KevinMD.com

May 28, 2013May 28, 201316

I read the New York Times. I read the health section as much as I can to keep track of what the paper is saying about health-related issues. I read Jane Brody. I like Jane Brody. I’m not sure what…

I read the New York Times. I read the health section as much as I can to keep track of what the paper is saying about health-related issues. I read Jane Brody. I like Jane Brody. I’m not sure what Ms. Brody is, but I don’t think she’s a clinician.

In her article “Avoiding Emergency Rooms,” she makes some suggestions on how people should get care if they need …

Patient voices

The safety data behind this ablation catheter

Dan Walter

May 28, 2013May 28, 20136

An excerpt from Collateral Damage: A Patient, a New Procedure, and the Learning Curve. To make the scars inside Pam's heart, Wu was “learning by burning” with the Chilli Cooled Tip ablation catheter. One big problem with cardiac catheter ablations,…

An excerpt from Collateral Damage: A Patient, a New Procedure, and the Learning Curve.

To make the scars inside Pam’s heart, Wu was “learning by burning” with the Chilli Cooled Tip ablation catheter. One big problem with cardiac catheter ablations, which they discovered as the procedures got more and more popular, was that blood tended to coagulate near the hot tip of the catheter, resulting in clots and strokes. …

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Health policy

Why isn’t primary care idolized?

Rebecca Divers

May 28, 2013May 28, 201312

The Baylor PCP chapter co-hosted a screening of Escape Fire at Rice University. I had heard about the film some time ago when it first came out and had always wanted to see it myself, but now I am convinced…

The Baylor PCP chapter co-hosted a screening of Escape Fire at Rice University. I had heard about the film some time ago when it first came out and had always wanted to see it myself, but now I am convinced that it should be screened at every medical school orientation.

The film provided a poignant portrayal of several all-too-familiar stories: the overworked, underpaid primary care doctor who cannot afford to spend …

Read more…

Why isn’t primary care idolized?

Conditions and diseases

What Angelina Jolie and bariatric surgery patients have in common

Sara Stein, MD

May 28, 2013May 28, 201343

Angelina Jolie discovers she has a breast cancer gene, the same one that caused her mother to die an early death, and she decides on a proactive, and possibly radical, prevention – double mastectomy. By doing so, she lowers her risk of genetic breast cancer from 70% to 5%. No guarantees, but definitely improved odds of survival. Assuming she continues her lifestyle changes to support her good …

Physician voices

Introducing the Automated Psychiatrist Machine

Maria Yang, MD

May 28, 2013May 28, 20136

Are you tired of waiting fifteen minutes only to spend ten minutes with your psychiatrist? Do you hate rearranging your busy schedule, fighting traffic, and trolling for a parking space just to spend a few minutes with your doctor? Wouldn’t it be easier if you could take care of your mental health according to your schedule, instead of someone else’s?

We are pleased to introduce the Automated Psychiatrist Machine (APM). The …

Conditions and diseases

Resistance to fundamental truths about food

David L. Katz, MD

May 27, 2013May 27, 2013

In that riveting courtroom scene we all know from the movie A Few Good Men, Jack Nicholson's character famously tells us: We can't handle the truth. That often seems the case with regard to food. I have encountered the resistance…

In that riveting courtroom scene we all know from the movie A Few Good Men, Jack Nicholson’s character famously tells us: We can’t handle the truth. That often seems the case with regard to food.

I have encountered the resistance to fundamental truths about food often, but I am committed to doing the best I can to tell them even so. I tell them in narrative every chance I …

Physician voices

We must change how we discuss procedures with our patients

Kevin R. Campbell, MD

May 27, 2013May 27, 201312

Medicine is about balancing risk and benefit. Certainly, as healthcare providers, we attempt to provide the best care for our patients based on available evidence. Physicians often are seen as shepherds, helping to guide patients through disease and therapy. As I have mentioned in previous blogs, ultimately medicine will be personalized and tailored to one’s particular genetic make-up. However, the need for a clear discussion of treatment options …

Conditions and diseases

What’s scarier than a colonoscopy?

Sophie M. Balzora, MD

May 27, 2013May 27, 201352

Colorectal cancer. Shudder. That’s the knee-jerk response that most of my patients give me when mention of their 50th birthday creeps into the conversation and I reveal that it is time for their screening colonoscopy. Admittedly, a colonoscopy is not…

Colorectal cancer.

Shudder. That’s the knee-jerk response that most of my patients give me when mention of their 50th birthday creeps into the conversation and I reveal that it is time for their screening colonoscopy.

Admittedly, a colonoscopy is not an experience that the overwhelming majority of the human race embraces with excitement and anticipation. Instead, it is a life event that is filled with …

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What’s scarier than a colonoscopy?

Physician voices

Another reason why the house call is dead

James C. Salwitz, MD

May 27, 2013May 27, 201365

We think the reason doctors rarely make house calls is money. Doctors can charge, but it is hard to charge enough to justify the time it takes to drive door-to-door, fill the tank and attend lengthy visits. Thus, the house call has faded into history. However, I have another theory about the end of this valuable service: perhaps it is increased emotional distance between patients and their doctors.

I watched an …

Physician voices

What I’ve learned from saving physicians from suicide

Pamela Wible, MD

May 27, 2013May 27, 2013492

A psychiatrist in Seattle had picked out the bridge. At 3 a.m. he would swerve across his lane and plunge into the water. Everyone would assume he fell asleep. A surgeon in Oregon was lying on the floor of her…

A psychiatrist in Seattle had picked out the bridge. At 3 a.m. he would swerve across his lane and plunge into the water. Everyone would assume he fell asleep.

A surgeon in Oregon was lying on the floor of her office with a scalpel. Nobody would find her until it was too late.

An internal medicine resident in Atlanta heard an anesthesiologist joking about …

Health policy

As health care consolidates, physicians face a choice

Angelo Falcone, MD

May 27, 2013May 27, 20132

Amid massive change in our healthcare delivery systems and seismic shifts in many regional markets, physicians are increasingly being faced with a simple choice: be acquired or become employed as part of a large healthcare system, or stay independent while…

The changes occurring in our care delivery systems have generated great interest, innovation, and yes, fear among many in healthcare, doctors …

Health technology

Bedside ultrasound tips for the general internist

Janice Boughton, MD

May 26, 2013May 26, 20137

I first picked up an ultrasound transducer 17 months ago, at an emergency medicine ultrasound course at Harvard University. I had just barely heard about using ultrasound as a clinical tool and was vaguely interested. The course was 3 days…

Emergency physicians have embraced the …

Physician voices

Inspired after seeing my 5-year-old patient

BirdStrike, MD

May 26, 2013May 26, 20136

Off I go to work a few shifts at a desperately understaffed rural hospital in a state far away. The rental car GPS leads me to the ED address and it’s not there. All that is there is what looks…

Off I go to work a few shifts at a desperately understaffed rural hospital in a state far away. The rental car GPS leads me to the ED address and it’s not there. All that is there is what looks like a small supermarket with a funeral home next door. I see a security guard in the parking lot. He has a lump in his cheek and a badge that says “Sam.” …

Physician voices

Do Lego Friends promote stereotypic gender roles?

Natasha Burgert, MD

May 26, 2013May 26, 20136

She spends hours with them. Literally hours. And, apparently she is not alone. Lego Friends have captured the heart of my daughter, as well as thousands of other school-aged girls across the country. In fact, the Lego Friends series has…

She spends hours with them. Literally hours. And, apparently she is not alone.

Lego Friends have captured the heart of my daughter, as well as thousands of other school-aged girls across the country. In fact, the Lego Friends series has been a financial boom to the Lego corporation in just a few months.

The Friends series is essentially pastel colored building sets, ultimately creating items …

Conditions and diseases

Finding the best diet for you is an art, not a science

Barbara Berkeley, MD

May 26, 2013May 26, 20133

Let's consider salt. The American Heart Association says, "It is estimated that if Americans cut their average sodium intake by more than half – to an average of 1,500 milligrams a day – there would be a nearly 26 percent…

Let’s consider salt.

The American Heart Association says, “It is estimated that if Americans cut their average sodium intake by more than half – to an average of 1,500 milligrams a day – there would be a nearly 26 percent decrease in high blood pressure and a savings of more than $26 billion in healthcare costs over just a year.”

The American Heart Association recommends foods with little or no salt to …

Medical education

Limiting resident work hours: Patients remain our utmost priority

Jennifer Middleton, MD

May 26, 2013May 26, 20133

When I was a fourth-year medical student in 2002, I signed up for an intense sub-internship rotation in family medicine. My goals for this rotation were two-fold: first, I wanted to make sure that I was ready for intern year and, second, I needed a good letter of recommendation to match into a good family medicine residency program.

On this rotation, I was essentially treated like the other interns. I had …

Health policy

Buying private insurance for Medicaid recipients

Naomi Freundlich

May 25, 2013May 25, 201310

Arkansas is now the first state to use Medicaid expansion dollars to buy private coverage for many of its 250,000 newly eligible residents rather than enroll them in the existing Medicaid program. The Arkansas House of Representatives approved the plan, followed by the Senate, to confirm that the state will be implementing this “market-based approach” to expanding Medicaid.

The idea of buying private insurance for Medicaid recipients is emerging as a “conservative …

Physician voices

The winds of change are blowing us out of the hospital

Jordan Grumet, MD

May 25, 2013May 25, 20135

The sweat coalesced on my forehead. I leaned forward to push the weight of my body into the wheel chair. I was terrified. Behind me strode the baffled parents with their arms full of coats and scarves. The young boy shrunk into the chair and balanced his IV’ed arm on the rest, trying not to disrupt the tubing that had been so painfully inserted.

I was lost. A week into my rotation as a volunteer …

Real physician voices, twice a week

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