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Is the era of patient centered care decidedly anti-physician?

Physician

April 2, 2013

I’m lucky to practice in a national regional anesthesiology center, a hospital with five dedicated nerve block suites, each with the latest in ultrasound equipment, nurses trained in conscious sedation, regional anesthesiology colleagues and infrastructure to support regional practitioners. It seems like there is so much we can do for patients, but really, there is only so much a physician can do. We need a little help from the patient …

Writing your medical school personal statement: Tips and myths

Jessica Freedman, MD

Medical Education

April 2, 2013

“I have no idea what to write.”

“I want to stand out.”

“I want to be different.”

“I want to have a theme.”

These are all comments I hear from medical school applicants as they start thinking about what topics to include in their medical school personal statement. I find that applicants often feel pressured to be unique and to write something the medical school admissions officer has never read before. But if you …

The heroic task of finding a physician who takes Medicaid

Beth England

Patient

April 2, 2013

While I am currently a second year medical student, my story is one of a sister.

When I was six years old, my mother asked me a question that would forever change my childhood: “Honey, would you be alright with having a foster child join our family? It would mean a little boy coming to live with us for a while.”

My response did not take much thought; how could I refuse …

Questions to ask when considering new medical technology

Leslie Kernisan, MD, MPH

Health Technology

April 2, 2013

“Hey doctor, what do you think about this product/solution/service?”

These days, I look at a lot of websites describing some kind of product or solution related to the healthcare of older adults. Sometimes it’s because I have a clinical problem I’m trying to solve. (Can any of these sleep gadgets provide data — sleep latency, nighttime awakenings, total sleep time — on my elderly patient’s sleep complaints?)

In other cases, it’s because …

Are physicians more afraid of death than the general population?

Benjamin Corn, MD

Physician

April 1, 2013

The cavernous hospital amphitheater in Tel Aviv, normally used to screen videos and new surgical procedures, was illuminated only by tea candles floating in decorative dishes of water on a recent Wednesday in January. Hundreds of doctors, nurses and other medical personnel filled the seats, as usual. But we had not come to learn the latest life-saving technique.

Dr. Ofira Ben-Tal, one of Israel’s leading hematologists, had lost her battle with …

The movement for medical price transparency is happening

G. Keith Smith, MD

Health Policy

April 1, 2013

Years ago, I hired a carpenter to build a deck in my backyard. He showed up with a pencil behind his ear, a spiral notebook, and a tape measure. I told him what I was looking for, and he made a few suggestions. After 15 minutes of measuring and taking notes, he handed me a piece of paper with how much it …

Am I smart enough for family medicine?

Raymond Tsai, MD

Medical Education

April 1, 2013

I’m not sure why my parents were surprised when I told them that I was applying to go into family medicine. It seemed like a logical transition after spending six years working in public health and primary care before medical school, but from the perspective of Taiwanese immigrant parents, I couldn’t have made a more absurd career choice. I was confronted with comments such as, “Most people choose careers to make …

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Am I smart enough for family medicine?

Match Day primary care aftermath: The Dean’s Lie continues

Kevin Bernstein, MD

Medical Education

April 1, 2013

Once again, medical schools continue their annual fraudulent and misleading statistics in regards to primary care workforce production. The Dean’s Lie is back and rampant across the country. It only seems to get worse.

When will they learn?

USA Today: Match Day: More medical graduates enter primary care

About one-quarter (11,762) of the applicants matched to resident positions that train doctors to be on the front line …

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Match Day primary care aftermath: The Dean’s Lie continues

Marriage and medicine: Both are not exact sciences

James C. Salwitz, MD

Physician

April 1, 2013

I have been married and practicing medicine for 32 years and during that time I have learned lessons that equally apply. First, listen carefully; both wives and patients need to be heard. Second, prepare and think before you speak; as the saying goes “put brain in gear before operating mouth.” Finally, perhaps the hardest lesson of all is, when necessary, be 100% inconclusive.

Any man or woman, who has been in …

Consider new treatment options for aortic stenosis

Steven R. Gambert, MD

Conditions and Diseases

March 31, 2013

Aortic_stenosis_rheumatic,_gross_pathology_20G0014_lores

I recently encountered a previously functional and independent 80-year-old woman who slipped and broke her hip. Surgery was required to repair the injury and was her only hope of returning to her premorbid state. She lived alone and was still able to shop, clean, and cook for herself, despite being on several medications for congestive heart failure. She had a long-standing history …

CRE bacteria: The next superbug threat in your hospital

Daniel J. Morgan, MD

Conditions and Diseases

March 31, 2013

A new CDC report is bringing a lot of attention to the emergence of drug-resistant bacteria in hospitals and long-term care centers across the country. Carbapenem-resistant Enterobacteriaceae, or CRE, strike critically-ill patients in nursing homes and intensive care units where infections can be fatal in up to 50 percent of cases, according to the report.

Without being able to count on …

The bond between medical students and their cadavers

Emily Howard

Medical Education

March 31, 2013

A letter from a medical student at the end of her gross anatomy course.

Dearest Walter,

The time we’ve spent together over the past few months has been wonderful, but I’m afraid it must come to an end. We knew this day would come. I must move on with my life, and you must move on, too. We will never see each other again, but I will never forget you. You have …

An academic medical center’s professional intellect is an asset

James E. Lewis, PhD

Medical Education

March 31, 2013

Institutional leaders in academic medicine are frustrated by what they perceive to be a short list of limited assets that can be used to guide or encourage individual and group behavior: faculty rank and/or institutional titles, compensation and budgetary authority, and space.

Even though the organization’s work takes place at the bottom, done largely by self-directed professionals, an academic medical center’s professional intellect is rarely recognized as an asset, let alone …

MKSAP: 51-year-old man with acute myeloid leukemia

mksap

Conditions and Diseases

March 31, 2013

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 51-year-old man is being followed in the hospital after receiving chemotherapy for acute myeloid leukemia 1 day ago. Kidney function was normal at the start of his treatment, which consisted of normal saline at a rate of 200 mL/h and rasburicase on the day of chemotherapy. He reports no symptoms except for some …

IBM’s Watson starts its medical career

Margalit Gur-Arie

Health Technology

March 30, 2013

IBM’s Dr. Watson of Jeopardy! fame has finally completed its residency and fellowships and, presumably to its creators’ utter delight, is now a practicing oncologist.

The prodigy “cognitive system” completed its training in less than a year at the illustrious Memorial Sloan-Kettering Cancer Center, and although only proficient in lung cancer right now, Dr. Watson’s career as an advisor to oncologists …

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IBM’s Watson starts its medical career

Doctors: It’s ok to shed the white coat and tie

Michael Edmond, MD, MPH

Physician

March 30, 2013

Those of you who have followed our blog for the past few years probably know that one of my favorite topics in infection prevention is the role of clothing in transmission of pathogens. But I’m also fascinated by the sociologic aspects of clothing in medicine, which is usually framed around questions of professionalism (for example, is a doctor in a white coat more “professional” than a doctor …

Be careful when ordering your own genetic tests

Benjamin T. Galen, MD

Conditions and Diseases

March 30, 2013

Direct-to-consumer genetic testing is increasingly available to the general public. Reduced cost and ease of testing make this service easy and seemingly harmless. For less than $100 and without even having your blood drawn (a saliva sample is sufficient), a private company promises to provide you with information about your ancestry and your health.

However, undergoing genetic testing of any kind is not a trivial decision. It is not like having …

It’s our duty as physicians to avoid needless tests

Anees Chagpar, MD

Physician

March 30, 2013

I recently presented Yale Surgical Grand Rounds focused on “Cost and Quality in Cancer Care.” Amidst the talks in Washington regarding our unsustainable health care spending, and provisions of the Affordable Care Act rapidly taking hold, it seemed appropriate to start to critically evaluate how we spend our health care dollar and the value we receive in return. The data are …

7 reasons why DTC drug marketing will decline in 2013

Richard Meyer

Medications

March 30, 2013

According to a new report from Cegedim Strategic Data, DTC promotional spending declined 22% versus last year. In fact they reported that “spending in nearly every channel saw decline year over year in 2012, the only exception being direct mail, which continued an upward trend. Here are the reasons why I expect DTC marketing to continue to decline in 2013.

1. Most big brands …

Make small bets during the era of health reform

Angelo Falcone, MD

Health Policy

March 29, 2013

A good hockey player plays where the puck is. A great hockey player plays where the puck is going to be.
–Wayne Gretzky

Recently, I attended an end-of-year review with one of our hospital partner’s executive team. We reviewed our performance for the past year, and discussed mutually strategic goals and how to improve upon our excellent service. As part of the conversation turned …

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