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Painting in the OR: The evolution of surgical preparation

Physician

September 16, 2013

One would never guess that a frequent activity in the OR is painting. I’m not referring to the application of paint to the walls of a room or house. The painting I’ve seen is limited to the patient and his or her body parts.

I suppose the first application of “paint” would be the initial scribble placed by the surgeon, marking the surgical site. This is a relatively new requirement and …

Positive or negative feedback: Which is best?

Alex Lickerman, MD

Conditions and Diseases

September 16, 2013

Whether delivered by a boss regarding a work goal, by a coach regarding an athletic performance, or by a trusted reader regarding the quality of a rough draft, the feedback we get often powerfully influences our ability to succeed. Yet significant controversy exists in the scientific literature about which type of feedback, positive or negative, is most effective.

As researcher Ayelet Fishbach explains: ”Several motivation theories attest that positive feedback is more …

ACP: Raising the profile of internal medicine

Yul Ejnes, MD

Physician

September 16, 2013

A guest column by the American College of Physicians, exclusive to KevinMD.com.

ACP recently launched a campaign to celebrate and increase awareness of internal medicine, the “I.M. Proud to Be an Internist” campaign. If you visit the website, you will find a summary of the campaign’s goals, information for patients and families, links to downloadable posters for the office, and merchandise that …

Ariel Castro: That could be your patient they’re talking about

Annette Hanson, MD

Physician

September 16, 2013

I thought I’d share what I saw on my Twitter feed as soon as I got up recently. I immediately felt a blog post coming on, particularly after reading the Twitter comments as they rolled in. I felt a bit sick, knowing what some of my colleagues in Ohio must be going through right now. This post is for you.

When it comes to patient suicide, correctional psychiatry is probably one …

The lessons of Annie Dookhan can apply to every laboratory

The Pathology Blawg, MD

Physician

September 15, 2013

1101_Dookhan

The attorney appointed by Massachusetts Governor Deval Patrick to investigate the case of Annie Dookhan, the Massachusetts state drug lab chemist who allegedly faked test results, tampered with evidence and neglected protocols over a several year period, now states more than 40,000 cases may have been affected.

So far the state has released 330 inmates and dismissed or declined to prosecute more than 1,100 other cases as …

The Triple Aim is vital to our collective health

David B. Nash, MD, MBA

Health Policy

September 15, 2013

In 2008, a couple of years before the Affordable Care Act became the law of the land, Donald M. Berwick, MD, and his colleagues at the Institute for Healthcare Improvement (IHI) introduced the Triple Aim concept and set to work on ways to (1) improve population health, (2) increase patient satisfaction and (3) reduce per capita healthcare costs.

In pursuit of these goals, IHI encouraged the exploration of a variety of …

Better patient care doesn’t require more mouse clicks

Fred N. Pelzman, MD

Health Technology

September 15, 2013

Here are just a few of the mouse clicks, key strokes, and computer screens I need to make or navigate to get through my day: Control-Alt-Delete. User Name. Password. Double click on the icon to load the electronic health record (EHR). User Name again. Password again. Schedule. In-basket. Results. Patient Calls. Rx Requests.

And that is just to get started. Before I finish my first cup of coffee.

Every patient interaction that needs …

Primary care doctors: It’s time to celebrate our generalization

Dr. Richard Cook

Physician

September 15, 2013

1984 was a great year — not just for George Orwell lovers, or for me as I embarked on my medical education. Daley Thompson won his second Olympic gold medal in the decathlon event, and in securing his place in athletics history also broke the world record. Picture the scene afterwards if you can, as journalists jostled to talk to the great man draped in Union flags and his gold …

AMA: The administrative burden of being a physician

Ardis D. Hoven, MD

Health Policy

September 15, 2013

A guest column by the American Medical Association, exclusive to KevinMD.com.

The administrative burden of being a physician continues to fuel discontent among doctors. The unfulfilling interface with the insurance bureaucracy is a major contributor to physician dissatisfaction. But not all health insurers are equal when it comes to hassle factors imposed on physicians.

New data released by the American Medical Association (AMA) ranks …

MD vs NP: Principles for a civil online discourse

John Schumann, MD, Anna Reisman, MD, and Matthew Freeman, DNP, MPH

Physician

September 15, 2013

For busy and opinionated physicians, online comments are both catharsis and a form of self-expression. After all, doctors are in the thick of it. We see how policies affect our patients. We know how politics affect our profession. While traditional editorials require time, editing, and an editor’s decision to publish the piece, online comments provide an easy and instantaneous way for even the most overworked and harried physicians to vent …

The difference between health care and disease management

Natasha Deonarain, MD, MBA

Physician

September 14, 2013

It’s no secret that America is suffering from a huge crisis in healthcare. As we watch the sun rise on Obamacare, doctors, patients, insurance executives, hospitals, small businesses and legislators alike stand agape. No one seems to have found a simple, logical solution.

The solution is in fact very simple. It’s so ridiculously simple, it might make one laugh. And, believe it or not, it’s also amazingly cheap.

But because of its …

What does it mean to be a doctor and a patient?

Rebecca Crow, DO

Physician

September 14, 2013

It is a doctor’s duty to take care of patients as has been our job since the first physician quoted the Hippocratic Oath. However, what happens if this distinction becomes somewhat blurred? What does it mean to be a doctor and a patient?

An experiment I inadvertently took on after feeling sick the night prior to my last day of wards. In my most resilient form I pushed forward with the …

Google Glass for medicine: 4 reasons why it could be disastrous

Matthew Katz, MD

Health Technology

September 14, 2013

The buzz is that Google Glass will transform medicine. But unless it’s carefully vetted it could be a disaster for patients, clinicians and hospitals. Until the FDA or research confirms its safety, Google Glass is banned from my clinic as a privacy and medical practice hazard.

Here are four reasons why:

1. Privacy violations. Google Glass make it extremely easy to take pictures or …

They say every physician has a graveyard

Freida McFadden, MD

Physician

September 14, 2013

An excerpt from The Devil Wears Scrubs.

They say every physician has a graveyard.

Mine may eventually contain Dr. Alyssa Morgan.

Watch out, Alyssa.

Sometime in July

Time: 3 a.m.
Hours awake: 21
Chance of quitting: 75%

This patient is the fattest man I’ve ever seen in my life. His name is George Leeman and he’s got fat …

Researching your health is about balance

Danea Horn

Patient

September 14, 2013

An excerpt from Chronic Resilience: 10 Sanity-Saving Strategies for Women Coping with the Stress of Illness.

The temptation was overwhelming. I typed “google.com” into my Internet browser and stepped into a hypochondriac’s dream. Once at Google’s home page, the search bar begged for something interesting. My fingers clicked out “kidney disease …

E-health initiatives that focus on patients can improve outcomes

Donald Tex Bryant

Health Technology

September 14, 2013

Health care providers want their patients to have the best outcomes possible. They know that for this to happen that the patient must be engaged in managing his or her condition, whether it is an acute or chronic condition. Patients need to follow the provider’s directions and orders. If they do not, then the outcomes will be sub-par.

For instance, if you the provider give a patient a prescription then they …

Stop cancer screening in patients with dementia

Ken Covinsky, MD

Conditions and Diseases

September 13, 2013

Cancer screening is of little benefit in persons with dementia but can cause very serious harms. Older persons with dementia have limited life expectancies which makes any benefit from cancer screening very unlikely. This is because cancer screening works by identifying a cancer many years (generally at least 5-10 years) before it would threaten health.

But cancer screening tests cause lots of burdens when given to persons with dementia. The …

The future of geriatrics: Questions to consider

Leslie Kernisan, MD, MPH

Physician

September 13, 2013

Recently, the New York Times featured a post about me and my practice. Titled “Walking Away from Medicare,” it describes my decision to opt-out of Medicare and create a different kind of geriatric practice.

It has generated quite a lot of comments. Most of them judge me pretty harshly. It seems that many people feel that I’m doing this for the money. And that I don’t care …

Dissection of a needless hospitalization

Jordan Grumet, MD

Physician

September 13, 2013

If Hattie had but one flaw, it was that she held her doctors in too high esteem. It was not unusual for an eighty-year-old woman of her culture to want to please her cardiologist. So when her blood pressure came up a little high, she was too embarrassed to admit that she had forgotten to pick up the Toprol and hadn’t taken it in over a week.

The cardiologist hemmed and …

Is your physician immune to drug marketing?

Roy Benaroch, MD

Medications

September 13, 2013

You’re at the doctor’s office, and you see strolling up to the window a good-looking, well-dressed professional. They’re usually pulling a little discreet cart, and after a few words with the receptionist they’re rushed right back. Sometimes they’ll bring a tray of cookies, or they’ll be followed by a caterer with a cartful of food.

You think they had an appointment? No, but you can be they’re here to see the …