KevinMD.com

February 4, 2012Feb 4, 20122

Everyone in our industry -- policymakers, clinicians, healthcare facility administrators, public and private payers, technicians, pharmacists -- shares concerns about the state of healthcare in the U.S., each of us from a slightly different viewpoint. The thread that joins us…

Everyone in our industry — policymakers, clinicians, healthcare facility administrators, public and private payers, technicians, pharmacists — shares concerns about the state of healthcare in the U.S., each of us from a slightly different viewpoint.

The thread that joins us all is that one day each of us will be a patient.

As its title suggests, patients are central to almost every provision of the Patient Protection and Affordable Care Act (Act), …

Patient voices

Why we need to go from e-patient to i-patient

Jackie Fox

February 3, 2012Feb 3, 201210

I found a recent Associated Press article on an aspect of the new health care law that many of us may have overlooked. It requires consumer-friendly summaries of what insurance plans cover, a provision that now seems to be at…

I found a recent Associated Press article on an aspect of the new health care law that many of us may have overlooked. It requires consumer-friendly summaries of what insurance plans cover, a provision that now seems to be at risk. The insurance industry is up in arms about implementation costs and added regulatory burdens. (There’s a good story at NPR, which includes a link to an example of what …

Health policy

Identical twins with different ideas about health care

Anonymous

February 3, 2012Feb 3, 20123

Jack and John are identical twins but have varying interests in life. One day Jack, 43 years old, decides he has had enough of these headaches and calls his family doctor and asks what he should do. He is told that his doctor can see him in 4 days and to take some over-the-counter ibuprofen. And to go to the ER if the headaches worsen.

John, who has also been having …

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Physician voices

Experiencing an uninvited gift

Carlene Oleksyn

February 3, 2012Feb 3, 201211

It's been five years since she was told she was cancer free. Today she was told it was back, and the future was quite grim. My job was to make sure she understood how to properly take the medication that…

It’s been five years since she was told she was cancer free. Today she was told it was back, and the future was quite grim.

My job was to make sure she understood how to properly take the medication that would reduce the swelling around the tumor so radiation could start as soon as possible.

That was my job. Clinically speaking it wasn’t the most challenging or difficult issue of the day as I …

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Experiencing an uninvited gift

Conditions and diseases

How the CA-125 became a $50,000 blood test

Keith Marton, MD

February 3, 2012Feb 3, 201233

What could be so simple as a blood test? A quick prick with a needle, a wait of a day or two for results and a discussion with the doctor about those results. In the words of our vaunted politicians,…

What could be so simple as a blood test?

A quick prick with a needle, a wait of a day or two for results and a discussion with the doctor about those results. In the words of our vaunted politicians, it would be an “up or down vote” on whether there was anything to deal with.

That was the thinking of my wife’s physician when she ordered a test called the “CA-125.” …

Health technology

Why EMR is a dirty word to many doctors

Adam Sharp, MD

February 2, 2012Feb 2, 2012112

Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and the healthcare industry. However, their origin and the ulterior motives currently driving their adoption is sowing the seeds…

Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and the healthcare industry.

However, their origin and the ulterior motives currently driving their adoption is sowing the seeds of their failure. First, what is actually happening out there? The most recent CDC data would seem to be encouraging for EMR adoption, with EMR use (finally) passing 50%.

Too bad …

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Why EMR is a dirty word to many doctors

Health technology

Why patients with implantable defibrillators deserve their data

David Lee Scher, MD

February 2, 2012Feb 2, 2012

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009. The objective of Measure 12/15 of Meaningful Use regulations…

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009.

The objective of Measure 12/15 of Meaningful Use regulations of the HITECH act which refer to electronic health records, states that eligible professionals “provide patients with an electronic copy of their health information (including diagnostic test results, problem lists, medication …

Conditions and diseases

Understanding the pain of fibromyalgia

Kim Kristiansen, MD

February 2, 2012Feb 2, 201210

Many healthcare professionals find fibromyalgia difficult to believe as “a real disease” and most of all difficult to handle, and to be honest it is not so difficult to see why. Doctors and other healthcare professionals have learned how to search for diseases based on the specific symptoms the patients present, but fibromyalgia – and several other chronic pain syndromes – do not fit into that model.

The patients are presenting …

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Understanding the pain of fibromyalgia

Health technology

How a doctor uses Google to market and recruit patients

Jamie Cesaretti, MD

February 2, 2012Feb 2, 201216

When I relocated my radiation oncology practice from Jacksonville to Tampa, Florida, I had to figure out how to compete against urologists in a market that was radically different from the one I had left. Unlike their peers in Jacksonville,…

To break the referral pattern, I updated and posted my physician profile for free on an online …

Medical education

A medical student is forced to step beyond the things he knows

Rick Pescatore, DO

February 1, 2012Feb 1, 20122

There comes a moment when you're forced to step beyond the things you know. It's a split second -- an instant adjustment from the safety of recollection to the insecurity of the unknown. Day after day we head into the…

There comes a moment when you’re forced to step beyond the things you know. It’s a split second — an instant adjustment from the safety of recollection to the insecurity of the unknown. Day after day we head into the library, hunching over twice-reviewed notes and hidden behind piles of books yet to be read. We push ourselves to work harder, study longer. We toil knowing that each page holds …

Conditions and diseases

3 best practices for both physicians and patients to treat diabetes

Alan L. Plummer, MD

February 1, 2012Feb 1, 20128

As diabetic patients and their physicians continue to work together to combat this metabolic disorder, researchers and medical organizations are uncovering new ways to fight this illness. With 26 million Americans currently battling the disease and 79 million already diagnosed…

With these startling statistics in mind, the Northern States Ambulatory Research Network (NORTHSTAR), a practice-based …

Health technology

How adopting an EHR is like treating cancer

Margalit Gur-Arie

January 31, 2012Jan 31, 201230

EHRs are not ready for prime time. EHR benefits are questionable and there are documented instances where patients’ deaths were directly attributed to an EHR. EHRs are cumbersome and slow. They are unnecessarily complex and built on very old technology. The people who build EHRs have no concern for the end user and therefore EHR usability is pretty abysmal. And EHRs are expensive to buy and expensive to maintain, not …

Physician voices

Are physicians addressing the root causes of health problems?

Ricky Choi, MD

January 31, 2012Jan 31, 20123

While in residency, I took care of a toddler who was hospitalized following an anaphylactic reaction. During a diaper change at home the child suddenly developed lip swelling and severe difficulty breathing for no apparent reason. The child was urgently brought to the hospital by ambulance and initially treated in the emergency room. By the time I met her on the inpatient floor her breathing and swelling had significantly improved. …

Health policy

Analyzing what the President said about health care

Dominic A. Carone, PhD

January 31, 2012Jan 31, 20123

President Barrack Obama delivered a 6,944 word State of the Union address to the American people. Of the speech, less than .01% was devoted to healthcare, which is remarkable considering the major changes in healthcare that are on the horizon if Obamacare survives a challenge in an upcoming U.S. Supreme Court case. During the speech, there were only three sentences that mentioned healthcare.

The first was this: “I will not go …

Physician voices

Be aware of your food choices, especially when pregnant

Eric Marcotte, MD

January 31, 2012Jan 31, 20122

I come back into the exam room, keeping my best poker face, sit down and turn to face her. She’s on the edge of her seat, nervous and barely able to contain herself, maybe not even sure which answer she…

“Congratulations,” I say. She lets out her breath and smiles, huge.

“Thanks!”

Once the adrenaline settles down and she can hear me again, …

Health technology

How changing patient workflow can make using an EMR fun

Margaret Polaneczky, MD

January 30, 2012Jan 30, 20127

One day, about 5 years into using the electronic medical record in my practice, I came to the realization that I wasn't having fun anymore. I was sitting throughout most of every office encounter facing a computer screen, my back…

One day, about 5 years into using the electronic medical record in my practice, I came to the realization that I wasn’t having fun anymore. I was sitting throughout most of every office encounter facing a computer screen, my back to the patient on the exam table across the room. The joy of face to face interaction with people, the real reason I went into medicine in the first place, had been replaced with …

Health technology

Natural language processing in EMRs can improve disease tracking

Jaan Sidorov, MD

January 30, 2012Jan 30, 20123

Years ago, if you were elderly, had diabetes, high blood pressure, low back pain, needed a yearly flu shot and came to see this electronic health record-enabled physician (now with the nom de plume “Disease Management Care Blog”), you would have had your diabetes, high blood pressure and low back pain reassessed, you would have been given a flu shot and, for good measure, the DMCB would have tossed in a discussion …

Physician voices

How algorithm driven medicine can affect patient care

Jeffrey Parks, MD

January 30, 2012Jan 30, 201213

Whenever someone is scheduled for an operation, the assigned nurse is required to fill out a "pre-op checklist" to ensure that all safety and quality metrics are being adhered to. Before the patient is allowed to be wheeled into the…

Whenever someone is scheduled for an operation, the assigned nurse is required to fill out a “pre-op checklist” to ensure that all safety and quality metrics are being adhered to. Before the patient is allowed to be wheeled into the OR we make sure the surgical site is marked, the consents are signed, all necessary equipment is available, etc. One of the most important metrics involves the peri-operative administration of …

Patient voices

Good communication in health care is about listening

Rev. George Handzo

January 30, 2012Jan 30, 20127

A great deal of effort in the current health care environment is being put into improving communication - between patients and families and members of the health care team, among family members, and among members of the team. The case…

A great deal of effort in the current health care environment is being put into improving communication – between patients and families and members of the health care team, among family members, and among members of the team. The case can be made that good communication is at the heart of patient safety, cultural sensitivity, and the pillar of palliative care — aligning patient’s wishes and goals with treatment plans.

So …

Medical education

Appreciating the beauty of a time out in the OR

Allison A. Greco

January 29, 2012Jan 29, 201211

If you've ever spent time in the operating room, you are already familiar with the words the circulating nurse uses to signal the time out - the few minutes before a procedure begins when the surgical and anesthesia teams review…

If you’ve ever spent time in the operating room, you are already familiar with the words the circulating nurse uses to signal the time out – the few minutes before a procedure begins when the surgical and anesthesia teams review a patient’s case. If you’re a non-medical type, or a medical student whose surgical rotations are scheduled late in the 3rd year, then you’re just as clueless as I was …

Real physician voices, twice a week

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