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In medicine, is there a place for learning from those we serve?

Karan Chhabra

Medical Education

August 25, 2012

Inhalation. Exhalation. Perspiration. Equivocation. Self-Abnegation. Devastation. Urination.

The list of things I’ve endured in the name of getting to medical school could go on, and I doubt it’s any different from my classmates’. But we’re here, finally, freshly white-coated and already racing just to stay on track.

The White Coat Ceremony was a timely, though sometimes tearful reminder of what we did to get here, why we did it, and what we’re …

6 tips for choosing the right water drink

Mary Ellen Herndon, MPH, RD

Conditions and Diseases

August 25, 2012

Flavored water. Water with electrolytes. Tonic water. Sparkling water. Seltzer.

Grocery shelves are packed with so-called water options. But not every drink that bills itself as water is the real deal.

Many drinks labeled as water are loaded with sugar and empty calories. Even though these drinks have ‘water’ in their name, drinking them regularly may cause weight gain and may increase your risk of obesity.

And, that’s bad news because maintaining a …

Artificial death extension: It means that I actually care

Monica Williams-Murphy, MD

Physician

August 25, 2012

The names of things often greatly affect our perception. In end of life lexicon, there is a movement underway to change the name of the medical order DNR (do not resuscitate) to AND (allow natural death). No change in the medical reality of what occurs, but a radical change in our emotional reaction to the each term.

DNR: “They withholding a medical intervention” (evoking negative feelings).

AND: “They are giving care that …

Inducing anesthesia on YouTube: How many ways is this wrong?

Karen S. Sibert, MD

Physician

August 24, 2012

Really, sir. What were you thinking?

I’m talking to you—the anesthesia provider (I hate to think that you might be an anesthesiologist) who allowed himself to be videotaped while a patient injected his own induction dose of propofol. Most people know something about propofol even if they aren’t in the anesthesia business–that’s the medication that Dr. Conrad Murray gave Michael Jackson to everyone’s sorrow.

I would insert the link here, but the …

How do I tell my son that I have cancer?

Michael Solomon

Patient

August 24, 2012

An excerpt from Now It’s Funny: How I Survived Cancer, Divorce and Other Looming Disasters.

What am I supposed to tell Luke? When do I even tell him anything? How do I tell him? I remember when I was a kid and my mother was hospitalized with some problem (to this day I’m not quite sure what it was) and she was gone for a few days and then back …

While politicians are fighting, patients are being ignored

Rob Lamberts, MD

Health Policy

August 24, 2012

Us and Them
And after all we’re only ordinary men

The wanna-be congressman appeared with his neat hair and pressed suit, a competent yet compassionate expression on his face. ”The first thing I am going to do when I get to congress is to work to repeal Obamacare,” he said, expression growing subtly angry. ”I will do everything I can to give you back the care you need from those who think big …

Are emergency department pediatric transfers always necessary?

Christopher Johnson, MD

Physician

August 24, 2012

There are about 27 million visits by children to America’s emergency departments each year. About a quarter of those are to rural EDs or ones at some distance from a dedicated children’s facility, such as a children’s hospital. Over the last decade or so it’s become clear that, for critically ill children, early transfer to an advanced pediatric facility improves outcomes. The children do better if they can be transferred …

Test results without physician guidance will cause patient anxiety

Kevin Pho, MD

KevinMD

August 23, 2012

The following column was published on August 5th, 2012 in USA Today.

A patient once blamed me for causing him considerable anxiety because he had to wait several weeks before receiving the results of a lab test, which I had ordered. Many patients commonly have to wait days, if not weeks, before getting lab results from their doctor. The delay can affect patients’ health negatively.

For instance, one study looked at women who underwent …

Vitamin D and calcium in women: One doctor’s advice

Steven Reznick, MD

Medications

August 23, 2012

As a geriatrician who believes strongly in prevention, my perspective is that the recent high volume of research on healthy aging, chronic disease and its association with vitamin D and calcium supplementation has done nothing but confuse the picture for us all. I have always been an advocate of healthy eating – a balanced diet that is prepared in a manner that retains and promotes the absorption of the foods …

What the Romney-Ryan and Obama Medicare plans have in common

Bob Doherty

Health Policy

August 23, 2012

Which of the candidates for President proposes to give people a defined amount of federal money (call it a voucher) to buy coverage from competing qualified private insurers (under federal benefit mandates) offered through a health insurance marketplace run by government?

The answer: Mr. Romney, and his new running mate, Paul Ryan. And President Obama.

How is that, you say? Isn’t the Romney/Ryan vision of how to reform health care diametrically opposed …

Curbing Medicare costs: Are seniors or the government responsible?

Merrill Goozner

Health Policy

August 23, 2012

Medicare has moved to the center of this year’s presidential campaign for a single overriding reason: shrinking the nation’s long-term government deficit demands dealing with health care costs. No one – left, center or right – disagrees with that analysis.

What they also agree on is that limiting health care’s inexorable growth will require cutting future payments to those who deliver care – the doctors and hospitals, the nursing homes and …

Will physicians be caught in the ACO web?

Kerry A. Willis, MD

Health Policy

August 23, 2012

I’m a big fan of the current Direct TV ads. One of my favorites involves a guy who goes to a self-help seminar, becomes overconfident, goes to Las Vegas and loses everything, and has to sell his hair to eat. The ads are all based around the theme of avoiding making mistakes by becoming something that you are not intended to become.

I think there is much for doctors to learn …

Work hour reform is a moral imperative

Vinay Prasad, MD

Physician

August 22, 2012

While new doctors in Europe “enjoy” 50 to 60 hour work weeks, doctors in the US work up to 80 hours a week, and sometimes beyond that. But the situation is changing.

One year has passed since new limits on the number of hours doctors can work in their first job. For first year physicians, shifts are limited to 16 hours, and in other years, the limit is 28 hours.

There has …

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Work hour reform is a moral imperative

Helpful things to say to someone who’s sick

Toni Bernhard, JD

Patient

August 22, 2012

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It’s easy for those with health problems to complain about what we don’t want to hear others say to us, but I thought it might be helpful to let others know what we wish they would say to us.

“You look so good, but how are you really feeling?”

It’s hard for us to respond to comments like, “You look so good” (or …

Will Obama or Romney save Medicare? And who’s telling the truth?

Robert Laszewski

Health Policy

August 22, 2012

They both are and they both aren’t.

I’ve never seen a week in health care policy like last week. The media reports have to be in the thousands, all trying to make sense of the furious debate between Obama and Romney over Medicare.

As someone who has studied this issue for more than 20 years, it has also been more than exasperating for me to watch each side trade claims and for …

Use public health models to reduce gun violence

Katherine Ellington

Conditions and Diseases

August 22, 2012

Violence is the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.
-World Health Organization

When I was a child, I loved riding my purple bike up and down the street of my neighborhood. Boundaries were set as to how far and …

Why we need to suffer the growing pains of electronic health records

Richard Just, MD

Health Technology

August 22, 2012

My group purchased our electronic health records system (EHR) about 5 years ago. We had 4 clinical practice locations (soon to be 5 1/2) with 1 administration office. None of these sites are close to each other. A major reason for purchasing an EHR was, and still is, to collect and analyze all data from our entire practice for the purpose of determining outcomes of our treatments. In other words, …

Most of the homeless are invisible

Nilesh Kalyanaraman, MD

Physician

August 21, 2012

Last week I went on my first outreach visit to the homeless. In preparation we stocked up on water, gloves, gauze, and medications, put on our sneakers and headed out to the streets. We exited the front of the building, turned right and walked three blocks until we reached the corner with the highway on-ramp. We started crossing the street and about halfway, just past the service road and before …

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Most of the homeless are invisible

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