what they want?
I was talking to a young man who is starting medical school this fall. His tuition at one of South Carolina’s newer schools will be $40,000 per year. That’s admittedly on the high end. On the low end, it runs a paltry $33,000 per year.
And this is all after college, of course. He and others like him are taking out loans to the tune of $240,000 to pay for their …
Why medical education needs to be more affordable
Pauline Chen had a post in the New York Times recently about surgical informed consent. Informed consent is an important part of the surgeon/patient communication transaction.
Surgeon reviews the proposed operation, the rationale behind it, and the possible complications. For example— a patient comes in with biliary colic. We describe the anatomy and pathology. We aver that surgical resection will lead to …
Implications of the surgical buy in when discussing informed consent
One of my Facebook updates on my private account was that I “have a love-hate relationship with interleukin-6. Yes, macrophages and T cells, I know you are doing your job, but how many proinflammatory cytokines does it really take to fight this thing? What’s that? Be grateful you guys are even working? Oh, all right. I’ll shut up and eat my soup now.”
Yes, I’ve been sick this week. It started …
Calling in sick serves as a reminder for compassion for this doctor
One of the top hits that comes up on the Oracle of Googlius for “astroturf” is for the original company, now renamed SYNLawn, but still proudly stating, “We invented synthetic grass,” which is what astroturf is. More recently, this already synthetic term has become a verb, as in “astroturfing.”
My favorite of all credible information sources on the web, Wikipedia, has this to say about it:
Astroturfing denotes political, advertising, or public relations campaigns that are formally …
How astroturfing disease affects patients
A guest column by the American College of Physicians, exclusive to KevinMD.com.
by John Tooker, MD, MBA, MACP
Last month, my KevinMD.com column introduced a concept paper published in the Annals of Internal Medicine by Owens and colleagues titled High-Value, Cost-Conscious Health Care: Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions. …
ACP: Benefits, harms, and quality in high value, cost conscious care
The results of the application of reductionism in modern biomedical research and practice has been nothing short of miraculous, but while wondrous for some things, reductionism alone is incomplete.
The basic premise of reductionism is that by breaking down (or “reducing”) complex biological or medical phenomena into their many parts, one is much more likely to understand a single cause and devise a cure.
Historically, the invention of the microscope, the defining …
Reductionism and daily medical practice
I went to needle exchange to hang out. You may be asking yourself what a soccer mom from the burbs is doing perched on a folding chair in the parking garage of 101 Grove on a dark November night, surrounded by syringes.
I was there as a guest observer because I’m working on a series of articles about mortality and homelessness, as part of an Annenberg California Health Journalism Fellowship I …
Overeating is not a surgical problem.
This may seem to be a statement of the obvious, but the solution to a behavioral problem is not surgery. Overeating is not a surgical problem — it is a behavioral one. The problem is not because the stomach is too big and needs to be made smaller. It is a function of how …
Overeating is a behavioral problem, not a surgical one
Here are a few facts to enliven the next public discussion about death panels.
An analysis of Medicare claims by researchers at Dartmouth University found that nationwide nearly one in three cancer patients died in hospitals or in intensive care, the most expensive form of end-of-life care and contrary to most patients’ wishes. Nearly half are not offered hospice …
Reduce variations in cancer care that do not improve outcomes
It’s only been a little over fifty years since vaccinations became routine for the childhood killers like polio, measles, mumps and whooping cough. People my age and older had no choice but to suffer through childhood infectious diseases given how effectively and quickly they spread through a community.
Most of us survived, subsequently blessed with life long natural immunity. Some did not survive. …
Vaccination and the killers of yesterday now overcome by modern medicine
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The following op-ed was published on February 22nd, 2011 in AOL News.
If you woke up one day with an earache, you could call your doctor’s office for help. Or you could do what the majority of patients do today and Google what to do first.
Type “earache” into your Web browser and the results can vary wildly. Search engines can return results saying that an earache can be from the common cold, …
Guiding patients online is a new physician responsibility for the digital age
by Joanne Wilkinson, MD
I have a stress test nearly every year. I do this because my mother dropped dead of a heart attack when she was thirty-six, and now I am thirty-five.
They stick EKG leads on me, and for weeks I have blotchy red circles on my skin where it’s reacted to the adhesive. I run on …
I interview approximately 60 prospective physicians for medical school over the course of the year and 40 physicians who are applying for the residency program. The pre-med students (almost all of whom are the age of my children) tend to have pretty good interview skills and are trying very hard to get into medical school (“I’ve wanted to be a doctor for as long …
3 resident interviews for family medicine
Recently, I went to see a doctor about an EHR. Dr. Greene (not his real name) is a typical solo primary care physician in a typical small town in the typical middle of nowhere. Four hours from the closest airport and miles and miles of winding roads, cow pastures and corn …
EHR and the solo primary care physician
There isn’t a country on this planet where there isn’t someone dreaming of curing cancer. What if there was something even more spectacular than curing cancer? What if you could stop cancer right in its tracks and eliminate its existence. Prevent it. Squash it before it starts.
Vincent Tuohy, PhD, an immunologist at Cleveland Clinic, may be on a path toward …
Developing innovative solutions to battle cancer and disease
Recently, as I listened to leading researchers grapple with the question of how to design a feasible study of intervention for postpartum depression, I held in my mind an image of a particular moment in my office.
I was sitting on the floor with 10 month old Madison and her mother Nancy, who was struggling with postpartum depression. Nancy spoke of the strain Madison’s refusal to take a bottle and her …
How can research capture the complexity of tiny moments?
An excerpt from Doctor Confidential: Secrets Behind the Veil.
by Richard Sheff, MD
Dorothy suffered a second heart attack, leaving more of her heart muscle damaged and causing her to slip into congestive heart failure. There was not much we could do to reverse the many blockages in her arteries. Yet she was cheerful, as were her four children.
One morning Mary came to find me. “Dorothy says …
Giving the patient and family precious minutes to say goodbye
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