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Should we give more Tamiflu for influenza? A look at the evidence.

Medications

February 18, 2015

As the Centers for Disease Control and Prevention (CDC) reported that people who received this season’s influenza vaccine were only 23 percent less likely to be diagnosed with influenza than unvaccinated persons, CDC director Tom Frieden was publicly urging high-risk patients and their physicians to use antiviral medications to prevent complications and disease transmission:

People who are sick with flu, if they’re very sick in the hospital or if they have …

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Should we give more Tamiflu for influenza? A look at the evidence.

So what’s the big deal about measles?

Chad Hayes, MD

Conditions and Diseases

February 18, 2015

In a recent post (“Dear Anti-Vax Parents: We’re Not Mad At You”), I wrote about the critical need for better education and communication between doctors and vaccine-hesitant parents. It was far more popular than I would have imagined, and I appreciate all of you who shared it. And in the spirit of providing reliable information about vaccine-preventable illnesses, I wanted to take the time to write about why measles matters.

The measles vaccine …

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So what’s the big deal about measles?

What we can learn from cardiology-related malpractice claims

Sandeep Mangalmurti, MD, JD

Physician

February 18, 2015

In anticipation of American Heart Month, an examination of the liability risks faced by cardiologists was recently undertaken by The Doctors Company, the nation’s largest physician-owned medical malpractice insurer. This analysis of 429 closed cardiology claims from 2007 to 2013 revealed that the most common patient allegations against cardiologists and other clinicians were diagnostic errors, followed closely by procedural or surgical mishaps. This data is of particular interest to cardiologists, …

3 ways parents quash the kindness in their kids

Claire McCarthy, MD

Physician

February 18, 2015

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The other day, I read about some really cool research that suggests that little kids are naturally altruistic.

It got me thinking: What is it we do that stops them from being that way? Because, let’s face it, not all big kids — and definitely not all grownups — are kind and look out for others.

Felix Warneken, a Harvard researcher, studies the evolutionary …

Improve teamwork with better selection of medical trainees

Joshua Liao, MD

Medical Education

February 18, 2015

Amid the many ongoing changes to health care, it’s clear that better teamwork is needed in American medicine. Calls for stronger interdisciplinary collaboration have permeated position statements and policies, and organizations have begun redesigning care processes to include novel team-based approaches. Emerging data continue to affirm that strong teamwork and communication can increase the value of care.

Of the many efforts to improve teamwork, however, one potential area for significant improvement …

How to get your doctor to do what you want

Pamela Wible, MD

Physician

February 18, 2015

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Sick of phone trees, endless refill requests, packed waiting rooms, out-of-control bills, and other medical misadventures?

Follow these seven simple steps to get your doctor to do what you want.

1. Get organized. Be clear about what you need from your appointment. Make a comprehensive list of all the issues you want to discuss — and your ideal outcomes for each. Patients who are …

A patient, mortally wounded by those purported to love him

Jordan Grumet, MD

Physician

February 17, 2015

Neither of the two most important people in Aaron’s life could stand to be in the same room with each other. There was a long colorful history between his ex-wife and his brother, and as his disease began to accelerate, the feuding became quite intense. They argued over Aaron’s advance directives. They both tried to coerce and manipulate themselves into commanding positions. The shouting became louder, the fury more fierce. …

Real miracles: The love that we give to others

James C. Salwitz, MD

Physician

February 17, 2015

Short-of-breath, weak, in pain. Cancer — aggressive, cold, unfair — ravaged Roger’s body. But maybe, just perhaps, there was a modern medical miracle. A drug. A single daily pill to attack the genetic growth switch in each malignant cell. Only, there was a problem. Not a big problem, really, but possibly fatal. The kind of real life annoyance of living in a modern medical miracle society. The co-pay cost to …

5 things pediatricians should know about treating children who’ve had cancer

Lisa Diller, MD and Peter Manley, MD

Conditions and Diseases

February 17, 2015

As survival rates for pediatric cancer continue to improve, more and more pediatric practices include children who have been treated for cancer. Some patients are making the transition back to primary care after finishing their cancer treatment. Others are only a few years post-treatment and still being closely monitored for recurrence. Still others have survived five years or more and are considered cured. Whatever their circumstances, these patients can present …

Are safe harbors the answer to medical malpractice?

Bradley Flansbaum, DO

Physician

February 17, 2015

With the endless appearance of medical malpractice solutions in the press, any reader would think we have the answers to the logjam — but no will to implement them. If you follow the topic, you know every proposal has flaws and limited applications as they relate to individual states or delivery systems.

The worst offender seems to be safe harbor protections (i.e., “follow the …

Failure is part of advancing health care

Kevin R. Stone, MD

Conditions and Diseases

February 17, 2015

“Failure is not an option,” people sometimes say. I don’t agree.

I certainly have failed far more often than I have succeeded when I sought to do novel risky business adventures and/or create new products. Without failure, I would never have learned the lessons of life or the lessons of business necessary to succeed in these spaces. As a physician and surgeon, I can tell you that failure is part of …

Learning the language of Patient and Doctor

Heather Alva

Medical Education

February 17, 2015

At the outset of this process of becoming a doctor, a friend and mentor of mine, a professor emeritus of medicine known as a mentor who cares deeply about his students and for his New England style dinner parties, sat me down to explain the gist of medical school.

The first two years, he explained — bowtie notwithstanding — are the equivalent of studying a language from textbooks. You must first …

When patients’ anger leads to murder

Shirie Leng, MD

Physician

February 16, 2015

When we perceive any object of a familiar kind, much of what appears subjectively to be immediately given is really derived from past experience.
– Bertrand Russell, The Analysis of Mind

I’ve learned a few more things about Stephen Pasceri, the man who murdered a cardiovascular surgeon in Boston recently. He had money troubles involving credit card debt. He declared bankruptcy at one …

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When patients’ anger leads to murder

Doctor, why do you enjoy practicing gastroenterology?

David Sack, MD

Physician

February 16, 2015

Whenever I am asked this question, I can’t help but think of the punchline to a joke that was once supposed to be funny but would now be considered beyond the pale in all respects, so I won’t repeat it. The punch line is: “Just lucky, I guess.” That’s the short answer to why we gastroenterologists work in our field. Despite the distasteful aspect of human waste and the perverse …

Plastic surgery and the ability to enact surgical justice

Shane D. Morrison, MD

Physician

February 16, 2015

I felt out of place. It wasn’t the dull yellow flickering fluorescence of the hospital lights greeting me well before dawn. It wasn’t the photos of world-renowned surgeons lining the hallways as if monitoring my every step, or that some of those same surgeons were close by rounding on patients. It wasn’t the sea of dark suits swarming around me vying for a prestigious residency position. It was something far …

Solving the physician shortage requires these 3 things to happen

Suneel Dhand, MD

Health Policy

February 16, 2015

The nationwide shortage of physicians is a very real crisis across all 50 states, causing a huge strain at all levels of health care. Hospitals and clinics are struggling to hire, current physicians are overworked, and ultimately patients have to wait longer.

There are a number of reasons why this has happened, but one thing’s for sure: With the aging population, the …

Having surgery? Here’s how to manage your medications.

Kent B. Berg, MD, MBA and Gregory M. Janelle, MD

Conditions and Diseases

February 16, 2015

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

Before undergoing surgery, you should carefully discuss your medications with your surgeon and physician anesthesiologist. You may fare better during the operation and the early recovery phase if you continue required medications, but you might need to avoid some medications that could interfere with your anesthesia. Three …

My role in patients’ behavior is smaller than I thought

Aimee Falardeau English, MD

Physician

February 15, 2015

My mother is a very smart woman. I see it in the way she solves problems, creates complex crafts, and navigates hard conversations. She can’t, however, add fractions. She was never very good at math, she says.

“I was never very good at math” is a dirty phrase that garners much attention in my household. My husband, a sixth-grade math intervention teacher, spends just over 170 days each year attempting to …

The beginning of the end of Medicare as we know it

Lucy Hornstein, MD

Health Policy

February 15, 2015

Yikes:

The Obama administration on Monday announced an ambitious goal to overhaul the way doctors are paid, tying their fees more closely to the quality of care rather than the quantity.

Holy crap: They’re really doing it. Or trying to do it. Who the hell knows what they’re trying to do? Not “them,” that’s for sure.

The United States government via the Department …