KevinMD.com

Boston rises in the wake of tragedy

April 15, 2013Apr 15, 20132

“Daddy, a bomb blew up in Boston!” That was how my 4-year old greeted me when I came home this evening. Of course, I already knew about the horrific attacks during the Boston Marathon, first on Twitter, then realizing the…

“Daddy, a bomb blew up in Boston!”

That was how my 4-year old greeted me when I came home this evening.

Of course, I already knew about the horrific attacks during the Boston Marathon, first on Twitter, then realizing the gravity of the event as mainstream media caught up.

I practice in Nashua, NH, which is about 45 minutes north of Boston. But …

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Boston rises in the wake of tragedy

Health technology

Prevent physician burnout with these 2 mobile apps

Dike Drummond, MD

April 15, 2013Apr 15, 2013

Forget Angry Birds and other mobile apps that do a great job of helping you waste time. And set aside for now the apps that help you find information and practice clinical medicine more efficiently. It was only a matter of time before mobile apps would be developed that can actually help you prevent physician burnout.

Here are my two favorite free mobile apps to help you lower stress and create …

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Physician voices

The fallout of chance medical findings

Kevin R. Campbell, MD

April 15, 2013Apr 15, 20132

I can remember making rounds with a seasoned surgical attending in medical school. In typical fashion, surgical rounds were a lot like the military. The “General” (attending physician) at the front, always commanding respect (and often fear) followed by the chief resident, junior residents, interns and finally medical students. Cases were presented, statuses were updated and plans were formulated. Then came the barrage of medical fact questions–mostly directed at the …

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The fallout of chance medical findings

Physician voices

Hospitals are still awful: The movement toward patient centered care

Janice Boughton, MD

April 15, 2013Apr 15, 201310

First a disclaimer: People often receive compassionate, considerate and effective care at hospitals. They have countless interactions which impart the miracle of human caring and enrich their lives. It is also institutionally prevalent to have haphazard care with poor communication,…

I have been working at a university hospital emergency room as part of a mini-fellowship in bedside ultrasound. It is the first time I have spent …

Physician voices

Medicine and climate change have common elements

Michael Kirsch, MD

April 15, 2013Apr 15, 20132

On the morning that I began this post, I read in our local newspaper that Tennessee is soon expected to have a law that would permit public school teachers to offer views on climate change and evolution that are counter…

No, I don’t think that creationism is science and it should not be disguised as such. Global warming, or climate change, however, is more nuanced. …

Physician voices

The rise of ultimatums in medicine: Do they work?

Katie Noorbakhsh, MD

April 15, 2013Apr 15, 201330

Has anyone else noticed the growing presence of ultimatums in medicine today? The New England Journal of Medicine published a discussion of the ethics of not hiring smokers. My hospital adopted this policy six months ago, and they are not…

Has anyone else noticed the growing presence of ultimatums in medicine today?

The New England Journal of Medicine published a discussion of the ethics of not hiring smokers. My hospital adopted this policy six months ago, and they are not alone. There is a tobacco blood test that new employees have to pass. If they fail, they can look for a job elsewhere. I do not know the exact details, but …

Physician voices

No one asks oncologists how they feel

James C. Salwitz, MD

April 15, 2013Apr 15, 20133

I was watching a macho shoot-em-up movie the other day; the type where everyone shoots everyone and in the final scene, the dirty blood-stained hero rides homeward on a helicopter or maybe a horse, into a red sunrise or sunset. He stares blankly, focused on nothing, focused on everything, his look reflecting the turmoil of what he has seen, done and lost. The hero’s grease-smeared face shows the understanding that …

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No one asks oncologists how they feel

Social media in medicine

Why doctors should use their real name on Twitter

Dr. Henry Woo

April 14, 2013Apr 14, 20138

The General Medical Council (UK) published new guidelines that state, “If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the views of the profession more widely.” This has …

Physician voices

8 surprising thoughts about patient wait times

Adam Banks

April 14, 2013Apr 14, 201326

Every one of us feels a high level of anxiety when we are made to wait. In grocery stores, we jockey back and forth to the line we perceive is moving the fastest and easily get frustrated when we choose the “wrong” line. When driving, we will swerve across multiple lanes of traffic to avoid a line at a toll booth or …

Physician voices

A more sustainable model of palliative care

Deep J. Shah

April 14, 2013Apr 14, 20133

During morning rounds on my sub-internship, we always spoke softly about TG. There was never any good news. The 56-year-old writer’s lifelong battle with substance abuse was coming to an end – her heart, liver, and kidney were slowly failing. But TG’s devoted husband was in denial. And behind the scenes, we were struggling, too. The patient needed pain control, symptom management, and psychiatric support among other things. At this …

Medical education

The flat and shrinking medical world

Mark J. Rosen, MD

April 14, 2013Apr 14, 20135

Columbus gets the credit, but in 240 BC, Eratosthenes of Cyrene discovered that the earth was round. In 1990, the Hubbell telescope proved that the universe is expanding. In the 21st century we know that the world is round but with the Internet and smart phones, it feels small and flat. With ease of travel and technology, all aspects of modern life have changed, including medical science, practice, and education.

The …

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The flat and shrinking medical world

Physician voices

The largest barrier to achieving humanistic nirvana in medical care

Larry Istrail, MD

April 14, 2013Apr 14, 201347

The dictionary defines humanism as “a system of thought that centers on humans and their values, capacities, and worth.” No sector of the economy comprehends this definition better than a small business. In a sea of competition, the small business whose primary focus strays from its customer’s best interests will surely sink. Those with business experience will undoubtedly attest that, whether in a hair salon or restaurant, a happy customer …

Patient voices

With health reform, flexibility is important

Rob Burnside

April 13, 2013Apr 13, 2013

Flexibility is important these days, perhaps more than ever before. I'm reminded of this almost every time I order lunch at a fast food joint: "I'd like a double cheeseburger, please, with ketchup only." "You mean 'only ketchup,' don't you?"…

Flexibility is important these days, perhaps more than ever before. I’m reminded of this almost every time I order lunch at a fast food joint: “I’d like a double cheeseburger, please, with ketchup only.” “You mean ‘only ketchup,’ don’t you?” “Okay, a double cheeseburger with only ketchup.” “Right, got it, coming up!”

So many changes on the medical care horizon and everyone speaking a slightly different language — it’s bound to …

Health policy

America’s health system is dangerously out of balance

Brian Klepper, PhD

April 13, 2013Apr 13, 20133

For a large and growing number of us with meager or no coverage, health care is the ultimate “gotcha.” Events conspire, we receive care and then are on the hook for a car- or house-sized bill. There are few alternatives…

Steven Brill’s recent cover story clearly detailed the predatory health care pricing that has been ruinous for many rank-and-file Americans. In Brill’s report, a key mechanism, …

Health technology

If you build a patient portal, why won’t they come?

Steve Wilkins, MPH

April 13, 2013Apr 13, 201334

I hate saying I told you so. But "patient engagement is a physician-patient communications challenge and not an HIT (health information technology) challenge.” Just take a look at the Mayo Clinic’s patient portal experience which was discussed at a HIMSS…

I hate saying I told you so. But “patient engagement is a physician-patient communications challenge and not an HIT (health information technology) challenge.”

Just take a look at the Mayo Clinic’s patient portal experience which was discussed at a HIMSS 2013.

The headline: “Mayo Clinic struggles to meet stage 2 meaningful use thresholds for engaging patients.”

Always innovating, the Mayo Clinic some three years ago introduced a web-based portal to share information with …

Health policy

Health reform faces tension with integrated health systems

Kevin Pho, MD

April 13, 2013Apr 13, 20134

Room for Debate blog. In the coming years, health care reform will drive consolidation in the industry. Reformers, including the president himself, point to integrated health systems like Kaiser Permanente as the future of health care delivery. While this movement…

The following column was published on March 26th, 2013 in the New York Times’ Room for Debate blog.

In the coming years, health care reform will drive consolidation in the industry. Reformers, including the president himself, point to integrated health systems like Kaiser Permanente as the future of health care delivery. While this movement may improve patient care, whether it will shield …

Conditions and diseases

MKSAP: 19-year-old woman with bilateral leg weakness

mksap

April 13, 2013Apr 13, 20132

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 19-year-old woman is admitted to the hospital because of a 2-week history of bilateral leg weakness and numbness accompanied by urinary incontinence that…

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

A 19-year-old woman is admitted to the hospital because of a 2-week history of bilateral leg weakness and numbness accompanied by urinary incontinence that began after a viral gastrointestinal illness of 3 days’ duration. She has no personal or family medical history of note and takes no medication.

On physical examination, temperature is 36.7 °C …

Patient voices

The power of words in guiding patients toward recovery

Joyce Hyam, RN

April 12, 2013Apr 12, 20134

Just three words, a short phrase, heard from an ICU nurse that changed my friend’s well-being as she lay in an ICU bed. In fact, it is the only phrase my friend remembers from her entire hospital stay after having…

She was experiencing nausea, a sick feeling, and needing and wanting care, direction, and guidance from hospital staff. And three powerful words spoken from a …

Health policy

The Physician Payment Sunshine Act is here: Are you ready?

American Medical Association & Jeremy Lazarus, MD

April 12, 2013Apr 12, 20132

A guest column by the American Medical Association, exclusive to KevinMD.com. Information is a source of learning. But unless it is organized, processed and available to the right people in a format for decision making, it is a burden, not…

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

Information is a source of learning. But unless it is organized, processed and available to the right people in a format for decision making, it is a burden, not a benefit.

-Former ServiceMaster CEO C. William Pollard

The new Physician Payment Sunshine Act (Sunshine Act) was created by Congress to ensure transparency in physicians’ interactions with the pharmaceutical, biologic and medical device …

Real physician voices, twice a week

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