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Why physicians are susceptible to hardball tactics

Physician

May 21, 2012

I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the meeting. The topic was healthcare reform and its effect on hospitals and physicians. Included were discussions on patient-centered medical homes, accountable care organizations, bundled payments and physician integration and alignment with hospitals.

The course director made it crystal clear that there will be no place in the future for …

When it comes to doctors and social media, hospitals fail miserably

Kevin Pho, MD

KevinMD

May 21, 2012

When it comes to medicine and social media, much of the attention is negative.

Doctors losing their hospital privileges because of Facebook.

Or other health care workers taking pictures of patients and posting them on the web.

It’s no wonder that many hospitals are taking a heavy handed approach when it comes to their doctors and social media.

Consider this story, Doctors warned …

What should America’s health care vision be?

Stephen C. Schimpff, MD

Health Policy

May 21, 2012

America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the same time has a dysfunctional care delivery system. A new vision is needed.

Vision is a leadership concept that presents an idea, garners support and then develops the coalitions to bring it to fruition. America needs to envision what its care delivery system should be and then determine, as …

Struggling with the idea of leaving for medical school

Imraan Allarakhia

Medical Education

May 21, 2012

The lines of text on my laptop screen blurred together as I lost focus. I knew there was at least one error on my medical school re-application I would regret later on. My eyes scanned the familiar body of words but failed to connect the information to my brain. Frustrated, I closed the application and shut my computer off.

My bedroom door abruptly swung open, revealing my mother with the phone …

What if stress management was actually ridiculously easy?

Susan Biali Haas, MD

Conditions and Diseases

May 20, 2012

I keynoted at a conference a few weeks ago. As usual, as the date approached I felt the pressure intensify. It’s much better than when I first started public speaking years ago. For my very first paid speech, which was in front of several hundred people, I shook for the three months leading up to it – some days when I got really worked up it was actually a challenge …

How we deliver bad news is critical to how families deal with grief

Kevin R. Campbell, MD

Physician

May 20, 2012

As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during my career. How a physician goes about this process can make an enormous impact in the lives of those affected by the news that must be delivered.

Precious little time is devoted to teaching this essential communication skill in the training of physicians today. I can remember back to …

His father’s suffering had already been too great

Monica Williams-Murphy, MD

Physician

May 20, 2012

He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I thought the patient was dead. He was nearly the same color as the pale sheet covering his thin frame. His cheeks were sunken in and his eyes were gazing upward, in what I sometimes call the “death stare.” Then, surprisingly, he moved his arm upward to push his …

A Life After Residency Alliance to ease the transition to practice

Adriana Tobar, MD

Medical Education

May 19, 2012

I recently wrote about the ways in which residents’ lives change dramatically during the transition to practice. For many, this transition feels like a complete 180.

I’m going to devote today’s post to introducing the concept of a “Life After Residency Alliance,” which is a group of people you can rely on for support, guidance and direction as you transition to practice.

The concept is taken from Napoleon Hill’s Mastermind Alliance, …

Diversity provides color to the tapestry of human experience

Anees Chagpar, MD

Physician

May 19, 2012

I was recently appointed the Assistant Director of the Yale Cancer Center with the portfolio of Diversity/Disparities. While I’m not sure I’m the most qualified for this, it has gotten me thinking a lot about diversity, disparities, and what it means to achieve health equity. Too often, I think, we are plagued by narrow thinking … the impression that our …

Necessary is a word best defined when looking back in time

Stewart Segal, MD

Physician

May 19, 2012

How do you define a “good” doc? I was reading the patient responses to an article here on KevinMD.com and was saddened by how many of the patients were angry with their docs. Anger is an unhealthy emotion! One of the respondents was particularly angry about the “unnecessary” tests her doc performed on her and her family.

I have written about the vagaries of the term “unnecessary” in the past. What …

Medicine involves a tension between isolation and connection

Reflex Hammer

Medical Education

May 19, 2012

I was skeptical when a doctor casually mentioned that 2% of all pregnancies are ectopic pregnancies (in which the fertilized egg is implanted somewhere other than the uterus, usually the fallopian tube). Without treatment, a common outcome is fallopian tube rupture, which jeopardizes the life of the mother. It is a serious medical concern. I shot a confused look at a fellow first-year medical student. Two percent? It seemed way …

The user interface for EHRs should be uniform

Roheet Kakaday

Health Technology

May 18, 2012

The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with names and organized alphabetically. There were three of these cabinets, taking up the entire length of the back wall, filled with hundreds upon hundreds of patients’ records.

“I see you still have paper records. Do you plan on implementing an EHR anytime soon?” I inquired.

The doctor paused for a …

Medical school and residency aren’t places for human growth

Paul E. Smith, MD

Physician

May 18, 2012

The end of my residency and beginning of my practice was the most wrenching experience of my life. I was woefully prepared for the transition. Full disclaimer: I was trained many years ago when residencies were acknowledged brutal demeaning processes. Things have changed considerably, but the psychological passage I endured still holds.

I think my process of becoming a surgeon was fairly typical, with the exception that there was no one …

How death can be a beautiful experience

Tracy Granzyk, MS

Patient

May 18, 2012

I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law at the direction of Trinity Hospice in Aiken, SC. Having never thought I would describe death as beautiful the word choice comes as a surprise even to me, a Sagittarius and straight shooter, and in combination with mother-in-law, I would also guess, very suspect. However, sharing in her …

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How death can be a beautiful experience

Keep the care in the health care

Myles Riner, MD

Physician

May 18, 2012

I believe the greatest challenge in medicine today is keeping the “care” in healthcare. One of the most frustrating aspects of practicing medicine for me had to do with how difficult it had become to incorporate caring into my practice. I am not necessarily talking about the kind of caring associated with having a long-term, close and mutually appreciated association with my patients: if that had motivated me, I would …

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Keep the care in the health care

Can pit crews really heal medicine?

Scrub, MD

Physician

May 17, 2012

In his recent TED talk, Atul Gawande harkens back to the central thesis of his recent book The Checklist Manifesto: How to Get Things Right that medicine has become too complex for physicians to act as cowboys and instead should adopt the paradigm of a pit crew, utilizing teamwork and the humble checklist to solve problems and avert emergencies.

Is this really true though? Can “pit …

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Can pit crews really heal medicine?

Hospitals around the world aim to remain relevant to patients

Tim Richardson, PT

Health Policy

May 17, 2012

“It was the best of times, it was the worst of times …”

So begins a story called A Tale of Two Cities by Charles Dickens. Its about the differing responses of two different nations to the revolutionary events and social upheaval of 1775. I’m going to tell a tale of three hospitals. You’ll see why soon.

Today, in 2012, health care systems around the world, including the United States, are launching …

Help your radiologist out and provide as much history as you can

Tashfeen Ekram, MD

Physician

May 17, 2012

The art of practicing medicine is in realizing that there is an overlap between normal variants and pathology. Being able to tell the difference can be difficult, but this where the art comes in. However, as physicians we must realize that sometimes this can not be differentiated. Radiology is no different. Many clinicians and non-health care professionals believe that radiology is cut and dry. There is no art in radiology …

9 skin signs for a yearly visit to the dermatologist

Carol R. Drucker, MD

Conditions and Diseases

May 17, 2012

Visiting your dermatologist every year may be an important step to staying skin cancer-free. So, how do you know if you should schedule that annual appointment?

The answer depends on how likely you are to get skin cancer. Do you fall into one of these groups? Then, it’s time for a skin check-up.

1. Red hair and freckles. If you’ve got red or blond hair, fair skin, freckles and blue or light-colored eyes, you‘re …

What meaningful encouragement can be given to someone who is dying?

Taruni Tan

Patient

May 16, 2012

Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved.

Being with a dying person is challenging; it penetrates through discomfort seeking honesty and courage. It brings you confrontationally into the present which is shocking for many. But if you spend time with the dying you’ll find that their needs are not so different from ours, only they have a limited time …

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