KevinMD.com

May 18, 2012May 18, 20123

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 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

Physician voices

Can pit crews really heal medicine?

Scrub, MD

May 17, 2012May 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…

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 crews” heal medicine? To extend the …

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Can pit crews really heal medicine?

Health policy

Hospitals around the world aim to remain relevant to patients

Tim Richardson, PT

May 17, 2012May 17, 20122

"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…

“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 …

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Physician voices

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

Tashfeen Ekram, MD

May 17, 2012May 17, 20125

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 …

Conditions and diseases

9 skin signs for a yearly visit to the dermatologist

Carol R. Drucker, MD

May 17, 2012May 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…

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 …

Patient voices

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

Taruni Tan

May 16, 2012May 16, 201211

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…

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 …

Physician voices

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

The Red Humor, MD

May 16, 2012May 16, 20124

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…

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 …

Physician voices

The malpractice risk of volunteer medical coverage at sporting events

Shadowfax, MD

May 16, 2012May 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,…

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 …

Health technology

EMR liability needs to go further than just the physician

Scot Silverstein, MD

May 16, 2012May 16, 20128

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…

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 …

Physician voices

What does a perfect pediatrics practice look like?

Wendy Sue Swanson, MD

May 15, 2012May 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 …

Conditions and diseases

Why legislators need sex education

Arthur Chernoff, MD

May 15, 2012May 15, 20125

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, …

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Why legislators need sex education

Conditions and diseases

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

Stacey Vitiello, MD

May 15, 2012May 15, 20123

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…

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 …

Health technology

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

American Medical Association & Peter W. Carmel, MD

May 15, 2012May 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…

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 make revisions so physicians can more easily participate in Stage …

Drugs and prescribing

Go ahead, let patients buy prescription drugs over the counter

WhiteCoat, MD

May 14, 2012May 14, 201223

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 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 …

Conditions and diseases

How transplants are causing ethical dilemmas

Janet Radcliffe Richards

May 14, 2012May 14, 20122

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 …

Physician voices

Tips to improve your patient satisfaction scores

Donald Tex Bryant

May 14, 2012May 14, 20124

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 …

Health technology

EMRs require better user-centered design

Barbara J. Moore, MD

May 14, 2012May 14, 20128

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…

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 …

Patient voices

Health care journalists have tendencies similar to those of doctors

Katherine Leon

May 13, 2012May 13, 20124

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…

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 …

Conditions and diseases

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

Kevin Pho, MD

May 13, 2012May 13, 20123

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…

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 …

Medical education

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

Amanda Xi, MD

May 13, 2012May 13, 201211

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,…

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 …

Real physician voices, twice a week

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