KevinMD.com

January 19, 2012Jan 19, 201212

Dear Doctors: I am writing no less than 45 days after my mother died from a GI bleed from ovarian cancer. Not once did my mother's team of doctors mention palliative care. It was not until days and even hours…

Dear Doctors:

I am writing no less than 45 days after my mother died from a GI bleed from ovarian cancer. Not once did my mother’s team of doctors mention palliative care. It was not until days and even hours before her death that hospice was discussed and implemented. Our family was blindsided by this.

While no one likes to talk about the topic of death, it is important to remember that …

Conditions and diseases

Early lessons from Haiti in global health

Katherine Ellington

January 18, 2012Jan 18, 2012

Doctors, nurses, ministers, first-responders and many individuals have interrupted their daily lives for weeks and months at time to lend a helping hand. To show solidarity communities have thrown parties, organized fundraisers and joined with relief organizations. “Text for Haiti” became a popular way to make individual contributions through mobile phone text messages as many leaders urged financial contributions over direct donations of foodstuffs, clothes and other supplies. Early indications …

Medical education

Sleep deprivation as a medical student

Sujay Kansagra, MD

January 18, 2012Jan 18, 201210

An excerpt from Everything I Learned in Medical School: Besides All the Book Stuff. My body jolts awake to a familiar sound. After a few blind swipes, my blows hit their target, and once again, there is silence. The air…

An excerpt from Everything I Learned in Medical School: Besides All the Book Stuff.

My body jolts awake to a familiar sound. After a few blind swipes, my blows hit their target, and once again, there is silence. The air in the room is cool and crisp, and every fiber of my being wants me to remain in the welcoming warmth under the covers. It is Saturday morning. On any other …

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Sleep deprivation as a medical student

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Health policy

Implementing strategies to encourage patient accountability

Miles Snowden, MD

January 18, 2012Jan 18, 20122

While payers and providers are usually in the spotlight when it comes to accountable care, the most successful models will be the ones that place a strong focus on patient accountability. More and more frequently patients are selecting doctors with the best outcomes, asking proactive questions, and taking an active role in their lifestyle and behaviors. Empowering patients with the support and tools to be responsible for and more involved …

Medical education

A medical student’s first patient encounter

Amanda Xi, MD

January 17, 2012Jan 17, 2012

This is an account of my first encounter with an in-patient from a little while back -- I have provided only minimal details about the patient to maintain compliance with HIPAA. After a firm handshake with each of us, our…

This is an account of my first encounter with an in-patient from a little while back — I have provided only minimal details about the patient to maintain compliance with HIPAA.

After a firm handshake with each of us, our preceptor embarked purposefully up two floors to our first in-patient encounter. As we walked, I peeked into the rooms with the door left ajar and wondered what brought each individual to …

Physician voices

Doctors who give cash to patients for running late

Pamela Wible, MD

January 17, 2012Jan 17, 201227

When Dr. Timothy Malia of Fairport, New York, runs behind schedule, he passes out five-dollar bills to everyone in the waiting room. And when Dr. Cyrus Peikari of Dallas, Texas canceled his appointments for a family emergency, he gave each…

Most doctors apologize. Few offer cash. Others get creative: Dr. Gwen Hanson of Bellevue, Washington gives out Starbucks cards; Dr. Sharon McCoy George of Irvine, …

Medical education

Radiologists who cheat on their board exams: Who’s to blame?

Kevin Pho, MD

January 17, 2012Jan 17, 201210

In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an exam to become board certified in radiology have cheated by memorizing test questions, creating sophisticated banks of…

In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: “Doctors around the country taking an exam to become board certified in radiology have cheated by memorizing test questions, creating sophisticated banks of what are known as ‘recalls,’ … The recall exams are meticulously compiled by radiology residents, who write down the questions …

Medical education

When pimping a medical student can backfire on a doctor

Collin Creange

January 17, 2012Jan 17, 20129

The third year of medical school is a lesson in humility. In the OR, you’ll invariably cut the suture too short, or too long, or too slowly. On the floors, the one laboratory value you haven’t checked is the only value vital to the patient’s survival. And just when you think you know everything there is to know about a disease, the Attending Physician will keep asking you questions until …

Health policy

AMA: A new model of patient care

American Medical Association & Peter W. Carmel, MD

January 17, 2012Jan 17, 20124

A guest column by the American Medical Association, exclusive to KevinMD.com. Let me start by wishing you and your families a very happy and healthy new year. This is my first column of 2012 for this blog, and I am…

A guest column by the American Medical Association, exclusive to KevinMD.com.

Let me start by wishing you and your families a very happy and healthy new year. This is my first column of 2012 for this blog, and I am excited to talk about a new initiative that is beginning this year. Medicare accountable care organizations (ACOs) have been discussed at length since the passage of the Affordable Care Act. Until recently, …

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AMA: A new model of patient care

Patient voices

How I became a hospice volunteer

Frances Shani Parker

January 16, 2012Jan 16, 2012

People often ask me how I became a hospice volunteer. For the record, nobody is more surprised than I am. You know how some people can walk into a patient’s room, plump pillows, and make all the right comments? Years ago, I was not that person. I never really felt comfortable visiting sick people. Working in the healthcare arena seemed depressing. Besides, I had made a conscious decision to become …

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How I became a hospice volunteer

Conditions and diseases

Meaningful treatments in the battle against coronary disease

Eric Van De Graaff, MD

January 16, 2012Jan 16, 20122

I saw a patient in my office this week who had received a stent from one of my partners last month. The man was highly satisfied with his experience—the procedure was tolerable, the recovery short, and the nurses were pretty (he specifically made a point of this, presumably because the post-hospitalization customer surveys don’t include what seemed to him to be the most important feedback metric)—but his wife had a …

Health policy

How hospitals are gaining leverage over physicians

Richard Reece, MD

January 16, 2012Jan 16, 201233

Most hospital managers have never had the power to exert leverage over their most valuable resource, the physician, who, after all, admits the patients who make the hospital’s economic existence possible in the first place. So I wrote in introducing…

So I wrote in introducing a chapter in my first book in 1988. I hastened to add, however, at the close of that chapter, these admonishments:

1. The economic powers of the hospital is shifting from those …

Health technology

Robotics can revolutionize the delivery of medical care

Stephen C. Schimpff, MD

January 16, 2012Jan 16, 20126

Robotics has the potential to revolutionize the delivery of healthcare. It can help extend the delivery of information, expertise and clinical care across time and geographical space barriers. Robotics offers the opportunity to enhance quality of care through extension of clinical expertise and leveraging of integrated datasets and best practices. It can be used across the continuum–from the hospital setting (e.g. OR, ER, etc.) into primary care offices and even …

Physician voices

When it comes to smoking, I am a militant

Stewart Segal, MD

January 15, 2012Jan 15, 20127

It is obvious to those who know me that I am an avid anti-smoker and work hard to help those afflicted with a tobacco addiction break their habit. Knowing your shortcomings is an important part of being successful. One of…

It is obvious to those who know me that I am an avid anti-smoker and work hard to help those afflicted with a tobacco addiction break their habit.

Knowing your shortcomings is an important part of being successful. One of my short comings is not knowing when to quit. When it comes to helping smokers stop smoking, I am a zealot. Today, I went to work on one of my smokers, …

Physician voices

The covenant between doctor and patient is sacred

Jordan Grumet, MD

January 15, 2012Jan 15, 2012

You know Mr. Miller? I adjusted the phone on my ear as I slipped out of bed and snuck into the bathroom. I tiptoed across the floor and winced as the old hardwood started to creek beneath my feet. I…

You know Mr. Miller?

I adjusted the phone on my ear as I slipped out of bed and snuck into the bathroom. I tiptoed across the floor and winced as the old hardwood started to creek beneath my feet. I craned my head and listened for signs of stirring children.

Remembering the resident holding on the line, I whispered into the cell.

Yeah. What about him? He had a cholecystectomy this morning.

I waited …

Conditions and diseases

Physicians should be concerned about malingering

Dominic A. Carone, PhD

January 15, 2012Jan 15, 201239

Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives such as avoiding military duty, avoiding work, obtaining financial compensation, evading criminal prosecution, or obtaining drugs. The word “malingering” comes from the French word “malinger” meaning “poor or weakly” as these are the characteristics feigned or exaggerated by the malingerer. Malingering has been documented as far back as in the Bible when …

Conditions and diseases

Why mammography is an imperfect test

Stacey Vitiello, MD

January 15, 2012Jan 15, 201218

It is a scenario familiar to all breast imaging practices. A patient feels a lump in her breast and calls her doctor. The doctor examines her, agrees that a lump is present, and refers the patient to a breast imaging…

It is a scenario familiar to all breast imaging practices.

A patient feels a lump in her breast and calls her doctor. The doctor examines her, agrees that a lump is present, and refers the patient to a breast imaging facility for a diagnostic mammogram and breast ultrasound (also known as a sonogram). At her mammogram appointment, a little sticker is placed on the lump felt by the patient, and mammogram …

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Why mammography is an imperfect test

Health policy

Doctors are forced to choose between really small or super big

Anonymous

January 14, 2012Jan 14, 201252

I am a little fish in a big sea. And so are most of us. Or we are used to be. For better or worse, the era of private practice, outpatient medicine as we know it, is ending. And faster…

I am a little fish in a big sea. And so are most of us. Or we are used to be. For better or worse, the era of private practice, outpatient medicine as we know it, is ending.

And faster than we thought. The choice now: downsize or supersize. No longer can a doctor operate a private practice as a solo practitioner or in a small group practice. We are getting …

Physician voices

How long do you expect to live?

George Lundberg, MD

January 14, 2012Jan 14, 20127

To just what age do you expect to live? You haven't thought about it? I bet you have. Would you like to live as long as Methuselah? Television's "Today Show" antes up centenarians to celebrate from time to time. There…

To just what age do you expect to live? You haven’t thought about it? I bet you have. Would you like to live as long as Methuselah?

Television’s “Today Show” antes up centenarians to celebrate from time to time. There are about 70,000 American outliers past the age of 100. But that’s out of a population of some 311,000,000 people.

The most sensible place I know to read about this conundrum of …

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How long do you expect to live?

Patient voices

How well does your child play?

Yolanda Wong, MD

January 14, 2012Jan 14, 2012

All play is not equal. With the power of marketing, play has become increasingly associated with toys, electronic gadgets, television, and video games. Just think about the amount of ads for children’s toys over the holidays. Just think about the…

Without realizing it, we may be intervening in a child’s most natural form of …

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How well does your child play?

Real physician voices, twice a week

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