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How to train more physician leaders

Physician

July 30, 2012

In today’s healthcare environment, nearly half of all new physicians are salaried employees of a hospital or healthcare system. Now, more than ever, physician leadership is of paramount importance. With increasing pressure to increase care quality and simultaneously lower healthcare delivery cost, it is essential that physicians and administrators work together. Physicians must continue to grow into executive roles and lead both healthcare systems as well as manage other doctors …

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How to train more physician leaders

Go ahead and let teens read x-rays

Keegan Duchicela, MD

Physician

July 30, 2012

Costs are spiraling out of control, access is declining, and our quality of care doesn’t match what other developed nations are delivering at half the cost.

In the search to reduce costs and bring our ever inflating health care budget under control, the powers that be (insurers, government, health policy wonks (and maybe a few doctors) have looked to individuals with less formal education to perform medical services that were once …

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Go ahead and let teens read x-rays

Go behind the scenes of naming a drug

Suzanne Koven, MD

Medications

July 30, 2012

One summer in college, when I couldn’t think of what else to do, I lived near campus in a punishingly hot walk up apartment, held down three boring jobs, and took intensive Latin. Every morning we met in a blissfully air-conditioned classroom–that was the upside!– to conjugate and decline: a whole year of Latin in 6 weeks. I remember nothing I learned, of course. I’m reminded of the great Woody …

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Go behind the scenes of naming a drug

A tragedy based on administrative decisions

Jordan Grumet, MD

Physician

July 30, 2012

I gently rotated his arm as the beads of sweat formed on his forehead. The pain came in waves. His face contorted and relaxed in repetitive spasms. I wondered if my exam was in vain. The cancer had spread from his lungs to his liver and into his bones. Once the blood stream had been tainted, the aggressive cells took flight and landed in various organ systems.

We already had the conversation. I …

The circle of support in the critical moments of the cancer journey

Don S. Dizon, MD

Physician

July 29, 2012

On a recent trip to Philadelphia, I caught up with Dan, a friend of mine since college. He is an artist in Philly, where he lives with his wife and daughter. He had asked me about being an oncologist, told me he had read my ASCO blogs.

We spent hours discussing everything—parenthood, careers, and mutual friends, and one in particular. Her …

How to avoid Zumba injuries: 10 physician tips

Orly Avitzur, MD

Conditions and Diseases

July 29, 2012

Zumba, the Latin dance-inspired fitness craze, is a great way to burn calories, up to 500 per hour. It also gives you a good cardiovascular workout without making you feel like you’re exercising. This increasingly popular workout attracts a diverse crowd at dance studios and health clubs, including a sizable number of those 50 and up.

But for people who are out of shape, taking the first classes can be like …

Integrated care cannot change how we behave

Robert Provenzano, MD

Physician

July 28, 2012

I am a patient. Yes, and a physician; a brother, father, husband, grandfather, uncle, friend, neighbor, taxpayer and concerned citizen. What healthcare reform means to you means the same to me, or more. Maybe because as a physician I focus on it a little more than the average person, I have an additional responsibility to share my perspectives? Maybe a little knowledge is a dangerous thing, as the saying goes.

I …

Why health and medical apps should be certified

David Lee Scher, MD

Health Technology

July 28, 2012

A draft of standards for a health and medical app certification program was released recently by Happtique. As a matter of disclosure I am proud to have been the Chair of the panel that drafted these standards. The standards are in draft form and are open to public comment until August 17, 2012.

While some might say that these standards add even more barriers to the commercial adoption of these technologies, there are …

The HIV vaccine does not promise the end of AIDS

Satyam H. Veean

Conditions and Diseases

July 28, 2012

In a recent report released by the UNAIDS, the number of new HIV (human immunodeficiency virus) infections has fallen by 19% since 1999. And of the 33.3 million people living with HIV, only a little over 5 million people are receiving HIV treatment. That is, roughly 15 percent of the world’s population. Ghastly, some might say, but improving, optimists would say.

According to the 2010 UNAIDS Report on the Global Aids …

5 questions every patient needs to ask

Alex Lickerman, MD

Patient

July 27, 2012

I once had a patient in whom I found a small breast lump. She was only thirty-two, and the lump was soft, non-tender, and mobile. But it was new. She examined her breasts monthly and was certain that she hadn’t felt it the month before. And she had a family history of breast cancer.

So, I asked myself, what to do? Her age—as well as the lump’s characteristics on exam—made the …

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5 questions every patient needs to ask

Why do we teach surgery the same way we did 40 years ago?

Skeptical Scalpel, MD

Medical Education

July 27, 2012

When I was a surgical residency program director, I often wondered what the establishment, you know those guys who ran surgical education, was thinking. Some may remember the rule that a resident had to see at least 50% of the patients he operated on in the clinic or the private surgeon’s office in order to claim credit for having done the case.

There was the emphasis that still exists today on …

Reinforcing my desire to become a pediatrician

Katie Gesbeck

Medical Education

July 27, 2012

One evening during my first year of medical school, I was waiting by the entrance to The Salvation Army to let another student back into the free clinic. The weekly clinic was organized by MEDiC, an organization of student-run free clinics in the Madison area. A family with four small children was returning to spend the night at the shelter, and one of the kids saw the stethoscope around my …

Dr. Google is currently only medical student Google

Linda Pourmassina, MD

Physician

July 27, 2012

A few days ago, I came across an article entitled “Calling Dr. Google” by Jeff Jarvis. The writer describes his experience “Googling” his symptoms and finding that the internet brought him the correct diagnosis. He uses his personal story of appendicitis to point out that physician fear of information on the internet is overblown.

One would hope that the argument that you cannot find any trustworthy information on the web is …

EKG reading: It’s shocking what medical residents don’t know

Wes Fisher, MD

Medical Education

July 26, 2012

“Dr. Fisher, can you teach our residents EKG lecture series?”

Naively, I said “Sure!”

What I didn’t realize is how hard this is to do today.

Much of this is not residents’ fault. They only have so many hours in so many days to attend lectures while caring for patients. Thanks to residency work-hour restrictions, those hours have become even fewer. To make matters much worse, through the year residents are torn to …

Why is whole person care so difficult to attain?

Rev. George Handzo

Patient

July 26, 2012

Recently I was privileged again to be on the faculty for the Summer Institute of the George Washington Institute for Spirituality and Health in Washington, DC which draws participants from several health care disciplines, including medicine, chaplaincy and nursing.

One afternoon, we break up into interdisciplinary teams and interview patient actors as if we were a palliative care consultation team. For those who have not experienced patient actors in this context, …

Does our caring crush the ones for whom we care?

James C. Salwitz, MD

Physician

July 26, 2012

When we love someone, we want for them the best. We fight for and with them. We push them to attack disease. Is it possible that our very love can cause suffering? Can we mistake our eternal love for each other with a futile fight for immortality? Does our caring crush the ones for whom we care?

In a fascinating article, the Wall Street Journal followed the terminal case of …

The dramatic change in the causes of death

Stephen C. Schimpff, MD

Physician

July 26, 2012

Most of us will not have the opportunity to just die of “old age” or to simply fall to sleep one night never to wake again. Most often, we develop an illness which causes our death. These have changed markedly over the years. For the pioneers, accidents, infections, childbirth were times and causes of great likelihood of death. A century ago, infections were the leading causes of death. Today, we …

Learning about patients as a phlebotomist

Connor Benton

Medical Education

July 25, 2012

“I swear to God, if you come any closer, I will kill you,” said the 30-something year old, arms as wide as bazookas, eyes as piercing as the very needles I was about to stick him with. He was hooked up to IVs on every limb, had tubes coming out of his nose and going down his throat, but other than that, he was about as physically fit as anyone I’d …

How health insurance exchanges can improve quality

John Lumpkin, MD, MPH

Health Policy

July 25, 2012

Most of the attention given to the nascent state health insurance exchanges has largely focused on their role in improving access to insurance for individuals and small employers, not on the role they can play in improving health care quality.

As envisioned by the Affordable Care Act, health insurance exchanges provide an opportunity to create more organized and competitive insurance markets by offering a choice of plans, establishing rules on the …

How should physicians give bad news to patients?

Michael Kirsch, MD

Physician

July 25, 2012

When I see patients in the office, I try to guess their occupations from their demeanor and mannerisms. Salesmen are the easiest to ID. In general, they are gregarious males with manly handshakes. They laugh loudly and like to tell jokes. Teachers are more reserved and often give their narrative in a logical and chronological order, as would be expected. Another clue that the patient is an educator is that …

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