KevinMD.com

Alzheimer’s inevitably leads to loss of financial capacity

Alex Smith, MD

Conditions and Diseases

August 14, 2011

“Mom’s been writing goofy checks…”
“Dad stopped paying his bills….”
“Grandma wired her savings to Nigeria…”

Have you heard these phrases from the family caregivers of your elderly patients? Have you ever been concerned that your patient may lack capacity for financial decision making? How do you decide if they lack capacity? What is the clinician’s role in making these decisions? What is their responsibility?

These important questions are addressed in a terrific new article in …

Female doctors and the physician shortage

Darrell E. White, MD

Physician

August 13, 2011

Someone has gone and rained the facts down on what is generally considered a feel–good story in American medicine, the dramatic increase in female doctors in America.

In response to Dr. Herbert Parde’s “The Coming Doctor Shortage” article in the Wall Street Journal, Dr. Curtis Markel pointed out that there is a difference between the raw, gross number of physicians in America, and the effective number of practicing physicians. Not only …

HIV is devastating poor and minority communities

PalMD

Conditions and Diseases

August 13, 2011

The HIV pandemic in the US has developed a stable appearance over the last few years, and that appearance is notably non-white and non-wealthy. When the pandemic was discovered nearly thirty years ago, it was—in the US—primarily a disease of gay men. In Africa, the disease is everyone’s. Women make up significantly more than half of HIV cases in Africa, and tens of thousands of children are infected during …

Why doctors should accept protocol medicine

Stephen C. Schimpff, MD

Health Policy

August 13, 2011

We hear that doctors do not like “protocol medicine” – they do not want to follow a “cookbook” when every patient is different. It is not a good understanding of the issues.

Some years ago when I worked in a branch of he National Cancer Institute and then the University of Maryland Cancer Center, we admitted many patients with acute leukemia. The treatment approach including the necessary special tests to …

What medicine will be like 20 years from now

Aaron J. Stupple, MD

Health Technology

August 13, 2011

I was asked recently to predict the practice of medicine in 20 years. After stating that any such prediction is massively speculative, I indulged because it is massively fun.

I am persuaded by Clayton Christensen’s arguments in The Innovator’s Prescription that healthcare will go the way of other massively disrupted industries, wherein healthcare will follow the arc of decentralization.

Using the music industry as an example, the arc begins …

Why is the iPad be revolutionary for doctors and nurses?

Jared Sinclair, RN

Health Technology

August 13, 2011

As a nurse, I spend a lot of time with other nurses. When they ask me to explain why I think the iPad is great, I respond with the following metaphor: imagine that you are a nurse who has been asked to design a new hospital from scratch. You are free to question every prior assumption, to throw out old ideas that no longer fit, to redesign everything according …

MKSAP: 64-year-old man with abdominal bloating and epigastric discomfort

mksap

Conditions and Diseases

August 13, 2011

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 64-year-old man is evaluated for a 3-month history of abdominal bloating and mid-epigastric discomfort associated with a 6.8-kg (15-lb) weight loss. The patient has no significant medical history and takes no medications.

On physical examination, vital signs are normal, and the only significant finding is mild …

How early closure can cause doctors to misdiagnose

Alex Lickerman, MD

Physician

August 12, 2011

I had a patient once—a fellow physician—who came to see me complaining of mid-back pain. When I examined him, I found I could reproduce his pain by pressing firmly on the spot he said was hurting him. He said pressing there also made the pain radiate around to his stomach, a phenomenon known as “referred pain” that meant his pain was almost certainly caused by a trigger point. I …

6 reasons why doctors won’t call patients back

Mary Pat Whaley

Physician

August 12, 2011

Patients want to know why they can’t get a return call from their doctor’s office – here are six reasons why the calls have increased and physician offices are having trouble meeting the needs of their patients.

1. Medication questions and requests for a prescription change. The average number of retail prescriptions per capita increased from 10.1 in 1999 to 12.6 in 2009 (Kaiser Family Foundation calculations using data from …

An apology to patients with chronic fatigue syndrome

Toni Bernhard, JD

Conditions and Diseases

August 12, 2011

I’ve been sick since 2001 when I failed to recover from what appeared to be an acute viral infection. It has left me mostly house-bound, often bed-bound. In effect, I’ve had the flu without the fever for almost ten years: the aches and pains, the dazed sick feeling, the low grade headache, the severe fatigue. It cost me my career as a law professor; it cost me the ability to …

There is no such thing as a complete physical examination

Lucy Hornstein, MD

Physician

August 12, 2011

A reader writes, “Can you do a post on what procedures constitute a thorough physical, in your opinion? I haven’t had one in several years and thinking of making an appointment now. The last doctor I went to didn’t even listen to my heart or go though the motions with feeling my belly and that stuff. And of the last 3 doctors I went to, I realized they didn’t …

Do patients accept hurried, fragmented, disconnected care?

Steve Balt, MD

Physician

August 12, 2011

A cover story by Gardiner Harris in the New York Times spotlights the changes in modern psychiatry, from extensive, psychotherapy-based interaction to brief, medication-oriented “psychopharm” practice.

The article shares nothing new, particularly to anyone who has paid any attention to the rapid evolution of the psychiatric profession over the last ten years (or who has been a patient over the same period). While the article does a nice …

How a nephrologist assesses your kidney function

Michael Aaronson, MD

Conditions and Diseases

August 12, 2011

Doctors use laboratory values to interpret your medical condition. With respect to kidney disease, the BUN and the creatinine help your nephrologist (as well as your internist and family physician) determine if your kidneys are working correctly. These two tests are commonly ordered for many reasons and are invaluable tools to help your doctor assess your condition. Let’s define what BUN (pronounced by spelling out the letters “B”, “U”, …

Are our privacy rules robust enough to protect our patients?

Dan McCoy, MD

Health Technology

August 12, 2011

Ok, imagine this.

You take a video of your little girl’s soccer practice with your iPhone. Within moments it’s posted on YouTube for the grandparents to see.

Minutes later search engines called spiders begin to crawl across the data set of images on your upload. Face recognition technology identifies a face on the video and, with some assistance from the geo-tagging of the built in GPS metadata that accompanied the upload, …

What this doctor learned when he was a patient

Doctor D, MD

Physician

August 11, 2011

Doctor D has been blogging about the doctor-patient relationship for a while now. It’s sort of the thing I’m known for. I’ve usually been on the doctor side of this equation. Most of my blogging, however, is to help patients figure out the weird world of medicine.

Doctor D recently found himself on the patient side of a nasty injury.

Even as Doctor D looked down and realized his leg wasn’t …

AMA working to improve e-prescribing incentives and help physicians adopt health IT

Cecil B. Wilson, MD

Health Technology

August 11, 2011

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

Health IT holds the promise of improving the efficiency of a physician’s practice, but physicians can easily become overwhelmed by the broad range of products and the multiple, varying federal incentive and penalty programs currently underway. The American Medical Association (AMA) continues to be in close contact with the Centers for …

Women with these 5 pelvic symptoms should call their doctor

Neil Baum, MD

Conditions and Diseases

August 11, 2011

For most women, a couple of irregular menstrual cycles or an occasional yeast infection are just a part of life — nothing that time or simple treatment won’t cure.

However, there are a few symptoms that warrant a call to the doctor. This article will cover when you should call your doctor for problems “down there”?

1. Pelvic pain. Pain at the time of ovulation is referred to as Mittelschmerz. However, if …

Caregiver burnout is just a fancy term for exhaustion

Maria Basso Lipani

Patient

August 11, 2011

Are there moments when caregiving makes you want to scream?

Any number of things related to caring for your aging parent can cause you to feel like you’re at the end of the proverbial rope including:

your relationship with your parent
elements of your work life/family life which are separate from, but inextricably linked to, your caregiving
the myriad experiences inside the elder care maze

But here’s where things get a bit dicey: While …

How to choose a better health app

Alexander V. Prokhorov, MD, PhD

Health Technology

August 11, 2011

From helping you wake up rested to getting couch potatoes ready for a 5K, there really is an app for everything.

But when it comes to health apps, many don’t get the job done.

Companies are often in such a hurry to sell their app that they don’t conduct a study to see if users will adopt real, lasting change. And, app stores don’t have medical reviewers who make sure health …

Read more…

How to choose a better health app

The problem with I Heart Boobies bracelets worn by middle school students

Ann Silberman

Patient

August 11, 2011

Many of you know that a judge in Pennsylvania has determined that the popular “I Heart Boobies” bracelets worn by middle school students are a form of free speech intended to raise awareness of breast cancer and cannot be restricted by schools.

As much as I love a good double-entrendre, I find the entire situation to be sad, particularly the misinformed comments I’ve seen made by parents of …

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts