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Holding doctors accountable: The role of teaching hospitals

Medical Education

January 7, 2013

Fourth year medical students are starting the interview process to match into a residency program – their next and potentially final stage of training.

Over the next few months, these students will rank the programs they visit based on features such as geography, research funding, and hospital affiliations. But there’s another factor to consider – one that gets little attention but that probably matters more for the kind of doctors they’ll become. …

Screening for ovarian cancer: Where’s the outrage?

Peter Ubel, MD

Conditions and Diseases

January 7, 2013

In September the United States Preventive Services Task Force, a panel of medical experts, concluded that tests to screen for ovarian cancer do more harm than good. As a result, insurers will not be required by federal law to pay for such tests.

And the announcement was met with near silence.

Why was this recommendation greeted with such malaise when the same panel’s earlier and similar conclusions about Read more…

Screening for ovarian cancer: Where’s the outrage?

Cut back on screen time for kids

Claire McCarthy, MD

Conditions and Diseases

January 7, 2013

When it comes to getting parents to cut back on their kids’ screen time, we doctors aren’t doing such a great job.

Like most of my colleagues, I talk about screen time at almost all checkups. I talk about how too much screen time makes a kid more likely to be overweight and have behavioral problems. With the parents of babies and …

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Cut back on screen time for kids

When physicians don’t communicate about their patients

Michael Kirsch, MD

Physician

January 7, 2013

One of the gripes that patients have about the medical profession is that we physicians don’t communicate sufficiently about our patients. In my view, this criticism is spot on.

Patients we see in the office often have several physicians participating in their care. The level of communication among us is variable. While electronic medical records (EMR) has the potential to facilitate communication between physicians’ offices and hospitals, the promise has not …

The recipe for a great hospitalist program

Janice Boughton, MD

Physician

January 7, 2013

Internal medicine is the branch of medicine that deals with diseases of the internal organs in adults. It also involves dermatology, minor surgical procedures, general psychiatry and preventive care of well people. It is an excellent field, full of opportunities to think and feel and connect with people, mysteries to be solved and an endless variety of stuff to be learned. …

The role of alcohol in health costs

Edmund Kwok, MD

Physician

January 6, 2013

Defined as someone “having the faculties impaired by alcohol, those of us who work in an acute healthcare facility are witness to many illustrious examples of drunk patients coming through our doors.

Underaged kids passed out at a house party? Yup. Raging alcoholics who are brought into the ER at least once a week? Sure. Elderly women who secretly binges on wine …

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The role of alcohol in health costs

It’s time to stop being afraid to study gun violence

Cathleen Collins, MD, PhD

Physician

January 6, 2013

A new message pops up on my phone. I signal to the attending and step out of the OR. I’m on anesthesia rotation at Santa Clara Valley Medical Center, as a pediatrics resident at Lucile Packard Children’s Hospital at Stanford. But because I’m also a mom to a first grader in Cupertino, both my pager and my cell phone are frequently “on call”.

“I want to take this opportunity to update …

The duality that cancer patients face

Andrew Griffith

Patient

January 6, 2013

We are often pulled in different, opposing directions, and take time to find the balance between acceptance and anger, surrender and control, individual and group, being and thinking, living and dying. How we find balance and what that balance is influences our attitude.

Throughout my journey, I was struck by a number of dichotomies, or dualities, as I reflected on my reactions …

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The duality that cancer patients face

Incremental improvement in medical education is not enough

Michael Moore

Medical Education

January 5, 2013

Going to a new medical school working its way through the accreditation process is, by design, a bit of an experiment. A school wants to establish itself as distinctive, but in the end, it seems that doing anything radical is out of the question. The drive to conform to professional standards and expectations is a good thing. It generally prevents schools from bilking students of grand amounts of money while …

2 ways to help your patients get better sleep

Julia Schlam Edelman, MD

Conditions and Diseases

January 5, 2013

Are you or your patients sleeping well? Mine are not, and I wasn’t either. Do you ask them how they sleep? I never used to ask, and no one asked me. When I was in medical school, we had rigorous instruction in taking detailed medical histories. Sleep quantity and quality were not included.

What changed? Is it the digital age we live …

Protect yourself against fraudulent EHR documentation

Robert Hitchcock, MD

Health Technology

January 5, 2013

As physicians, we know that no matter what care we provide, Medicare and private payers are going to do what they can to reduce payouts. For the health of the nation, healthcare spending simply cannot continue on its current trajectory. Reform measures such as accountable care organizations, bundled payments and penalties for potentially preventable complications and readmissions may help reduce expenditures, …

The increasing stress that radiologists face

Matthew D. Rifkin, MD

Physician

January 5, 2013

In the past, the radiology profession was seen as a very financially successful specialty, but as every businessperson knows, success often has peaks and valleys. Radiology residencies are some of the most competitive to obtain, which is due to the combination of expected financial compensation and the assumed quality of life.

In the early 1990’s, when financial pressures first appeared on the …

How to get the most out of your oncology appointments

Naoto Ueno, MD, PhD

Patient

January 4, 2013

As a patient, you’re entitled to ask your health care providers anything. In that sense, there are no bad questions.

But some questions will help you get more out of your interaction with your health care providers than others. This advice comes from my experience as a medical oncologist and a cancer survivor.

Before asking your questions, remember that you’re dealing with a …

Will doctors recommend health apps to patients?

Jeff Livingston, MD

Health Technology

January 4, 2013

There has been an explosion in health apps. Patients are using them for weight loss, calorie counting, exercise monitoring, ovulation calculation and for many other health needs. But to truly integrate the concept of health apps in the health care system healthcare providers will need to get involved. There is discussion in the health IT world lately regarding physician adoption of …

The critical factors driving up American health costs

Samuel Metz, MD

Health Policy

January 4, 2013

The Bipartisan Policy Report titled “What is Driving US Health Care Spending? America’s Unsustainable Health Care Cost Growth” issued in September lists seven factors increasing American health care costs. The “fiscal cliff” debates include many of these arguments.

While these factors do indeed play roles in American health care, almost all are at work in other industrialized countries, all of whom provide better care to more people for half what we …

The physicians of today have given up their unique soul

David Gelber, MD

Physician

January 4, 2013

I had a conversation with a family practice physician today, a man who is far closer to the end of his career than the beginning. He is part of a private practice group that recently was sold to one of the larger hospital groups in the area, which put him on a salary, but also allowed him to work only three days per week. He stated that the decrease in …

Dramatically influence drug prices by positive action

Jay Ham, MD

Medications

January 4, 2013

Doctors at Memorial Sloan-Kettering Cancer Center recently declared they would not use Zaltrap (Sanofi), for advanced colorectal cancer. In a New York Times editorial, they suggested the extraordinary cost for incremental benefit could not justify its use. Sanofi appeared to cave to the pressure and announced a 50% discount – which only made things worse.

This August, Zaltrap received FDA approval for the treatment of advanced colorectal cancer. In …

ObamaCare: All roads lead to single payer

David Mokotoff, MD

Health Policy

January 3, 2013

When the marketing of ObamaCare began in 2009, I always believed that the end game was for a federal single payer system. Since the present Affordable Care Act, (ACA), was passed in 2010, there has been nothing to convince me otherwise. The only reason single-payer wasn’t passed two years ago was because it was hard enough to arm-twist and bribe even …

How health reform can eliminate health disparities

Steven A. Green, MD

Health Policy

January 3, 2013

As millions of Americans gain health care coverage under the Affordable Care Act, we have an unprecedented opportunity to work on eliminating health disparities based on race, income and insurance status. Several states, including California, soon will begin marketing their Health Benefits Exchanges (in our state it’s called “Covered California”). Through these exchanges, millions will enroll in health plans and expanded Medicaid programs for coverage that takes effect in January …

Your doctor has sold his practice: 6 tips for patients

Cary Presant, MD

Physician

January 3, 2013

The Affordable Care Act comes with the promise of a dramatic overhaul in what many see as a broken health care system. It promotes the potential for “better all around” – better care, easier access to hospitals, and affordable treatment. It also comes with a price. For one reason or another, the turbulence within the American health care system is causing doctors to shut down, downsizing or sell their practices …

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