KevinMD.com

March 20, 2012Mar 20, 201239

Primary care residency numbers didn't change much this year. Depending upon your vantage point, that's either a good or bad thing. For those who were hoping that the numbers would continue that 2-year steady climb out of the dumps, the…

Primary care residency numbers didn’t change much this year. Depending upon your vantage point, that’s either a good or bad thing. For those who were hoping that the numbers would continue that 2-year steady climb out of the dumps, the 1% increase in FM positions seemed to be a disappointment. But for many of us who work day to day to revitalize the primary care pipeline, we breathed a sigh …

Physician voices

What health care can learn from a Super Bowl loss

Davis Liu, MD

March 20, 2012Mar 20, 2012

Although my team, the New England Patriots lost Super Bowl XLVI to the New York Giants in one of the most exciting and tense games in recent memory, reviewing both the pre and post game coverage provided even more learning for doctors and healthcare than my prior post. One can demand excellence and still fall short. When one fails to achieve the intended goals, the learnings can be as …

Medical education

Should medical schools be mandated to teach nutrition?

George Lundberg, MD

March 20, 2012Mar 20, 201216

Doctor, do you know a lot about human nutrition? You said "yes?" Congratulations, if that is true. But I suspect that South Carolina Congressman Joe Wilson's infamous quote "you lie" is applicable. American medical schools traditionally have done a horrible…

Doctor, do you know a lot about human nutrition? You said “yes?”

Congratulations, if that is true. But I suspect that South Carolina Congressman Joe Wilson’s infamous quote “you lie” is applicable.

American medical schools traditionally have done a horrible job with their curricular treatment of clinical nutrition. University curricula are controlled by the faculty and, when the faculty don’t know or care much about a topic, it often gets short shrift.

I …

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Conditions and diseases

Cancer pain is often undertreated

Jennifer Kelly, MD, PhD

March 20, 2012Mar 20, 20123

Pain is the result of a physiological series of electrical and chemical events that occur in the body. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential…

Pain is the result of a physiological series of electrical and chemical events that occur in the body. The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”

Pain receptors are bare nerve endings that are widely distributed throughout the body in the skin and mucous membranes. When pain receptors are …

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Cancer pain is often undertreated

Health policy

Will patients accept focused networks in today’s economy?

Kevin Pho, MD

March 20, 2012Mar 20, 20123

In a bid to save money, health insurers are coming out with what's known as "focused networks," which typically exclude the highest cost hospitals. In the Boston area, one such plan comes from health insurer Harvard Pilgrim Health Care, whose…

In a bid to save money, health insurers are coming out with what’s known as “focused networks,” which typically exclude the highest cost hospitals.

In the Boston area, one such plan comes from health insurer Harvard Pilgrim Health Care, whose plan excludes Partner’s Health Care institutions. That’s significant, since Partners includes the famed Massachusetts General Hospital as well as Brigham and …

Medical education

When medical students first deal with death

Dr. Irma Faruqi

March 20, 2012Mar 20, 20124

Very few are as starkly aware of the transience of life as those working in the healthcare profession. We are expected to be, for want of a better word, immune to it; as if each death we face is somehow a vaccine that will eventually, with regular booster doses, provide us with enough immunity to be resistant to the Grim Reaper.

We spend years studying, arming ourselves with pages and pages …

Health technology

Is the patient experience enhanced by modern technology?

Robert Rowley, MD

March 19, 2012Mar 19, 20127

Most physicians went into the practice of medicine motivated (at least in part) by the reward that comes from that human-to-human connection. The reward that comes from helping people. It was true of my generation of physicians, it was true of those before me, and is true of newer generations of physicians who grew up in a more interconnected, digitized world.

We are now at a time in medicine where an …

Health policy

10 strategic questions to ask yourself about the future of health care

Joe Flower

March 19, 2012Mar 19, 2012

Today and for the next few years the weather of this industry will be dominated by pervasive, discontinuous change. Structures, revenue streams, relationships of every level: All are shifting in fundamental ways. Specifically, the weather will be driven by: i)…

i) invention and propagation of new business models;
ii) shifting risk onto both the provider and the patient, accompanied by building of new risk-based relationships, contracts and alliances;
iii) smart primary care coming to …

Health policy

How political agendas erode the doctor-patient relationship

Maggie Kozel, MD

March 19, 2012Mar 19, 201213

Your doctor’s exam room is getting overcrowded. Modern US health care means that, like it or not, you and your physician are sharing that once private space with an insurance executive constantly hissing in your doctor’s ears to move it along. You are also sharing it with pharmaceutical marketers, lobbyists from the food industry … special interest groups of every stripe.

Now move over and make room for one more interested …

Health technology

Why doctors aren’t prescribing health apps to patients

Travis Good, MD, MBA

March 19, 2012Mar 19, 201212

The BBC had a story recently about general practitioners (GPs) in the UK prescribing health apps to patients. The idea is that prescribed apps would be free to patients, even if they had a cost associated with them, so I’m…

The BBC had a story recently about general practitioners (GPs) in the UK prescribing health apps to patients. The idea is that prescribed apps would be free to patients, even if they had a cost associated with them, so I’m assuming that the NHS would pick of the tab for such apps.

The story has gotten a lot of attention, and I think with good reason. I’ve written before and …

Physician voices

Why isn’t everyone excited about robotic assisted surgery?

Kelly Wright, MD

March 19, 2012Mar 19, 20127

It’s cool. So cool, that President Obama used one. So cool, it’s been on the cover of Newsweek. It’s been in multiple television commercials, radio advertisements, highway billboards, and was even coined one of the top 14 medical breakthroughs of…

It’s cool. So cool, that President Obama used one. So cool, it’s been on the cover of Newsweek. It’s been in multiple television commercials, radio advertisements, highway billboards, and was even coined one of the top 14 medical breakthroughs of 2011 by Boston Magazine, a city teeming with medical innovation. Yet surgeons and health economists are unable to explain the fascinating rise of robotic-assisted surgery.

Currently, a single company manufactures and …

Physician voices

How to be like Betty White when you get older

Melanie Lane, MD

March 19, 2012Mar 19, 20123

I aspire to be Betty White when I grow up; she's witty, funny, brilliant, and beautiful. I can't wait to coo, "My eyes are up here," to the hot guy who's just busted down my door, when I'm 90 years…

I aspire to be Betty White when I grow up; she’s witty, funny, brilliant, and beautiful. I can’t wait to coo, “My eyes are up here,” to the hot guy who’s just busted down my door, when I’m 90 years old.

“What’s the secret to her vivaciousness?” I wonder. She is probably genetically gifted a la George Burns, but I bet she has done more to preserve her looks and her …

Physician voices

Physician burnout: Why it’s not a fair fight

Dike Drummond, MD

March 19, 2012Mar 19, 201213

Every day physicians and other healthcare professionals are engaged in an invisible battle at work. In one corner is our desire to help other people, make a difference and practice the skills we worked so hard to perfect. In the…

Every day physicians and other healthcare professionals are engaged in an invisible battle at work.

In one corner is our desire to help other people, make a difference and practice the skills we worked so hard to perfect.

In the opposite corner is burnout and it’s entire gang. Most of us don’t recognize burnout has a whole team on its side. We are outnumbered at least ten to one. I call this …

Physician voices

Neglecting the patient in the era of health IT and EMR

Abraham Verghese, MD

March 18, 2012Mar 18, 20123

In advance of their annual User Conference, the social media team at athenahealth was able to talk about modern medicine with the event’s keynote speaker, Dr. Abraham Verghese. A physician and Stanford professor, Verghese has also authored several books, including the New York Times bestseller, “Cutting for Stone.” Here he talks about the importance of being present during the exam, in an era with so many distractions threatening to …

Conditions and diseases

Hearing loss affects more people than you think

Mike Armstrong, MD

March 18, 2012Mar 18, 20126

Despite remarkable changes in technology, only 20% of patients who could benefit from hearing aids actually wear them. Reasons vary, but include a lack of awareness among patients and physicians, fear of stigmatization, and failure to recognize the immense value…

Hearing loss affects 36 million Americans according to the National Institute on Deafness and other Communication Disorders (NIDCD). One third of people …

Physician voices

Bias and error are rampant in medical literature

Anonymous

March 18, 2012Mar 18, 20127

A heretic essay in JAMA by Vinay Prasad (Northwestern of Chicago), Adam Cifu (U. of Chicago) and John Ioannidis (Stanford) should be required reading for every medical student and resident and to pass any board certification exam in any specialty…

A heretic essay in JAMA by Vinay Prasad (Northwestern of Chicago), Adam Cifu (U. of Chicago) and John Ioannidis (Stanford) should be required reading for every medical student and resident and to pass any board certification exam in any specialty … in my humble opinion.

John Ioannidis became one of my personal heroes with the publication of his great paper in PLoS Medicine, “Why Most Published Research Findings Are False,” and its …

Drugs and prescribing

Unregulated supplements are a tragedy in waiting

George Lundberg, MD & Gilbert Ross, MD

March 17, 2012Mar 17, 20128

The latest supplement toxic alert thankfully involves only two young soldiers who died suddenly, both reported to have the unregulated amphetamine-like dimethylamylamine, DMAA, aka "Jack3d" and "OxyelitePro," as the suspected death-dealing toxicant. Who knows how many other unexplained deaths and…

The latest supplement toxic alert thankfully involves only two young soldiers who died suddenly, both reported to have the unregulated amphetamine-like dimethylamylamine, DMAA, aka “Jack3d” and “OxyelitePro,” as the suspected death-dealing toxicant.

Who knows how many other unexplained deaths and near-deaths can be attributed to the vast experiment foisted upon an unwary American populace by such drugs — I mean, “supplements”?

Thanks to 1994’s Hatch Act, the Dietary Supplement Health …

Health policy

Care coordination is key to fixing health care

Stephen C. Schimpff, MD

March 17, 2012Mar 17, 20126

Author of the new book “The Future of Health Care Delivery” and the former CEO of the University of Maryland Medical Center, Stephen C. Schimpff, MD, FACP, says effective care coordination, especially for patients with chronic illness, requires technology, more…

A physician, educator and cancer researcher for more than 40 years, Dr. Schimpff shares his …

Health policy

Why this pediatrician quit medicine

Lumi St. Claire, MD

March 17, 2012Mar 17, 201223

There are an awful lot of reasons that led up to my eventual resignation from a career in primary care medicine. I don't know that any one of them is more important than the other (it really just depends on…

There are an awful lot of reasons that led up to my eventual resignation from a career in primary care medicine. I don’t know that any one of them is more important than the other (it really just depends on which day you ask me). One that stands out for me though as a universal problem shared by millions is Managed Health Care, and the imposition it has posed on …

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Why this pediatrician quit medicine

Physician voices

Essential patient communication tips for physicians

Jennifer Kelly, MD, PhD

March 17, 2012Mar 17, 20122

The manner in which a physician communicates information to a patient is as important as the information being communicated. Patients who understand their doctors are more likely to acknowledge health problems, understand their treatment options, modify their behavior accordingly, and follow their medication schedules. In fact, research has shown that effective patient-physician communication can improve a patient’s health as quantifiably as many drugs—perhaps providing a partial explanation for the powerful placebo …

Real physician voices, twice a week

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