Coronary CT screening is low value health care

Physician
August 30, 2011

Like many states, Texas is facing a fiscal crisis caused by decreased revenue from the economic recession and skyrocketing health care costs. Even without the expansion of publicly financed health insurance mandated by last year’s health reform law, the percentage of the state budget devoted to Medicaid expenses is projected to rise from 28 percent to 46 percent by 2020, even faster if the law withstands current …

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Coronary CT screening is low value health care

How generational changes of physicians will affect oncology

Physician
August 30, 2011

Nothing makes a physician feel older (or should) than realizing that he/she just started a discussion with a younger colleague, fellow, resident or student with the sentence “When I was in training … ”

In a recent article in the health section of the New York Times, Gardiner Harris skillfully depicts the culture gap between younger and older generations of physicians. Using a …

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How generational changes of physicians will affect oncology

Consider half life during drug detoxification

Medications
August 30, 2011

A young man on my sobriety-based detox program (only after showing positive for opiates) admitted to heroin-usage, but hedged the matter saying it was “5 days ago.” His implicit presumption was that an isolated episode, days ago — compared to continuous, more recent, heroin-usage — would lessen the likelihood of his getting kicked off the program.

Is his story of “no heroin [ingestion] in the last five days,” likely, the whole …

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Consider half life during drug detoxification

10 tips from 10 years sick

Patient
August 29, 2011

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Ten years ago this summer, my husband and I flew from California to Paris, planning to immerse ourselves in Parisian culture for three weeks. The second day there, I got sick with what appeared to be an acute viral infection. I spent most of those three weeks in a Parisian bed. Ten years later—I’m still sick. I didn’t research what I should …

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10 tips from 10 years sick

The expensive progression of pill crushing technology

Medications
August 29, 2011

We have to crush pills sometimes.  Either the patient (through aversion or physical limitation from stroke) can’t swallow whole pills so we crush them and put them in applesauce, or the patient gets their pills through a tube, so we crush them and dissolve them in water.

When I started nursing, we had a mortar and pestle.

 

Anyway, this is what we used …

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The expensive progression of pill crushing technology

Why medicine needs new schools to drive innovation and change

Medical Education
August 29, 2011

Let’s face it, medicine is slow to change – the profession has produced successful physicians for centuries using an education system based on grueling hours and unwavering dedication. Many established medical schools boast impressive Step 1 scores and match rates, so why should they modify what works?

Change is necessary because our society needs the next generation of physicians to be technologically savvy and driven toward innovation. With the increasing prevalence …

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Why medicine needs new schools to drive innovation and change

The secret to better patient care is time

Physician
August 29, 2011

Lets face it — the system of primary care medicine in the United States is broken. Even in Boston, the mecca of medicine, patients struggle hard to find an accessible doctor. And when they finally land an appointment, their well-intentioned internist, pediatrician or family physician often seems overworked, rushing from patient to patient, with little time to really listen to details.

As a primary care family physician for 20 years, …

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The secret to better patient care is time

Hold funerals for unclaimed dead bodies

Patient
August 29, 2011

Rest in peace. These words are a common theme at funerals honoring loved ones. But many people die with no one claiming their bodies. For example, at hospitals there are unclaimed bodies of patients and the unborn. Corpses are found abandoned often in police cases. Mortal remains can go unclaimed due to insufficient funds for burial or cremation, insufficient concern for the deceased, and lack of available or known family …

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Hold funerals for unclaimed dead bodies

Doctors learn through mistakes during medical school

Medical Education
August 29, 2011

In most other professions, once you’re halfway through your education, you begin to develop confidence; slowly, but surely, fitting into shoes that once seemed too big for your petite, newbie feet. Not so in medicine.

Three years into it, and I still feel unsure – unsure of the answer to a rather simple question asked by an attending and unsure of whether I’m fit to be doing this in the first …

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Doctors learn through mistakes during medical school

Social media tips for students applying to medical school

Social Media in Medicine
August 29, 2011

I started my first blog, Chick Lit MD, in December of 2009. By the time I began filling out my medical school applications I had been actively blogging for approximately 7 months. As someone interested in the intersection between medicine and media, the use of social media was integral to my exploration of both fields. As such, I included my adventures in social media in my application in a tactful …

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Social media tips for students applying to medical school

Health insurers have come up with the idea of the century

Health Policy
August 29, 2011

I have come up with the idea of the century.  My idea will make your company the richest in the world while attracting millions of new patrons to your credit and debit card services.  I don’t know why no one has done it in the past.  It has made the insurers of America countless billions of dollars and now you can profit as well.  My only request is that you …

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Health insurers have come up with the idea of the century

Doctors should learn personal finance during medical school

KevinMD
August 28, 2011

I read somewhere in the comments here something to the effect of this: “Physicians are only good for one thing: doctoring.”

That would explain the general ineptitude of many physicians when it comes to skills outside medicine, such as political lobbying, or business and personal finance decisions.

The New York Times has written a helpful column that’s required reading for any new …

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Doctors should learn personal finance during medical school

Celebrating 50 years of coronary angiography

Physician
August 28, 2011

When I recommend that a patient needs coronary angiography (synonyms: heart catheterization, coronary angiogram, cardiac catheterization, or simply “cath”) I take a moment to bring up the risks of the procedure—complications that include the rare likelihood of stroke or heart attack (less than one in a thousand), a reaction to the dye, and bleeding at the arterial access site (most often the femoral artery in the groin).

Patients …

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Celebrating 50 years of coronary angiography

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A rural medical school to train rural physicians

Medical Education
August 28, 2011

Are big-city academic institutions really necessary to train excellent clinicians? What irreplaceable benefits do they provide?

When I attended medical school a decade ago, there was a group of students comprising about 50% of my classmates that I rarely ever saw. Most of these were students who had come to medical school straight out of college, and still denied that anything important in the world happened before noon. They skipped …

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A rural medical school to train rural physicians

How health reform is like accident reform

Health Policy
August 28, 2011

“Do you know how many people died in car crashes in the United States in 2010? 32,000. That’s the lowest number since 1949. That’s impressive, but wait: It’s far more impressive than it sounds at first, because people in the United States drove about 10 times as many vehicle miles in 2010 as they did in 1949. In other words, if you drove a car or truck in 2010, you …

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How health reform is like accident reform

The effect of therapeutic touch is based on pure chance

Patient
August 28, 2011

There is no “alternative medicine.” There is only medicine:

  • Medicine that has been tested and found to be safe and effective. Use it; pay for it.
  • And, medicine that has been tested and found to be unsafe or ineffective. Don’t use it; don’t pay for it.
  • And, medicine for which there is some plausible reason to believe that it might be safe and effective. Test it and then place it into one …

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The effect of therapeutic touch is based on pure chance

Manage malpractice risks with self-diagnosed patients

Patient
August 28, 2011

Search engines and the Internet are impacting patient behavior—eight out of 10 people use the Internet to look for health information, but only 25 percent of those people verify the credibility of their information source before self-diagnosing. It gets even more complicated when patients order drugs directly over the Web.

The debate among physicians about the credibility of online information is as old as the Internet itself. As a caregiver, …

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Manage malpractice risks with self-diagnosed patients

Why I love community health fairs

Patient
August 27, 2011

There is nothing like a good community health fair. Away from the formal, detached sterility of the office this is an opportunity to meet patients on their turf. No longer adorned with white coat, power outfit and accompanying entourage, physician meets patient as just another member of the community, an equal almost. With a backdrop of blaring music, sweltering heat and flavorful eats people young and old gather, eager to …

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Why I love community health fairs

The ethics of being on a pharmaceutical advisory board

Medications
August 27, 2011

While diligently perusing a stack of unread journals, a piece in the July 25, 2011 issue of Modern Healthcare caught my attention.

Titled “What’s the Agenda?” this special report deftly navigated the murky waters of “physician participation on advisory boards” and managed to present an accurate appraisal of the issues.

Here is a brief recap.

Back in the days before “medical ethics” issues were commonplace, pharmaceutical and medical device manufacturers were accustomed …

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The ethics of being on a pharmaceutical advisory board

The trouble with Dr. Google

Patient
August 27, 2011

Things have been a bit tough of late, the bad economy is starting to bite, and you’re feeling the pressure.  To top it all, your body has been acting strangely in ways it never has before.  Your muscles twitch in funny areas for hours at a time, you tire easily, and you have fleeting pins and needles in your limbs.  Over the weeks these symptoms have become worse. The last …

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The trouble with Dr. Google

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