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When it comes to my patients, waiting is unacceptable

Physician

March 22, 2013

The waiting is the hardest part
Every day you see one more card
You take it on faith, you take it to the heart
The waiting is the hardest part.
-Tom Petty and the Heartbreakers

I’ve never been good at waiting for anything. Instant gratification has been my middle name, and I’ve gotten in lots of trouble because of it. I think that I have improved with age—I am less likely to become apoplectic when …

3 business skills doctors need to know

Brian J. Secemsky, MD

Medical Education

March 22, 2013

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Prior to entering the medical field, my preconceived notion of what makes a good doctor essentially compromised of compassion, intelligence, and the ability to think fast on ones feet. Although I continue to believe that these professional qualities are paramount to excellent patient care, I am finding that other, less obvious proficiencies are also required. Ironically, these skills that I have in …

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3 business skills doctors need to know

Cost is a gaping hole in scientific discourse

Wes Fisher, MD

Medications

March 21, 2013

My perspective on scientific publications has been greatly affected by my experience with this blog and social media in particular. The ability to serve as author, reviewer, advertiser and marketer can be easily achieved in this space thanks to the power of self-publishing. But with this new platform comes new responsibilities and for those of us who chose to work with people daily, perhaps none is as great as maintaining …

Why OB/GYNs are not primary care physicians

Lucy Hornstein, MD

Physician

March 21, 2013

You may have heard of the “Dean’s Lie“, the artificial padding of numbers allowing medical schools to claim ever-increasing percentages of their graduates are going into primary care medicine. This is accomplished by counting everyone going into internal medicine, pediatrics, and med-peds, in addition to family medicine as “primary care.”

It makes their schools sound more attractive by seeming more progressive, but it does nothing to enhance the supply …

Measuring quality: What doctors and teachers have in common

Shirie Leng, MD

Health Policy

March 21, 2013

newsweek-cover-michelle-rhee-education-reform

I was watching Jon Stewart recently, and he had Michelle Rhee on. For anyone who doesn’t know her, she’s the superintendent of schools in Washington D.C. who made a bunch of reforms that caused some controversy and resulted in her being one of the main spokespersons for education reform in this country. Her conversation with Jon made me realize the similarities between …

Become a disruptive physician: How to do it right

Dike Drummond, MD

Physician

March 21, 2013

“Disruptive physician” is one of the most misused terms in healthcare these days. In many organizations, those two words have become the c-suite’s trump card to quash any physician resistance to new administrative programs. These programs are often have purely financial motives or are a brazen attempt to dump additional tasks on the physicians with no regard for their workload or stress levels.

The doctor’s legitimate concerns about quality of care …

Medical malpractice stress syndrome: The ignored side of litigation

Sherry Gorman, MD

Physician

March 21, 2013

In March 2008, prominent Denver business owner Leslie Fishbein suffered cardiac arrest and died after receiving trigger point injections with bupivacaine for chronic neck pain. Ms. Fishbein owned a chain of high-end furniture stores. She was well known within the community because of her starring role in television commercials promoting her business. Her death drew tremendous media attention and heavy scrutiny for …

Dear lawmakers: This is what it’s like to be a doctor today

Matthew Moeller, MD

Physician

March 20, 2013

I am writing this letter because I feel that our leaders and lawmakers do not have an accurate picture of what it actually entails to become a physician today; specifically, the financial, intellectual, social, mental, and physical demands of the profession. This is an opinion that is shared amongst many of my colleagues. Because of these concerns, I would like to …

I’m a part time physician, and I’m not sorry

Katie Noorbakhsh, MD

Physician

March 20, 2013

I began the medical school application process 10 years ago. I was 23, single and most of my role models worked full time. I had no idea that a part-time medical career lay in my future. Quite a bit has changed since the days of hoping and praying and crossing my fingers for a medical school acceptance letter. In the past 10 years I have, at varying times, declared …

Is Chris Christie too obese to run for president?

Jeffrey Parks, MD

Physician

March 20, 2013

Former White House physician Connie Mariano, MD, set off a firestorm recently by stating the patently obvious fact that New Jersey governor Chris Christie ought to address his morbid obesity prior to entertaining thoughts of running for the presidency in 2016.

“It’s almost like a time bomb waiting to happen unless he addresses those issues before he runs for office,” Mariano …

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Is Chris Christie too obese to run for president?

The New York Times didn’t kill this patient

John Schumann, MD

Physician

March 20, 2013

A loyal reader sent me a doctor-written column with the provocative headline, “My Patient, Killed by The New York Times.”

First, keep in mind that the website that posted this, Mediaite, is all about the media covering (really fawning and dishing) itself. The purpose of this story, with its provocative headline, sad outcome, and mea culpa tone, is to generate “buzz.”

Then understand that this is a story of one patient who made …

AMA: Helping physicians thrive in an evolving healthcare system

Jeremy Lazarus, MD

Health Policy

March 20, 2013

A guest column by the American Medical Association, exclusive to KevinMD.com.

As American health care continues to transform, physicians in every state and specialty are attempting to comply with new rules, expectations and costs, and must evolve to meet new health care demands. The American Medical Association (AMA) is committed to helping physicians not only navigate the changing environment, but thrive in …

What doctors are supposed to do when your child has an earache

Claire McCarthy, MD

Conditions and Diseases

March 19, 2013

Your child has an earache. You are worried it is an ear infection. You call the doctor and make an appointment. After all, he needs antibiotics, right?

Maybe not.

We have a real problem of antibiotic overuse in our country–and because we are overusing our antibiotics, many bacteria are getting smarter and stronger. Because ear infections is the diagnosis that kids in the United …

Cancer patients who are positive in the face of terrible adversity

Bruce Campbell, MD

Physician

March 19, 2013

God helps those who help themselves.
-Something that sounds like truth but fortunately isn’t mentioned in any religious text

“I’m gonna beat this thing again, Doc! I just know it!”

Over the course of several years, I helped care for a man with a very rare cancer that recurred over-and-over. With each new tumor, he became more focused on beating the disease and despite the repeated setbacks, he remained eternally positive. He spent …

When you’re feeling sad or depressed, try to find anticipatory joy

Alex Lickerman, MD

Conditions and Diseases

March 19, 2013

Having to confront an indeterminate outcome that might be bad seems to cause more anxiety than having to confront an outcome known to be bad.

In one study, patients requiring colostomies (a rerouting of the passage of stool from the rectum to an opening in the abdomen) that were potentially reversible were actually found to be less happy six months after their operation …

Doctor ratings need to be physician driven

Kevin Pho, MD

KevinMD

March 19, 2013

In the new book, Establishing, Managing, and Protecting Your Online Reputation, physician ratings are highlighted. This is a topic that gives many physicians some pause, and for some, causes tremendous anxiety.

Whether doctors know it or not, they already have online profiles. Third-party rating sites, like Vitals or Healthgrades, already have web pages of most physicians, and they …

Embrace the gift that our patients are giving us

Leana Wen, MD

Physician

March 19, 2013

Everyone knows that life in the ER is fast-faced, extremely busy, and ever-challenging. When things get crazy, it becomes habit for busy physicians to see patients as “the chest pain in room 6” or “the broken wrist in the hallway.” We turn people with their amazing lives and fascinating stories into a nameless number and a “chief complaint”.

It’s a practice that’s easy to justify—after all, taking a long …

Comprehensive annual physical exams have no scientific value

Davis Liu, MD

Physician

March 18, 2013

Is the Ontario Annual Physical Exam going the way of the dinosaur? That appears to be the case for healthy individuals between the ages of 18 to 64 in the Canadian province of Ontario. Effective in 2013, these patients no longer would have available an annual physical examination, but instead a “personalized health review.”

The new personalized health review would only be available to those who were healthy and did not …

Empower whistleblowers to improve the health of all Americans

Kenneth Lin, MD

Physician

March 18, 2013

The first instinct of a bureaucracy is self-preservation, and health care bureaucracies are no exception. This rule applies not only to government agencies, but to academic and industry settings as well. This was the conclusion I came to after listening to a panel of scientist and physician “whistleblowers” at the Selling Sickness 2013 conference in Washington, DC.

One by one, they described their painful discoveries that widely prescribed …

An OB/GYN perspective on Choosing Wisely

Margaret Polaneczky, MD

Conditions and Diseases

March 18, 2013

From ACOG comes five new cautions, part of the American Board of Internal Medicine Foundation’s Choosing Wisely campaign, to eliminate wasteful and unnecessary medical interventions that can actually cause harm. All the recommendations are evidence-based and have broad consensus.

1. Don’t schedule elective, non-medically indicated inductions of labor or cesarean deliveries before 39 weeks 0 days gestational age. Delivery prior to 39 weeks 0 days has been shown to be associated with an increased risk …

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