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Being a good doctor is no more an achievement than being a good Mom

Physician

May 16, 2012

At no other time in my medical training was I as confident that, with hard work and dedication, I could master the field of internal medicine as when I was a newly minted third year medical student.

Fresh from having taken the USMLE step 1, I interpreted my ability to recite the mechanism of penicillin resistance or the role of histamine in the immune response, and describe in great detail the …

The malpractice risk of volunteer medical coverage at sporting events

Shadowfax, MD

Physician

May 16, 2012

From Outside Online, an article about how physicians are increasingly hesitant to provide volunteer medical coverage at athletic events:

“Last year, 13 Americans died during running races, and another eight while competing in triathlons. While those numbers might seem troubling, the deaths are attributable mostly to the booming popularity of endurance sports—13 million Americans enter running races each year, and 2.3 million compete in triathlons. But the rising participation and the …

EMR liability needs to go further than just the physician

Scot Silverstein, MD

Health Technology

May 16, 2012

This example of a disaster waiting to happen, in the form of an error-promoting CPOE, is a poster example of why the net of litigation needs to be cast far wider than just clinicians when EHR-related errors result in injury or death.

This order entry screen, from a production system shows the following. In all fairness, I do note it’s unclear if the vendor or the customer’s configuration “experts” were responsible …

What does a perfect pediatrics practice look like?

Wendy Sue Swanson, MD

Physician

May 15, 2012

I had a phenomenal day in clinic yesterday. Imperfect for sure but inspiring, connected, and busy. I felt useful and like anybody else, that feels so good to me. Productivity can be defined in various ways and yesterday I fulfilled my personal definition. I wrote an email to a friend and cardiologist this morning where I said, “But I must say, it’s a sincere fortune to be a doctor some days. Yesterday …

Why legislators need sex education

Arthur Chernoff, MD

Conditions and Diseases

May 15, 2012

Physicians as guardians of science have an obligation to teach the facts of life to our patients and our legislators. And today the need to dispel ignorance of biologic facts is more urgent than ever. Just as President Obama is deferring legislation on marriage to the states, I will defer the issue of whether the government can or should regulate marriage to legal scholars and our duly elected representatives. However, …

Read more…

Why legislators need sex education

Where you have your mammogram, and who reads it, matter

Stacey Vitiello, MD

Conditions and Diseases

May 15, 2012

I’ve received several inquiries from women living in various regions of the country, asking how they should choose where to go for their mammogram, and if it really matters. I cannot emphasize this enough: It matters! Here are a few tips to help your search:

The most basic requirement is whether a facility is accredited under the MQSA (Mammography Quality Standards Act). The accrediting body for most states is the ACR …

AMA: Changes are needed in the stage 2 meaningful use EHR proposal

Peter W. Carmel, MD

Health Technology

May 15, 2012

A guest column by the American Medical Association, exclusive to KevinMD.com.

Continuing our efforts to move medicine forward while prioritizing patient care and minimizing administrative and financial burdens for physician practices, the American Medical Association (AMA) along with 100 state and specialty medical societies submitted a detailed comment letter to the Centers for Medicare & Medicaid Services (CMS). We urged CMS to …

Go ahead, let patients buy prescription drugs over the counter

WhiteCoat, MD

Medications

May 14, 2012

The FDA is deciding whether to allow patients to purchase prescription medications over the counter for many common ailments.

This idea is controversial.

On one hand, deregulation would remove one of the largest barriers to receiving treatment for some conditions – the doctor’s visit. If no doctor’s visit is necessary to receive necessary blood pressure medications or diabetes medications, then patients don’t have to wait for an appointment and the patient/government …

How transplants are causing ethical dilemmas

Janet Radcliffe Richards

Conditions and Diseases

May 14, 2012

The trouble with many significant advances in medicine is that that they take us out of our moral depth. They may raise quite different problems from the ones we are used to and, if we are not careful, we may inadvertently undermine the wonderful potential of new technologies by forcing them into existing legal, ethical and institutional frameworks.

Transplantation is a case in point. Transplants save and transform lives; but the …

Tips to improve your patient satisfaction scores

Donald Tex Bryant

Physician

May 14, 2012

Recently I was asked, “How can I improve my Press Ganey scores?” Presently this question applies mostly to hospitals as CMS is requiring hospitals to use the HCAHPS as a part of their quality reporting. Press Ganey can manage the HCAHPS for hospitals. Few physicians or physician groups presently survey patients for satisfaction; they should begin thinking about doing so in the near future as it seems likely that CMS …

EMRs require better user-centered design

Barbara J. Moore, MD

Health Technology

May 14, 2012

Healthcare IT News recently asked, “Do doctors have to be typists to get MU incentives?”

That question reminded me that given the many hours of unreimbursed labor performing EMR data entry at end of day, a significant chunk of a clinician’s workday is spent performing medical secretary services. Let me set the record straight, I am a good typist. But EMR data entry interfaces are often unnecessarily cumbersome, so clinicians put …

Health care journalists have tendencies similar to those of doctors

Katherine Leon

Patient

May 13, 2012

As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert. I wasn’t in a “backless gown,” rolling my IV pole down the hall of some hospital’s cardiac care unit. I wore an official lanyard and badge and mixed among health care journalists, yet I felt more like a dugout mom than savvy reporter.

My goal was to present the …

Warren Buffett’s prostate cancer choices aren’t right for every man

Kevin Pho, MD

KevinMD

May 13, 2012

A version of this column was published on April 24, 2012 in USA Today.

There has been a recent uptick of elderly men in my primary care clinic asking about prostate cancer, perhaps because they heard of Warren Buffett’s recent prostate cancer diagnosis and his proposed treatment.

Patients are wondering if they should also be screened. Other patients who already have been diagnosed …

I am just a medical student, I am not a doctor yet

Amanda Xi, MD

Medical Education

May 13, 2012

This morning started off like any other. I parked my car, walked into Starbucks and pulled up my iPhone app while waiting in line. The usual suspects were already there — the elderly fellow that always flirts with the baristas, the business man with his freshly pressed suit and the tired-looking mother. As I approached the counter, I ordered my usual summer morning beverage and went through the motions to …

Shorten medical training by 30% without sacrificing quality

Kenan Omurtag, MD

Medical Education

May 13, 2012

As a teenager in the mid-late 1990s, my father, an engineering educator, and I would talk about the ills of the healthcare system and how physicians lost control of healthcare: primarily because they concentrated on medicine rather than the forces changing healthcare delivery. I realized this was due to an outdated medical education system and reforming it might actually improve healthcare in this country. That was my Sputnik Moment.

Since graduating …

Becoming an organ donor requires more thought than a Facebook click

Barbara Bronson Gray, RN

Conditions and Diseases

May 12, 2012

Facebook recently announced on Good Morning America that users in the U.S. and the U.K. can enroll as organ donors through links to official registries, making it easier for people who want to donate their organs to sign up. They’re working with Donate Life America, a nonprofit alliance of national organizations and state teams across the United States committed to increasing organ, eye and tissue donation.

But deciding to become an …

Are smokers to blame for the damage they do to their bodies?

James C. Salwitz, MD

Conditions and Diseases

May 12, 2012

He had yellow nails, leather neck, stained teeth and a deep cough. He wheezed slightly, breathed too quickly and occasionally sprinkled the white handkerchief red. No surprise his ticket to my office was a lung mass to match. We talked about tests, treatment and prognosis. About the future, probably short. Devastated, he was not surprised. He was reaping the reward of 30 smoking years. He sadly admitted, “I knew better, …

The unholy alliance between Big Pharma and the medical profession

Barbara H. Roberts, MD

Medications

May 12, 2012

An excerpt from The Truth About Statins.

Like all physicians, I’ve had interactions with pharmaceutical companies. Shortly after I went into private practice in Rhode Island in 1977, I received a telephone call from a drug company representative. He offered me an all-expense-paid weeklong trip to Germany to attend a medical conference. I was taken aback, knowing that the cost of such a trip would run to thousands of dollars. I …

MKSAP: 22-year-old man with type 1 diabetes mellitus

mksap

Conditions and Diseases

May 12, 2012

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 22-year-old man comes for a routine evaluation. He has a history of type 1 diabetes mellitus and began taking insulin glargine and insulin lispro 8 years ago. Two days ago, he participated in a marathon race.

On physical examination, temperature is 36.4 °C (97.5 °F), blood …

Adaptation can be painful, but it can also be a gift

Maria Ross

Patient

May 11, 2012

Nothing will force you to live life on your own terms faster than almost losing it.

In 2008, I was on fire. My husband and I had just moved, bought a house, adopted a dog – and I started my own consulting business while continuing to write and act in my spare time. Life was crazy because I was trying to live all of my dreams – at the same time.

While …

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