KevinMD.com

October 12, 2012Oct 12, 2012

Republicans and Democrats don’t agree on much about Medicare, except for getting rid of the fee-for-service system for paying doctors. “If reducing the growth of Medicare spending to sustainable rates and moving away from fee-for-service are ‘ending Medicare as we…

Republicans and Democrats don’t agree on much about Medicare, except for getting rid of the fee-for-service system for paying doctors.

“If reducing the growth of Medicare spending to sustainable rates and moving away from fee-for-service are ‘ending Medicare as we know it,’ then both parties have embraced that goal, writes former OMB Budget Director Alice Rivlin in a Daily Beast commentary.

“Paying providers on a fee-for-service basis offers incentives to …

Health policy

Why hospital pricing practices concern me

Peter Ubel, MD

October 12, 2012Oct 12, 2012

The gynecologist made several incisions and inserted the laparoscope. With the help of her surgical team of nurses, students and anesthesiologists, she removed the patient’s uterus, which had been bleeding uncontrollably for the past six months despite aggressive medical therapy.…

Meanwhile in a nearby hospital, another gynecologist removes another woman’s uterus, in a procedure no more complicated or time consuming than the first …

Health policy

A patient is not a dish off the menu

Zackary Berger, MD, PhD

October 12, 2012Oct 12, 20128

Atul Gawande, MD, is a technophile and a believer in the checklist, and he yokes these ideologies to an attractive metaphor in his newest essay for the New Yorker. The article is worth reading in its entirety, but it can…

Atul Gawande, MD, is a technophile and a believer in the checklist, and he yokes these ideologies to an attractive metaphor in his newest essay for the New Yorker. The article is worth reading in its entirety, but it can be easily paraphrased.

The Cheescake Factory, like other successful restaurant chains, has “brought chain production to complicated sit-down meals.” They’ve done it by far-reaching standardization of the best possible …

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A patient is not a dish off the menu

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Health policy

Stop setting hospital benchmarks at the state average

Ashish Jha, MD, MPH

October 12, 2012Oct 12, 2012

Recently, I discovered the statewide report on quality of stroke care in Massachusetts. It’s a plain document, mostly in black and white, much of what you might expect from a state government report. Yet, this 4-page document is a reminder…

The report is about 1,082 men and women in Massachusetts unfortunate enough to have a stroke …

Physician voices

How our children turn out isn’t really up to us

Claire McCarthy, MD

October 11, 2012Oct 11, 2012

My two oldest children recently left for semesters abroad: Michaela went to Paris, and Zack to Beijing. I have all sorts of Mommy nervousness about this, but in my heart I know they’ll be fine. They are adults now, at…

I don’t know how that happened.

I know that sounds stupid. And it’s not like I have no clue at all. …

Medical education

5 pieces of advice nobody tells you before starting residency

Deep Ramachandran, MD

October 11, 2012Oct 11, 2012

Since medical school, I’ve gone through an additional 6 years of training, read countless volumes of medical literature, and had the fortune of having some great teachers. Through it all, experience has been the greatest teacher, which I suppose is what training is about. I’ve watched with interest as advice has been hashed out on the web around this time of year to new trainees on all matter of subjects. …

Physician voices

Viagra for women: Prescribe 50 Shades of Grey to your female patients

Sara Stein, MD

October 11, 2012Oct 11, 201228

Could “mommy porn” have value in the doctor’s office? Unless you live in a cave (and we physicians sometimes do), you have heard of British author E.L. James’ modern erotic 50 Shades of Grey trilogy, 30-plus million copies sold, overwhelmingly to women. The trilogy is an erotic love story about a naïve college graduate who rescues an abused billionaire – a …

Health policy

Align employers with doctors, hospitals and insurance companies

Manoj Jain, MD, MPH

October 11, 2012Oct 11, 20125

I once thought that only the federal government in Washington could effect changes that would impact the cost of health care in the United States, especially with so much attention on the recent Supreme Court decision on the 2010 health…

Now I believe that emboldened employers in places like Memphis can use their clout. They can influence insurers and work directly with doctors …

Health technology

What EMRs are doing to our notes, and our brains

Robert Wachter, MD

October 11, 2012Oct 11, 20128

A colleague recently sent me a remarkable video – of Professor Lawrence Weed giving Medical Grand Rounds at Emory University in 1971. It’s fun to watch for many reasons: the packed audience composed mostly of white men in white jackets…

But the real treat is …

Conditions and diseases

Chuck Pagano has leukemia: An oncologist discusses his prognosis

John Salter, MD

October 10, 2012Oct 10, 2012

I’ve been getting a lot of questions about Indianapolis Colts’ Head Coach Chuck Pagano lately, so I thought I would dedicate a blog entry to discussing his disease and prognosis. Coach Pagano was recently diagnosed with acute myeloid leukemia (AML),…

I’ve been getting a lot of questions about Indianapolis Colts’ Head Coach Chuck Pagano lately, so I thought I would dedicate a blog entry to discussing his disease and prognosis.

Coach Pagano was recently diagnosed with acute myeloid leukemia (AML), a form of blood cancer that typically carries a rather grim long-term prognosis in adults. While early reports were quite sketchy on the details of Pagano’s presenting symptoms, it seems that …

Physician voices

Reform needs more than expanding health care coverage

Steve Balt, MD

October 10, 2012Oct 10, 2012

Whatever your opinion of the Affordable Care Act, you must admit that it’s good to see the American public talk about reducing health care costs, offering more efficient delivery systems, and expanding health care services to more of our nation’s people. There’s no easy (or cheap) way to provide health care to all Americans, particularly with the inefficiencies and absurdities that characterize our current health care …

Physician voices

10 reasons for physician burnout

Rob Lamberts, MD

October 10, 2012Oct 10, 201211

It happened again. I was talking to a particularly sick patient recently who related another bad experience with a specialist. “He came in and started spouting that he was busy saving someone’s life in the ER, and then he didn’t…

It happened again. I was talking to a particularly sick patient recently who related another bad experience with a specialist.

“He came in and started spouting that he was busy saving someone’s life in the ER, and then he didn’t listen to what I had to say,” she told me. ”I know that he’s a good doctor and all, but he was a real jerk!”

This was a specialist that I hold …

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10 reasons for physician burnout

Physician voices

My flirtation with the ER has made me more sympathetic to patients

Leana Wen, MD

October 10, 2012Oct 10, 20124

As emergency physicians who are trained in acute resuscitation and thrive in high-stress situations, we tend to roll our eyes at the less acute complaints our patients come in with. “Back pain for three months? Headache for a week? Why…

Patients, too, complain about this. “Can’t they see it’s not a real emergency and go see their primary care doctor? This must be costing our healthcare system …

Physician voices

How a drug addicted scrub tech changed my life forever

Kate O'Reilley, MD

October 10, 2012Oct 10, 20128

It was a cold winter day in 2009 when my life changed forever, however, it would be months before I figured that out. On that fateful day, a drug-addicted surgical scrub tech assigned to my operating room stole syringes of fentanyl, a potent intravenous narcotic, from my anesthesia cart. According to news reports, investigative summaries, and the scrub tech’s confession, once she took the syringes, she used them on herself.

It’s …

Conditions and diseases

ACP: Make flu vaccination a team effort

American College of Physicians & Yul Ejnes, MD

October 10, 2012Oct 10, 20122

A guest column by the American College of Physicians, exclusive to KevinMD.com. Fall is the time of year when the CDC, CMS, insurance companies, and professional societies bombard physicians with reminders to vaccinate their patients against influenza. I will do…

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

Fall is the time of year when the CDC, CMS, insurance companies, and professional societies bombard physicians with reminders to vaccinate their patients against influenza. I will do these groups one better and not only remind you, but also share a couple of ideas for improving your immunization rates. These are strategies that I use in …

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ACP: Make flu vaccination a team effort

Physician voices

National Primary Care Week 2012: What makes this year different?

Andrew Morris-Singer, MD

October 9, 2012Oct 9, 20125

It’s National Primary Care Week, an annual celebration when members of the primary care community come together across the country in events largely organized by trainees to celebrate, promote and advance primary care. So what makes this year different? Put…

Put simply, the momentum for advancing primary care in the US has never been stronger. Those of us who believe that a robust foundation of primary care is essential to the health …

Physician voices

10 tips for new college students with chronic disease

Kitty O'Hare, MD

October 9, 2012Oct 9, 2012

For some of my patients, going to college is especially nerve-wracking because it will be their first time living away from home with a chronic disease. I deal with teen health daily. I care for a lot of adolescents and…

For some of my patients, going to college is especially nerve-wracking because it will be their first time living away from home with a chronic disease.

I deal with teen health daily. I care for a lot of adolescents and young adults with chronic disease, everything from asthma to diabetes to congenital heart defects. As my patients grow up they have a lot to deal with because of medical issues: taking …

Physician voices

Why Lance Armstrong will always be a hero

J. Leonard Lichtenfeld, MD

October 9, 2012Oct 9, 20128

Like many of you, I have been reading the various news stories about Lance Armstrong, especially one recently in a major newspaper, which went into great detail about the allegations surrounding Lance Armstrong’s cycling career. But what I didn’t see…

But what I didn’t see in all of that coverage was much mention of the other side of the man, the side that I …

Conditions and diseases

3 unexpected ways to help you lose weight

Lucy Hornstein, MD

October 9, 2012Oct 9, 20123

After all the hullabaloo generated by my passing on the accurate but controversial information that exercise will not help you lose weight, I thought I should give equal time to the other side, and discuss several things that appear to…

Sleep

Although I’m not aware of any formal studies documenting this, I can report from personal and professional experience that the value of sufficient …

Conditions and diseases

ADHD: Not all complex problems have simple answers

Claudia M. Gold, MD

October 9, 2012Oct 9, 2012

I've been thinking about the phrase, "the fallacy of simple answers," in preparation for writing about a new book I was asked to review, Pills are Not For Preschoolers. Author Marilyn Wedge gives a clear and compelling argument for the…

I’ve been thinking about the phrase, “the fallacy of simple answers,” in preparation for writing about a new book I was asked to review, Pills are Not For Preschoolers. Author Marilyn Wedge gives a clear and compelling argument for the use of family therapy in treatment of behaviorally symptomatic children. Unlike the title suggests, the book is not primarily about preschoolers, but offers multiple examples of her successful …

Real physician voices, twice a week

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