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The silliest four letters in health care: PQRS

Health Policy

April 4, 2015

It has become perhaps the silliest four letters in health care: PQRS. It stands for Physician Quality Reporting System. It’s another this and another that created by the Centers for Medicare & Medicaid Services (CMS). After you read this, you’ll be like me, scratching your head trying to understand why anyone thinks our health care system is better under CMS’s leadership.

CMS has setup a thing called PQRS, so physicians across the country …

Most doctors lack formal training in diet and nutrition

Angie Eakin, MD

Conditions and Diseases

April 3, 2015

It’s hard to miss the headlines and breaking news feeds on the latest medical studies showing the health benefits of plant-based eating patterns: Vegetarian diets lower the risk or colorectal cancer. Dementia can be delayed through a healthful diet, cognitive training, and physical exercise. Folic acid — a plant-based product of foliage, or leafy greens — boosts heart health. And that’s just in the past few days.

As a primary care specialist …

I don’t know: The honest answer that patients need to hear

Sarah Mongiello Bernstein, MD

Medical Education

April 3, 2015

As I reflect back on the last four years of medical school, I am reminded of the ghosts of patients past. Those of you already entrenched in the dredges of patient care know what I mean. The images of their faces burned on your brain: the ones you couldn’t help, the promises you never meant to break, and the hope you weren’t able to give.

Those ghosts take on several shapes …

Want to decrease physician burnout? Stop blaming the victim.

Tom Peteet, MD, MPH, MEd

Physician

April 3, 2015

I recently took another survey confirming the obvious: As a resident, I am horribly burnt out. I sat, along with a half-dozen health care providers and bemoaned our current states. What, if anything, can we do about this? The typical answers came up: sleep more, increase our commitment to enjoyable activities outside of work. Oddly enough, there was little talk about the daily work itself, and how the medical culture …

Preventing peanut allergies. What does the recent data mean?

Brian Smart, MD

Conditions and Diseases

April 3, 2015

Peanut allergy is a worldwide concern, but especially in Western countries, in which prevalence has doubled in the last ten years, to a rate of 1.4 to 3.0 percent of children. To prevent the development of peanut allergy, national guidelines have attempted to keep pace with this crisis, with recommendations, at first, of delayed exposure to peanut and, more recently, of earlier exposure. But a universally accepted and research-supported approach …

Be your own patient advocate. Here’s how.

Karen Hickman

Patient

April 3, 2015

There are a lot of frustrated and unhappy people out there when it comes to their perception of health care today. The contemporary practice of medicine is changing, rapidly, and those changes have been a challenge for patients and physicians alike. The list of reasons for this is lengthy. Certainly physicians and hospitals are finding it difficult at times to meet all the changes and demands put on them, by …

When referring to specialists, keep these 3 things in mind

Mark Krivopal, MD

Physician

April 3, 2015

Referring physicians are critically important not just for the care and attention we provide patients but also for the referrals we make to specialists. Patients don’t have access to the same data or knowledge that we as healthcare professionals possess, so as referring physicians we can have a significant impact on our patients’ health after they’ve left our immediate care.

Big data has given us more information than ever in making …

From a hospice volunteer: Yes, you make a difference

Ellen Rand

Patient

April 2, 2015

One winter afternoon during my first year as a hospice volunteer, I drove slowly through the kind of neighborhood where the only people you see during the day are landscapers, contractors and housecleaning services and where one house is grander than the next. I was looking for the ranch house where Bobby had been living since his diagnosis.

Most people I visit, as a hospice volunteer, are my senior by 20 …

What great basketball coaches can teach us about doctoring

Melissa Stiles, MD

Physician

April 2, 2015

Tournament time!

The time of year that brings friends, family, and colleagues together to cheer and commiserate over brackets and games. When it comes to the final two weekends, it is often the same teams year after year. What can the coaches of great teams teach us about doctoring?

Preparation and fundamentals (John Wooden, UCLA)

The first thing coach John Wooden taught his players was how to put on their shoes and socks. …

Boarded to death: When will testing for doctors ever end?

Brian Levine, MD

Medical Education

April 2, 2015

I am relieved and proud to report that I passed my boards: I am officially a diplomate of the American Board of Obstetrics and Gynecology. While the oddly formal “diplomate” is a term in common use with physicians, I didn’t understand what “diplomate” and its sister phrase “board-certified physician” meant until I undertook my own board preparation.

The Medical College Admission Test (MCAT) is a memorably stressful element of applying to …

The special privilege of being a doctor

Amy T. Hou, MD

Physician

April 2, 2015

“Samantha is your next patient,” my medical assistant informs me in my primary care clinic. Samantha is a Caucasian woman in her late 40s, and I typically find her in the room with well-groomed blond hair and a cheerful outfit, such as a pink blouse, a flowery skirt, and golden sandals. She has been my patient for over a year, and I know that her life is anything but cheerful. …

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The special privilege of being a doctor

ER physicians can help meet the triple aim

Vipul Kella, MD

Health Policy

April 2, 2015

It is amazing to me how far emergency medicine has come as a specialty. Until the 1970s, emergency rooms were staffed by low-level resident interns who moonlighted for extra money or physicians who couldn’t find work elsewhere. After finally getting recognized as a specialty, the specialty still spent a few decades finding its way: developing training programs, improving quality, and generally trying to raise the bar on emergency care in …

Binge eating disorder: Real or disease mongering?

Allen Frances, MD

Conditions and Diseases

April 2, 2015

A drug company recently received FDA approval to peddle its speed-like pill for “binge eating disorder” (the very same pill that is already widely overused for ADHD). And it is sparing no expense pushing the drug — a former world tennis champ is the shill and commercials are everywhere.

Five years ago, I predicted binge eating disorder (BED) would become a new fad diagnosis and a wonderful target for pharma disease …

Why primary care is like Jeopardy

Hans Duvefelt, MD

Physician

April 1, 2015

Wheel-of-Fortune-and-Jeopardy-Moving-to-THQ-2

The last few days have been really busy, but they still felt controlled, almost leisurely and smooth. Patients have been seen on time, my office notes have been completed in real-time, and my superbills have been submitted before each patient reached the check-out station. Things were really humming.

The new nurse noticed that I was humming each time I dashed back to …

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Why primary care is like Jeopardy

The case of Purvi Patel: Scoring anti-choice political points

Jennifer Gunter, MD

Physician

April 1, 2015

Purvi Patel was found guilty of both feticide and child neglect in Indiana in February and now faces 70 years in jail. A jury deliberated for about 5 hours, even though there are no facts supporting either the feticide claim or the neglect, never mind the travesty that child neglect and feticide are incompatible charges. It’s hard to neglect a baby you have already been found guilty of killing as a fetus. …

ADHD and early death: We often miss the story

Claudia M. Gold, MD

Conditions and Diseases

April 1, 2015

Alarming headlines, based on a recent study, declare that diagnosis with ADHD doubles the risk of early death. Psychiatrist Stephen Faraone, commenting on the original study published in the Lancet, concludes that: “for clinicians early diagnosis and treatment should become the rule rather than the exception.” This conclusion represents a false assumption that the deaths occurred in cases that were not treated.

The large cohort study in Denmark, that looked at records of …

This is what patient safety means to me

Christine A. Sinsky, MD

Physician

April 1, 2015

What does patient safety mean to you?

I believe patients get the safest care when

The patient is known as an individual.
The health care team gives the patient their undivided attention.
The team is well-supported with efficient workflows and organized, easily accessible information.
The health professionals find joy in their work.

By being “known” I mean, that the nurses and physicians know the patient as a real person, what their life is like, who are their …

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This is what patient safety means to me

Capturing moments of innuendo in the emergency department

StorytellERdoc, MD

Physician

April 1, 2015

Although I pride myself on catching the obscure snapshots of typical life moments that occur daily while dealing with patients and their families in the emergency department, occasionally there are times when I am so focused on the task at hand that I completely fail to see a glaring moment of obvious humor, sadness, or tenderness. At times like this, then, I am glad to have our hard-working nurses and …

Testifying in support of medical student mental health

Pamela Wible, MD

Physician

April 1, 2015

The following is Dr. Pamela Wible’s testimony in support of medical student mental health to the Missouri State Legislature for House Bill 867.

I’m Dr. Pamela Wible, a family physician in Oregon. I’ve submitted my CV, witness form, and transcript of my testimony to Chairman Frederick. My schedule prevents me from traveling to Missouri for today’s hearing; however, I thank Vice Chairman Morris and the Committee for allowing me to …

The intimacy gap between doctors and patients

Jordan Grumet, MD

Physician

March 31, 2015

I used to think that there was a communication gulf between doctors and patients. Somewhere in the hubbub of the harried office visit some secret sauce was missing. A divide that was so fundamental that both parties often left the room feeling disjointed and uneasy. Patients wondered if doctors truly heard them. Physicians wondered if anyone was listening to what they were saying. The tension ebbed and flowed but never …

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