It was 11:47 p.m. That meant that I had 13 minutes to reach my pre-set goal of “activity” that the fitness tracker on my wrist had been registering throughout the day. If I met the goal, I would get a “trophy” on the accompanying app. I probably looked pretty funny bouncing around my living room doing a squat here and a sit-up there, punching a pretend opponent, and running in …
What a medical student learned from using a fitness band
A guest column by the American College of Physicians, exclusive to KevinMD.com.
How many of you have heard a flight attendant or pilot announce, “We know you have a choice of airlines when you fly, and we want to thank you for flying with us”? Over the years, many other industries have adopted similar statements. Continuing medical education (CME) …
Scientific meetings are worth more than CME
Do physicians in training take better care of patients or perform better on their exams when their work hours are restricted? Two recent studies in the Journal of the American Medical Association suggest that the answer is no. In one, patients of surgery residents showed no difference in morality or postoperative outcomes after duty hour restrictions were implemented. Their test scores …
Duty hours restrictions may be doing more harm than good
A patient story tonight, from Jackie:
It was one of those days. I had been to the gynecologist the week prior because I somehow knew the sporadic bleeding, which I had experienced, was not a simple urinary tract infection for which I had been treated three times. My doctor did the scrapings and biopsies and had me run down the hall for an ultrasound. I’d had lots of ultrasounds during my pregnancies — …
When cancer comes to call you, rise up and fight the good fight
What defines a competent psychiatrist? To staunch critics of the field, perhaps nothing. Some believe psychiatry has done far more harm than good, or has never helped anyone, rendering moot the question of competency. What defines a competent buffoon? A skillful brute? An adroit half-wit? Having just finished Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, a reader might easily conclude that psychiatric competency is …
What does it mean to be a competent psychiatrist?
Most readers know that an EMR (electronic medical record) is the back-end software that runs a health care organization. EMRs have been around for a while. Recently most large hospitals and health systems have begun building out the patient-facing version of their EMR; allowing patients to communicate electronically with their doctors, refill prescriptions, schedule appointments, and view clinical information.
I’ve written at length about the differences between B2B software and B2C …
Patient portals and EMRs: Each requires a different skillset
When my husband and I stopped watching television a few months after we were married, we often didn’t notice what had changed until we’d compare notes with friends. “I miss my old hobby,” a neighbor might complain, “but I just don’t have the time.” And yet we’d see his head just above the back of the couch, silhouetted against his big screen TV for hours. Not only did we regain …
How to create more primary care role models
In the past half century or so, medicine has changed the complexity of the human population as it has never been seen in the past. Think about it, there are people walking around today that fifty years ago, wouldn’t even be alive. This evolution in medicine has not only brought about transformation in the human population, but it is also changing the approach of how clinicians need to treat these complex …
Patients have changed. How do we manage them?
I think it’s fair to say that digital health is warming up. And not just in one area. The sheer number and variety of trends are almost as impressive as the heat trajectory itself. The scientist in me can’t help but make the connection to water molecules in a glass — there may be many of them, but not all have enough kinetic energy to ascend beyond their liquid state. …
Digital health in 2015: What’s hot and what’s not?
If F. A. Hayek were alive today, he would support the revival of labor unions in general and professional labor unions in particular. Towards the end of the Second World War, Hayek wrote a book warning us all that allowing governments to engage in extensive central planning of economic activities is nothing more than a road to serfdom for humanity. F.A. …
Physicians must unionize. Here’s why.
The action steps, in any health emergency, are: ABC. Airway, breathing, circulation. The airway has to be open, the patient has to be making an effort to breathe, and the heart has to pump blood. In any emergency, health care people are trained to address these, one by one, in order. Fix what you can before moving on, and concentrate on what’s going to kill the child first. Then, arrange …
Airway, breathing, call your insurance company?
Welcome to Friday night as a hospitalist in the ultimate Green State, Colorado: Time to gear up for some marijuana-facilitated paranoia, memory loss, nausea and vomiting, and memory loss. I’m not a teetotaler, but I do find the new surge in cases of preventable disease a bit disheartening if not occasionally humorous. Prior to this past year, it wasn’t uncommon for me to encounter an occasional marijuana medical problem, but …
Treating the influx of marijuana-associated hospital admissions
India is not, yet, a wealthy country. Nevertheless its people experience many of the same expensive-to-treat illnesses as wealthier populations in the U.S. and Europe. Therefore, the country has made a series of policy decisions designed to lower the cost of medical treatments.
For example, until 2005, it offered no — I repeat, no — patent protection for pharmaceutical products, thereby spurring the development of its robust and relatively inexpensive generic …
High drug costs. Low drug costs. Each has a price.
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Stuart Scott revolutionized the sportscasting industry with his unique style and likable demeanor on ESPN. Mr. Scott recently passed away after an 8-year battle with recurrent appendiceal cancer. Mr. Scott was a devoted father and put his relationship with his two daughters above everything else. He was a sensational broadcaster and was passionate about his craft. He inspired many young athletes …
4 things we can learn from Stuart Scott
Perhaps doctors should be more like the president.
After all, we also carry the ultimate responsibility for our constituents, even though we, too, have team members who do part of that work.
The way I understand things to work at the White House, those other team members collect, review and prioritize the information the president needs in order to manage his, and all …
What if the president worked like doctors today?
“Blessed. I’m so blessed.”
She kept repeating this, from her seat on the examining table.
“I’m so blessed.” I unwrapped the bandage holding on the splint that had covered her arm for the three weeks since the bullet went in above her elbow and came out through her forearm, hitting no bone, touching no major artery.
“Blessed.”
Homeless. With diabetes that needed insulin, which needed a refrigerator, that she didn’t have.
Vulnerable. A few years earlier, …
Blessed to be alive after a gunshot wound
Happy 2015! Health care in the United States continues to change faster than any of us can keep pace with and this shows no signs of slowing down. Having written a lot in 2014 on a variety of different topics, I wanted to focus on my own 5 wishes for hospital care this New Year. A lot of you may think that what you’re about to read sounds like wishful …
5 health care wishes for the New Year
If you delve into the personal stories of health IT innovators, most journeys rest on their personal interaction with the health care system on behalf of themselves, a parent, a child, or perhaps a sibling. Just a few weeks ago, I had a small interaction with the health care system that confirmed many of the impressions I have developed of providers’ strengths and weaknesses.
There’s no way to start except with …
How health IT fails transgender patients
As we welcome another year, many of us make resolutions to live a better life, usually one that is healthier than the year before. As I planned my own resolutions for 2015, I was reminded of a talk given by my rabbi, David Ingber of Romemu. His sermon centered on the Torah portion about the importance of “the Shemittah” or the sabbatical year, noting how we as a society should be observing the “five Rs” …
What my rabbi taught me about being a healthier, happier physician
2014 was the most exciting year in digital health since 2000, when the human genome was cloned. In February 2001, The Human Genome Project and Craig Venter’s Celera Genomics published the hallmark event. What followed was over a decade of glimmers of the potential for personalized medicine and new insights into disease, but also realistic mitigations in expectations, as is wont to happen in health care.
There is every indication that …
Why 2014 was a groundbreaking year in digital health
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