Physician voices

12,713 articles · Since 2006

Articles, page 609

How much time do doctors spend on paperwork?

Kevin

May 29, 2009May 29, 20096

A common complaint is that doctors these days are spending more time doing clerical tasks. Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do…

A common complaint is that doctors these days are spending more time doing clerical tasks.

Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do not need a medical degree to do these tasks.

Bob Doherty points to a study that gives some numbers to back up the claims. Primary care doctors spend about 3.5 …

6 top medical comments, May 10th, 2009

Kevin

May 10, 2009May 10, 2009

Here are some of the more interesting comments readers have left recently.1. Anonymous on whether emergency physicians best served to staff urgent care centers:As an ED doc, I understand the problem. We are taught to always rule out the emergencies,…

Here are some of the more interesting comments readers have left recently.

1. Anonymous on whether emergency physicians best served to staff urgent care centers:
As an ED doc, I understand the problem. We are taught to always rule out the emergencies, and I am constantly worrying about the worst case scenario, and likely will order more tests since they are at my disposal, which is …

Read more…

6 top medical comments, May 10th, 2009

How the primary care doctor shortage threatens Obama’s health reform plan

Kevin Pho, MD

April 27, 2009Apr 27, 200920

Top story in The New York Times.Excellent.There's hope that maybe, just maybe, we're getting through to the decision makers in Washington.The article itself is old news to regular readers of this blog, and regurgitates many of the arguments impeding health…

Top story in The New York Times.

Excellent.

There’s hope that maybe, just maybe, we’re getting through to the decision makers in Washington.

The article itself is old news to regular readers of this blog, and regurgitates many of the arguments impeding health reform, as well as the problems in solving them.

“Obama administration officials, alarmed at doctor shortages, are looking for ways to increase …

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Edwin Leap: Who pays when politicians commit malpractice?

Edwin Leap, MD

April 2, 2009Apr 2, 20094

My kids love to play Monopoly. They delight in acquiring properties, making money and crushing their siblings. They play with passion and savagery. That is, until recently. A couple of weeks ago I walked past the Monopoly board, spread on…

“˜How’s it going guys?’

“˜Great game, but we all ran out of money. So, we just put some more money on the …

Most hospitalists are good, but some, like these ones, aren’t

Kevin Pho, MD

April 1, 2009Apr 1, 200912

It's a well known phenomenon that hospitalists are taking over inpatient medicine.And no wonder, the payment system strongly discourages newly minted doctors to practice outpatient medicine, and the demand that hospitals have for inpatient physicians is surging at an unprecedented…

It’s a well known phenomenon that hospitalists are taking over inpatient medicine.

And no wonder, the payment system strongly discourages newly minted doctors to practice outpatient medicine, and the demand that hospitals have for inpatient physicians is surging at an unprecedented rate.

It’s a good time to be a hospitalist, but, as this reader writes to me, that may lead to an increasingly variability in the quality …

Nighthawks, dayhawks, and the demise of the American radiologist

Kevin

March 29, 2009Mar 29, 20099

More hospitals are resorting to so-called "dayhawk" radiology services to read their x-rays.It's modeled after the "nighthawk" model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.Now, the…

More hospitals are resorting to so-called “dayhawk” radiology services to read their x-rays.

It’s modeled after the “nighthawk” model, where radiologists (via Shadowfax), in some cases as far away as India, remotely read films in the middle of the night.

Now, the phenomenon is happening during business hours as well, which according to radiologist Giles W. L. Boland, means that “some radiologists can no longer assume long-term …

Did the Canadian health system fail Natasha Richardson?

Kevin Pho, MD

March 20, 2009Mar 20, 200920

Would Natasha Richardson be alive today if she had gone skiing in the United States instead?I don't think it would have made a difference.To recap the tragedy, Ms. Richardson died from an epidural bleed, after she fell while skiing. Her…

Would Natasha Richardson be alive today if she had gone skiing in the United States instead?

I don’t think it would have made a difference.

To recap the tragedy, Ms. Richardson died from an epidural bleed, after she fell while skiing. Her presentation was somewhat classic, with the well-described “lucid” period before she deteriorated.

According to Canada’s Globe and Mail, “ambulance workers were not …

Is Natasha Richardson brain dead? Was an epidural bleed, or “talk and die” syndrome, to blame after her ski accident?

Kevin Pho, MD

March 18, 2009Mar 18, 20096

Tragic news this morning regarding actress Natasha Richardson, who reportedly, suffered a head injury during a ski lesson in Canada.According to reports, she fell on a beginner's ski hill, and did not hit anyone or anything during the fall. There…

Tragic news this morning regarding actress Natasha Richardson, who reportedly, suffered a head injury during a ski lesson in Canada.

According to reports, she fell on a beginner’s ski hill, and did not hit anyone or anything during the fall. There was no obvious sign of injury, and in fact, she was “was walking around and feeling fine for an hour after her accident.”

Things then …

Will reforming the malpractice system be a deal breaker for health reform?

Kevin Pho, MD

March 17, 2009Mar 17, 200924

In a surprise, President Obama has signaled a willingness to discuss medical liability as part of the health reform process.Good for him for standing up to the trial lawyers, a core constituency of the left.That's a good sign, as the…

In a surprise, President Obama has signaled a willingness to discuss medical liability as part of the health reform process.

Good for him for standing up to the trial lawyers, a core constituency of the left.

That’s a good sign, as the costs of defensive medicine brought on by the broken malpractice system, should be addressed if there is any hope of reducing health care spending. …

What emergency medicine teaches about our shared humanity

Edwin Leap, MD

October 26, 2008Oct 26, 20084

While I was driving my rental car a few days ago in another city, a man passed me on his chopper. He was covered in tattoos and his long hair was blowing wildly in the wind. He looked the very…

While I was driving my rental car a few days ago in another city, a man passed me on his chopper. He was covered in tattoos and his long hair was blowing wildly in the wind. He looked the very image of freedom, of unrestricted energy. Snug in my safe (boring) Chevy Cavalier, on the way to a meeting, with Mozart on the radio, I didn’t give him another thought. …

Why your work already counts as giving back to society

Edwin Leap, MD

July 6, 2008Jul 6, 20084

I have read many articles about professionals who left their career fields after many years and decided to teach. Many of them go into the public school system to share their knowledge and experience with the next generation. In fact,…

But I have been stricken by a comment made by many of those who changed careers. Almost …

Op-ed: What we have in health care today is a failure to communicate

Kevin Pho, MD

June 23, 2008Jun 23, 20087

The following op-ed was published on May 4th, 2008 in the Nashua Telegraph. Communication in medicine grows worse by the day. What should be a pillar of quality health care is instead a resounding failure. Patients are rushed through office…

The following op-ed was published on May 4th, 2008 in the Nashua Telegraph.

Communication in medicine grows worse by the day. What should be a pillar of quality health care is instead a resounding failure.

Patients are rushed through office visits and often leave without having their questions answered. Labyrinthine barriers have to be overcome before speaking with a physician. Reaching a medical provider via the …

Doctors are not gods: a surgeon on empathy with patients

Sid Schwab, MD

June 15, 2008Jun 15, 20088

There's an old joke about a guy waiting in line at the Pearly Gates, slowly working his way forward to sign in with St. Peter. Wearing a white coat, carrying a black bag and with a stethoscope slung around his…

There’s an old joke about a guy waiting in line at the Pearly Gates, slowly working his way forward to sign in with St. Peter. Wearing a white coat, carrying a black bag and with a stethoscope slung around his neck, a man walks past those in line and is waved right into Heaven. “Hey, what’s up with that?” asks the guy in line. “How come that person gets to …

Humor in medicine: why laughter helps patients open up

Rob Lamberts, MD

April 25, 2008Apr 25, 20088

The following is a reader take by Dr. Rob.I don't remember why he came to see me on that day. He was anxious on most of his office visits, so I had to spend most of my time dealing with…

The following is a reader take by Dr. Rob.

I don’t remember why he came to see me on that day. He was anxious on most of his office visits, so I had to spend most of my time dealing with his surplus of symptoms. As I walked in to see him on this day, he started rapidly hitting two fingers of against the top …

4 reasons doctors order unnecessary tests at checkups

Kevin Pho, MD

May 20, 2006May 20, 200630

I'm happy that this study is getting some play in the media. Essentially, many of the "routine" tests done on a physical are not recommended (the whole concept of a "routine physical" is controversial - but that's for another discussion).…

I’m happy that this study is getting some play in the media. Essentially, many of the “routine” tests done on a physical are not recommended (the whole concept of a “routine physical” is controversial – but that’s for another discussion). Merenstein concludes:

# 37 percent of checkups included a urinalysis.

# 9 percent of checkups included an electrocardiogram.

# 8 percent of checkups included an

…

Is the physical exam dying in American medicine?

Kevin Pho, MD

February 8, 2006Feb 8, 200631

I have written before that the physical exam is useless in American medicine:This is why the physical exam is useless in American medicine - it cannot hold up in court. Clinical evaluation and judgment skills now needs to be supported…

I have written before that the physical exam is useless in American medicine:

This is why the physical exam is useless in American medicine – it cannot hold up in court. Clinical evaluation and judgment skills now needs to be supported with objective, and often expensive, tests. Here we have a case of three separate physicians who, in their clinical opinion, did not feel a CT scan was warranted.

…

Physician voices

Articles, page 609

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