Physicians’ voices heard through AMA advocacy activities in Washington, DC

Health Policy
February 10, 2011

A guest column by the American Medical Association, exclusive to KevinMD.com.

by Ardis Dee Hoven, MD

This week, hundreds of physicians and medical students converged in Washington, D.C., for the AMA’s annual National Advocacy Conference. The current and future physicians learned about and discussed key legislative issues, including how new policy will impact physician practices, and heard from officials including CMS Administrator …

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Physicians’ voices heard through AMA advocacy activities in Washington, DC

What is job satisfaction for physicians?

Physician
February 10, 2011

“I can’t get no satisfaction,” sang the Rolling Stones. And so it goes for many of the physicians who contact me.

I was struck by the fact that the word “satisfaction” in connection with work was used in two separate conversations with physicians recently.

It got me curious.  Just what is job satisfaction?

How is it defined by the folks who study this kind of stuff?

And why is it so hard to come …

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What is job satisfaction for physicians?

A person’s attitude toward their illness has a huge impact

Patient
February 10, 2011

In classic Aristotelian drama, there comes a moment when the main character is presented with an insurmountable obstacle, be it physical, psychological, spiritual, or otherwise. The nature of the obstacle forces the character to make a choice: a critical choice, an act of free will that determines the glide path of the rest of the story, irrevocably altering its arc.

So it is with the arc of illness, a medical drama …

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A person’s attitude toward their illness has a huge impact

Pelvic exam by a medical student for the first time

Medical Education
February 10, 2011

They say you never forget your first “real” patient.  Mine was a woman who didn’t need a pelvic exam, but who got one anyway.

Next door, minutes later, my second patient provided another personal first: a male genital and rectal exam, also, without need. Medical students like me begin training by practicing the basics on one another–listening to heart sounds, and looking into each other’s ears and eyes—but eventually, every clinician-in-training must lay …

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Pelvic exam by a medical student for the first time

How anchoring leads to misdiagnosis

Conditions and Diseases
February 10, 2011

Anchoring refers to the tendency to latch on, or anchor, to the first symptom or bit of data and fail to consider the full spectrum of information, leading to misdiagnosis. Recently, we have received several cases where an anchoring error was triggered by a mistake in translating the patient’s words into clinical terms.

Case study #1

Henry Solomon, FACP, currently the medical director of Pfizer Global Pharmaceuticals, was for many years a …

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How anchoring leads to misdiagnosis

Ode to a family practice mentor

Physician
February 9, 2011

“Doctor Pete” was fifty-one when I started my residency in family medicine. “Family practice” we called it then, and I think I liked that name of our specialty better. It implies continued learning and brings to my mind visions of practicing a down-to-earth craft.

I had interviewed with his predecessor the summer before and was really impressed with him and the program. I ranked it as my first choice in the …

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Ode to a family practice mentor

Build EMR functionality into the exam room

Health Technology
February 9, 2011

In 2003 our practice had a rare opportunity to build EMR functionality into the floor plan of our new office.  I thought I had the perfect design for the EMR-based exam room.

The spring-loaded, cantilevered arms used to hold monitors and keyboards in ICU rooms would be perfect.  Fitting a touch screen monitor to a standard PC would allow the provider to work without a mouse.  I could turn the screen …

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Build EMR functionality into the exam room

Tips to help patients save money on prescriptions

Medications
February 9, 2011

As a primary care doc, I have compiled several tips to help patients save money on prescriptions.

All the prices quoted in the following examples are from Costco.

1. Patient assistance programs (PAP). Try to get free meds from the pharmaceutical company that manufactures your medication. Most of the time this service is only offered if there is not a generic available for your medicine. I heartily recommend you check out NeedyMeds.org and …

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Tips to help patients save money on prescriptions

The golden hour and the difference between life and death

Physician
February 9, 2011

An excerpt from Surviving the Emergency Room.

by Ron Clark, MD

With regard to emergency trauma care, a few minutes can mean the difference between life and death.  This first hour of definitive medical care is called the “golden hour.”  It is usually this first hour where the patient’s medical fate is sealed.  In general, the faster that medical care is rendered, the better the medical outcome will be.

The old adage …

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The golden hour and the difference between life and death

Closed loop bowel obstruction in your surgical partner

Conditions and Diseases
February 8, 2011

“Musta been the ham sandwich,” he said as he leaned onto the operating table and belched a couple of times. We were half-way through a thyroid operation and Doug, my partner, didn’t look all that good. I’d been in practice for all of a year, and Doug, ten years my senior, was my guardian angel, my guide through the vagaries of the world of private practice, and the best surgeon …

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Closed loop bowel obstruction in your surgical partner

How to check your scientific paper for plagiarism

Medical Education
February 8, 2011

We were taught in grammar school that plagiarism is wrong. It is stealing someone else’s property.

Imagine in high school asking your mother to buy you “Cliff Notes” so you can copy it word for word. Mother would not have liked that, and it wouldn’t have been right.

To write an essay today, you’ll probably start with a search engine. Instantly, Mr. Google delivers many intelligent commentaries on anything, probably better than …

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How to check your scientific paper for plagiarism

Online tools to help shop for the most affordable health care

Health Technology
February 8, 2011

by Ray Carlson

Two recent articles posted here at KevinMD.com regarding the inclusion of discussions about the cost of health care services between doctor and patient highlighted the growing emphasis on not only the quality of care but the cost of that care to the patient as well. The first article was written by Dr. Leslie Ramirez, who advocated for a more proactive stance by doctors regarding …

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Online tools to help shop for the most affordable health care

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Do stroke centers improve patient outcomes?

Conditions and Diseases
February 8, 2011

Another good paper for a journal club recently appeared in JAMA. What makes this one worth discussing is the research question the investigators posed and how they addressed it. Although this is not focused on cardiac care, the issues are germane to literature in our field and cardiac care certification is also spreading.

Do stroke centers improve patient outcomes?

Integrating doctors and hospitals may worsen cost control in health reform

KevinMD
February 8, 2011

Health reformers propose the proliferation of integrated health systems, like the Mayo Clinic or Kaiser Permanente, which, according to the Dartmouth Atlas, lead to better patient care and improved cost control.

To that end, Accountable Care Organizations have been a major part of health reform, changing the way health care is delivered.

Never mind that patients may not be receptive to the new model, but the creation of these large, integrated physician-hospital …

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Integrating doctors and hospitals may worsen cost control in health reform

Physicians love a CIO who lets them focus on patients, not technology

Health Technology
February 8, 2011

by Donald Burt, MD

Many hospital CIOs face an uphill battle winning the hearts, minds and fingers of physicians. It’s not because doctors are technology phobic. Quite the opposite: physicians are some of the most ravenous consumers of new information technology.  Smartphones and tablets are becoming as ubiquitous as stethoscopes at many hospitals.

The truth is doctors are happy to make screen touches, mouse clicks and keyboard strokes if the application is …

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Physicians love a CIO who lets them focus on patients, not technology

The AIDS crisis in Zambia

Conditions and Diseases
February 7, 2011

Wednesday, December 1st was World AIDS Day — a day to raise awareness for the ongoing AIDS pandemic around the world and to remember the past. As a trainee intern I spent 3 months in Zambia, a time that really opened my eyes up to what AIDS was doing to the world.  Much has changed since then, antivirals have arrived in Zambia for instance, yet the disaster continues: 1 in …

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The AIDS crisis in Zambia

If you’re in medicine, you’re in politics

Medical Education
February 7, 2011

by Nicholas J. Rohrhoff

Each generation of physicians has no choice but to take on the responsibility of learning the science of medicine – how best to care for patients.  But current circumstances dictate that we must also bear the burden of developing policy that creates the best system in which to provide that care.

Creation of a 21st century American healthcare system will require engagement and …

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If you’re in medicine, you’re in politics

Why the CME community is lacking in its use of social media

Social Media in Medicine
February 7, 2011

Both the Patient Protection and Affordable Care Act (PPAC), as well as the stimulus bill from last year included funding, which focused on the use of health information technology (HIT) and electronic health records (EHRs). These initiatives are aimed at getting health care providers and entities to begin using information technology to improve the quality, efficiency, and delivery of care to patients.

Along the same lines as using HIT, a recent article …

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Why the CME community is lacking in its use of social media

iPhone medical apps for patients with migraine headaches

Health Technology
February 7, 2011

by Diana E. Lee

Some are free, others are not, but there are some great, off the beaten path apps on this list that are well worth downloading to your iPhone.

1. iHeadache (free version, with ads).This app isn’t bad, but I did find some features less than ideal. You’re limited to their list of symptoms, which may not include all of your symptoms. It didn’t include all of mine, …

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iPhone medical apps for patients with migraine headaches

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