| KevinMD.com

August 24, 2010Aug 24, 2010

Have you ever read what your physicians and nurses have written in your medical chart? If not, would you want to? The OpenNotes project is a recently launched observational research study that involves 100 primary care doctors and about 25,000…

Have you ever read what your physicians and nurses have written in your medical chart? If not, would you want to?

The OpenNotes project is a recently launched observational research study that involves 100 primary care doctors and about 25,000 patients. Lead author Dr. Tom Delbacoa, a primary care physician at the Beth Israel Deaconess Medical Center, poses the research question succinctly: “After a year, will the patients and doctors still want to continue sharing notes?”

In the study, …

Patient

Adults living with dementia and disability need research funding

Alex Smith, MD

August 23, 2010Aug 23, 2010

I heard a prominent speaker talk about studies at the National Institute of Aging. The speaker described several new large and well funded trials aimed at preventing illnesses associated with aging, such as dementia and disability. These studies are terrific,…

I was disappointed, however, that little was said about funding for studies of older adults already living with dementia and disability. Research in prevention will not help these patients. I asked: where is the …

Patient

How patients can stop doctors from blaming them for their health

WarmSocks

August 23, 2010Aug 23, 2010

If doctors need to listen to patients to figure out what’s going on, patients need to tell doctors what’s going on. Why is that so hard sometimes? It’s hard to speak up when you feel rushed, but have doctors ever…

Sometimes doctors blame the patient

Years ago I got a terrible abdominal pain. I could only explain that it felt like …

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Health Policy

Insurance does not have incentives to lower costs or improve quality

Stephen C. Schimpff, MD

August 23, 2010Aug 23, 2010

Whether we have commercial insurance through our employer or Medicare, the incentives are poorly aligned to lower costs and improve quality. In fact, they actually encourage greater and greater expenditures. In most instances, our insurance covers everything from prevention to…

Whether we have commercial insurance through our employer or Medicare, the incentives are poorly aligned to lower costs and improve quality.

In fact, they actually encourage greater and greater expenditures. In most instances, our insurance covers everything from prevention to basic routine care to complex care of serious illness. Coverage may not be all that good for some things like preventive care and our primary care …

Conditions and Diseases

Is placebo a therapy, like surgery or medication?

PalMD

August 23, 2010Aug 23, 2010

The New England Journal of Medicine recently published a troubling article on acupuncture, which was ably deconstructed by Dr. Mark Crislip. This incident has reignited a discussion of what, exactly, “placebo” is. A common argument is that placebo is like…

The New England Journal of Medicine recently published a troubling article on acupuncture, which was ably deconstructed by Dr. Mark Crislip. This incident has reignited a discussion of what, exactly, “placebo” is.

A common argument is that placebo is like any other intervention, something that can be intentionally harnessed for the benefit of patients. This is both true and overly simplistic.

First, we must review what “placebo” …

Conditions and Diseases

Fetal heart rate monitoring is given too much importance

Nicholas Fogelson, MD

August 23, 2010Aug 23, 2010

Continuous fetal heart rate monitoring is at its core an almost laughable idea. We are checking a single vital sign and using that vital sign to extrapolate a host of ideas and meanings. OBs that have read strips for years…

Continuous fetal heart rate monitoring is at its core an almost laughable idea.

We are checking a single vital sign and using that vital sign to extrapolate a host of ideas and meanings. OBs that have read strips for years can make some sense of them, but would we give so much meaning to any other single vital sign? Would we do it with an adult? Of course not, but …

Physician

Balancing a surgeon’s beliefs with the needs of the practice

Peter J. Polack, MD

August 20, 2010Aug 20, 2010

Not long ago, we interviewed a physician for possible partnership in our practice. After showing him around our town, some of us partners had dinner with him to discuss business. He was a quite pleasant fellow, well trained, and seemed to be a good ‘fit’ for our practice. As dessert was being served, he said he needed to get one more thing off his chest: he prays aloud in the …

Health Policy

Americans will need doctors but physicians are leaving primary care

Davis Liu, MD

August 20, 2010Aug 20, 2010

Everyone understands the need for a robust primary care workforce in making healthcare more affordable and accessible while keeping those in our care healthy. With the aging of America and healthcare reform, even more Americans will need primary care doctors at precisely the same time doctors are leaving the specialty in droves and medical students shun the career choice. So as a practicing primary care doctor, I’ve watched with …

Health Technology

Why nurses need better EMR design to care for patients

Jared Sinclair, RN

August 19, 2010Aug 19, 2010

There’s always a lot of stink from physicians over usability problems with EHRs: too many clicks, too many contextual menus, etc. The gist of these complaints is, “Physicians aren’t data entry clerks!” The computer is getting in the way of…

Everybody has a finite amount of mental space available at any given moment. Imagine having to transcribe a conversation in real-time. If half of your mental …

Physician

Family doctors cannot be obsolete, for patients’ sake

Kevin

August 19, 2010Aug 19, 2010

by Pepi Granat, MD Yesterday, and every day, in my office we had one or two patients we call our "Oldie Goldies". People who have been with us since 1971 when I opened my practice, 39 years ago. People whose…

by Pepi Granat, MD

Yesterday, and every day, in my office we had one or two patients we call our “Oldie Goldies”.

People who have been with us since 1971 when I opened my practice, 39 years ago. People whose progress, medical and personal, I’ve shared, and who share mine. We know their parents, kids and cousins either because they call us in crisis, or they’re our ongoing …

Physician

Why primary care is like air traffic control

angienadia, MD

August 18, 2010Aug 18, 2010

Recently I had an interesting conversation with a few young doctors regarding the new health care reform that had been passed in the United States. One future specialist asked me why primary care doctors should receive more money than they…

And this is an important question that I think sheds light on the suboptimal state of our current health care system. It is important to specialists because …

Patient

“I’m a patient, not a consumer”

Jackie Fox

August 17, 2010Aug 17, 2010

I’ve been hearing and reading a lot lately about how the doctor-patient relationship is under siege. There are many reasons for this, ranging from care decisions increasingly being made by insurers to the shortage of primary care physicians, to patient empowerment. I didn’t quite understand how patient empowerment could be a threat, until I started thinking about the recent perceptual shift from patients to health-care consumers.

I agree with the consumer …

Read more…

“I’m a patient, not a consumer”

Health Technology

AMA: A roadmap to qualifying for EHR incentives

Kevin

August 12, 2010Aug 12, 2010

A guest column by the American Medical Association, exclusive to KevinMD.com. by Steven J. Stack, MD The high cost of an electronic health record (EHR) system, the often challenging process of implementing new technology into a physician practice, and the…

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

by Steven J. Stack, MD

The high cost of an electronic health record (EHR) system, the often challenging process of implementing new technology into a physician practice, and the difficulty in deciding which system best meets a practice’s needs have deterred many physicians from …

Potpourri

HIMSS 2010 Better Health social media coverage

Kevin

February 18, 2010Feb 18, 2010

This year, the Better Health team will be offering live coverage of healthcare’s largest tech conference: HIMSS in Atlanta, March 1-4. Three medical bloggers, Dr. Val Jones, Dr. Mike Sevilla, and Dr. Nick Genes will interview over 40 different exhibitors…

This year, the Better Health team will be offering live coverage of healthcare’s largest tech conference: HIMSS in Atlanta, March 1-4.

Three medical bloggers, Dr. Val Jones, Dr. Mike Sevilla, and Dr. Nick Genes will interview over 40 different exhibitors and stream their interviews live via UStream.

You can ask questions of the interviewees by submitting questions to @drval during …