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Scribes for physician burnout: How scribes help reconnect doctors with their patients

Physician

August 3, 2017

Recently, I had an opportunity to drop in on two of the foremost researchers in physician burnout, Sara Poplau and Mark Linzer of Hennepin County Medical Center in Minneapolis. We chatted about various aspects of the current burnout crisis and exciting new initiatives on the horizon. Then we spent some time contemplating a frustrating truth: leaders in health care often fail to acknowledge a reality that leaders in other industries …

Artificial intelligence in health care: Better studies are needed

Skeptical Scalpel, MD

Health Technology

August 3, 2017

An article in Newsweek magazine says, “Artificial intelligence will cure America’s sick health care system” using data and automation to “drive down the costs of health care while increasing effectiveness.”

According to Newsweek, it will work like this for diabetes. A company called Virta Health has come up with a smartphone app that is like “a live-in doctor and diabetes coach.” Type 2 diabetics who enroll will enter data such as blood sugar …

How EMRs are making informed consent meaningless

Fred N. Pelzman, MD

Physician

August 2, 2017

Recently, getting dressed after working out in the gym, the guy in the next locker decided to complain to me about his recent surgery.

Having lockers next to each other had led over time to “What do you do for a living?” After discovering that I was a physician he has occasionally asked some medical questions, and done what a lot of people do when they know you’re a health care …

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Let’s talk about the ethics of breastfeeding

Jennifer Lincoln, MD

Conditions and Diseases

August 2, 2017

In the spirit of World Breastfeeding Week, I want to highlight all we can about breastfeeding; why it’s great for you and your baby, some ways to make it easier, and how to manage common challenges.

But one challenge that often gets ignored in the offices of doctors and lactation consultants is the issue revolving around the ethics of breastfeeding. That is, addressing uncomfortable questions like these:

Are moms who choose …
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Let’s talk about the ethics of breastfeeding

Dear Sen. McCain: 9 ways to live with glioblastoma

Adam Hayden

Conditions and Diseases

August 2, 2017

Dear Sen. McCain,

I was saddened to hear that you received a diagnosis of glioblastoma. I also live with this particularly aggressive type of brain cancer. On the surface, you and I are very different. I am a 35-year-old dad with three sons aged 5 and under. I have a beard and listen to indie rock. I hold …

Find the right doctor for you: Here’s what to look for

Linda Girgis, MD

Physician

August 2, 2017

Many people love to vilify doctors. They think we are all greedy and we don’t listen. They say we perform procedures just for profit. We are not available when we need them. Sure, there are doctors that fit this stereotype. But, in my experience, most doctors do not and care about their patients trying to do the best for them.

I hear patients complain about other doctors and some of the …

A physician’s mixed feelings about clinical pathways

Christopher Johnson, MD

Conditions and Diseases

August 2, 2017

As the kids say, it’s complicated. Practicing physicians are seeing an ever increasing list of protocols and pathways coming their way. These arrive in several forms — order sets for medications, guidelines in how to proceed for various conditions, when to do this, when to do that, and when not to do either one. They generally are the product of various committees trying to synthesize what these days we call …

A medical student is diagnosed with cancer. Here is his story.

Ari Bernstein

Conditions and Diseases

August 2, 2017

I began medical school, like many of my peers, with some experience working with patients. I worked as a volunteer EMT with Cornell University EMS for four years during my undergraduate years; shadowed a cardiologist and an anesthesiologist through Cornell’s Urban Summer program at NYP Hospital–Cornell and worked with patients during Global Medical Brigade trips to rural Honduras. All of this sparked my interest in medicine, but to claim I …

Dear parents: We’re fighting for your children

Chad Hayes, MD

Physician

August 2, 2017

I just wanted to let you know that we’re fighting for your kids. Because, whether you realize it or not, they are in danger.

You usually see us in the office, or maybe making rounds in the hospital. We decorate our offices with bright colors and sea creatures, and we give your kids stickers when they’re cooperative (and even when they aren’t). In general, we’re a pretty friendly bunch.

We’re people — …

5 communication mistakes physicians should avoid

Suneel Dhand, MD

Physician

August 1, 2017

Being a doctor is about as much of a social job as one can get. Even though computers and healthcare information technology mean that physicians are now spending a disproportionately large amount of their time staring at their computer screens, there’s no getting around the importance of good old face-to-face interactions. That’s also what’s valued by your patients. In this time of great upheaval in healthcare, everything has …

Deep extubation is a useful technique for any anesthesiologist to master

Karen S. Sibert, MD

Conditions and Diseases

August 1, 2017

There are two schools of thought about how to extubate patients at the conclusion of general anesthesia:

Allow the patient to wake up with the endotracheal tube in place, gagging on the tube and flailing like a fish on a line, while someone behind the patient’s head bleats, “Open your eyes! Take a deep breath!”

Or:

Remove the endotracheal tube while the patient is still sleeping peacefully, which results in the smooth emergence …

Explore the behavioral factors behind antibiotic misuse

Peter Pronovost, MD, PhD

Medications

August 1, 2017

None of us wants to live in a world without access to lifesaving antibiotics. No patient should be subject to an allergic reaction or organ dysfunction from these drugs. No one wants to contract a potentially deadly form of diarrhea, claiming roughly 30,000 lives a year in the U.S., that can take hold after antibiotics wipe out healthy gut bacteria.

Yet, every day, patients are prescribed antibiotics that they did …

Health reform: It’s time for Congress to grow up and do their jobs

Roy Benaroch, MD

Health Policy

August 1, 2017

Health – /helTH/ – The state of being free from illness or injury

Care – /ker/ – The provision of what is necessary for the health, welfare, and protection of someone or something.

System – /’sistəm/ – A set of things working together as parts of a mechanism or an interconnecting network.

It’s not keeping us Healthy, it doesn’t seem to Care, and it’s certainly no kind of System. What we’re got is …

When an erythrocyte sedimentation rate leads to a serious diagnosis

Hans Duvefelt, MD

Conditions and Diseases

August 1, 2017

In Sweden, back when I trained, three blood tests were the “routine labs” done at most doctor visits: hemoglobin, white blood cell count, and erythrocyte sedimentation rate. I’m trying to remember, but I don’t think everyone waited an hour to see the doctor, so they must have used a modified rapid sedimentation rate.

The “sed rate,” or “sänkan” as we call it, was invented by Robin Fåhraeus, a relative of one …

Does the public shaming of Carmen Puliafito go too far?

Vamsi Aribindi, MD

Physician

August 1, 2017

Recently, the Los Angeles Times broke a story that Dr. Puliafito, former Dean of the Keck School of Medicine of USC, had been abusing drugs and keeping company with a group of younger individuals who engaged in drug use and illicit activity. Much of this activity occurred while he was dean, and it is a shocking story: A 66 year-old titan of the field of ophthalmology, renowned for inventing …

Against medical advice: When patients and doctors defy expectations

Abraar Karan, MD

Physician

July 31, 2017

Mr. B. was ready to leave. A short, stocky Boston construction worker with an even shorter temper and a tough attitude, he was not going to stay in the hospital one minute longer than needed.

Mr. B.’s life had taken a turn for the worse recently: He was going through a divorce, had lost his health insurance, and had become temporarily homeless at the time we met. He had brought himself …

Parents: Interact with your kids!

Edwin Leap, MD

Physician

July 31, 2017

After years and years of practicing emergency medicine, I’ve seen and treated thousands of children for everything from beads in the nose to leukemia, ruptured spleens to sprained ankles.

A father of four myself, I take great delight in interacting with the kids that come through my workplace. I consider it a personal challenge to make them smile whenever possible and to put them at ease.

I’ve learned a few things over …

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Parents: Interact with your kids!

When it comes to after-hours care, expectations need to be adjusted

Michael Kirsch, MD

Physician

July 31, 2017

Today’s patients must adjust to seeing many physicians, many of whom are strangers. If you need a doctor on the weekend, at night or just need a same day appointment, you may very well not be seen by your physician. This is not your father’s medical practice. The days of the physician house call have vanished. There are many reasons responsible for this evolution (or devolution) in medical care. Patients …

Are pharma gifts to doctors a red herring?

Brian C. Joondeph, MD

Medications

July 31, 2017

Physicians are influenced by marketing. That’s no surprise. So are most consumers, as evidenced by television and radio commercials, billboards, pop up ads and targeted ads for drugs on your computer screen. Big Pharma markets not only to physicians, but also directly to consumers.

In a recent Washington Post op-ed, Dr. Nicole Van Gronigen made the case that Big Pharma successfully influences physician prescribing behavior via marketing. Specifically, drug …

Neil Gorsuch and the case of Charlie Gard

Michel Accad, MD

Physician

July 31, 2017

Kenan Malik writes in the New York Times in support of Charlie Gard’s parents, presenting a secular, utilitarian argument for the continuation of the child’s treatment.

In the article, Malik draws attention to a contradiction between the State’s position regarding Gard and its position regarding the wishes of a patient with a terminal neurological condition who wishes for assisted suicide.

The practice of withdrawal of care is often invoked in the …

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