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Why work hour restrictions won’t improve patient safety

Kevin Pho, MD

KevinMD

August 11, 2011

Darshak Sanghavi recently wrote an excellent piece in the New York Times summarizing the controversy over resident work hours.

The topic has been discussed here frequently, with ramifications ranging from the fact that errors arising from patient handoffs negate any benefit gained from restricting work hours, to surgeons not accumulating enough experience during their work hour-restricted training.

I’ve often …

Should Lipitor go OTC? A cardiologist says yes, an internist says no

Kevin Pho, MD

KevinMD

August 4, 2011

With the patent for Lipitor expiring, Pfizer is considering selling an OTC version of the statin.

It’s generated a firestorm of debate, with doctors speculating on the impact for patients.

According to Pharmalot, “an OTC version would allow Pfizer to capture some of the sales that will be lost when the Lipitor patent expires in November. In fact, Pfizer execs recently changed …

Hospitalist care is more expensive but don’t blame hospitalists

Kevin Pho, MD

KevinMD

August 3, 2011

Hospitalists save money. Until the patient leaves the hospital, at least.

A recent study from the Annals of Internal Medicine ignited debate over the cost effectiveness of hospitalists. Looking at Medicare patients from 2001 to 2006, researchers found that “those who were followed by a primary care physician spent about half a day more at the hospital, costing Medicare …

Why the debt ceiling deal is a horrific outcome for physicians

Kevin Pho, MD

KevinMD

August 2, 2011

If you’re a physician or hospital that relies on Medicare payments, grim times are ahead. Yes, even worse than the scheduled 29% payment cut that’s scheduled to go into effect in 2013. Emergency physician Shadowfax calls the debt deal “a terrible deal for health care providers.”

Under the contentious debt ceiling agreement, significant cuts in Medicare dollars will be made. …

Advances in cancer treatment are hyped by headlines

Kevin Pho, MD

KevinMD

July 31, 2011

The following op-ed was published on June 5, 2011 in USA Today.

A patient recently asked me if I had heard about the new “wonder drugs” used to treat skin cancer. Indeed, I had. In a widely reported story in early June, two novel cancer drugs were found to benefit patients with advanced melanoma, a devastating form of skin cancer. These …

Medical education cost is a health policy imperative

Kevin Pho, MD

KevinMD

July 28, 2011

Whenever I talk about the cost of medical education, I like to bring up this chart. It starkly illustrates just how expensive it is to train a doctor in the United States, compared to Canada and France.

New York Times contributor Pauline Chen wrote a column on the issue recently. Most doctors graduate with a debt exceeding $150,000, and …

Why receptionists are integral to the health care team

Kevin Pho, MD

KevinMD

July 25, 2011

Health care is a team sport, and one of the most important members is the office receptionist.

Receptionists are often the first people patients see when the visit the clinic. And those first impressions count.

In a recent piece from the New York Times, Pauline Chen notes a study of the responsibilities of the medical receptionist, and finds they impact …

Medicare should stop paying for prostate cancer screening in men over age 75

Kevin Pho, MD

KevinMD

July 3, 2011

The following op-ed was published on June 1st, 2011 in the New York Times’ Room for Debate blog.

Medicare should stop paying for prostate cancer screening in men over the age of 75.

You may be surprised to hear that, especially coming from a primary care doctor. But evidence is mounting that screening for prostate cancer is not only ineffective in older men, but may actually be harmful.

The cornerstone of …

Google Circles may be why physicians will embrace Google+

Kevin Pho, MD

KevinMD

June 30, 2011

After playing around with Google+ today, I’ve come away on a more positive note than my speculative post on Google’s social network recently.

Before experiencing Google+, I asked whether doctors can separate their personal and professional relationships, and how the Google Circles feature would help.

Well, if Google+ ever takes off for physicians, it will be because of Circles.

Tech blogs, …

Google+ for doctors, and why physicians should be careful

Kevin Pho, MD

KevinMD

June 29, 2011

Google has announced its social networking product, Google+.

I haven’t received an invite yet, so I don’t have first-hand experience with the service. But reading the major tech blogs’ take from Engadget, TechCrunch and Mashable, you have a pretty good idea of what to expect.

What should doctors know about Google+?

Obviously, this is Google’s last, best attempt to combat …

Should doctors be scared of government mystery shoppers?

Kevin Pho, MD

KevinMD

June 27, 2011

The government is going to find out about the primary care physician shortage for themselves.

They’re resorting to “mystery shoppers,” used frequently in other industries, to see what the wait times really are for a new primary care doctor. As mentioned before, come 2014, there will be over 30 million newly insured patients looking for a doctor. This will further stress a system short of primary care resources.

Doctors, as …

One more thing: Works for Apple, but killed Google Health

Kevin Pho, MD

KevinMD

June 27, 2011

Google Health is dead.

There have been plenty of post-mortems as to why, ranging from the fact that it’s not social enough (uh … no), to the realization that only a minority of practices have electronic medical records, yet alone a patient portal that can incorporate PHRs like Google Health.

I’ll chip in with my own reason — it suffered from “one more thing” syndrome.

PHRs today aren’t seamlessly incorporated into …

Team based care in health reform needs patient involvement

Kevin Pho, MD

KevinMD

June 25, 2011

The following op-ed was published on June 7, 2011 in USA Today.

More than ever, I find myself fielding questions from patients about the health care reform law. The most common one is, “How will reform affect me?” It’s a complicated question, with a different answer for each patient. But as the law’s full effects unfold, one of the more significant changes will be in how patients interact with their …

Physician consolidation places health reformers in an ironic dilemma

Kevin Pho, MD

KevinMD

June 23, 2011

One of the major efforts of the Affordable Care Act is to consolidate physician groups, so they can be modeled after integrated health systems like the Minnesota’s Mayo Clinic or California’s Kaiser Permanente.

According to health reformers, these integrated systems can reduce variation in care, which improves quality, and potentially reduces costs.

There’s been a major effort to re-organize hospitals and physicians under guises of Patient Centered Medical Homes and Read more…

Physician consolidation places health reformers in an ironic dilemma

Why the AMA is in decline, and should doctors care?

Kevin Pho, MD

KevinMD

June 20, 2011

The American Medical Association recently released its membership numbers, and they’re declining.

According to MedPage Today, the AMA “saw another steep drop in its membership in 2010 — this time losing about 12,000 members or 5% of its total membership.”

It’s been well publicized that the AMA only represents a minority percentage of physicians, depending on what you read, it’s between 20 and 30%. But it seems many physicians have little …

Hospitals that ban physicians from social media are long term losers

Kevin Pho, MD

KevinMD

June 20, 2011

I’ve heard that a few academic medical centers, the identities which I will keep anonymous, are advising incoming medical residents to stay off social media. Meaning, they have to close their blogs, and shutter their Twitter or Facebook accounts.

As hospitals and doctors try to best use social media, and prevent damage from its improper use, taking the extreme measure of forbidding doctors in training from utilizing social is …

Why doctors shouldn’t have to choose between medicine and family

Kevin Pho, MD

KevinMD

June 12, 2011

For the past few Sundays, the New York Times has published provocative op-eds involving physicians.

The first tackled physician bullying. Next was the cost of medical education. And, most recently, the phenomenon of part-time, mostly female, physicians.

This is obviously a live-wire topic, sure to generate passionate commentary.

In the piece, anesthesiologist Karen S. Sibert goes over ramifications of part-time physicians. …

Hospital bullying requires everyone to share in the blame and solution

Kevin Pho, MD

KevinMD

June 12, 2011

The following column was published on May 28, 2011 in FoxNews.com.

Theresa Brown’s New York Times op-ed, Physician, Heel Thyself, recently introduced hospital bullying into the national health care conversation.

In it, she recounted a hospital vignette while working as an oncology nurse. A patient asked a doctor who should he blame for a late test result. The …

ABIM Maintenance of Certification (MOC) internal medicine exam tips

Kevin Pho, MD

KevinMD

June 10, 2011

This past spring, I took the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) exam.

7 weeks later, I received my results. Thankfully, I passed.

This was not entirely a surprise, as the pass rate for first-time test takers was 88%. But it definitely requires some studying. It’s not a gimmie.

Considering that I last took my board exam in …

Do doctors have more influence than the media in cancer screening?

Kevin Pho, MD

KevinMD

June 6, 2011

Not all cancer screening saves lives.

I alluded to this recently in a New York Times’ Room for Debate piece, discussing why Medicare shouldn’t pay for prostate cancer screening in men over the age of 75.

And, when it comes to ovarian cancer screening, a recent study showed that annual CA-125 antigen testing and transvaginal ultrasound did not save lives. In …

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