KevinMD.com

September 16, 2013Sep 16, 20138

My patient Maria sits before me, looking vaguely distressed. She's returned for a follow-up visit, six weeks after our first. The morning is half over, and I'm clipping along, staying on time, using the new electronic medical record system (EMR)…

My patient Maria sits before me, looking vaguely distressed.

She’s returned for a follow-up visit, six weeks after our first. The morning is half over, and I’m clipping along, staying on time, using the new electronic medical record system (EMR) without a glitch and with a sense of satisfaction. Three months back, when I joined this small-town practice as part of my new position as a health-system medical director, I found …

Physician voices

In the midst health care cynicism, an affirmation of enduring love

Miranda Fielding, MD

September 16, 2013Sep 16, 20139

When I was young, one of my favorite stories was O. Henry’s “The Gift of the Magi.” Originally published in 1905, the short story became standard fare in public school reading classes and I doubt that there are any of you out there who have not read it. But just in case — the story is about a young couple, poor and deeply in love. At Christmas, they have no …

Physician voices

Painting in the OR: The evolution of surgical preparation

David Gelber, MD

September 16, 2013Sep 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…

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 …

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Conditions and diseases

Positive or negative feedback: Which is best?

Alex Lickerman, MD

September 16, 2013Sep 16, 20135

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 …

Physician voices

ACP: Raising the profile of internal medicine

American College of Physicians & Yul Ejnes, MD

September 16, 2013Sep 16, 20137

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…

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 publicizes the campaign, such as t-shirts and coffee mugs …

Physician voices

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

Annette Hanson, MD

September 16, 2013Sep 16, 20132

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…

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 …

Physician voices

The lessons of Annie Dookhan can apply to every laboratory

The Pathology Blawg, MD

September 15, 2013Sep 15, 201313

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…

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

Health policy

The Triple Aim is vital to our collective health

David B. Nash, MD, MBA

September 15, 2013Sep 15, 201321

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 …

Health technology

Better patient care doesn’t require more mouse clicks

Fred N. Pelzman, MD

September 15, 2013Sep 15, 20136

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…

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

Every patient interaction that needs …

Physician voices

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

Dr. Richard Cook

September 15, 2013Sep 15, 201314

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…

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 …

Health policy

AMA: The administrative burden of being a physician

American Medical Association & Ardis D. Hoven, MD

September 15, 2013Sep 15, 20133

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…

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 major health insurers according to their administrative cost …

Physician voices

MD vs NP: Principles for a civil online discourse

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

September 15, 2013Sep 15, 201388

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 …

Physician voices

The difference between health care and disease management

Natasha Deonarain, MD, MBA

September 14, 2013Sep 14, 20139

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…

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 …

Physician voices

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

Rebecca Crow, DO

September 14, 2013Sep 14, 201311

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…

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 …

Health technology

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

Matthew Katz, MD

September 14, 2013Sep 14, 201374

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…

Here are four reasons why:

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

Physician voices

They say every physician has a graveyard

Freida McFadden, MD

September 14, 2013Sep 14, 20134

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…

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 folds on his belly that are so deep, I think I could stick my whole fist inside. …

Patient voices

Researching your health is about balance

Danea Horn

September 14, 2013Sep 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…

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 and easily bruising.” I’d had this bruise on my leg for a week. It wasn’t dramatic, but …

Health technology

E-health initiatives that focus on patients can improve outcomes

Donald Tex Bryant

September 14, 2013Sep 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 …

Conditions and diseases

Stop cancer screening in patients with dementia

Ken Covinsky, MD

September 13, 2013Sep 13, 20133

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…

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

Physician voices

The future of geriatrics: Questions to consider

Leslie Kernisan, MD, MPH

September 13, 2013Sep 13, 20132

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…

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 …

Real physician voices, twice a week

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