KevinMD.com

April 18, 2012Apr 18, 20128

Over the past few years, insurers and Medicare officials have fostered the idea that physicians should be reimbursed on a pay for performance (P4P) basis. Many articles, both pro and con, have been written regarding P4P. I have been strongly opposed to P4P, believing that the sole purpose of the performance indicators designed by the government and insurers is to reduce payments to docs and hospitals. I also believe that …

Physician voices

When doctors are incorrect in their prognosis of terminal illness

Manoj Jain, MD, MPH

April 18, 2012Apr 18, 20122

In January, when my close friend’s lymph node biopsy came back as a rare form of T-cell lymphoma, I scoured the scientific literature. What was his prognosis?He was 56, a little overweight but otherwise healthy. He had helped us move…

In the literature I found jagged graphs plunging downward, indicating that my …

Conditions and diseases

Tips for successful home blood pressure monitoring

Erin Marcus, MD

April 18, 2012Apr 18, 2012

Sometimes, the simplest tools in medicine are the ones that give us the most useful information. Take the humble blood pressure machine, for example. It's been around for years, and it's cheap, compared with a lot of other medical devices.…

Sometimes, the simplest tools in medicine are the ones that give us the most useful information.

Take the humble blood pressure machine, for example. It’s been around for years, and it’s cheap, compared with a lot of other medical devices. It’s simple to use, and it doesn’t require a medical or a nursing degree to operate. But the numbers it reports are valuable in helping predict a person’s risk of a …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Health policy

Why doctors should drive health reform

Kohar Jones, MD

April 17, 2012Apr 17, 20128

Who better knows how to fix a leak than a plumber? Who better knows how to repair a cracked doorway than a carpenter? Who better knows how to solve the conundrum of our leaking cracked health care system than a…

Who better knows how to fix a leak than a plumber?
Who better knows how to repair a cracked doorway than a carpenter?
Who better knows how to solve the conundrum of our leaking cracked health care system than a doctor?

Doctors are an important part of public discussions about health care reform. Our prescriptions drive healthcare costs. We are the crucial middlemen between the biomedical industry and patient health. Sharing our first hand experiences in health care …

Read more…

Why doctors should drive health reform

Physician voices

A Hindu physician in a Christian hospital

Deep Ramachandran, MD

April 17, 2012Apr 17, 201215

As I enter the hospital in which I work, I am struck by a number of signs that denote that my place of employment is a Christian hospital, with Christian values, and a Christian "vision" of health care. I don’t…

As I enter the hospital in which I work, I am struck by a number of signs that denote that my place of employment is a Christian hospital, with Christian values, and a Christian “vision” of health care. I don’t have the vaguest clue as to what that means. And I don’t really mind either, it’s not like they’re paying me with Jesus biscuits and Christmas ornaments, nor does it seem …

Health policy

The unintended cost consequences of patient centered care

Richard Young, MD

April 17, 2012Apr 17, 201212

I’ve just come back from my semi-annual renewal in my belief that family medicine is the foundational solution to make healthcare more affordable in America: the interim session of the Texas Academy of Family Physicians. The most important activity at these meetings is the networking: the chance to bounce ideas and experiences off colleagues from around the state.

The issue of cost came up and two colleagues in private practice told …

Health policy

Take charge of your healthcare quality and costs

Stephen C. Schimpff, MD

April 17, 2012Apr 17, 201212

Fed up with our health care delivery system? Maybe even angry? What should a person do? What can a person do? I recently wrote a post on drivers of change in health care delivery such as the aging population, adverse…

Fed up with our health care delivery system? Maybe even angry? What should a person do? What can a person do?

I recently wrote a post on drivers of change in health care delivery such as the aging population, adverse lifestyle behaviors, shortages of physicians and developing consumer expectations. I planned to follow up today with what those drivers will produce as change in the delivery system. But a commentator responded …

Physician voices

Bullies are not born, they are raised

Katie Hurley

April 17, 2012Apr 17, 20124

People often wonder what causes children to bully. Why is it that some children feel the need to hurt and humiliate other children? What do they really stand to gain from this cruel behavior? Some studies indicate that some (not…

People often wonder what causes children to bully. Why is it that some children feel the need to hurt and humiliate other children? What do they really stand to gain from this cruel behavior?

Some studies indicate that some (not all) bullies have naturally aggressive and/or hyperactive personalities from the start. Some. But that doesn’t mean that all “spirited” kids will bully while all “mellow” kids will be perfectly empathic and …

Read more…

Bullies are not born, they are raised

Physician voices

The computer had stopped the doctor from communicating

James C. Salwitz, MD

April 17, 2012Apr 17, 201220

There was no mistake, but a bad thing has happened. Despite the best efforts of the doctors, Bob’s wife is very sick. Due to a rare side effect of treatment, her liver is failing. Bob believes this could have been…

“When we go to see the doctor, he stares at the computer,” says Bob. “He does not look at us. Most of the time, the doctor …

Physician voices

Why the physician path today is far from linear

Philippa Kennealy, MD, MPH

April 16, 2012Apr 16, 20125

As a child, the only physician I ever knew was our crusty opinionated and entirely trustworthy family doc. His physician career spanned almost five decades, in one unbroken line from his first days as a GP in solo practice until…

His was the typical physician career, representing continuity, professional satisfaction and a lifelong commitment …

Health policy

Chaos for doctors if the Affordable Care Act is struck down

Bob Doherty

April 16, 2012Apr 16, 201233

Imagine you’re a physician, and you have a full schedule of patients to see the day after the Supreme Court has thrown out the entire Affordable Care Act. Imagine you never liked “Obamacare” in the first place, so you are…

Your first patient, an elderly retiree named Mrs. Jones, comes in for her annual Medicare wellness visit—one of the new Medicare preventive benefits …

Medical education

The residency journey is just getting started

Allison A. Greco

April 16, 2012Apr 16, 20122

Every career has that one question that is notoriously hated by all. For nurses, that question is, “So, why didn’t you want to be a doctor?” For teachers, it’s questions about the age-old adage, “Those who can’t do, teach.” For…

It’s not that people who ask medical students about their career plans are ill-intentioned or nosy; in …

Medical education

CME limitations and how we can improve Continuing Medical Education

Behnood Bikdeli, MD

April 16, 2012Apr 16, 20122

Some people critique Continuing Medical Education (CME) programs as spoon-feeding. As a young physician struggling to learn a lot of material, I actually appreciate a bit of ready-to-consume content that I can learn quickly and effectively. The American College of Cardiology (ACC) and other reputable institutions provide CME programs that, overall, help to keep physicians up on the literature and integrate new findings with existing knowledge. However, despite the basic …

Physician voices

Part time medicine and birth of the new normal

Dike Drummond, MD

April 16, 2012Apr 16, 201233

One of the most common stressors for physicians is the sheer toxicity of what are considered full time hours. While the rest of the world considers full time to be 40 hours a week, we all know a full time…

In physician surveys, schedule flexibility and the ability to function as a part time …

Patient voices

What to say to a newly diagnosed cancer patient

Salli Camphouse

April 15, 2012Apr 15, 20123

“So, the doctor told me I have breast cancer. I just wanted to let you know. I’m doing fine right now, but I have some decisions to make regarding my treatment options. I’ll keep you posted.” This may be a…

“So, the doctor told me I have breast cancer. I just wanted to let you know. I’m doing fine right now, but I have some decisions to make regarding my treatment options. I’ll keep you posted.”

This may be a typical email sent to family and friends after receiving a breast cancer diagnosis. Sending emails seems more practical at this point. With so many friends and family to update, unless a …

Health technology

We need to systematically evaluate digital health technologies

Fard Johnmar

April 15, 2012Apr 15, 2012

An old colleague once told me: “When you assume it makes an ass out of u and me.” Many of us would consider being an ass a bad thing. If so, why are we making so many assumptions about digital…

An old colleague once told me: “When you assume it makes an ass out of u and me.”

Many of us would consider being an ass a bad thing. If so, why are we making so many assumptions about digital health? Belief in the power of digital technologies to solve a host of pressing problems in health has us poised to devote billions of dollars to their adoption and development. But …

Physician voices

Tips to fight depression during medical residency

Adriana Tobar, MD

April 15, 2012Apr 15, 20129

Even though I love my job, I’ve been feeling a little burned out lately. I think it comes from being stretched too thin, which is something I’ve coped with off an on ever since med school. As the saying goes,…

Even though I love my job, I’ve been feeling a little burned out lately. I think it comes from being stretched too thin, which is something I’ve coped with off an on ever since med school.

As the saying goes, there are never enough hours in the day, and sometimes that really gets to me. While my practice is incredibly important, I also place a lot of value on my family. …

Physician voices

What does it take to have successful end of life conversations?

Virginia L. Seno, PhD

April 15, 2012Apr 15, 20128

Everyone suffers when communication fails at the end of life. Though we may “know in our hearts” what to do in difficult situations; anxiety and bias close us down. We lose our ability to say and act on what we…

Physicians and nurses suffer when they “know in their hearts” that they are doing harm performing CPR on people at a natural end of their lives on people …

Conditions and diseases

Making sense of the rise in autism diagnoses

Rob Lamberts, MD

April 14, 2012Apr 14, 201210

Hello, Pandora. What do you have in that box? Yes, I am going to talk about ... autism. The last time I did so I was inundated with people trying to convince me of the dangers of immunizations and their…

Hello, Pandora. What do you have in that box?

Yes, I am going to talk about … autism. The last time I did so I was inundated with people trying to convince me of the dangers of immunizations and their causal link to autism. I really, really, really don’t want to go anywhere near that one.

No, I am not going to talk about the cause of autism; I am going to …

Physician voices

What does writing fiction and being a doctor have in common?

Richard Barager, MD

April 14, 2012Apr 14, 20125

I have been asked a lot lately, owing to the release of my novel Altamont Augie, what writing fiction and being a doctor could possibly have in common? Patients and colleagues seem shocked that the rational, left-brain doctor they have…

I have been asked a lot lately, owing to the release of my novel Altamont Augie, what writing fiction and being a doctor could possibly have in common? Patients and colleagues seem shocked that the rational, left-brain doctor they have come to know and depend on to deliver technologically complex medical care to patients with kidney failure could produce such a right-brain thing as a novel. Where did this …

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular