For the families who lost children, their world as they knew it has effectively ended. Yet somehow the sun rises again and the next day is here. For the rest of us grieving along with these families, the only way to move forward is to take what President Obama called “meaningful action.” I interpret this to be action that is radical and significant enough that it will somehow give meaning …
How can we as a society honor the dead children?
For the majority of physicians in the U.S., taking their skills abroad and providing care via medical missions in undeveloped countries is usually not an option. For me, that was always an option. I am an OB-GYN who works as a locum tenens, a traveling physician who temporarily fulfills the duties of another. This has provided me the flexibility to have …
Locum tenens prepared me to volunteer in undeveloped countries
“As flies to wanton boys, are we to the gods. They kill us for their sport.”
-King Lear, Act IV
There are certain days that everyone will always remember. People of my generation uniformly remember where they were and what they were doing the day that John F. Kennedy was shot. My children’s generation will never forget 9-11. For my parent’s generation, images of Pearl Harbor, D-Day, Hiroshima and Nagasaki were burned …
It is almost midnight: Can this day be over soon?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 65-year-old man is evaluated for a 1-month history of headaches and blurred vision, early satiety, and itching that occurs after showering. He has a 90-pack-year smoking history. He has no history of cardiopulmonary or sleep disorders, no other medical problems, and he takes no medications.
On physical examination, temperature is normal, blood pressure is …
MKSAP: 65-year-old man with headaches and blurred vision
Recently, “60 Minutes” (in my view the last bastion of great traditional network news investigative reporting) described a for-profit hospital system that apparently uses percent targets (allegedly 20%) to encourage high admission rates by their ER doctors.
In setting up this report, the reporter commented that as much as 10% of healthcare expenditures in this country were “unnecessary.”
Actually, most health experts I have read and consulted would put that number much …
Medical homes need ready access to good data
A lot of us get health benefits through our workplace, and employers are increasingly turning to wellness programs as a means of reducing costs and improving productivity.
In the coming year, as aspects of the Affordable Care Act take effect, many employers will provide even greater incentives for participation in programs that require the employee to achieve certain wellness goals, such as smoking cessation or weight loss.
What this means for the …
Motivating employees to meet their wellness goals
You may have noticed that stores everywhere, and restaurants, too, are getting mobile — as in mobile technology. In a store like Nordstrom, where thousands of items in many departments must be inventoried and managed, it saves a lot of time, personnel, and therefore money, at least for the store. From last season’s belts to the spring’s platform shoes, it is in the system, on the iPod and available for …
Shopping for items in the operating room
Even if you’re not involved on social media as a business, your employees or staff are more than likely on social media in their personal lives. And even innocent-seeming posts, tweets, pins or shares can leads to big repercussions if they are perceived as violating patient confidentiality. It is because of this that every medical office needs to set a social media policy to avoid any privacy or HIPAA violations.
First …
Does your medical office have a social media policy?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 62-year-old man is evaluated during a routine examination. Medical history is significant for a myocardial infarction 3 years ago, dyslipidemia, hypertension, tobacco use, and drinking two alcoholic drinks per day. Medications are an ACE inhibitor, a statin, a β-blocker, and aspirin. He participates in cardiac rehabilitation, exercising four to five times per week.
On …
MKSAP: 62-year-old man is evaluated during a routine examination
Insurers will also play a pivotal role in the development and adoption of patient-focused mobile health (mHealth) technology adoption for wellness as well as for the management of chronic diseases.
1. Payers hold the purse strings. Insurers will be the ones paying for the use of mHealth for chronic disease management for the vast majority of patients. They have a vested interest …
Mobile health technology adoption depends on insurers
It used to be that radiologists mainly helped out your doctor so that they could figure out what was ailing you. Such is no longer the case.
Nowadays, with the easy access to almost any doctor of any specialty, you can visit your radiologist, obtain a needed study (or procedure, in the case of an interventional radiologist), and never even see your …
Don’t be afraid to ask your radiologist for help
It’s Saturday night at an emergency department (ED) in Boston, MA, and I am faced with a medical student’s dream dilemma: which one of the many interesting cases should I observe? Should I watch trauma surgeons operate on the 17-year-old gunshot victim or work with the ED docs to assess whether a 59-year-old woman is having an acute stroke? That is exactly what I adored about emergency medicine as a …
How my ER rotation turned me into a primary care doctor
A guest column by the American Medical Association, exclusive to KevinMD.com.
When health plans have merged, they’ve said that a bigger insurance company would drive down premiums. The casual acceptance of this economic fallacy led to more than a decade of unchecked megamergers that helped health plans cement dominant market positions across the country.
It’s now clear that when health insurers talk …
AMA: Patients are vulnerable to health plan monopoly power
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Let me tell you a secret. Examining eardrums in a squirming, angry child is really difficult—if not impossible. If the doc in your screaming, struggling child’s ear for a half-second, it’s unlikely that anything useful was seen.
Sometimes, it is just impossible to get a decent exam. But there are ways that parents (and doctors!) can help at least increase the chance …
Tips to examine the eardrum of the squirming, angry child
On November 17th, I celebrated the three-year anniversary of the end of my leukemia relapse treatment. In going through the day, I thought a lot about what I went through. I thought a lot about how I ever survived it all. I remember so vividly those hopeless moments, hours, days, months of nausea, pain, and so many forms of discomfort. What stands out to me was the hopelessness and …
When there was no hope, I used my imagination to create it
Chains do not hold a marriage together. It is threads, hundreds of tiny threads which sew people together through the years.
– Simone Signoret
Allen’s cancer has continued to grow quickly. He raises his chin so I can see. I check my notes from a month ago and pull out my ruler and make new measurements. I jot down my findings and turn to look him in the eye. We both know this …
Tiny threads hold a marriage together
Be obscure clearly.
-E. B. White
As a family doctor, I work at clarifying obscurity about the human condition daily, dependent on my patients to communicate the information I need to make a sound diagnosis and treatment recommendation. To begin with, there is much that is still unknown and difficult to understand about psychology, physiology and anatomy. Then throw in a disease process …
I work at clarifying obscurity about the human condition daily
Doctor: What medicines do you take at home?
Patient: Something for the diabetes.
Doctor: Do you know the name of it?
Patient: “Starts with an M. Or a P. Honey, what’s the name of that pill?
Wife: Well dear, I don’t know but it’s a little blue one. You know doc, the little blue one?
Nothing will drive your health care provider more crazy than conversations …
Know which medicines you take and why you take them
When you walked into the voting booth on Tuesday, November 6, did you do so with a feeling of calm certainty that the man who would get your vote for President was unquestionably the best choice, or even the only possible choice? Did you feel confident that your candidate’s political party fully supports your political views as well as your personal values?
For many physicians, I suspect that the answer to …
Neither political party truly represents doctors or their patients
It’s 3:30 am and my clock alarm is singing some song that I used to like. I roll over to turn it off all the while thinking to myself: “I am waking up to stand for the next 12 hours straight holding a retractor. No one is going to care that I am there, and if I am even acknowledged …
To the health professionals during hurricane Sandy: Thank you
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