KevinMD.com

February 25, 2012Feb 25, 201236

How many people would purchase phones if those phones only communicated with other phones in their household? Would a postal service create sufficient value if you could only send letters within your town? Would the value obtained by purchasing a $20,000 car that included a powerful engine, nice audio system, seats with lumbar support and a great air conditioner justify purchase if, after the fact, you learned that to be …

Patient voices

Why physicians should care about Amanda Trujillo

J. Doe, RN

February 25, 2012Feb 25, 2012214

For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient was slotted for pre-transplant evaluation …

Physician voices

Doctors need to stop being so complacent

Anonymous

February 24, 2012Feb 24, 201215

Four brutally honest declarations: 1. I can perfectly decide what is best for myself, my family, my patients, and my practice. I don't need outside guidance telling me how to lead. 2. I decide what works best on my terms…

Four brutally honest declarations:

1. I can perfectly decide what is best for myself, my family, my patients, and my practice. I don’t need outside guidance telling me how to lead.

2. I decide what works best on my terms to practice the best medicine.

3. I will succeed and lead because I am focused on my goals just as much (if not more) than my patient’s goals.

4. My goal is to make …

Real physician voices, twice a week

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Physician voices

When is it better for doctors to make mistakes?

Karen S. Sibert, MD

February 24, 2012Feb 24, 20123

Back in the 1990’s, my husband and I spent a year working at one of the largest hospitals in West Virginia. The patients were the nicest people in the world, and the hospital staff was terrific—kind, generous, and hard working. Some of the surgeons were excellent, but others definitely were not. My husband (a cardiac anesthesiologist) and I had to cope with surgical complications the likes of which we had …

Physician voices

Why maintaining a distance is necessary for doctors

Michelle Au, MD, MPH

February 24, 2012Feb 24, 2012

You would think that for doctors, who work with life and death issues every day, the issues of our own frailties or the tenuous line between health and sickness for our own families would be, if not accentuated, then at least more immediate than to those who, say, do investment banking for a living. But the strange thing is that despite our easy familiarity with human mortality, it is not …

Physician voices

Why the civil litigation system is unfair to physicians

Chris Rangel, MD

February 24, 2012Feb 24, 201234

It’s unclear how many non-legal persons actually understand how different civil trials are from criminal proceedings. Most people have heard that juries in criminal trials are told that they can only find a defendant guilty if their belief that the defendant is guilty is beyond a reasonable doubt. Federal courts define this term further as, “proof of such a convincing character that a reasonable person would not hesitate to act …

Physician voices

Why doctors should be allowed to fire patients

Matthew Mintz, MD

February 23, 2012Feb 23, 201238

A recent article in the Wall Street Journal is getting a lot of attention: More Doctors 'Fire' Vaccine Refusers. The article discussing the increasing frequency of pediatricians who are “firing” patients/families from their practices because they refuse to take recommended…

A recent article in the Wall Street Journal is getting a lot of attention: More Doctors ‘Fire’ Vaccine Refusers. The article discussing the increasing frequency of pediatricians who are “firing” patients/families from their practices because they refuse to take recommended vaccines for fear of autism or other concerns (rampant on the internet, but all proven untrue).

It is important to note that not only should physicians be able to fire patients, …

Conditions and diseases

The lack of concussion awareness in the medical field

Mandy Huggins, MD

February 23, 2012Feb 23, 20123

With all the media attention to concussion these days, most people are familiar with the term “concussion” and know what it means. If you're not involved in the medical field, and you never watch CNN or ESPN, fine. You might…

With all the media attention to concussion these days, most people are familiar with the term “concussion” and know what it means. If you’re not involved in the medical field, and you never watch CNN or ESPN, fine. You might not be in the loop. But it is extremely alarming when we still see the lack of awareness in the medical field.

I don’t mean to speak ill of other specialties, …

Drugs and prescribing

Should doctors talk about the cost of drugs with their patients?

Peter Ubel, MD

February 23, 2012Feb 23, 201221

I first realized something was amiss when I picked up my prescriptions and the pharmacist explained that she could not fill the anti-malarial medications as prescribed: "Your medication plan only pays for 30 days of pills, and your prescription was…

I first realized something was amiss when I picked up my prescriptions and the pharmacist explained that she could not fill the anti-malarial medications as prescribed: “Your medication plan only pays for 30 days of pills, and your prescription was for five pills.” The pharmacist continued: “Your PBM [that’s an acronym for pharmacy benefits management company, the type of company that coordinates many peoples’ medication coverage] only fills this medication …

Health policy

America has a medical care system not a health care system

Stephen C. Schimpff, MD

February 23, 2012Feb 23, 201223

As Americans we believe we have the best healthcare system in the world. But think again, it’s really not the truth. We do have superb medical schools, very well trained providers, superb science and technology but the delivery of medical care is just not what it should be. We spend more for healthcare than any other country does on a per capita basis.

And yet when we compare ourselves to other …

Health technology

Why physicians don’t want patients to have their cardiac device data

David Lee Scher, MD

February 22, 2012Feb 22, 2012

There is a groundswell of discussion concerning patients demanding to have direct access to data derived from their implantable defibrillators and pacemakers. I have discussed in other articles why patients deserve their data and the benefits derived thereof. There are no substantive arguments against this practice, and I always thought, throughout my 12 years of remotely monitoring patients with these devices, that they not only were entitled to the …

Health technology

Impersonal communication on the Internet fuels cyberbullying

Dominic A. Carone, PhD

February 22, 2012Feb 22, 2012

In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over another, typically from a roughly similarly aged peer group. The bullying could be mild such as occasional name calling and having one’s books knocked down when walking in the hallway. This does not mean the effects of the bullying were mild but comparatively speaking, this is generally not …

Physician voices

The analogy between baseball hierarchy and medical systems

Michael Fisch, MD, MPH

February 22, 2012Feb 22, 2012

From age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but the lure of the game has always remained. To my colleagues, it must seem that I can hardly understand the world without the comfort of baseball analogies. I was thrilled when my son Ryan, age 12, saw the …

Physician voices

Saving patients from Internet health information

Stewart Segal, MD

February 22, 2012Feb 22, 201224

Lately, I get the feeling that I’m doing something wrong. I’m supposed to form a partnership with my patients. My patients are supposed to be the working partner and I’m supposed to be the consulting partner. My job as the…

My job as the consulting partner is to offer sagely medical advice to the boss (working partner). As a consultant, I’m supposed to help in the making of key decisions, find the appropriate tools to …

Physician voices

Understanding what patient centered care really means

Jordan Grumet, MD

February 21, 2012Feb 21, 20127

There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He often cringed as he walked by the examining room and imagined the hand holding that was taking place…

There was nothing the professor despised more then the syrup that oozed out of his partner’s lips when dealing with patients. He often cringed as he walked by the examining room and imagined the hand holding that was taking place behind closed doors.

Privately, they argued about the different approaches. One saw the world in terms of black and white, while the other was steeped in a foggy haze of gray. …

Physician voices

A letter of thanks to my organ donor

Jim deMaine, MD

February 21, 2012Feb 21, 20123

I have tried to write a letter of thanks but don't know what to say or even how to begin. I don't know the persons I am writing to, but part of their loved one is literally now a part…

I have tried to write a letter of thanks but don’t know what to say or even how to begin. I don’t know the persons I am writing to, but part of their loved one is literally now a part of me.

It began with a phone call from my brother. “Jim, what the hell is Fuchs’ Dystrophy anyway – do you have it too?”

I racked my brain and tried to …

Read more…

A letter of thanks to my organ donor

Health technology

Health IT and doctors: A framework for successful partnerships

Jeeshan Chowdhury & Sean O'Grady

February 21, 2012Feb 21, 20125

We are on the front lines of the healthcare revolution along side our patients and our colleagues in technology. We have firsthand experience of the shortcomings in the healthcare industry, and we know that it’s going to take a concerted effort to upend the system. Those of us who are able to adapt and apply new technology solutions to existing problems will undoubtedly make positive changes.

Barriers to entry into entrepreneurship …

Drugs and prescribing

Answers to common vaccine questions

Erica Armstrong, MD

February 21, 2012Feb 21, 201217

Here are some of the most common questions I encounter regarding vaccines and my answers. I’m writing this post, from a parent to a parent, because I want to equip you with accurate information to protect your child. We give…

We give so many vaccines now and it seems like we are constantly adding more. Isn’t this too much for my child’s immune system? Isn’t it antigen overload?

The immune system is very complex, …

Read more…

Answers to common vaccine questions

Physician voices

Doctors cannot be expected to be financial engineers

Andrew Schutzbank, MD, MPH

February 20, 2012Feb 20, 20126

Peggy was in her early 70s and suffered from a terrible lung disease known as pulmonary hypertension. So bad in fact, that she had a pump infusing a medicine under her skin 24 hours a day to keep the blood supply to her lungs open. Once started, this medicine, treprostinil, was known to improve life in those with pulmonary hypertension. Unfortunately, like all continuous infusion medicines of this type, it …

Health policy

Reading between the lines of breast cancer treatment studies

Clayton Christensen & Vineeta Vijayaraghavan

February 20, 2012Feb 20, 20122

Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently, breast cancer has certainly gotten a lot of play in the media as of late. Every major news…

Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently, breast cancer has certainly gotten a lot of play in the media as of late.

Every major news outlet in America covered the breast cancer study released by JAMA which said that nearly half of the women who had second surgeries for breast cancer may not have needed the …

Real physician voices, twice a week

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