Part of the KevinMD toolkit series.
A lot of people ask me, “What tools do you use for blogging, speaking, when you’re on the road, seeing patients etc. …” So I decided to start a series that describe what tools I use, and why.
The first explored my speaking toolkit. This one details the technical tools I use to run KevinMD.com. I’ll discuss what I …
At some point, this gets to be ridiculous. Online, I can buy any item from anywhere at any price, pay any bill, watch any movie, listen to any song, order dinner, schedule car repair or read about any subject on Wikipedia. I can determine the weather in Rio, sport scores of Barcelona, Parisian traffic or by GPS the location of my kids, just down the block.
However, I absolutely cannot learn …
A plea for a universal, unified EMR
Next in a continuing series.
Inside the belly, everything is slippery. The peritoneum is a glistening layer of self-moistening plastic wrap, enveloping the surfaces of all the organs, and the inner aspect of the abdominal wall. Undisturbed, the intestines coil and slither, reptilian. Watching waves of peristalsis makes me smile: there’s something always entertaining about those moving contractions, following one upon another, gurgling, surprisingly tight bands of tension moving …
That slippery bowel wants to be everywhere
As an addiction psychiatrist, I have seen marijuana do far more harm than good. So with the medical use of marijuana in Massachusetts now legal under state law, what should physicians do?
Recently, I attended a chilling presentation from Dr. Kevin Hill, an addiction psychiatrist at McLean Hospital, at a meeting of the Massachusetts chapter of the American Society of Addiction Medicine on the topic “Medical Marijuana: What is the Proper …
Against the medicalization of marijuana
As a second year medical student in 1971, I still remember an article in the prestigious New England Journal of Medicine, describing a new phenomenon, The Emperor’s New Clothes Syndrome. It was based upon the famous Danish author, Hans Christian Anderson’s fairly tale from the 1800’s.
A vain emperor, who cares for nothing except wearing and displaying clothes hires two swindlers who promise him the finest, best suit of clothes from …
Copy and paste medicine is not new
I visited with 5 charming teenagers last week. Four of them had something in common: These teenagers are texting in the middle of the night, nearly every night.
Texting in the middle of the night is not a new phenomenon. Over 2 years ago, reports on teenagers texting at night began to surface. One study concluded the average teenager sends 34 texts after lights out. Simply based on the conversations I …
The problem of teens texting throughout the night
A crunchy friend of mine on Facebook re-posted something from an even crunchier friend of hers who was shocked to find that many naturopaths sell supplements. Actually, she feels that selling them is okay; so is prescribing them. But selling what they prescribe apparently tips her ethics meter over into “unacceptable”.
As I read her screed against the ND who conducted a cursory history and exam before checking off $750 worth …
The ethical shortcomings of selling supplements
It was recently the Affordable Care Act’s third birthday, but you might have missed it for all of the (lack of) attention it received. Sure, there was the usual back and forth from the law’s supporters and opponents, but almost nothing that provided any new insights.
Supporters, such as the liberal New York Times editorial page, marked the ACA’s anniversary by touting the tens of millions already being helped …
First, it was the MMR-autism link—that turned out to be a complete fabrication, a fraud invented by a single “researcher” who made up his data. He was taking money from plaintiff’s lawyers, and he was trying to patent his own, competing vaccine. Too bad for the scare and the resulting surge in measles.
Then, the mercury connection. A mercury-containing preservative, thimerosal, …
It’s time to put the vaccine-autism link behind us
Even stronger controls have just been set out for HIPAA. They come in the final regulations for the Omnibus Health Insurance Portability and Accountability Act, or the HIPAA rule. The new rules became effective March 26. However, medical offices and business associates have until September 23 to comply.
Mostly, the changes affect patient requests and approvals, breach reporting, and business associates. Along with that, the penalties for noncompliance have gone up. …
The new HIPAA regulations: Do you know the rules?
After reading Dr. Mona Kotech’s article titled “Is the era of patient centered care decidedly anti-physician?” I immediately thought of several instances when knowing my health history and current lab readings were vital for providing me with safe care.
I was born with VACTERL Association, a birth disorder that impacts a variety of systems in the body. I have had more than twelve surgeries and a variety of medical …
Patients are the most important piece of the medical team
People are people, whether they are identified by their career or their role in the healthcare process. So, whether you’re working with a referring physician or a patient, it’s important to consider emotions, their role in the sales process and how they drive and destroy value. One of the most valuable emotions to have in our business is loyalty. Loyalty is what providers work towards with referring physicians and what …
Loyalty and honesty are key to improving transparency in healthcare
For over a decade, I have advised pre-meds on how to maximize their chances of getting into medical school. During this time, as I witnessed thousands of anxiety-ridden pre-meds wade doggedly through the murky waters of medical school admissions, I have noticed pre-med difficulties often pale in comparison to those of pre-meds parents. It’s often much easier to be the athlete on the field than the coach on the sidelines. …
Practical advice for the parent of a pre-med
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A 35-year-old woman is evaluated in an urgent care center for an acute exacerbation of asthma. She has a history of frequent asthma exacerbations requiring unscheduled visits; however, between these exacerbations, her examination and pulmonary function studies have been unremarkable. Her current medications are inhaled budesonide and inhaled albuterol.
On physical examination, she is in moderate distress with audible inspiratory and expiratory wheezing. Temperature is 37.0 °C (98.6 °F), pulse rate …
MKSAP: 35-year-old woman with an acute exacerbation of asthma
First I believe our health care system must be better so I’m always curious to hear how others might propose to fix it. I recently had the opportunity to listen in two conversations with businessman David Goldhill about how healthcare might be made better. Goldhill lost his father to a hospital acquired infection and witnessed multiple errors during his hospitalization which compelled him to write not only a piece in …
Can David Goldhill fix healthcare?
I was sitting in the resident workroom at Massachusetts General Hospital (MGH) when my co-resident showed me the text from her sister: two explosions had shaken the finish line of the Boston marathon. Though news sites had not yet published the headline, it was immediately corroborated by the cacophonic wails of ambulances heading towards us and our shock was quickly replaced by the urge to learn more and to do …
Being a doctor in a time of crisis
I am old enough to remember when physicians did not advertise. It was considered a professional ethical issue. Hospital advertising consisted of institutional “We’re here” ads. Anything aggressive by docs or hospitals was considered bad taste… but that was before health care became as competitive as any other type of business.
I have been barraged, as have many of you, by a wave of hospital advertisements as our health care marketplaces …
There is minimal oversight of hospital marketing
An important study in the Journal of the American Medical Association finds that misdiagnosis is more common than you might think. According to the study, almost 40% of patients who unexpectedly returned after an initial primary care visit had been misdiagnosed. Almost 80% of the misdiagnoses were tied to problems in doctor-patient communication, and more than half of those problems had to do with things that were missed in the …
Misdiagnosis is more common than you think
Ensuring that Americans who live in rural areas have access to healthcare has always been a policy priority. In healthcare, where nearly every policy decision seems contentious and partisan, there has been widespread, bipartisan support for helping providers who work in rural areas. The hallmark of the policy effort has been the Critical Access Hospital (CAH) program– and new evidence from our latest paper in the Journal of the …
Access to care isn’t enough: It’s about access to high quality care
Not long ago I noted a certain older patient’s name on my schedule. I really dreaded seeing her. It’s not that I dislike her–in fact she’s one of my favorite patients. It was just that I hated the prospect of seeing her looking as poorly as I knew she would. She’d been through so much: an accident resulting in devastating injuries followed by painful surgeries, and, worst, in the middle …
After the Boston Marathon: Trauma itself can bring strength
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