KevinMD.com

March 16, 2012Mar 16, 201211

The United States Preventive Services Task Force (USPSTF) is a federal committee composed of private sector experts in prevention and primary care. Its mandate is to make recommendations as to which preventive services are beneficial, which are useless and which are harmful. Disconcertingly, there is a small but vocal opposition to the USPSTF as embodied by an op-ed piece in the Wall Street Journal by Dr. Scott Gottlieb.

Dr. Gottlieb’s main argument against the USPSTF is …

Physician voices

Empathy is an essential ingredient of the work of a doctor

Dr. Leah Kaminsky

March 16, 2012Mar 16, 20123

They say a good doctor needs to be able to stand in his patient’s shoes, but Stuart only had one; a size 12, left foot Nike Air Max. Back in May 1991, after his car ran off an Australian country…

They say a good doctor needs to be able to stand in his patient’s shoes, but Stuart only had one; a size 12, left foot Nike Air Max. Back in May 1991, after his car ran off an Australian country road, wrapping itself around a gum tree, Stuart ended up losing a leg. In a photo taken at the scene of the accident the following day, you can see a …

Health policy

Healthcare consolidation may bend the cost curve the wrong way

Mitchell Brooks, MD

March 16, 2012Mar 16, 201213

Last year, Ann Mathews wrote a brilliant piece in the Wall Street Journal about the future of medical care in the United States. It is an extremely informative study and provides the reader with a very fine 50,000-foot view of…

Last year, Ann Mathews wrote a brilliant piece in the Wall Street Journal about the future of medical care in the United States. It is an extremely informative study and provides the reader with a very fine 50,000-foot view of the current condition of its subject.

What she did not mention, or truly highlight, is the threatening trend that is taking place with ever increasing rapidity, of hospital conglomerates, both …

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Physician voices

Complex, painful and expensive medical procedures at the end of life

Janice Boughton, MD

March 16, 2012Mar 16, 201214

It isn't that it was a bad day, because it wasn't really. There was too much work, yes, and I ended up staying late, but it was mostly made of good interactions and I felt generally competent. So, no, it…

It isn’t that it was a bad day, because it wasn’t really. There was too much work, yes, and I ended up staying late, but it was mostly made of good interactions and I felt generally competent. So, no, it wasn’t just a bad day. Still, this evening I feel like the best possible future would be one in which there was no technological medical care, where we just worked …

Physician finance

Should doctors be forbidden to complain about money?

Kevin Pho, MD

March 16, 2012Mar 16, 201230

The Patient Centered Medical Home is supposed to be the solution to our primary care woes. Endorsed by both the American Academy of Family Physicians and the American College of Physicians, this new model of primary care creates a team-based…

The Patient Centered Medical Home is supposed to be the solution to our primary care woes.

Endorsed by both the American Academy of Family Physicians and the American College of Physicians, this new model of primary care creates a team-based approach to patient care, with a cadre of care managers and nurses assisting physicians to manage patients with chronic disease. If …

Medical education

Reflections on the Match: Improving the interview process

William Bain

March 16, 2012Mar 16, 2012

We are sorry, you did not match to any position. – NRMP Staff Despite more than one-quarter-million dollars in tuition and expenses at a top-notch medical school, several of my classmates received that stark e-mail on Monday. Most quickly began…

We are sorry, you did not match to any position. – NRMP Staff

Despite more than one-quarter-million dollars in tuition and expenses at a top-notch medical school, several of my classmates received that stark e-mail on Monday. Most quickly began the SOAP (the new “scramble”) to find an unfilled position. Although many factors influence whether a medical student finds success in The Match, this week’s results suggest to me that the …

Physician voices

A family bucket list is a reminder to have fun together

Yolanda Wong, MD

March 16, 2012Mar 16, 2012

Parenthood. It has changed everything. Snot on my sweater goes unnoticed. Hobbies gather dust in the closet. Kissing away the boo-boos and wiping away tears become daily ritual. Screams, laughter, tantrums, and toys crashing to the floor become the household…

Parenthood. It has changed everything.

Snot on my sweater goes unnoticed. Hobbies gather dust in the closet. Kissing away the boo-boos and wiping away tears become daily ritual. Screams, laughter, tantrums, and toys crashing to the floor become the household white noise. All my Facebook status updates are about my kids.

Some people manage to continue their lives with style.

Me? I’m just tired. And I need a haircut. Smartypants would say I need a …

Medical education

Heed the 4th year medical student spoils

Nonmaleficence

March 16, 2012Mar 16, 20122

Looking back on the first three years of medical school, it’s hard to imagine living through the endless days of studying again. Weekends were spent cooped up in the library and there were countless holidays that I wasn’t able to spend with my family. Instead, they were spent memorizing indecent aspects of the human anatomy and performing DREs on strangers. There are better ways to get to know a person …

Conditions and diseases

Cancer screening stories need to report on the uncertainties

Gary Schwitzer

March 16, 2012Mar 16, 2012

A Miami Herald story, heralds “Prostate cancer hits younger men.” You know right away how this one is going to play out. The story begins by profiling a 48-year old man with prostate cancer. It says his “doctor ordered the…

A Miami Herald story, heralds “Prostate cancer hits younger men.” You know right away how this one is going to play out.

The story begins by profiling a 48-year old man with prostate cancer. It says his “doctor ordered the test as a routine practice for his male patients.” There isn’t any discussion about how such ordering as a routine practice doesn’t demonstrate the kind of shared decision-making model that the …

Patient voices

Improving patient safety requires a commitment to transparency

Paul Levy

March 15, 2012Mar 15, 20125

An excerpt from Goal Play!: Leadership Lessons from the Soccer Field. I recently had lunch with one of my soccer alumnae, now aged 28. Tovah said to me, “Do you remember that play I made in the tournament we went…

An excerpt from Goal Play!: Leadership Lessons from the Soccer Field.

I recently had lunch with one of my soccer alumnae, now aged 28. Tovah said to me, “Do you remember that play I made in the tournament we went to in Connecticut? I mean when I mistakenly headed the ball into our own goal and caused us to lose the game.”

“Well, I was devastated and was sitting on the …

Conditions and diseases

The problem with obesity counseling

Christina Girgis, MD

March 15, 2012Mar 15, 201214

Recently I have become interested in the obesity epidemic plaguing our country. I’ve actually been interested in obesity and co-morbid psychiatric illness since residency, but recently my interest has been revived. I read that Medicare is going to be reimbursing health care practitioners for obesity counseling and screening. My initial thought was that this is a positive step in the right direction. But the cynic in …

Read more…

The problem with obesity counseling

Patient voices

How dare strangers tell me to ditch my doctor

Kris Byrd

March 15, 2012Mar 15, 20124

It’s always amazing to me how quick folks can be to offer advice. Unwanted advice. Medical advice. Near strangers jump at the chance to give input without a second thought. Isn’t everyone quick to judge a doctor they’ve never met, particularly when the doctor is treating something they’ve never even heard of? What does this say about me? When someone does this to me, they are basically telling me that …

Conditions and diseases

Planned Parenthood can’t accept Medicaid in Texas: Why we should care

Jennifer Gunter, MD

March 15, 2012Mar 15, 201225

She knew she was supposed to be careful about getting pregnant, although truthfully she didn’t think it could happen because of her blood pressure and kidney problems. The nurses at the county clinic started her on the pill, but her blood pressure went all crazy. They asked her to come back on a Wednesday night when the doctor was there. The doctor asked lots of questions and spent a lot …

Conditions and diseases

Will Peyton Manning ever fully recover from his spinal nerve injury?

Edward Pullen, MD

March 15, 2012Mar 15, 20125

Does muscle weakness improve after disc surgery? For an NFL fan arguably the best thing that could happen to your team is to sign Peyton Manning and have him perform at or near his pre-injury level. The corollary is that…

Does muscle weakness improve after disc surgery?

For an NFL fan arguably the best thing that could happen to your team is to sign Peyton Manning and have him perform at or near his pre-injury level. The corollary is that one of the worst things to happen to your team would be to take a huge salary cap hit to get a Peyton Manning with such weak throwing arm that even …

Physician voices

Doctors need to be better trained to deliver bad news

John Salter, MD

March 15, 2012Mar 15, 20125

Last week was tough. I had to refer several patients to hospice, and a few more received bad news regarding their disease. This has always been the toughest part of my job, but it’s also the part patients need me to handle best. I have to remind myself that no matter how hard it is for me to give bad news, the patient and their families are the ones receiving …

Health policy

Why one-third of hospitals will close by 2020

David Houle & Jonathan Fleece

March 14, 2012Mar 14, 2012330

For centuries, hospitals have served as a cornerstone of the U.S. health care system. During various touch points in life, Americans connect with a hospital during their most intimate and extraordinary circumstances. Most Americans are born in hospitals. Hospitals provide care after serious injuries and during episodes of severe sickness or disease. Hospitals are predominately where our loved ones go to …

Conditions and diseases

A radiologist disagrees with the breast cancer screening guidelines

Stacey Vitiello, MD

March 14, 2012Mar 14, 201216

As a veteran of World War II, my grandfather was a GI Bill success story, the first man to go to college from his impoverished neighborhood in Jersey City thanks to government at its finest. A card-carrying member of the state teachers’ union, and a politically active Democrat for most of his life, it came as something of a shock to me when, after a few decades of observing big …

Match Day 2012: Medical students anticipate this Friday

Perelman School of Medicine

March 14, 2012Mar 14, 20124

Match Day marks one of the most important days in a medical student’s career. Match Day is held annually to announce the results of the National Residents Matching Program (NRMP), which places graduating medical students with residency programs throughout the country. On March 16, 2012, the wait will be over for Perelman School of Medicine students who will open their envelopes revealing the location where they will spend …

Patient voices

Changing older adult stereotypes through children and nursing homes

Frances Shani Parker

March 14, 2012Mar 14, 20123

"What's considered a sexual risk for an old person? Not wearing a diaper?" "How about old people just stop having sex?" These comments from an Internet social media “discussion” group on older adult AIDS prevention reflect blatant eldercare bias. They…

“What’s considered a sexual risk for an old person? Not wearing a diaper?”

“How about old people just stop having sex?”

These comments from an Internet social media “discussion” group on older adult AIDS prevention reflect blatant eldercare bias. They are just more of many examples of negative stereotypes about them that are embedded in our society. Not only do they affect older adults who are currently victimized by them, they also …

Real physician voices, twice a week

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