KevinMD.com

June 2, 2012Jun 2, 20125

Patients often don’t get the respect they deserve. Take the subject of patient engagement. Just about everywhere you turn in the health care literature these days we are told how physicians and other providers need to do a better job…

But is that really their role?

Patient engagement is not the job of health care providers

Why? Because by the time a person (aka patient) …

Physician voices

How doctors handle fear will determine their ability to give care

James C. Salwitz, MD

June 1, 2012Jun 1, 2012

There was a night when I was in training that all the decisions, disasters and chaos, which are the practice of medicine, caught up to me. In those dark hours, I felt practically despondent. What I had seen left me…

At that moment a wise attending physician took a moment to sit with me. Rather than tell me how wonderful …

Drugs and prescribing

5 questions to ask about your prescription

Carlene Oleksyn

June 1, 2012Jun 1, 20123

When you are handed a prescription by your physician or your pharmacist there are many questions you should know the answer to before walking out the door. 1. What is this medication for? This may seem obvious, but countless times…

When you are handed a prescription by your physician or your pharmacist there are many questions you should know the answer to before walking out the door.

1. What is this medication for?

This may seem obvious, but countless times when I ask a patient if they know what their prescription is for they tell me they have no idea. When someone doesn’t know what a medication is for, there is little motivation to take it correctly or …

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Drugs and prescribing

Who pays for the cost of switching medications?

Victoria Rentel, MD

June 1, 2012Jun 1, 20126

Nine months ago I saw a new patient, a delightful 86-year old male. His past medical history included lymphoma many years ago, a stroke five years ago, dyslipidemia and hypertension. Medications included aspirin, a generic statin, and a non-generic ARB-HCT combination, which he had been on for years. He lived alone with a lot of support from his loving and attentive family. The patient looked great. I refilled his meds …

Health technology

We must get past the complaints doctors have about EMRs

Deepak Ramesh

June 1, 2012Jun 1, 201212

Any new technology necessarily has a phase in which unnoticed bugs as well as unforeseen challenges crop up. In its early stages, the snail’s pace of a dial-up connection often made using the Internet onerous: before completing an email, one was often interrupted by pop-ups, viruses, cryptic 404 error messages, and a cacophony of sounds from the modem as the line repeatedly disconnected. Yet, as technology matures, the ability to …

Physician voices

Create peace and dignity at the end of life

Monica Williams-Murphy, MD

May 31, 2012May 31, 20129

Never heard of the 90-80 dilemma? That’s because I have just coined the phrase. You see, tied into soaring healthcare costs in this country, is another humanitarian crisis of massive proportions. A huge gap exists between what Americans want for…

Never heard of the 90-80 dilemma? That’s because I have just coined the phrase. You see, tied into soaring healthcare costs in this country, is another humanitarian crisis of massive proportions.

A huge gap exists between what Americans want for end-of-life care and what they actually receive. 90% of people wish to die at home, yet nearly 80% of us actually die in institutions (hospitals and nursing homes.)

So, how did we …

Physician voices

Shared decision making is a necessary concept in modern patient care

Shabbir Hossain, MD

May 31, 2012May 31, 20126

There's nothing better than sitting down with a patient, going though an entire visit, and collaborating on a well thought out plan that meets everyone's expectations. Shared decision making is a wonderful and necessary concept in modern patient care. Paternalistic…

There’s nothing better than sitting down with a patient, going though an entire visit, and collaborating on a well thought out plan that meets everyone’s expectations.

Shared decision making is a wonderful and necessary concept in modern patient care. Paternalistic attitudes are fading away in the medical community as the next generations of doctors continue to get educated on how to manage patients who are very knowledgeable and yearn to be …

Physician voices

Is a good patient simply one who never complains or disagrees?

Suzanne Koven, MD

May 31, 2012May 31, 201216

I'm currently having a chance to do one of my least favorite things: be a patient. And the whole time, I'm missing no opportunity to declare what a bad patient I am. "I'm sorry I'm such a bad patient," I…

I’m currently having a chance to do one of my least favorite things: be a patient. And the whole time, I’m missing no opportunity to declare what a bad patient I am. “I’m sorry I’m such a bad patient,” I said to the phlebotomist when I winced as she drew my blood. “I know I’m a bad patient,” I said to the x-ray technician who re-positioned my fractured arm. “We …

Physician voices

How we need to take risk to reduce risk in hospitals

Richard Corder

May 31, 2012May 31, 20129

The show-stopping line from the Hans Christian Anderson’s 1837 fairytale is actually, “But he has nothing on!” A brave, young, clear thinking boy in the crowd is the only person confident enough to say what he thinks and speak up.…

The show-stopping line from the Hans Christian Anderson’s 1837 fairytale is actually, “But he has nothing on!”

A brave, young, clear thinking boy in the crowd is the only person confident enough to say what he thinks and speak up. Perhaps even more simply, the young voice in the crowd has not had the life experience that often builds (and rewards) the filters of loyalty, flattery and only saying and thinking …

Health technology

Young physicians will become the champions of technology

David Lee Scher, MD

May 30, 2012May 30, 20128

“Generation C” has recently been defined by Nielsen as adults between 18 and 34 years old, who are entrenched in digital technologies. They are indeed the connected generation and use technology by choice in all facets of life. It is…

“Generation C” has recently been defined by Nielsen as adults between 18 and 34 years old, who are entrenched in digital technologies.

They are indeed the connected generation and use technology by choice in all facets of life. It is part of their fabric. Those entering the field of medicine would logically desire and expect to carry that over to their professional lives. However, there are multiple barriers to the continuity …

Conditions and diseases

Autism is a social justice problem

Claire McCarthy, MD

May 30, 2012May 30, 20127

A child with autism is more likely to do well if his mother is white and educated. This is the message of a study just released in the journal Pediatrics, and it’s something we need to pay attention to—now. Researchers…

A child with autism is more likely to do well if his mother is white and educated.

This is the message of a study just released in the journal Pediatrics, and it’s something we need to pay attention to—now.

Researchers from Columbia University wanted to find out what happens to children with autism over time. So they looked at the records of more than 6,000 children with autism who were enrolled …

Read more…

Autism is a social justice problem

Health policy

Isn’t caring for your child worth as much as caring for your parents?

Nilesh Kalyanaraman, MD

May 30, 2012May 30, 201210

I love it when I see Medicaid patients on my schedule for the day. Working at a community health center, our doors are open to all people, regardless of their ability to pay. It’s hard to run a medical office when you get $20 for a visit, which is what our uninsured patients pay. So when a patient has Medicaid we know we’ll get paid a decent reimbursement for that …

Physician voices

The power of words in cancer care

Don S. Dizon, MD

May 30, 2012May 30, 201210

In oncology, there are certain words and phrases that (no matter how carefully said) suck the air out of a room, like "you have cancer," "you've recurred," "incurable," "terminal," and "hospice." Such phrases require careful consideration before they are spoken,…

In oncology, there are certain words and phrases that (no matter how carefully said) suck the air out of a room, like “you have cancer,” “you’ve recurred,” “incurable,” “terminal,” and “hospice.” Such phrases require careful consideration before they are spoken, and most (if not all) oncologists understand the power of these words, and use them carefully. However, there are others that can …

Read more…

The power of words in cancer care

Physician voices

When the homeless disappear

Maria Yang, MD

May 29, 2012May 29, 20125

Two weeks had passed before I learned what happened. I hadn’t seen him in several months. At our last meeting, the trees were full of red and orange leaves. He, as usual, was not interested in talking to me. He…

Two weeks had passed before I learned what happened.

I hadn’t seen him in several months. At our last meeting, the trees were full of red and orange leaves. He, as usual, was not interested in talking to me. He was sitting in front of a closed shop.

“Hi. How are you?”

“Fine.”

People in the neighborhood took care of him. Surrounding him were several plastic bags holding neatly stacked styrofoam containers filled with soup. …

Read more…

When the homeless disappear

Physician voices

A radical transformation in healthcare decision making is needed

Marya Zilberberg, MD, MPH

May 29, 2012May 29, 20126

I love when an article I read first thing in the morning gets me to think about itself all through my morning chores and then erupts into a blog post. So it was with this little gem in the statistical publication Significance. The author suggests making gambling safer by placing realistic odds estimates right on the poker machines in casinos. He even goes through the generation of the odds of …

Medical education

Listening is what a patient needs most

Anonymous

May 29, 2012May 29, 20125

Hard time is here And ev’rywhere you go Hard times is harder Than th’ever been befo’ The opening lines of a century-old Delta blues song rings out among the stars and the dark of a rural Virginia night. I sit…

Hard time is here
And ev’rywhere you go
Hard times is harder
Than th’ever been befo’

The opening lines of a century-old Delta blues song rings out among the stars and the dark of a rural Virginia night. I sit tenuously awake atop an old wooden stump in front of a farmhouse, where four minds sleep peacefully inside. It is 3:00 am. From the window, I hear the sound of the needle dragging …

Read more…

Listening is what a patient needs most

Health policy

A population health approach to wellness

David B. Nash, MD, MBA

May 28, 2012May 28, 20123

FACT: Four determinants of health account for 40% of all deaths in the U.S. – smoking, unhealthy diet, physical inactivity, and alcohol use. FACT: A mere 3% of Americans do all of the relatively "simple" things they should to stay…

FACT: Four determinants of health account for 40% of all deaths in the U.S. – smoking, unhealthy diet, physical inactivity, and alcohol use.

FACT: A mere 3% of Americans do all of the relatively “simple” things they should to stay healthy – i.e., exercise for 20 minutes 3 times a week, don’t smoke, eat fruits and vegetables regularly, wear seat belts regularly, and remain at their appropriate BMI.

FACT: According to the …

Physician voices

Compassion fatigue is an early warning sign of physician burnout

Dike Drummond, MD

May 28, 2012May 28, 20129

For anyone in the helping professions, compassion fatigue is a common occurrence and a clear signal to take better care of your own needs. Compassion fatigue is when you find yourself challenged to care about your patients in the way…

For anyone in the helping professions, compassion fatigue is a common occurrence and a clear signal to take better care of your own needs.

Compassion fatigue is when you find yourself challenged to care about your patients in the way you know is proper and expected in your position. One of the key components of quality healthcare is the ability for you to connect with your patients and for them to …

Medical education

How we treat sexual assault matters more than we will ever know

Natalie

May 28, 2012May 28, 20124

My psych final was this morning, which I am 90% confident I did well enough on to pass the class (which is all I need to be satisfied). Considering I counted watching “Girl, Interrupted” as studying, I say that’s not…

I felt like there were many necessary topics left out of our behavioral medicine and psychiatry course. One of the many: sexual assault.

For the past eight years I have …

Real physician voices, twice a week

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