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Combat compassion fatigue in caregivers to improve patient care

Physician

February 7, 2011

Six months down. Six to go. I am officially halfway through what people have told me will be one of the most challenging years of my life. I’ve rotated through Cardiology, Primary Care, Gastroenterology, General Medicine, Psychiatry, Palliative Medicine, the Medical Intensive Care Unit (MICU), and Rheumatology. Finally I have reached every resident’s favorite rotation – vacation.

Intern year has been hard work, but I’ve enjoyed it and am extremely pleased …

Discussing smoking habits with patients

Gregory Bratton, MD

Physician

February 6, 2011

I saw two patients recently that really made me scratch my head.

The first was a 15-year-old girl who was smoking a pack of cigarettes daily and had been for 3 years; the other was a 26-year-old man who smoked 1.5 packs daily for 10 years and had recurrent oral ulcers and bleeding gums. In sitting and talking with these two patients, it became blatantly obvious that the risks of tobacco …

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Discussing smoking habits with patients

ProPublica’s Dollars for Docs: Strengths and weaknesses

Daniel J. Carlat, MD

Medications

February 6, 2011

The non-profit media organization ProPublica last year announced a new website/database called Dollars for Docs. It lists cash payments made to 17,000 U.S. doctors by seven large drug companies.

I’ve been browsing through the database and I have some thoughts about its strengths and weaknesses—and how it might be useful for patients.

First, here’s what these journalists did. Rather than waiting for the provisions of the Physician’s Payments Sunshine Act …

Kernels of humor in a tragic cancer story

Colleen Kelly Mellor

Conditions and Diseases

February 5, 2011

I didn’t always recognize its importance. I mean when I was younger, I thought that being attractive, slim, athletic, articulate were sure-fire antidotes to one’s suffering a life of mediocrity. I just never recognized the value of something I took for granted, my sense of humor. And then life happened.

When I was 36, my husband (who was older by 12 years) was diagnosed with lung cancer. Inoperable, incurable, his type …

Stressful life events in suicide attempts and completed suicides

William R. Yates, MD

Conditions and Diseases

February 5, 2011

The role of stressful life events in suicide attempts and completed suicides has been a key area of study in the epidemiology of mental disorders. Although suicidal behavior often occurs in the context of acute and chronic stressor, this does not prove a causal link. We all could probably report serious life stressors throughout out lives and these could be interpreted as a reason for suicidal behavior. So these associations …

Finding out the cost of lab tests is a real challenge for patients

Brad Wright, PhD

Conditions and Diseases

February 4, 2011

In the spring of 2005, the sinus infection returned. I awoke severely congested with a pounding forehead and pain around my eyes that grew worse when I bent to tie my shoes. The feeling was familiar. Two years earlier, I had similar symptoms, but was uninsured and endured a miserable week with nothing but over-the-counter medication. Now they were back.

Fortunately, when I started graduate school, my father insisted that I …

10 questions asked by children whose parents are in prison

Kevin

Patient

February 4, 2011

An excerpt from What Will Happen to Me?

by Howard Zehr and Lorraine Stutzman Amstutz

Children need time to adjust to the separation caused by having a parent in prison. But it takes more than time. As we have heard in their voices, children also need to make sense of what has happened to them and to their parent or parents. Because of this, they have many …

Radiation treatment errors with Intensity-Modulated Radiation Therapy (IMRT)

Richard Leff, MD

Physician

February 4, 2011

In a recent series of articles in the New York Times, Walt Bogdanich uncovered an alarming series of radiation treatment errors associated with implementation of new computerized treatment technologies such as Intensity-Modulated Radiation Therapy (IMRT).

Based on this article, reporting hundreds of cases, some of them fatal, it appears that a variety of causes are associated with errors, including inadequate training of physicists and radiation therapists, difficulty physically validating computer-generated treatment …

Does a physician need an MBA degree?

Joseph Kim, MD, MPH

Physician

February 4, 2011

There’s a great blog post on Harvard Business Review titled, “Does an Entrepreneur Need an MBA?” I’m now enrolled in business school and I’m pursuing an MBA. I don’t consider myself a traditional entrepreneur, but I’ve started a few things here and there. Someday, I may take a big risk and start a “real” company, but for now I’m comfortable bootstrapping my way through a few little ventures.

The …

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Does a physician need an MBA degree?

A stent anecdote from a former FDA Associate Commissioner

Kevin

Physician

February 4, 2011

by Peter J. Pitts

As the saying goes, the plural of anecdote isn’t data. That is unless the anecdote supports your theory. Here’s a personal anecdote — a story of how the system works.

Being adopted, I have no family history, so when I suffered through some late night chest pains I figured I’d better act on the warning signals. I called my GP and got a same-day consultation, resulting in a next-day referral …

Bioethics and bedside communication in daily patient interaction

Kevin

Patient

February 4, 2011

by Zakari Tata, MD

Biomedical ethics and bedside communication is currently taught to medical students in a classroom mainly in the first two years. In residency it is not usually given a lot of attention. This is leading to a situation where a very basic part of daily patient interaction is not addressed. This leads to many complex problems in the hospital that lead to moral dilemmas and conflicts.

The idea needs …

Why is there a gender gap in physician salaries?

Emily Lu

Physician

February 3, 2011

Some research studies just contain too many revelations to not share with the world. The Health Affairs study on the pay gap between newly-trained male and female physicians is just such a study, demonstrating conclusively that:

1. The gender gap in physician salaries is not related to specialty choice or work hours. No matter where women are choosing to work (solo practice vs. hospital, city vs. rural), which specialty they choose …

Can posting ER wait times be dangerous to patients?

Brian Goldman, MD

Physician

February 3, 2011

You’ve probably experienced that age-old ritual of cooling your heels in an ER waiting room hoping that it won’t be too many hours before a nurse lets you inside the sliding doors.

Simon Bradley tweeted this to my Twitter Account @WCBADoctorBrian: “My buddy had a deep laceration between the thumb and the index finger – a full layer of skin. Took 10 hours at (name of hospital withheld), fastest in town.”

A …

Kids with allergies can die in school

Gina, RN

Conditions and Diseases

February 3, 2011

Like many other parents of kids with allergies, I was very dismayed to see this article, titled, Allergic boy, 7, suffers two heart attacks after teacher hands him chocolate nut in class, last week. It seems a boy of 7 was accidentally given a chocolate candy containing a hazelnut, to which he is allergic. After biting into the candy, he realized immediately that he shouldn’t have it and …

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Kids with allergies can die in school

Food is an essential part of a doctor’s success strategy

Susan Biali Haas, MD

Physician

February 3, 2011

Nutrition fascinates me – I’ve been studying it for over twenty years and have a university degree in Dietetics. These days I’m particularly interested in the secrets of high-performance eating; the busier and bigger my life gets, the more I need to be on the ball. Food is an essential part of my success strategy. Put another way: if I didn’t know how to eat right for my brain, I’d …

Confidence in a student’s ability to become a competent physician

Timothy Dempsey, MD, MPH

Medical Education

February 3, 2011

by Timothy Dempsey

Looking in the mirror before heading out the door for my first patient encounter, I slouched. Something looked off. I had on my new, absurdly short white coat complemented nicely by the equally as new black stethoscope draped around my neck; yet the way I looked wasn’t the problem. It was the way I felt. No matter how well I dressed the part …

Why the time is right for collaborative care

Kevin

Patient

February 3, 2011

by John Mooney

A recent study conducted by Dove Press Patient Intelligence Journal asked this question of patients: “Have you ever asked your physician to prescribe something different than the original recommendation?” Thirty-four percent of the respondents indicated that in fact they had. Perhaps even more interesting: of that 34 percent, 69 percent of the doctors agreed to prescribe the alternative drug when asked. Why is this important? The health …

Alternatives to NSAIDs, pros and cons

Kevin

Medications

February 3, 2011

by Marianna Rakovitsky, RPh

Recently, I have talked about the concerns with the use of NSAIDs and their effects on the heart. All medications carry a risk of adverse effects. NSAIDs are usually very effective in controlling pain especially muscle and bone pain, but they also carry a potential risk of side effects such as stomach and kidney problems, increased risk of bleeding and adverse effects …

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Alternatives to NSAIDs, pros and cons

Can President Obama and the GOP agree on improving health reform?

Bob Doherty

Health Policy

February 2, 2011

Everything seems to be pointing toward two years of partisan and ideological confrontations over health reform. The leadership of an emboldened Republican party has made it clear that it will use its newfound House majority to seek to “repeal and replace” the Affordable Care Act (ACA), and if that doesn’t work, to “defund” it. Huge GOP gains in statehouses make it likely that more states will resist implementation. Meanwhile, President …

Ethics of the individual mandate

Kevin

Health Policy

February 2, 2011

by Raymond Raad, MD, MPH

There is a remarkable inconsistency between the ethics of medical practice and the discussion about the health care reform law passed this past March, especially the individual mandate.

In medicine, it is considered unethical to force a patient to do something against his will. Patients are allowed to disagree with their doctors and to decide for themselves whether they want to heed their advice. Patients are even …

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Ethics of the individual mandate

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