A version of this column was published in USA Today on July 3, 2013.
One recent day in my primary care clinic, I had a full schedule and was unable to see a patient for her cough. She instead sought medical care at a local drugstore, where she was treated for bronchitis. Normally housed in pharmacies and department stores like Target or Walmart, …
Drug store retail clinics for primary care? Not so fast
We’re spending an inordinate amount of time and effort trying to convince doctors to change the way they practice.
Most recently, for instance, a study came out saying that doctors aren’t following back pain guidelines. Or from a broader perspective, consider the Choosing Wisely campaign, which lists scores of tests and treatments that are ordered too frequently.
Various carrots and sticks have been used to steer physicians to …
Atul Gawande provides clues on how to change doctor behavior
The following column was published on May 29th, 2013 in the New York Times’ Room for Debate blog, which asked the question, “Is Obamacare too complicated to succeed?”
Is the Affordable Care Act complicated? Of course it is. Even one of its architects concedes that it is phenomenally complex. Why? To pass, it had to be contorted to satisfy a number of special interest groups.
As its major reforms are implemented …
Complicated Obamacare clears a very low bar
How do we reduce medical errors?
It’s a question at the forefront of the minds medical and policy leaders today. Entire books have been devoted to the subject, and there is no shortage of suggestions to improve patient safety.
Internist Danielle Ofri recently wrote a New York Times op-ed on the issue, where she reflected on a “near miss” she had during …
To improve patient safety, lawyers need to embrace transparency too
Part of the KevinMD toolkit series.
“How can I find a doctor online?”
A seemingly simple question, but patients are often confronted with too much information on the Internet, with variable quality.
Finding a doctor a similar to completing a puzzle. Like puzzle pieces, there are many resources available, including word of mouth, hospitals, insurance companies, and physician …
Finding a doctor online and researching your physician on the Internet
One of the more contentious topics on my site is the scope of practice for non-physician providers, such as nurse practitioners. This echos the debate on the national stage where leaders of physician organizations, who want to protect their scope of practice, conflict with those of nurse practitioners’, who want to perform the tasks that physicians traditionally have.
Simply Google “nurse practitioner” on this site, for instance, and you’ll see …
How I would end the war between nurse practitioners and doctors
Part of the KevinMD toolkit series.
A lot of people ask me, “What tools do you use for blogging, speaking, when you’re on the road, seeing patients etc. …” So I decided to start a series that describe what tools I use, and why.
The first explored my speaking toolkit. This one details the technical tools I use to run KevinMD.com. I’ll discuss …
A version of this column was published in USA Today on April 1, 2013.
Prescription drug abuse is a growing national tragedy. One of the biggest culprits is opioid painkillers, such as Oxycontin and Percocet. Shockingly, more than 200 million of these types of drugs are prescribed annually, and they account for more than 16,000 deaths a year. And for every death, significantly …
Curb prescription drug abuse by following Mayor Bloomberg
As part of the health reform movement, hospitals that meet various quality measures, like reduced readmission rates or improved patient satisfaction measures, get financially rewarded. Those that don’t will be penalized.
How’s it going so far?
Well, it appears that safety net hospitals that can least afford a financial hit are getting dinged, while doctor-owned hospitals are getting rewarded.
Oops.
According to Kaiser Health …
Health reformers should learn from doctor-owned hospitals
“Daddy, a bomb blew up in Boston!”
That was how my 4-year old greeted me when I came home this evening.
Of course, I already knew about the horrific attacks during the Boston Marathon, first on Twitter, then realizing the gravity of the event as mainstream media caught up.
I practice in Nashua, NH, which is about 45 minutes north of Boston. But …
Boston rises in the wake of tragedy
The following column was published on March 26th, 2013 in the New York Times’ Room for Debate blog.
In the coming years, health care reform will drive consolidation in the industry. Reformers, including the president himself, point to integrated health systems like Kaiser Permanente as the future of health care delivery. While this movement may improve patient care, whether it will shield …
Health reform faces tension with integrated health systems
Will your next primary care appointment be at a drugstore?
Yes, if Walgreens can help it.
It was recently announced that the drug chain will have its nurse practitioners and physician assistants begin to diagnose and manage chronic conditions, such as hypertension and diabetes.
“We’re not trying to take over primary care, but we think we can help support physicians and transform the …
Walgreens moves into primary care, and it’s our own damn fault
Part of the KevinMD toolkit series.
A lot of people ask me, “What tools do you use for blogging, speaking, when you’re on the road, seeing patients etc. …” So I decided to start a series that describe what tools I use, and why.
First in this series are tools I use for my social media keynote presentations. …
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The Boston Globe recently had a front page story on how a neurosurgeon sued a patient’s husband for a blog critical of the physician.
According to the story, the patient underwent a complicated back operation as a result of her bone cancer. She tragically had a stroke post-operatively, and that’s where the situation between the family and doctor deteriorated. On the advice of his psychiatrist, the patient’s husband wrote a …
How a doctor’s online reputation survived a front page newspaper story
The problem of medical resident work-hours has vexed medical educators for decades. The traditional model of sleep-deprived residents led to highly publicized medical mistakes, most famously the Libby Zion case in 1984.
Nobody wants tired doctors caring for them.
In response, various restrictions have been placed on how many hours medical residents are allowed to work. Since 2011, for instance, medical residents were …
Solving the issue of tired doctors: My radical idea
In the new book, Establishing, Managing, and Protecting Your Online Reputation, physician ratings are highlighted. This is a topic that gives many physicians some pause, and for some, causes tremendous anxiety.
Whether doctors know it or not, they already have online profiles. Third-party rating sites, like Vitals or Healthgrades, already have web pages of most physicians, and they …
Doctor ratings need to be physician driven
To cut costs in our health system, reformers target the massive of waste. One way to reduce waste is to change the way doctors are paid. The fee for service payment system, they say, encourages doctors to prescribe more expensive care, which lines their pockets and drive up the cost of care.
To combat this trend, reformers often have providers in their crosshairs, …
Health reformers fail to hold patients accountable for health costs
A version of this column was published on February 3, 2013 in USA Today.
I’m seeing more patients than ever consume so-called “energy drinks,” a rapidly emerging class of beverage which promise to increase energy, improve alertness, and boost attention span. The energy drink business is booming, with more than $12 billion sold last year, eclipsing established beverage categories like iced tea …
Why energy drinks should be considered stimulant drugs
A version of this column was published on January 13, 2013 in USA Today.
Like many other primary care doctors across the country, I’m seeing my fair share of patients with runny noses during this winter season.
I recently saw a patient for a sinus infection whom asked, “Why did I have to come in to see you? Couldn’t you have given me an …
A virtual office visit for your cold is not a good idea
The following column was published on January 11, 2013 in CNN.
During the past few months, I have gently suggested to my patients that they receive the flu vaccine. Many said yes, but some declined.
Today, as I look up Google’s national flu trend map, I see nearly the entire country painted in an alarming red, signifying “intense” flu activity. According to the Centers …
What you can learn from the flu epidemic: Get vaccinated earlier
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