Thankfully, there have been more news stories recently illustrating the overuse of tests.
Specifically with cancer screening, the PSA test and mammograms have come under increasing scrutiny.
I think this type of media attention is long overdue, as the public needs to be aware of the potential downsides of diagnostic tests.
Now comes the MRI.
A recent piece in the New …
The media’s role in educating patients about MRI overuse
Just as posited in a prior article featured on KevinMD.com, where it was suggested that implementing an EMR/EHR has significant attraction to prospective physician candidates, I would like to also recommend that a similar stance can be adopted with respect your practice’s your web presence.
In other words, is your website putting your best foot forward for not only prospective patients, but also to prospective physicians and others who …
Why your website is important to recruit physicians
During our medical training we are taught to use evidence based medicine. This means using the most up to date scientific research data that has been analyzed and accepted as fact. But does this mean every patient we see fits into the evidence based medicine algorithm that we have been taught to use?
I hope not. For this would mean we would only be following half of medicine. The art of …
What happened to the art of medicine?
Not many years ago it was assumed that most cancers were not caused by viruses. Today it is clear that many are and the list is growing. Head and neck cancers are either caused by the environment (especially tobacco) or by the human papilloma virus, the same virus that causes cervical cancer and some genital warts.
The incidence of HPV-related head and neck cancer has been rising rapidly in the past …
Quality of life issues in caring for cancer patients
My 64-year-old patient with terminal cancer and less than six months to live wanted to go to Oregon. He was contemplating assisted suicide, which is legal there. “My life has been long and good,” he said. “I believe it is my right. I want the ability to say it’s too much, I can’t do it anymore. A person should have a dignified quality of life.”
Another one of my patients, an …
Doctors are reluctant to have end of life conversations
Doctors love their Apple Products. Just walk into any hospital ward, and see the types of mobile devices we are using. At weekly Grand Rounds conferences, you see plenty of iPads in use. At physician meetings, the laptop of choice is often the Macbook Pro. The data backs these anecdotal examples as well.
Doctors love their Apple Products – and Steve Jobs was obviously an extension of these …
3 reasons why doctors will miss Steve Jobs
We are finally in the midst of American football season again, after so many dull months. Are you ready for: “We’re Number 1; we’re Number 1”?
School pride; conference pride; regional pride; confirmation of identity; proof of manhood.
Think Summer Olympics in London, 2012. As the Gold Medals add up, the chants will ring out … U.S.A, U.S.A.
Goose bumps; spine tingles; national pride.
Years back, when John McKay coached the USC Trojans, he …
How to control health care costs in the USA
I took my daughter to the orthodontist last week to get braces.
There’s a lot about the process that seems better than when I was a kid. Mostly, it’s that instead of having to slide brackets around each of your teeth (yishk!) the orthodontist just paints a special glue on the enamel and places the brace on the front of each tooth. Kids get to pick the color of their braces …
What doctors can learn from the orthodontist’s office
The digital age has had a deep and likely permanent effect on the patient-physician relationship. I can’t tell you how many times I’ve had physicians beg me to provide them with a way to stop their patients from Googling their symptoms and diagnosing themselves before their first office visit and much to their chagrin, my answer is always the same, “You can’t stop them. Get over it.”
The Internet acts …
Patients and physicians in the digital age
Few things smell worse to me than the stank of a cigarette while trying to trying to load up on cholesterol via awesome blossom. Perhaps one such thing is the beguiling tale of what perverse fate has befallen the gobs of cash money rewarded to state governments from Big Tobacco.
This seemingly righteous pursuit was fought by brave attorneys general of 46 various states to regain money we dished out to pay …
How state governments are addicted to tobacco revenue
Last year I was assigned to complete a history and physical on a patient in the hospital. Stifling my excitement to be doing this on a weekend night, I walked to the operator’s desk and paged the on-call intern, who — I’d been assured — knew I was coming. “You’re who now for what?” she stared blankly back at me after I’d explained my task.
My patient (we’ll call her Betty) …
A nurse offers a medical student sage advice
Recently, our whole class was asked to “become” a diabetic to try and really understand what it is we’re diagnosing people with. Fantastic idea. Fantastic opportunity.
Not so fantastic to carry out. I opted for the insulin-dependent, type I option, which meant I had to keep a diary of what I ate (including counting carbohydrates), regularly check my glucose level, and inject myself before meals. (We didn’t actually inject insulin or saline, …
A medical student becomes a diabetic and finds public disapproval
By mid-November, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) must respond to the legal complaint filed in a Maryland federal court by six Augusta, Georgia family physicians.
These doctors are not asking for money, but for relief from the negative effects brought about by CMS’ twenty year reliance on the American Medical Association’s Relative Value Scale Update Committee (RUC) …
Why CMS should settle with primary care plaintiffs
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“Better” is another one of the difficult words I have to deal with on a daily basis.
“Doc, I’m better” can mean a lot of things and can lead to both misdiagnosis and poor treatment. Does “I’m better” mean you are well? If not, are you really better or is it just wishful thinking? How much better are you?
On a busy, stressful day, even the most skilled physician can fall for, …
Doctor, I’m better: What does that really mean?
Physicians, nurse practitioners, nurses, psychologists, physical therapists, and a whole host of other health care professionals entered their respective professions to help people. One part of being an effective health care provider is to advocate for your patient when they need it. For example, if your patient (who is a mechanic) broke his arm and needs a note for the employer for a few weeks off, you provide it. If …
When patient advocacy leads to patient enabling
When they first discovered the tumor in his pancreas in October 2003, his doctors told him an immediate operation was necessary, and could lead to a cure.
As first reported by Peter Elkind in 2008, Jobs decided to think different, declined surgery, and explored alternative medicine treatments for his disease.
Nine months later, in July 2004, the tumor had grown. Only then would he allow his doctors to operate.
Would Steve Jobs be alive today had he consented to surgery when they first discovered …
How alternative medicine may have killed Steve Jobs
There’s a new term that has entered the medical lexicon. The word is wellness. Hospitals and medical offices are incorporating this term into their mission statements, corporate names, business cards, medical conferences and other marketing materials. The Cleveland Clinic Foundation has appointed a Chief Wellness Officer, an intriguing fluffy title that does not clearly denote this individual’s role and function. This is deliberate, as the word wellness is designed …
Is wellness simply a hospital marketing term?
Today I went to Middle of Nowhere, Ireland for a rural lumps and bumps clinic. I really enjoy the outings to the country, hanging around the little hospitals, and seeing the old farmers who drive in on their tractors (true story).
I had the chance to see a nice variety of patients: from swallowing difficulties to sebaceous cysts, urinary retention to infected toe nails. For me the real fun is with …
A Canadian medical student training in Ireland
In 2000, nearly 60% of physicians were practicing independently. Compare that to two years from now, when it’s predicted that just 33% will continue to practice solely outside of a larger health system. According to a report from Accenture, the global consulting company that released those figures, between now and 2013, the rate at which independent doctors are being employed by larger systems will increase by 5% …
How physicians develop their careers is undergoing a fundamental shift
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 25-year-old man is evaluated for a 2-year history of infertility. He and his wife have been unable to conceive since marrying 2 years ago. Analysis of a semen sample provided 3 weeks ago during an infertility evaluation showed azoospermia. The patient has a strong libido …
MKSAP: 25-year-old man is evaluated for infertility
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