KevinMD.com

July 21, 2013Jul 21, 201314

There is a certain irony in the nearly immediate juxtaposition of the rare introduction of a new FDA-approved drug for weight loss (Belviq) to the marketplace and the recognition of obesity as a “disease” by the AMA. A line from the movie Jerry Maguire comes to mind: “You complete me!” Drugs need diseases; diseases need drugs.

And that’s part of what has me completely worried. The notion that obesity is a disease will inevitably invite a …

Physician voices

Check to see if your teen is texting when driving

Claire McCarthy, MD

July 21, 2013Jul 21, 2013

I'm not big on spying on teens generally. I think that privacy is important. And by the time they are teens, in most cases we need to trust that at least some of the stuff we've said for years has…

I’m not big on spying on teens generally. I think that privacy is important. And by the time they are teens, in most cases we need to trust that at least some of the stuff we’ve said for years has stuck–and we need to let them learn to be independent and make choices without us.

That said, if you have a teen who drives, there’s some spying I suggest, assuming you …

Conditions and diseases

How to reduce the risk of oral cancer

Jennifer Gunter, MD

July 21, 2013Jul 21, 201310

The fact that cunnilingus increases a man’s risk of developing oral cancer has been all over the Internet recently with Michael Douglas’ disclosure that he had an HPV-positive tumor. To recap: some strains of human papilloma virus (HPV) are oncogenic,…

The fact that cunnilingus increases a man’s risk of developing oral cancer has been all over the Internet recently with Michael Douglas’ disclosure that he had an HPV-positive tumor.

To recap: some strains of human papilloma virus (HPV) are oncogenic, meaning they induce changes in a cell’s DNA that can lead to cancer. The same strains of HPV that are oncogenic in the genital tract for women, causing both cervical cancer …

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How to reduce the risk of oral cancer

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Conditions and diseases

Determining the prognosis of patients with pulmonary fibrosis

Deep Ramachandran, MD

July 20, 2013Jul 20, 20134

Sometimes it’s the simplest things that can make all the difference. Unfortunately, when it comes to informing patients with a new diagnosis of pulmonary fibrosis what to expect, things are anything but simple. For years, pulmonologists have dreaded the moment…

For years, pulmonologists have dreaded the moment when we inform patients of a diagnosis of pulmonary fibrosis. The discussion invariably involves informing them that this disease (which they have probably never heard of) may either kill them or …

Health policy

There should be no quarterbacks in health care

Bob Doherty

July 20, 2013Jul 20, 201317

The seemingly irreconcilable conflict between the medical and nursing professions usually boils down to one question: who is in charge? Physicians often use a football analogy: they are the quarterbacks of the team, calling the plays that others on the gridiron must follow, because of their greater training and skills. Advanced practice nurses (APNs) respond: not so, we are also highly trained and qualified to call the plays and lead …

Health policy

Is the hospital readmission rate a measure of quality?

Brad Wright, PhD

July 20, 2013Jul 20, 201312

Unplanned readmissions to the hospital have been the focus of much attention in recent years for obvious reasons. First, they are relatively easy to measure using administrative claims data. Second, like all inpatient hospitalizations, they cost a lot of money–and are therefore a target for reducing spending. Third, they are a proxy for quality of care, as at least some portion of them are likely avoidable if the hospital does …

Drugs and prescribing

News on cancer breakthroughs: Curb your enthusiasm

Christopher Johnson, MD

July 20, 2013Jul 20, 2013

Hardly a day goes by when some news outlet does not report, often breathlessly, some new breakthrough in cancer research. We need to turn a skeptical eye on most of these reports, particularly those that contain information about very preliminary research findings. The always astute Gary Schweitzer gives a good perspective on this in his HealthNewsReview.org; it’s a good site to bookmark if you follow the medical news.

…

Physician voices

Would C. Everett Koop be an effective Surgeon General today?

Peter Ubel, MD

July 19, 2013Jul 19, 20134

I have been thinking a lot about C. Everett Koop lately, ever since his death on February 25 at the ripe old age of 96 and more recently with the announcement that our current Surgeon General, Regina Benjamin, is planning to step down from that post. In particular, I have been pondering what made Koop such an effective Surgeon General, and what …

Conditions and diseases

Three tumors, two breasts, one very difficult decision

Jan Gurley, MD

July 19, 2013Jul 19, 20136

The more complex and high stakes a health care decision is, like with genetic testing and mastectomies, the more difficult it can be to find your way. There are no “right” answers, only guideposts to help you choose a path…

Decision-making alone. When my kids went to camp in the fifth grade, they got to experience something called the Solo Hike. Counselors took them up into the …

Physician voices

The words I say aren’t as important as my presence

Carl V. Tyler Jr., MD

July 19, 2013Jul 19, 20132

I knew from last night's house call that my patient Bessie's time was near. All day long I'd felt the familiar churning inside, the sickly sweet combination of anticipated dread and anticipated relief. So when the phone rang while I…

I knew from last night’s house call that my patient Bessie’s time was near. All day long I’d felt the familiar churning inside, the sickly sweet combination of anticipated dread and anticipated relief. So when the phone rang while I was exercising at home, I wasn’t surprised. I quickly dropped the barbell weights to answer the call before it went to voice mail.

It was Bessie’s daughter, Susan.

“Mom is gone,” she …

Physician voices

Confessions of a recovering doctor

Rob Lamberts, MD

July 18, 2013Jul 18, 201312

Hi. I’m Rob and I am a recovering doctor. Yeah, I am recovering ... doing a lot better, actually. Things are tough, but they are a lot better since I left my destructive relationship with Medicare, Medicaid, and insurance companies.…

Hi.

I’m Rob and I am a recovering doctor. Yeah, I am recovering … doing a lot better, actually. Things are tough, but they are a lot better since I left my destructive relationship with Medicare, Medicaid, and insurance companies. I’ve had to learn how to manage my own money (now that I can’t count on them to bail me out any more), but things are looking a lot better. I …

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Confessions of a recovering doctor

Physician voices

What is the biggest mistake patients make?

Alex Lickerman, MD

July 18, 2013Jul 18, 201316

The biggest mistake patients make isn’t what you think. It isn’t turning down tests or treatments their doctors recommend. Nor is it deciding not to take the medicines their doctors prescribe. It isn’t insisting on getting a test or beginning a treatment their doctors recommend against, either, and it isn’t failing to exercise, stay out of the sun (or use sunscreen), quit smoking, or lose weight. No, the biggest mistake …

Patient voices

The financial costs of bringing our daughter into the world

Ray Burow

July 18, 2013Jul 18, 20133

We entered the hospital with great anticipation. Our baby was overdue and with no signs of delivery, I was admitted and was to be induced the following morning. Three days later our baby would be our greatest blessing on Thanksgiving…

It wasn’t until weeks later that we found ourselves scratching our heads over costs we incurred bringing our daughter into the world. We were fortunate to have had fantastic health …

Physician voices

Should a patient’s financial concerns influence physician decisions?

Michael Kirsch, MD

July 17, 2013Jul 17, 201330

I treat uninsured patients and insured folks who face high deductibles who are under financial strain because of the sagging economy and other personal pressures. These folks need care that may be unaffordable. Medical diagnostic testing is expensive. Even routine laboratory testing can be very costly as those without insurance may be forced to pay the ‘retail cost’, which is quite different from insurance company discounted pricing.

This absurdity is often …

Physician voices

The 3 biggest HIPAA myths debunked

Mary Pat Whaley

July 17, 2013Jul 17, 201314

As a healthcare consultant, it is not unusual to be asked about HIPAA regulations on a weekly basis. Three questions come up regularly and seem to cause the most confusion when discussing HIPAA. I call them the Three Big HIPAA Myths – you can’t place medical charts on exam room doors, you can’t use sign-in sheets, and you can’t leave messages on patients’ voice mail or answering machines.

Here, then are …

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The 3 biggest HIPAA myths debunked

Physician voices

Hospice care for the transgendered patient

Robert Killeen, MD

July 17, 2013Jul 17, 201316

Hospice faces numerous societal obstacles in providing care for transgender patients. I recently witnessed a striking example of this in our local community hospice. An elderly individual assigned female at birth (MTF) was suffering from metastatic cancer. Chemotherapy had proven ineffective and had left her profoundly weak and infirm. With no connection to her family, she had only a few friends to rely on, but even they were only available …

Physician voices

How big data is affecting medical judgment

Wes Fisher, MD

July 17, 2013Jul 17, 20133

Decisions in medicine are supposed to rest on concrete observations and hard evidence. Often, hard evidence does not exist or when it does, it isn't used. Why is this? Concrete observations, too, are increasingly missed as we stare at computer…

Decisions in medicine are supposed to rest on concrete observations and hard evidence.

Often, hard evidence does not exist or when it does, it isn’t used. Why is this?

Concrete observations, too, are increasingly missed as we stare at computer screens longer and patients less. Yet we persist. Why?

This is our reality now, our evolving medical world.

But if we stop and think about it, medicine, by definition, is a world of technological …

Physician voices

Doctors should give patients their damn data

Zackary Berger, MD, PhD

July 16, 2013Jul 16, 201334

An excerpt from Talking to Your Doctor: A Patient's Guide to Communication in the Exam Room and Beyond (Rowman & Littlefield, 2013. All rights reserved.) There are plenty of books out there to teach us how to boldly and proudly…

There are plenty of books out there to teach us how to boldly and proudly advocate for ourselves in the doctor’s office. Doctors have held the reins too long, goes the story, and ignored what patients want and need. So it’s time for patients …

Health policy

Protecting us from the terrors of unhealthy lifestyles

Margalit Gur-Arie

July 16, 2013Jul 16, 201315

If a mosquito lands on someone’s head and you hit the mosquito with a shovel, is the death of the guy under the mosquito considered an unintended consequence? So now we know that the government of the United States of…

If a mosquito lands on someone’s head and you hit the mosquito with a shovel, is the death of the guy under the mosquito considered an unintended consequence?

So now we know that the government of the United States of America is spying on its own citizens, not specifically on any one in particular, but massively and indiscriminately collecting troves of data on all American people. All perfectly legal, …

Real physician voices, twice a week

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