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Radiologists who cheat on their board exams: Who’s to blame?

Kevin Pho, MD

KevinMD

January 17, 2012

In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: “Doctors around the country taking an exam to become board certified in radiology have cheated by memorizing test questions, creating sophisticated banks of what are known as ‘recalls,’ … The recall exams are meticulously compiled by radiology residents, who write down the questions …

When pimping a medical student can backfire on a doctor

Collin Creange

Medical Education

January 17, 2012

The third year of medical school is a lesson in humility. In the OR, you’ll invariably cut the suture too short, or too long, or too slowly. On the floors, the one laboratory value you haven’t checked is the only value vital to the patient’s survival. And just when you think you know everything there is to know about a disease, the Attending Physician will keep asking you questions until …

AMA: A new model of patient care

Peter W. Carmel, MD

Health Policy

January 17, 2012

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

Let me start by wishing you and your families a very happy and healthy new year. This is my first column of 2012 for this blog, and I am excited to talk about a new initiative that is beginning this year. Medicare accountable care organizations (ACOs) have been discussed at length …

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AMA: A new model of patient care

How I became a hospice volunteer

Frances Shani Parker

Patient

January 16, 2012

People often ask me how I became a hospice volunteer. For the record, nobody is more surprised than I am. You know how some people can walk into a patient’s room, plump pillows, and make all the right comments? Years ago, I was not that person. I never really felt comfortable visiting sick people. Working in the healthcare arena seemed depressing. Besides, I had made a conscious decision to become …

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How I became a hospice volunteer

Meaningful treatments in the battle against coronary disease

Eric Van De Graaff, MD

Conditions and Diseases

January 16, 2012

I saw a patient in my office this week who had received a stent from one of my partners last month. The man was highly satisfied with his experience—the procedure was tolerable, the recovery short, and the nurses were pretty (he specifically made a point of this, presumably because the post-hospitalization customer surveys don’t include what seemed to him to be the most important feedback metric)—but his wife had a …

How hospitals are gaining leverage over physicians

Richard Reece, MD

Health Policy

January 16, 2012

Most hospital managers have never had the power to exert leverage over their most valuable resource, the physician, who, after all, admits the patients who make the hospital’s economic existence possible in the first place.

So I wrote in introducing a chapter in my first book in 1988. I hastened to add, however, at the close of that chapter, these admonishments:

1. The economic powers of the hospital is shifting from those …

Robotics can revolutionize the delivery of medical care

Stephen C. Schimpff, MD

Health Technology

January 16, 2012

Robotics has the potential to revolutionize the delivery of healthcare. It can help extend the delivery of information, expertise and clinical care across time and geographical space barriers. Robotics offers the opportunity to enhance quality of care through extension of clinical expertise and leveraging of integrated datasets and best practices. It can be used across the continuum–from the hospital setting (e.g. OR, ER, etc.) into primary care offices and even …

When it comes to smoking, I am a militant

Stewart Segal, MD

Physician

January 15, 2012

It is obvious to those who know me that I am an avid anti-smoker and work hard to help those afflicted with a tobacco addiction break their habit.

Knowing your shortcomings is an important part of being successful. One of my short comings is not knowing when to quit. When it comes to helping smokers stop smoking, I am a zealot. Today, I went to work on one of my smokers, …

The covenant between doctor and patient is sacred

Jordan Grumet, MD

Physician

January 15, 2012

You know Mr. Miller?

I adjusted the phone on my ear as I slipped out of bed and snuck into the bathroom. I tiptoed across the floor and winced as the old hardwood started to creek beneath my feet. I craned my head and listened for signs of stirring children.

Remembering the resident holding on the line, I whispered into the cell.

Yeah. What about him? He had a cholecystectomy this morning.

I waited …

Physicians should be concerned about malingering

Dominic A. Carone, PhD

Conditions and Diseases

January 15, 2012

Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives such as avoiding military duty, avoiding work, obtaining financial compensation, evading criminal prosecution, or obtaining drugs. The word “malingering” comes from the French word “malinger” meaning “poor or weakly” as these are the characteristics feigned or exaggerated by the malingerer. Malingering has been documented as far back as in the Bible when …

Why mammography is an imperfect test

Stacey Vitiello, MD

Conditions and Diseases

January 15, 2012

It is a scenario familiar to all breast imaging practices.

A patient feels a lump in her breast and calls her doctor. The doctor examines her, agrees that a lump is present, and refers the patient to a breast imaging facility for a diagnostic mammogram and breast ultrasound (also known as a sonogram). At her mammogram appointment, a little sticker is placed on the lump felt by the patient, and mammogram …

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Why mammography is an imperfect test

Doctors are forced to choose between really small or super big

Anonymous

Health Policy

January 14, 2012

I am a little fish in a big sea. And so are most of us. Or we are used to be. For better or worse, the era of private practice, outpatient medicine as we know it, is ending.

And faster than we thought. The choice now: downsize or supersize. No longer can a doctor operate a private practice as a solo practitioner or in a small group practice. We are getting …

How long do you expect to live?

George Lundberg, MD

Physician

January 14, 2012

To just what age do you expect to live? You haven’t thought about it? I bet you have. Would you like to live as long as Methuselah?

Television’s “Today Show” antes up centenarians to celebrate from time to time. There are about 70,000 American outliers past the age of 100. But that’s out of a population of some 311,000,000 people.

The most sensible place I know to read about this conundrum of …

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How long do you expect to live?

How well does your child play?

Yolanda Wong, MD

Patient

January 14, 2012

All play is not equal. With the power of marketing, play has become increasingly associated with toys, electronic gadgets, television, and video games. Just think about the amount of ads for children’s toys over the holidays. Just think about the things your child might have asked for and the latest trends that become the new must-have of the season.

Without realizing it, we may be intervening in a child’s most natural form of …

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How well does your child play?

MKSAP: 25-year-old with diffuse muscle and joint pain

mksap

Conditions and Diseases

January 14, 2012

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

A 25-year-old woman is evaluated during a follow-up visit for a 6-month history of diffuse muscle and joint pain above and below the waist, fatigue, and difficulty sleeping. She has a 2-year history of hypothyroidism treated with levothyroxine. Her only other medication is hydrocodone-acetaminophen, which has …

What health care can learn from the New England Patriots

Davis Liu, MD

Health Policy

January 13, 2012

As the new year starts, I’m eager for a fresh start and working on improving myself both physically and emotionally. I’m also eager for the NFL playoffs and seeing how my favorite team, the New England Patriots, fares under the leadership of Coach Bill Belichick and quarterback Tom Brady. Doctors and health care can learn much from their examples.

Over the past decade, the New England Patriots have been dominant …

The cost of being America’s drunkest city

Ford Vox, MD

Physician

January 13, 2012

Boston tops The Daily Beast’s 2011 list of the 25 tipsiest towns in America, moving up from the eighth position last year. The Beast credits its click-ready rankings to a mixture of market research surveys and CDC statistics. I don’t know about the scientific accuracy, but from my perspective in its trenches, ranking Boston the booziest rings true.

You see, I spent 2011 seeing most of the traumatic brain injury …

Each patient has something special that they can share with us

Neil Baum, MD

Physician

January 13, 2012

It was January 12, 2007 during rush hour traffic in the metro station in Washington, DC. A nondescript man wearing a baseball cap and khakis began to play the violin. He played six Bach pieces for about 45 minutes. During that time, since it was rush hour, it was calculated that at least a thousand people went through the station, most of them on their way to work. Nearly everyone …

Considering the preciousness of life and preservation of health

Emily Gibson, MD

Physician

January 12, 2012

Last night was clear with full moonshine and the owls were busy hunting on our farm, calling back and forth to each other, comparing notes on where to find prey.

Thankfully they were not calling my name. At least I don’t think so, nevertheless their hoots haunted me.

A coastal tribal legend has it that if you hear an owl call your name, your death is imminent. I’ve had no recent brushes …