KevinMD.com

January 16, 2013Jan 16, 20137

A guest column by the American College of Physicians, exclusive to KevinMD.com. Two years ago, my practice became a patient-centered medical home (PCMH), or more accurately, my practice began the transition towards delivering patient care under this new model. While…

A guest column by the American College of Physicians, exclusive to KevinMD.com.

Two years ago, my practice became a patient-centered medical home (PCMH), or more accurately, my practice began the transition towards delivering patient care under this new model. While that process is far from complete at this point, it’s been a positive experience. This month, I’d like to share some observations that might help those of you who are …

Health policy

The Affordable Care Act still has hurdles before full implementation

Brad Wright, PhD

January 15, 2013Jan 15, 20136

The Patient Protection and Affordable Care Act cleared two major hurdles in 2012: the Supreme Court ruling on constitutionality and the reelection of President Barack Obama. However, in 2013 there is a very good chance that Courts will see much more of the health care reform law due to objections regarding the contraception mandate. Despite the bills legal successes in the past, there are (at publication) more than …

Conditions and diseases

New Year’s resolution: Get healthy to improve surgical outcomes

Nina Singh-Radcliff, MD

January 15, 2013Jan 15, 2013

Losing weight can decrease the incidence of several chronic and debilitating diseases, as well as their associated complications and risks during the surgical period. Additionally, it can facilitate recovery after surgery. Obesity increases the risk for: Diabetes Obstructive sleep apnea…

Diabetes
Obstructive sleep apnea
Hypertension
Cardiovascular disease
Depression
Joint degeneration
Cancer

Additionally, obese patients may present special challenges for anesthesiologists:

Blood pressure monitoring (finding an appropriate fitting blood pressure cuff)
Locating

…

Real physician voices, twice a week

Free, and one click to unsubscribe.

Health technology

How secure messaging and email benefit patients and improve outcomes

Dave Chase

January 15, 2013Jan 15, 20132

”Email is the killer app of patient portals.” I heard a variation of that quote when interviewing people for the patient-provider communication chapter of the book I’ve been co-editing and writing for HIMSS with Jan Oldenburg, Brad Tritle and Kate…

”Email is the killer app of patient portals.”

I heard a variation of that quote when interviewing people for the patient-provider communication chapter of the book I’ve been co-editing and writing for HIMSS with Jan Oldenburg, Brad Tritle and Kate Christensen. For the organizations who’ve pushed patient portals the furthest into their patient base, email is always the place where things started. In other words, email is the gateway drug for …

Physician voices

Can winning the war of words help my patients?

Rob Lamberts, MD

January 15, 2013Jan 15, 2013

I should be encouraged. I was asked to talk on public radio last week about my new practice, then I was on a panel of “experts” in Washington DC on Monday. Everywhere I talk about what I am doing I get positive reactions. I get very positive reactions, actually. I was approached by someone wanting to work with me “when I get …

Medical education

Be the bad guy with good intentions

Shara Yurkiewicz

January 14, 2013Jan 14, 201324

“You’re not sorry.” Within two days two different patients said this to me, each with hatred in his voice. Each time I was alone, each time I had known the patient for only a few minutes, and each time the…

“You’re not sorry.”

Within two days two different patients said this to me, each with hatred in his voice. Each time I was alone, each time I had known the patient for only a few minutes, and each time the rage was directed at me and only me.

For seven months, I had avoided being the bad guy. When a patient got upset, he accused my superiors, and I hid behind their …

Read more…

Be the bad guy with good intentions

Patient voices

Organ recipients need strong partnerships with their doctors

Anabel Stenzel

January 14, 2013Jan 14, 2013

I am a cystic fibrosis (CF) patient with a complex medical history that either intrigues or intimidates medical providers. At 40, I’ve dealt with a lifetime of progressive lung disease, gastrointestinal complications and other later onset issues from CF such as osteopenia, diabetes and bowel cancer. I often joke that the recessive CF gene that my identical twin sister and I inherited from our Japanese mother and German father is …

Physician voices

Why is Medicare going after hospices?

Miranda Fielding, MD

January 14, 2013Jan 14, 201325

Seven months ago, in Carbondale, Colorado, staff at the skilled nursing facility where my mother had resided for over a year recommended that she be placed on hospice. My mother has severe advanced dementia and can no longer walk, speak,…

As much as I know about hospice care for cancer patients here in San Diego, I knew nothing about hospice care in Carbondale for …

Read more…

Why is Medicare going after hospices?

Health policy

Trust but verify: Medicare’s approach to detecting EMR fraud

Ashish Jha, MD, MPH

January 14, 2013Jan 14, 2013

A recent New York Times headline read that "Medicare Is Faulted on Shift to Electronic Records." The story describes an Office of Inspector General (OIG) report, released November 29, 2012, that faults the Centers for Medicare and Medicaid Services (CMS)…

A recent New York Times headline read that “Medicare Is Faulted on Shift to Electronic Records.” The story describes an Office of Inspector General (OIG) report, released November 29, 2012, that faults the Centers for Medicare and Medicaid Services (CMS) for not providing adequate oversight of the Meaningful Use incentive program. Going after “waste, fraud, and abuse” always makes good headlines, but in this case, the story is …

Conditions and diseases

Bed alarms don’t work and won’t reduce patient falls

Ken Covinsky, MD

January 14, 2013Jan 14, 20135

Many older patients fall in the hospital and these falls often lead to injury. Hospitals are under a lot of pressure to reduce falls. Generally, these falls happen when patients transfer such as when an older person tries to get out of bed or get up from a chair. While hospitalized, many patients are weak, dizzy, or confused, and they can be at risk of falling when ambulating …

Medical education

Is it justifiable to judge a paper by its author or funding source?

Ilana Yurkiewicz

January 13, 2013Jan 13, 2013

Doctors use different standards to judge scientific research depending on who funded it. They judge research funded by industry as less rigorous, have less confidence in the results, and are less likely to prescribe new drugs than when the funding…

Those were the results of a study published by Harvard …

Physician voices

The surgery gods can be your best friend or your worst enemy

David Gelber, MD

January 13, 2013Jan 13, 2013

“Will this case take very long?” “If the surgery gods are with me we should be done in an hour.” The above brief exchange took place between me and the anesthesiologist attending to my patient on a recent surgery. The…

“Will this case take very long?”

“If the surgery gods are with me we should be done in an hour.”

The above brief exchange took place between me and the anesthesiologist attending to my patient on a recent surgery. The patient was a middle aged woman who was about to undergo surgery to relieve a small bowel obstruction. She had been visiting her husband in a distant city where he was working …

Physician voices

Why can’t we be more proactive in discharging patients?

Skeptical Scalpel, MD

January 13, 2013Jan 13, 201310

The recent hurricane in New York City and the closures of some hospitals requiring the transfer of a large number of patients reminded me of something that happened on 9/11/2001. I was working at a hospital near New York. You…

The recent hurricane in New York City and the closures of some hospitals requiring the transfer of a large number of patients reminded me of something that happened on 9/11/2001.

I was working at a hospital near New York. You may recall that among the many problems that day was a breakdown in communications. Reliable information on the number of casualties and extent of injuries was hard to determine.

Late on the …

Physician voices

Medical journals are shifting from science to politics

Wes Fisher, MD

January 13, 2013Jan 13, 20133

Medical journals aren't what they used to be. Just ten short years ago, medical journals were places to report scientific study, interesting cases or clinical updates and reviews. They were, for the most part, about science and discovery. Now, there…

Medical journals aren’t what they used to be. Just ten short years ago, medical journals were places to report scientific study, interesting cases or clinical updates and reviews. They were, for the most part, about science and discovery.

Now, there is a dramatic shift of scientific content in our journals to politics and policy.

No where is this more evident than the much-heralded and widely read New England Journal of …

Health technology

Computers are meaningless in health care without computable data

Margalit Gur-Arie

January 12, 2013Jan 12, 20134

If this were a business concerned with bottom lines, cash flows and sustainability, this would be a good time to begin planning one of those posh executive retreats to evaluate current strategy. People would be feverishly working on pulling data for PowerPoint presentations, summarizing market research and deciding whether to select the vegetarian meal or not. If this were a better …

Physician voices

Why the medical professions should be color blind

Peter Ubel, MD

January 12, 2013Jan 12, 201311

The role of race in college and graduate school admissions remains controversial in the U.S. In fact, the Supreme Court is currently taking up a challenge to a University of Texas program that considers race in its admission decisions. Critics of race-based admissions question whether educational institutions would serve the goals of affirmative action better by relying exclusively on non-race based criteria, such as socioeconomic status and family …

Health policy

The fiscal disaster of healthcare costs has a human toll

Timothy Johnson, MD, MPH

January 12, 2013Jan 12, 201313

Today, I come back to the tragedy of medical economics in this country. And I would apply that word "tragedy" in at least two ways. The first tragedy is that we are headed for fiscal disaster in this country because…

Today, I come back to the tragedy of medical economics in this country. And I would apply that word “tragedy” in at least two ways.

The first tragedy is that we are headed for fiscal disaster in this country because of healthcare costs.

We now spend twice as much per person on healthcare as the average per person cost of all developed countries. During the past several decades, the inflation rate for …

Health policy

After Sandy: Change needs to go beyond traditional disaster planning

David B. Nash, MD, MBA

January 12, 2013Jan 12, 2013

Not long after posting a recent column which, admittedly, was somewhat critical of healthcare providers in and around New York City following Super Storm Sandy, I decided to get a clearer picture from someone intimately connected to the disaster –…

A few months ago, Ira Nash, MD, was appointed Medical Director for Physician and Ambulatory Network Services at North Shore Long Island Jewish Health System (NSHS), a …

Health technology

Unlike EMRs, paper charts never crash

Michael Kirsch, MD

January 11, 2013Jan 11, 201326

Which of the following events is most traumatic for a practicing physician? Your staff doesn’t show up because the roads are flooded, but the waiting room is full of patients. Medicare notifies you that coding discrepancies will result in an…

Which of the following events is most traumatic for a practicing physician?

Your staff doesn’t show up because the roads are flooded, but the waiting room is full of patients.
Medicare notifies you that coding discrepancies will result in an audit of 2 years of Medicare records.
You receive an offer of employment by a corporate medical institution who will bury your practice if

…

Read more…

Unlike EMRs, paper charts never crash

Physician voices

Regulate medical research so that it can help patients

Kevin R. Campbell, MD

January 11, 2013Jan 11, 20135

Recently, my middle school daughter has been learning about the use of the scientific method in science class. In her school laboratory, she and the other sixth graders learn how to ask a question, perform background research, formulate a hypothesis, design and execute an experiment to test the hypothesis, and ultimately synthesize conclusions. She is being taught to accurately record and interpret data; the concept of manipulating data to suit …

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular