KevinMD.com

The disturbing link between high fructose corn syrup and honey

Dr. Charles

Physician

August 19, 2013

High fructose corn syrup, that sweet over-produced commodity of agribusinesses everywhere, has been linked in two miserable ways to bees and honey. The first discovery was made almost two years ago, and the second only 2 months ago. First, most of the “honey” available for purchase in supermarkets is not really honey, but instead an ultra-filtered impostor often produced in China, and …

When donated blood is wasted

James C. Salwitz, MD

Physician

August 19, 2013

This week my toughest case involved futile care. We admitted a patient with very advanced cancer, dying naturally at home on hospice. Because of last minute family intervention, the patient ended up spending 48 hours on super-max support, dying quite horribly with tubes and lines in every natural and unnatural orifice. Liver failure, lung failure, kidney failure, bleeding, blood clots and …

Read more…

When donated blood is wasted

Primary care versus specialists: Sophie’s Choice in health care

Wes Fisher, MD

Health Policy

August 19, 2013

Sophie’s Choice is a novel by American author William Styron, whose plot ultimately centers around a tragic decision Sophie was forced to make upon entering the Nazi concentration camp: on the night that she arrived at Auschwitz, a sadistic doctor made her choose which of her two children would die immediately by gassing and which would continue to live, albeit in the camp.

While not of the same gravity, I have seen the discussion by policy wonks about physician payment reform …

Many hospitals approach safety improvement the wrong way

Paul Levy

Health Policy

August 19, 2013

The time has come to drive a stake through the heart of an oft-repeated assertion.

How often have you heard something like the following when those of us in healthcare who want to stimulate quality and safety improvements draw analogies to the airline industry?

“Well, in an airplane, the pilot has an extra incentive to be safe, because he will go down with the ship. In contrast, when a doctor hurts a …

Patient satisfaction: What restaurants can teach doctors

Neil Baum, MD

Physician

August 18, 2013

Americans are notoriously generous and good tippers. However, there are some servers who get “over the top” gratuities. How do they do it?

1. They make a concerted effort to reach out and touch someone. How many physicians enter a room and never touch a patient? They are touching more keyboards than hearts. I have learned from complementary healthcare providers that there’s a medicinal value of touching the patient. Every chiropractor, …

5 questions ACOs need to ask themselves

David B. Nash, MD, MBA

Health Policy

August 18, 2013

ACO — for accountable care organization — is by now a familiar acronym within the healthcare industry and among all Americans who have followed the steady implementation of the Affordable Care Act.

Easily described but very challenging to operationalize, ACOs rely on effective partnering among healthcare providers of all shapes and sizes — health systems, hospitals, clinics, physician practices, urgent care centers — to collectively share responsibility for the health of …

Read more…

5 questions ACOs need to ask themselves

The key to medical home success: Bringing the stakeholders together

Fred N. Pelzman, MD

Health Policy

August 18, 2013

One of the greatest challenges when it comes time to affect major change in any system is figuring out who the stakeholders are, who has a vested interest in seeing a project rise or fall.

Without knowing who all the players are from the word go, there is almost no way to move things forward. But recognizing that we can’t keep everyone happy is also a big part of this process.

So …

Direct pay is the solution to real world cost transparency

Kim Byars, ARNP

Health Policy

August 18, 2013

In an environment of increasing regulation, government mandated red tape, and shrinking reimbursement, health care practitioners find themselves caught between a rock and a hard place. They are being forced to see more patients to make ends meet and both parties are poorer for the process. Not necessarily in just a monetary way. Patients are beginning to feel frustrated and disengaged from their mutually frustrated and disengaged providers. Both parties …

7 golden rules to optimize EHR implementation

Rosemarie Nelson

Health Technology

August 18, 2013

Eligible physicians are dropping out of the HITECH incentive program. Why? Often, it’s because a practice implements an EHR and then tries to mimic all their old paper processes and workflows.

That can get them through the vendor’s initial implementation, but it is not sustainable for the long term.

Workflows and operational processes must be modified to optimize the new tool. Technology changes what is feasible, and to adapt, we need to …

Why the Accuracy In Medicare Physician Payment Act should pass

Brian Klepper, PhD and Paul Fischer, MD

Health Policy

August 18, 2013

With the recent release of two mainstream exposes, one in the Washington Post and another in the Washington Monthly, the American Medical Association’s (AMA) medical procedure valuation franchise, the Relative Value Scale Update Committee (RUC), has been exposed to the light of public scrutiny. “Special Deal,” Haley Sweetland Edwards’ piece in the Monthly, provides by far the more detailed and lucid explanation of the mechanics of the RUC’s arrangement with …

Why you should consider a second opinion from a pathologist

Roger Reichert, MD, PhD

Conditions and Diseases

August 17, 2013

Patients are becoming more and more adept at taking control of their own health care, and this often involves seeking a second opinion of their presumptive diagnosis. However, in far too many cases in which cancer or precancerous conditions are diagnosed, the consultation is at the level of another treating physician, without confirmation that the patient’s pathologic diagnosis is correct. In cases where clinical management decisions and prognosis hinge on …

Why EMRs will not placate technology-hungry medical students

Maureen Miller, MD, MPH

Health Technology

August 17, 2013

The first resident who really reamed me out on the wards was having trouble reading my handwriting. My handwriting became doctor-unreadable well before medical school, but how quaint. It was the beginning of my second month of clinical training, and hers of internship. She couldn’t follow our shared patient’s daily progress note. I didn’t tell the story in the right order. The format was wrong. Instead of noting only pertinent …

Teaching medical students to provide high value care

Brian Powers

Medical Education

August 17, 2013

Edward arrived at the hospital following a stroke; a standard work-up failed to reveal an obvious cause. His physician explained that a previously diagnosed patent foramen ovale (PFO), a hole in between the chambers of his heart, may have led to his stroke. He presented three possible treatment options to Edward: (1) medical management with drugs; (2) open surgery to correct the defect; or (3) interventional catheterization to correct the …

Get the most out of your first year of medical school

Ken Noguchi

Medical Education

August 17, 2013

As we enter the fall, we welcome a new class of bright-eyed medical students. To such students, you are about to embark on a life-transforming journey. My first year on the said journey has been full of highs and lows. There was the morning I woke up before 6 and got upset with myself for sleeping in. There was the day I received my first exam score and realized I …

How much information should doctors give to patients?

James Hubbard, MD

Physician

August 17, 2013

In my over three decades of family practice, I have come to the conclusion that we, as doctors, should provide non-medical people with as much medical information as we can. Not as much as we think they should have, or information just related to the problem at hand, but as much as we can provide. Period.

I started practicing when many still debated whether we should tell a patient if he …

Should doctors separate their personal and professional identities?

Kevin Pho, MD

KevinMD

August 17, 2013

Most social media guidelines for physicians, most recently from the American College of Physicians and Federation of State Medical Boards, suggest that doctors separate their personal and professional identity.

Until physicians are better educated on how best to act professionally on social networks, keeping their online personal lives private is more likely to keep them out of trouble.

But is it time for that recommendation to be revised?

In a recent JAMA perspective …

When sparrows fall: A tribute to a baby girl

Brenda Izen, MD

Physician

August 17, 2013

It began like any other day on the OB floor. My hair was still wet under my cap from my morning shower at 4:30am. I was just returning to labor and delivery after making postpartum rounds and performing the daily circumcisions. The doctors and medical students were all congregated for board rounds. During board rounds we learned who was working and what was going on with each patient.

As I approached …

Sleep problems are behavior problems: We must know the family story

Claudia M. Gold, MD

Conditions and Diseases

August 16, 2013

A study published in the Journal of Developmental and Behavioral Pediatrics showing a connection between hours of sleep and childhood behavior problems has received a lot of media attention. Children who slept less than 9.4 hours of sleep had more impulsivity, anger, tantrums and annoying behavior. The obvious conclusion-more sleep, better behavior. If only it were that simple.

If one takes the time to look closely, one will discover that what …

A physician’s advice in choosing your partner

Alex Lickerman, MD

Conditions and Diseases

August 16, 2013

When searching for a mate, most of us carry around a list of criteria or qualities that we tell ourselves we’re looking for. A brief perusal of any Internet dating site yields many such lists: “A sense of humor, a sense of adventure, and good teeth” says one. “Owns his own business, likes to travel, and works out,” says another. Curiously, however, we often end up with mates who seem …

Many medical interventions are 50/50: Who informs the patient?

Hans Duvefelt, MD

Physician

August 16, 2013

Lately, my virtual inbox in our electronic medical record has seen a surge in requests for prescriptions for the vaccine against herpes zoster, shingles. This has made me think a lot about our responsibility as physicians to inform patients about the evidence behind our recommendations – but who informs the patients when doctors are kept out of the loop or put under …

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts