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How should physicians be rated? Here are 8 factors that should be included.

Physician

August 30, 2017

Ratings have become a national obsession. U.S. News & World Report rates colleges, medical schools, hospitals, subspecialties, etc. Some private firms develop physician ratings. Many insurance companies provide physician report cards. Intuitively most physicians understand that these ratings have serious flaws, yet they persist.

Here’s a quote from a Malcolm Gladwell article that I had read and forgotten: “The Order of Things: What college rankings really tell us“:

A ranking …

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How should physicians be rated? Here are 8 factors that should be included.

A day in the life of an OB/GYN chief resident

Danielle Jones, MD

Physician

August 30, 2017

It’s 5:50 a.m. and my alarm is buzzing. It’s been going off intermittently since 5:30 a.m. Even though I really don’t need to be out of bed until 6:00 a.m., I’ve lived with myself long enough to know my biggest vice is the snooze button.

I roll out of bed and get ready for the day — blue scrubs, messy bun, enough makeup to feel like I tried, freshly clean teeth …

The Big Short in health care: What happens after the bubble bursts

Suneel Dhand, MD

Health Policy

August 30, 2017

Last week a physician friend recommended watching the movie the Big Short. The description given to me was that it was a great movie that was all about a bunch of guys who saw the 2008 financial crisis coming. Sure enough, that very weekend, I planned a night in to get take out and watch it on Netflix.

And it sure didn’t disappoint. Starring Ryan Gosling, Steve Carrell, Christian Bale, and …

How this physician transitions to becoming an empty nester

Manoj Jain, MD, MPH

Physician

August 30, 2017

Next month when our youngest child leaves for college, the biggest change may not be in his life but in ours.

We are done with dropping them off at school, or giving them driving lessons, or helping them with difficult homework assignments: We will officially become “empty nesters.”

My wife and I ponder sitting at the dinner table and standing by the kitchen counter, where exuberant political dialogue takes place, and …

Alarm fatigue is problem. Here’s a pragmatic solution.

Hans Duvefelt, MD

Physician

August 30, 2017

I missed a drug interaction warning the other day when I prescribed a sulfa antibiotic to Barton, a COPD patient who is also taking dofetilide, an uncommon antiarrhythmic.

The pharmacy called me to question the prescription, and I quickly changed it to a cephalosporin.

The big red warning had popped up on my computer screen, but I x-ed it away with my right thumb on the trackball without reading the warning. Quite …

We are clinicians in the era of information overload

Kerri Vincenti, MD

Physician

August 29, 2017

The age-old saying is that knowledge is power. But what happens when you are overwhelmed with the information you need to make a decision without the understanding of how that information fits together to answer your question? It’s like trying to put together a large, complex puzzle without a finished picture for comparison. Oh, and by the way, you also aren’t sure you have all the pieces. This situation can …

Hospital sushi and the 5 stages of grief

Ben Gold, MD

Physician

August 29, 2017

Prologue

It’s 1:30 p.m. on a beautiful Saturday afternoon. You’re on call, and hungry, and having not had the forethought to make food ahead of time, you decide you’ll take your chances and see what the hospital cafeteria has to offer. You bustle your way past screaming children, harried caregivers, and distracted hospital staff with their heads buried in smartphones, following signs for the fork and knife.

Finally, you arrive. After considering the stack of soaking wet trays …

Will bots replace docs?

David Kerr, MD

Health Technology

August 29, 2017

In days of yore, people in distress usually turned to family, friends and occasionally the clergy for help but for many years now, much of the burden of dealing with human misery has been transferred to medical professionals. Going forward and given that the iPhone and social media are ubiquitous in the daily lives of most of us, it is probably no surprise that the latest psychological support system comes …

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Will bots replace docs?

“That’s crazy”: Stop using psychiatric words as insults

Smitha Murthy, MD

Conditions and Diseases

August 29, 2017

Words matter. At some point, we all may have casually tossed a psychiatric adjective to describe a situation or person. There is usually no malicious intent behind the use of these colloquialisms. However, during these strange and unprecedented political times, psychiatric terms seem to be thrown around more so by those trying to paint a picture of current prominent figures. A late-night show host referred to someone as “being off …

A reminder of how important bedside manner is

Rakhi Dimino, MD

Physician

August 29, 2017

Being a physician is hard. Really hard. Four years of medical school, multiple years of residency and perhaps fellowship training add up to years of working endless days in a row and powering through exhausting nights. For many of us, this need to be able to power through continues even when we finally make it as an attending.

But being a patient is harder. Being the daughter or son or husband …

9 reasons the “golden age of medicine” was golden

Thomas D. Guastavino, MD

Physician

August 29, 2017

To listen to all those desperate to reform health care, you get the impression that physicians are pretty horrible people. We are all sexist, greedy, money grubbing tyrants who will perform unnecessary tests and procedures just to make money. We don’t care about quality or cost. We are killing off 250,000 patients every year with our ignored “errors.” We purposely keep our patients in pain, or we addict them to …

A patient becomes the teacher

Melanie McMinn, MD

Physician

August 28, 2017

It was an ordinary day in clinic — I had gotten very behind schedule when a 90-year-old gentleman, who was in for his third visit in a month related to falls, came in with his equally frail wife. We had to spend extra time discussing his placement in a nursing home for safety concerns.

I hastily entered the room of a 46-year-old attractive female, who was here to meet me as …

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A patient becomes the teacher

15 tips for working with women

Sasha K. Shillcutt, MD

Physician

August 28, 2017

I work in a male-dominated field. As a cardiac anesthesiologist, I work with mostly male cardiac surgeons in a department where the majority of my fellow anesthesiologists are male. I work with some fantastic male colleagues. They are caring, skilled doctors, and I consider many of them to be friends.

While most of them know how to handle emergencies, trauma and difficult work situations, many times they clam up when we …

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15 tips for working with women

The mythical unicorn of vaccine denialists

Christopher Johnson, MD

Conditions and Diseases

August 28, 2017

I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity.

Epidemiologists debate the concept around …

5 ways virtual doctors can help during a natural disaster

Latisha Rowe, MD, MBA

Physician

August 28, 2017

In Houston, all of my colleague’s offices are closed, and there is limited access to the Texas Medical Center due to Hurricane Harvey. As a virtual medical doctor, there was only one thought on my mind this entire weekend, “How can I help?”

As a Floridian, I have certainly faced my share of natural disasters beginning with Hurricane Andrew, a category 5 hurricane in 1992. Living through Hurricane Andrew gave me …

4 times a bedside ultrasound made a difference this week

Janice Boughton, MD

Conditions and Diseases

August 28, 2017

I bought a pocket ultrasound in 2011, determined to learn how to perform and interpret ultrasound at the bedside and thus transform my internal medicine practice. I bought it new, and it cost over $8,000. That was a staggering amount of money to spend on something I knew very little about. In 2015 after having performed many thousand ultrasound exams with my little GE Vscan with the phased array transducer, …

Physicians: Use your voice to make the difference

Vineet Arora, MD

Physician

August 28, 2017

Recently, there have been many times when you may have gotten a news alert on your phone or checked the latest Twitter hashtag and wanted to scream. Or you were too busy to even check until later that day and did not know what to say other than to lurk and watch a train wreck in progress. You may have thought about saying something, but paused and wondered, “Is this …

The white coat symbolizes 2 important commitments

Efrain Talamantes, MD

Medical Education

August 27, 2017

A white coat ceremony address to the University of California, Riverside School of Medicine, August 4, 2017.

“It takes a village” is one of my favorite proverbs, an African proverb, that resonates with each of us on this monumental day. There is without a doubt that every one of you worked very hard to get into medical school. However, this difficult journey was supported by dozens of important individuals: teachers, …

Fix the pay imbalance between specialists and primary care physicians

Zachary Janowski

Health Policy

August 27, 2017

Reformers have expended considerable effort to change the way Medicare buys health care for millions of Americans, finding a wide range of support across the political spectrum. But Medicare’s current structure may doom these reforms. Some primary care doctors fear that the skewed incentives in Medicare’s pricing system will get built into any new system, whether it is “accountable,” “affordable,” or “value-based.” This fear is well-founded. If special interests buy …

Patient first: How EHRs can better serve our shared mission

Bill Russell

Health Technology

August 27, 2017

An exchange between former Vice-President Joe Biden and EPIC CEO Judy Faulkner at a Biden Cancer Initiative event has again elevated the discussion of patient access to their medical records.

You can read the discussion on Politico. However, Biden’s main point was that patients needn’t justify their claim to their own EHR records.

In fairness to Ms. Faulkner, they did express a common view: medical records are too complex for …