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Health care transformation is local: The problem with scaling Iora Health

Rhea Boyd, MD

Physician

May 6, 2015

Scalability is the end goal of nearly every tech start-up, systems innovation, and teenager you-tubing their cat — it’s going viral, business-style. And traditionally, it’s been seen as a marker of relevance and success. Growth is good, right?

But in health care systems transformation, do we lose something meaningful when we measure the value of our work by its national impact?

Take Iora Health, a new health …

I care about structured data. Here’s why you should, too.

Brian Clare, MD

Health Technology

May 6, 2015

The government has doled out nearly $20 billion in incentive payments since 2010 for its meaningful use program in order to nudge physicians towards adopting electronic health records (EHR). U.S. hospital systems and physician practices pay billions annually to EHR vendors in order to qualify for those meaningful use incentive dollars and prevent penalty payments in the future.

EHR adoption has modernized the practice of medicine in innumerable ways. However, documentation …

Where the brothers at? Why aren’t they in medicine?

Dr. Dale

Physician

May 6, 2015

“It’s good to see you brother!”

I had never met this man, but I knew exactly what he was talking about. With a large smile on his face and a look of pride, he extended his arm to give me a handshake. “There aren’t too many of us doing what you do. I’m glad we got some representation in here.” I am a black man in the medical field. When I …

Pathology second opinions can be valuable even with no change in diagnosis

Roger Reichert, MD, PhD

Conditions and Diseases

May 6, 2015

Patients are gradually becoming more aware of the value of second opinions on their pathology slides. When there is a significant change in the diagnosis, the decision to get a second opinion can be life altering and even life-saving. A recent example is the case of Rita Wilson, where the self-initiated second opinion of her breast biopsy resulted in a change in diagnosis from a non-invasive lesion to invasive …

Physician-assisted dying: Has the pendulum swung too far?

Michel Accad, MD

Physician

May 6, 2015

When a terminally ill but mentally competent patient wishes to die, should a physician be allowed to bring about such wish? The California legislature is considering that question, and physicians will soon be asked to weigh in on it. Until recently, so-called “physician-assisted dying” (PAD) garnered little support among doctors. Currently, however, enthusiasm in its favor is growing. What are the reasons given to justify this emerging practice? Do they …

Why board certification is important to this physician

Christina Girgis, MD

Physician

May 6, 2015

Recently there has been a great deal of controversy surrounding the American Board of Internal Medicine (ABIM), and its board certification requirements. Currently, the board require physicians to take an exam and recertify every ten years in a process termed MOC, or maintenance of certification. The process is time-consuming and costly, and many physicians claim it does not improve their day-to-day practice. Doctors have become more vocal in their grievances …

A medical student, molded by experiences with patients

Rushil Patel

Medical Education

May 5, 2015

There she lay: a 59-year old woman who had become increasingly disoriented and confused. Not only did she have an infection in her bloodstream, years of alcohol abuse had taken its toll on her liver, leaving her skin yellowed.

“Welcome to the ICU,” I thought. In contrast to my previous clinical experience, I found this patient encounter unsettling.

No conversation.

No personality.

No interaction.

She was nothing more than a body in a bed punctured …

Primary care: Easing trepidation is a full-time job

Ahmad Bailony, MD

Physician

May 5, 2015

One night while on call, I was sitting in a loud downtown restaurant when I received a phone call from the hospital. I didn’t think I would be able to hear the call, and so I scurried around to find a place to speak. The bathroom appeared straight ahead, so I rushed into the first empty stall, locked the door and took the phone call. After wrapping up with the …

Counting 80 hours: The life of a pediatric resident

Katie Lockwood, MD

Medical Education

May 5, 2015

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At a recent block party, neighbors asked me questions about the life of a resident. It amazed me how little the general public still knows about the hours a resident works. Over the years, TV shows have shed some light on what the experience of a resident is like, although none are quite realistic, but it is hard to appreciate from …

Solving the VA patient crisis the right way

Nick Rohrhoff, MD

Medical Education

May 5, 2015

“Have you had any horrible problems with wait times?” shouted the reporter as he jogged towards the van pulling out of the parking lot.

Leaning in so far that his head actually crossed the window’s threshold yet still audible from across the street, he continued “We’re looking for people who’ve had terrible experiences here!” So it was last week walking in to work at the Durham VA Medical Center.

One year ago, …

A radiologist vs. Marc Cuban: 6 answers to his questions

Dr. Saurabh Jha

Physician

May 5, 2015

To his credit, Mark Cuban, engaged on Twitter in response to my post.

Mark, I’m sorry I had to leave Twitter abruptly. My wife threatened to kill me and then divorce me — in that order — if I didn’t get off Twitter instantly and get the groceries.

However, I caught the tail end of the Tweets. I’ll do my best to respond.

1. “Why is this contingency …

Drones in medicine: What are the possibilities?

Cornelius Thiels, DO

Health Technology

May 5, 2015

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A recent publication from the Mayo Clinic created a lot of buzz regarding the use of unmanned aerial vehicles (UAV), or drones, in medicine. However, in reality, most of the drones being used or tested in the U.S. are for things like aerial photography, small package delivery, and surveillance. While several corporations have been quick to expand existing applications …

A surgeon who wasn’t God in the OR after all

Hope Amantine, MD

Physician

May 4, 2015

Do you know the difference between a surgeon and God? God doesn’t think he’s a surgeon.

Everyone who goes into the study of surgery has ideas about what they’re going to be. I would imagine that each individual has different expectations of what the future holds, though few find their future at all resembles those expectations.

I recall when I started my surgery …

A physician anesthesiologist reports in from Afghanistan

Jesse M. Ehrenfeld, MD, MPH

Physician

May 4, 2015

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

As a physician, you never quite get used to being paged in the middle of the night. The shrill tones emitted via a radio frequency device that seems squarely stuck in the 1980s are almost always …

Dear drunk driver: From your trauma surgeon

Jamie Coleman, MD

Physician

May 4, 2015

Dear drunk driver,

Tonight, I am tired.

Tired from lack of sleep, tired from the long hours, and tired from bearing witness to your destruction.

Tonight, you caused an accident while under the influence of alcohol. And you are badly injured, requiring emergency surgery. Your liver is hard, cirrhotic, and unforgiving. Although I can get you through this first surgery, I know you will …

You’re a medical student. And it’s so obvious why.

Brian J. Secemsky, MD

Medical Education

May 4, 2015

We don’t even have to ask, and you certainly don’t need to get out your credentials.

It’s so obvious that you are a medical student.

And it’s not just the short white coat and student identification badge half-hidden in your linen pocket that says it all.

We’ve seen you at all hours around the hospital during your clinical rotations. You tend to appear a half-hour before everyone else, just in time to commandeer …

There’s hope for preterm births: Why aren’t more patients getting the message?

Elena Rossi, MD

Conditions and Diseases

May 4, 2015

I walk into the neonatal intensive care unit (NICU) each morning and see as many as 15 tiny patients. Some born just a few weeks premature, but others born so early they could fit into the palm of my hand, weighing as little as a pound. And I can’t help but think that there should be better communication about how to reduce the risk of preterm labor. Even if we …

It must be nice to be a doctor. Except when it isn’t.

Erica McCaleb Camp

Physician

May 4, 2015

“It must be nice.”

Without a doubt, this is my least favorite colloquialism in the English language. Though not explicitly stated in the phrase, I have always felt that it implied luck and/or privilege rather than plain old hard work. I have a problem with that because very few things in this precious world are easily obtained, whether it is a fit …

Is starting a private practice a dying art?

Eddie Fatakhov, MD, MBA

Physician

May 3, 2015

Going into my final few months of residency, I am somewhat puzzled, knowing that so many of my colleagues are signing contracts with hospital-owned outpatient practices, going into subspecialist fellowship training, or having plans to work as a hospitalist. As someone who plans to go into solo private practice, I feel like an outlier.

Yes, I know what you might be thinking. Who goes into solo practice these days when hospitals …