KevinMD.com

December 24, 2012Dec 24, 20122

I can always count on Mr. Wonderful to come up with a timely subject for my blog. Today’s quotable is, “Dear G-d, I have a problem. My problem is me!” Some days it feels like I spend half my time…

I can always count on Mr. Wonderful to come up with a timely subject for my blog. Today’s quotable is, “Dear G-d, I have a problem. My problem is me!”

Some days it feels like I spend half my time trying to convince patients that they need to change their ways in order to get healthy. I often spend the other half of my time treating the effects of their bad …

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I have a problem and my problem is me

Physician voices

Primary care doctors may no longer be needed

Doug Olson, MD

December 24, 2012Dec 24, 2012218

As a primary care doctor, my days are busy. Seeing patient after patient, I try to provide the most patient-centric, evidence based care that I can. But if I read anything about healthcare reform, it will tell me that 80-85% of the patients I see can be seen by a nurse practitioner or a physician’s assistant. So why did I train for an extra 3-4 years as a doctor, incur …

Drugs and prescribing

Advair and the long acting beta agonist paradox

Larry Chiaramonte, MD

December 24, 2012Dec 24, 20122

The long-acting beta agonist (LABA) paradox strikes again. A new article in a Milwaukee newspaper sounds an old theme. Advair, the most widely used asthma medicine, contains a long-acting beta agonist—salmeterol. “ ong-acting beta-agonists have been linked to 1,900 asthma…

“[L]ong-acting beta-agonists have been linked to 1,900 asthma deaths from 2004 through 2011, according to an estimate provided by AdverseEvents Inc., a private firm that analyzes drug side effect data reported to …

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Physician voices

The insanity of pain management in the ER

William Jantsch, MD

December 23, 2012Dec 23, 201249

One of medicine’s ethical traditions is to relieve suffering whenever possible. I believe in this, and try to treat all of my patients as I myself would want to be treated under similar circumstances. My dilemma is, even after practicing…

My dilemma is, even after practicing medicine for over 30 years, the definition of a “suffering patient” has become a moving target.

On the one hand, I hear arguments primarily from governmental agencies that presume to “advocate for …

Physician voices

At the end of life, never underestimate the power of a map

Monica Williams-Murphy, MD

December 23, 2012Dec 23, 20125

When you set out on an unfamiliar journey, you will need a map to get to your desired destination. You may pass landmarks, but not know exactly where you are unless you are able to identify these landmarks on your…

You may know …

Health policy

One doctor’s holiday wish list

Suzanne Koven, MD

December 23, 2012Dec 23, 20124

Many years ago, I wrote this essay in which I wondered why I receive so few gifts from my patients in the holiday season. I was prompted to write the essay by the memory of my father, an orthopedic surgeon in solo practice, whose patients showered him every December with foil-wrapped bottles of booze, tins of cookies, and all manner of goodies, including a “World’s Greatest Doctor Figurine.”

I speculated …

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One doctor’s holiday wish list

Physician voices

3 clear signs that you work in a hospital

Brian J. Secemsky, MD

December 22, 2012Dec 22, 20124

You try to hide it. You leave the scrubs in the locker-room, the shop-talk at the staff dining hall and the on-call phone consults outside in the cold, away from the highly-anticipated dinner date or holiday party. But regardless how…

You try to hide it.

You leave the scrubs in the locker-room, the shop-talk at the staff dining hall and the on-call phone consults outside in the cold, away from the highly-anticipated dinner date or holiday party.

But regardless how much effort you put into leaving your career where it belongs, it is so obvious that you work in a hospital.

And here are …

Physician voices

Improve your work life balance: A schedule hack for doctors

Dike Drummond, MD

December 22, 2012Dec 22, 201210

In this article I will show you a push button shortcut you can use to quickly create more work-life balance, no matter how busy your practice and your life feels at the moment. When it comes to creating balance between…

In this article I will show you a push button shortcut you can use to quickly create more work-life balance, no matter how busy your practice and your life feels at the moment.

When it comes to creating balance between your medical career and your life, there is a simple rule in play. The strongest structure wins. When we are talking about …

Conditions and diseases

Why the media will slow the healing of Sandy Hook

MedPage Today

December 22, 2012Dec 22, 2012

When Newtown children returned to area elementary schools less than a week after the massacre at Sandy Hook Elementary, the cameras were watching, a reality that may slow healing in the Connecticut community. Although there's no literature that's specific to…

Although there’s no literature that’s specific to the effects of a media frenzy after a school shooting on children’s psychological recovery, there’s plenty of other applicable evidence, according …

Conditions and diseases

Make the correct choice for cancer treatment: Questions to ask

Itzhak Brook, MD

December 22, 2012Dec 22, 20122

Choosing the best treatment for cancer may be challenging and difficult. Patients should be well informed before making their choice. Communication between the patient and family and their medical team including their physician is very important. The medical team should…

The medical team should describe the available treatment choices to the patient and the expected results of each of them as well as their possible side effects. Patients should carefully consider the available options and …

Physician voices

What doctors can learn from working at Starbucks

Linda Pourmassina, MD

December 21, 2012Dec 21, 201223

She sat in her crisp, white coat, probably not much older than I am now, leaning back with all of the assurance of someone who recently completed a cardiology fellowship, newly hired by the academic medical center to which I was applying for residency. One of the first of many interviews for me, the conversation was anything but smooth. She clearly …

Health policy

The deep professional rift between nursing and medicine

Alana Rose, RN

December 21, 2012Dec 21, 201213

I recently attended Primary Care Progress’s Gregg Stracks Leadership Summit. The summit brought together chapter leaders from around the country to get coaching in how to lead our chapters to accomplish our individual goals. I went to the summit knowing…

I went to the summit knowing that PCP values teams – the team-based model of organizing to improve the primary care profession and the team-based model of primary care delivery. In both cases, there would be a …

Health policy

Predicting the next 4 years of health reform

Joanne Conroy, MD

December 21, 2012Dec 21, 2012

Although members of the Obama team are now celebrating their election victory, the next four years will not be smooth sailing. Ignoring the campaign rhetoric, there is still much more work to be done in order to reshape our health…

The political conscience is still being driven by …

Physician voices

Dear patients: Thank you for teaching me

Maria Yang, MD

December 21, 2012Dec 21, 20122

Dear Patient(s), Thank you for educating me. Thank you for letting me shine bright lights into your eyes and place Q-tips up your nose. Thank you for not shooting me a dirty look when I ask you to lift up…

Dear Patient(s),

Thank you for educating me.

Thank you for letting me shine bright lights into your eyes and place Q-tips up your nose. Thank you for not shooting me a dirty look when I ask you to lift up your pendulous breast so I can listen to your heart. Thank you for letting me ogle at your protuberant belly—whether it contains a baby, a liver tumor, or liters of fluid inside. …

Patient voices

Learn to celebrate Christmas: Lessons from hospice patients

Andy Milligan, RN

December 21, 2012Dec 21, 20122

For years I've been asked the same question: "How can you work in hospice and be around death everyday?" As if death, like this year's flu, were something we could all just avoid so long as we stay away from…

For years I’ve been asked the same question: “How can you work in hospice and be around death everyday?” As if death, like this year’s flu, were something we could all just avoid so long as we stay away from it. This question, however, takes on a bit of a different form this time of year as people’s thoughts are centered much more around family. The question becomes more of …

Physician voices

The problem with discussing politics in the exam room

Manoj Jain, MD, MPH

December 21, 2012Dec 21, 20125

Four years ago, as I was making rounds on the oncology floor, one of my patients with leukemia asked, out of the blue, "Hey, Doc, who you gonna vote for?" He had an Obama T-shirt by his bedside. Chuckling politely,…

Four years ago, as I was making rounds on the oncology floor, one of my patients with leukemia asked, out of the blue, “Hey, Doc, who you gonna vote for?” He had an Obama T-shirt by his bedside.

Chuckling politely, I asked him why he wanted to know. “I’m curious, Doc,” he said. “It tells me your worldview.” He said that if we agreed on who should be the next president, …

Physician voices

The folly of breasts and politics

Michael Kirsch, MD

December 20, 2012Dec 20, 20125

This blog is about freedom and personal responsibility. I have opined that cigarette smokers should not be permitted to transfer total responsibility for the consequences of their choices to the tobacco companies, even if this industry has committed legal and ethical improprieties. I do not support the politically correct beverage ban in New York City, sure to spread elsewhere, where the …

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The folly of breasts and politics

Physician voices

Did any doctor ask Nancy Lanza about guns?

Suzanne Koven, MD

December 20, 2012Dec 20, 201238

Suppose 20 children and 6 adults died at a school in a very short time period. And suppose there were clusters of similar deaths, many of young healthy people, around the country: at a movie theater, a shopping mall, a high school, a house of worship. Would you expect the Center for Disease Control to get involved in trying to figure out why these people died and how to prevent …

Health policy

Why across the board Medicare cuts are a bad idea

Janice Boughton, MD

December 20, 2012Dec 20, 20123

American Medical News featured an article with the disturbing title, "Massive health job losses expected if Medicare sequester prevails." I wasn't entirely sure what a "sequester" was, since I thought it was a verb. Sequestration, I thought, was the noun.…

American Medical News featured an article with the disturbing title, “Massive health job losses expected if Medicare sequester prevails.”

I wasn’t entirely sure what a “sequester” was, since I thought it was a verb. Sequestration, I thought, was the noun. (I hear a loud knock. It must be the grammar police.) The story, as I understand it, is that when our government decided to pull together and raise the debt ceiling, …

Health policy

The cost of health insurance in 2014: Get ready for sticker shock

Robert Laszewski

December 20, 2012Dec 20, 20127

What will health insurance cost in 2014? Will the new health insurance exchanges be ready on time or will the law have to be delayed? There will be sticker shock First, get ready for some startling rate increases in the…

What will health insurance cost in 2014?

Will the new health insurance exchanges be ready on time or will the law have to be delayed?

There will be sticker shock

First, get ready for some startling rate increases in the individual and small group health insurance marketplace due to the changes the law dictates.

In a November 2009 report, the CBO estimated that premiums in the individual market would increase 10% to 13% …

Real physician voices, twice a week

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