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Is health IT modern day snake oil?

Health Technology

July 7, 2016

Recently, the American Medical Association CEO called digital health care products modern day “snake oil.”

As a provider and a technologist, I think we need a deeper dive to understand the issues, avoiding the kind of hyperbole that’s so common in politics today.

Paul B. Batalden, MD, Senior Fellow, Institute for Healthcare Improvement (IHI), once said “Every system is perfectly designed to get the results it gets.”

Let’s take …

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Is health IT modern day snake oil?

How the practice of medicine changed my prayers

Chiduzie Madubata, MD

Physician

July 7, 2016

I was standing outside of the patient room with two family members, a faithful wife, and a devoted mother. In the sea of faces that surrounded his bed on a daily basis, these were the two that stood out to me. For this young man in his 30s who was battling metastatic colon cancer, his wife, and his mother were his strongest advocates, constantly seeking answers about his prognosis and …

A case of abdominal pain in the ER. And a surprising cause.

Raj Waghmare, MD

Conditions and Diseases

July 6, 2016

(Triage note: 45-year-old male, vomiting for two days. Abdominal pain.)

Dr. Stephen Cluff is like Yoda. Judging by body hair, he’s more like Chewbacca. But he’s short, wise, and with his white hair and arthritic limp, he may as well have green skin, poor sentence structure, and a Muppet’s voice. If I’m stumped on a case, I’ll ask him. If I’m pissed off about department politics, I’ll call him for advice. If I want …

Real physician voices, twice a week

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We are suffering the grave consequences of a single survey question

Justin Reno, MD

Physician

July 6, 2016

“You’re nothing but a punk ass kid. And you’ll die a punk ass kid!”

With that, she stormed out of the exam room, leaving me sitting on a stool, slamming the door behind her. Apparently she walked straight up to the front desk and asked to file a complaint about me, but left prior to receiving the paperwork.

Most all physicians will immediately know what the interaction involved. I hadn’t been mean …

The end of residency means difficult goodbyes

Anne Toledo, MD

Physician

July 6, 2016

“It is easy to see the beginnings of things, and harder to see the ends. I can remember now, with a clarity that makes the nerves in the back of my neck constrict, when New York began for me, but I cannot lay my finger upon the moment it ended.”
– Joan Didion, Goodbye To All That

So it feels at the end of residency. Of course, there is a graduation date. …

It’s time to end the medical hierarchy

Jorge Roman

Medical Education

July 6, 2016

I was a few weeks into my surgery clerkship and was on the tail end of a student call shift. I had been at the hospital for almost 24 hours, and the last thing left to do before I embraced the comfort of my own bed was to round with the faculty surgeon on call that weekend. The night had been busy, but I was prepared to update my attending …

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It’s time to end the medical hierarchy

Hamilton mirrors the duel between doctors-patients and insurance companies

Chad Rudnick, MD

Physician

July 5, 2016

It’s likely that you or someone you know has attempted to purchase tickets, or at least talked about the difficulties of purchasing tickets to Broadway’s most popular show, Hamilton. While participating or overhearing the discussion, the conversation has likely pivoted to how expensive ticket prices are on the secondary market. It has become so difficult to get tickets through the box office, even with the partial block ticket releases that …

Physician-led anesthesia is safe anesthesia

Edward R. Mariano, MD

Physician

July 5, 2016

Many people, even those who work in the operating room every day, take safe anesthesia care for granted. There has been growing pressure recently to abandon the team model and remove physician anesthesiologists’ supervision of nurse anesthetists with the latest threat coming from within Veterans Affairs (VA) health care. For our veterans, our heroes and arguably some of the most medically complex patients, having both …

Collaboration is vital to mission of professional medical societies

Yul Ejnes, MD

Physician

July 5, 2016

A guest column by the American College of Physicians, exclusive to KevinMD.com.

“Before we end the meeting, I would like to thank our staff, without whom none of this would have been possible …” I can’t count how many times I said that or something similar when I was the American College of Physicians’ (ACP) Rhode Island …

Patients are blindfolded to charges and cost

Aida Cerundolo, MD

Physician

July 5, 2016

As she adjusts her sunglasses, Mary squints to protect her sensitive eyes from the sun. Four years ago when lymphoma threatened her life, doctors gave her a 5 percent chance of survival.

“I really should be dead right now,” she states casually. A bone marrow transplant gave this patient a new lease on life, allowing for the treasured opportunity to mother her 8-year-old son. The transplant has been successful, but her …

The health care system that failed Prince needs an immediate intervention

Shruti Kulkarni, JD

Health Policy

July 4, 2016

It has now been confirmed that Prince’s untimely death resulted from an overdose of the drug fentanyl.

It is unclear whether the lethal dose of fentanyl was a prescription medication or a counterfeit “analog” drug from the illicit market. Regardless, the facts are now clear enough to know that the U.S. health care system failed Prince in the same ways it is failing the 78 Americans who die every …

We live in a culture of mental health haves and have nots

Naomi Freundlich

Health Policy

July 4, 2016

In 2008, mental health advocates hailed the Mental Health Parity and Addiction Equity Act as “historic;” putting an end to what Sen. Edward Kennedy called “the senseless discrimination in health insurance coverage that plagues persons living with mental illness.” The law requires most group health plans to offer coverage for mental health and substance use disorders equal to that provided for medical problems. Two years later, the Affordable Care Act extended …

Sometimes the big picture isn’t apparent to patients

Laura Black, MD

Physician

July 4, 2016

Follow-up appointments at my continuity clinic have given me the opportunity to look at my clinical judgment in snapshots. Unlike on my inpatient rotations, where I see the same patients every day, I have to wait for a month or two to see if a medication is working, or if a patient is satisfied with their progress in physical therapy. Sometimes I have a crisp memory of my clinical decision-making …

A physician responds to Sarah Kliff

Niran S. Al-Agba, MD

Physician

July 4, 2016

A response to Unpaid, stressed, and confused: Patients are the health care system’s free labor.

Dear Sarah,

I am genuinely sorry about your chronic foot injury. Thank you for your insightful article and feedback. You are correct the system is fragmented and places “considerable burden” on patients to “coordinate their own care.” You (the patient) and me (a physician) are now in the same boat, headed the same direction with the …

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A physician responds to Sarah Kliff

Do-it-yourself lab tests are a bad idea. Here’s why.

Kenneth Lin, MD

Conditions and Diseases

July 3, 2016

It sounded too good to be true when I first heard about Theranos, a company that promised to revolutionize medical testing by making it possible to perform dozens of tests on a single drop of blood, rather than the several tubes that would typically be required. And that wasn’t all. Theranos CEO Elizabeth Holmes, a Stanford dropout and media magnet whose wardrobe seems to consist solely of all-black outfits, promised …

Your daughter is going to medical school. Please don’t worry.

Kathy Stepien, MD

Medical Education

July 3, 2016

Dear parents,

Congratulations on your daughter’s acceptance into medical school. Like the first day of kindergarten, this launch is notable for parents as well as children.

You may have some concerns about the stresses she will face. Having been there, I can tell you there will be many. Not to worry, though. Times are changing. You daughter is free to learn among the brightest of the bright while avoiding problems women before …

Tips to improve your communication with patients

Michael Ho, MD

Physician

July 3, 2016

“We experienced an iatrogenic event that produced an untoward sequela, and while it is now quiescent, it may still recrudesce.”

No one likes to be given bad news, especially of disease. But first, you have to understand what it means. When it comes to communication of medical information, the way the message is delivered is often just as important as the information itself. Indeed, good communication is the backbone of every patient-provider relationship.

The …

I live a life in which pain plays a constant role

Ronna Edelstein

Patient

July 3, 2016

When my friend Madeline turned seventy, she celebrated in a big way: She walked a half-marathon; she hosted a cabaret for family and friends at which she sang and told stories; she traveled to China. Now, six years later, this dynamic woman has become a virtual prisoner in her apartment. She has undergone back surgery, suffered a nearly fatal intestinal infection and, after a fall, had bolts and screws placed …

Don’t remove your own IUD. Please.

Jennifer Gunter, MD

Conditions and Diseases

July 2, 2016

Removing one’s own IUD is apparently “a thing.” There are even YouTube videos of women sharing their experiences. If you can get a medical degree from Google then why not get your OB/GYN residency from YouTube?

All kidding aside, I’m a gynecologist and I’m going to explain why you shouldn’t.

It’s not that people can’t technically pull out their own IUDs. It does happen accidentally, albeit rarely. An occasional …

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Don’t remove your own IUD. Please.

Open access endoscopy raises potential ethical issues

Michael Kirsch, MD

Conditions and Diseases

July 2, 2016

Like nearly every gastroenterologist, we have an open access endoscopy system. This means that patients can be referred, or refer themselves, directly to our office for a procedure without an office visit in advance.

Why do we do this? We offer it as a convenience, so patients do not need to make two visits to see us when it is clear that a procedure is necessary. For example, a referring physician …

Real physician voices, twice a week

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