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An opportunity for hospitalists to improve patient care

Physician

August 18, 2011

Some hospitalists are in denial. Some hospitalists have become methodologic critics. But all hospitalists should take the findings of the recent Annals of Internal Medicine article seriously. We should not argue about the article, but rather ask whether these findings point out a weak point in our care of patients.

This article provides an opportunity, not a scolding:

In an accompanying editorial, two other researchers from the VA Medical Center in …

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An opportunity for hospitalists to improve patient care

Without wives, men’s health suffers

Sharon Bahrych, PA-C, MPH

Patient

August 18, 2011

I was working as a PA in an internal medicine office seeing patients. One afternoon, I was in the clinic hallway when I saw an elderly looking wife in her 60s actually pushing her husband into the next exam room. He had his heels dug into the floor, but she was winning, due to his obvious shortness of breath and audible wheezing.

I walked in behind the medical assistant who …

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Without wives, men’s health suffers

Cultural competency leads to better patient care and higher patient satisfaction

Rev. George Handzo

Physician

August 18, 2011

It may sound obvious. But many years working in and with hospitals has taught me that many health care providers, although they want to treat their patients in a culturally and spiritually sensitive manner, often don’t know how. It seems that every day as our country becomes increasingly diverse, health care clinicians are confronted with someone from a cultural or ethnic group they have never encountered before.

At the same …

Medical school rotation at a free clinic for the uninsured

Suchita Shah

Medical Education

August 18, 2011

My patient had onychomycosis – toenail fungus. Not a devastating disease. The treatment for this fungus is a 12-week course of terbinafine. About $50 for a month’s supply … $150 for 3 months. Terbinafine’s potential side effects include liver toxicity.

During my primary care clerkship at the Bronx VA Hospital, I treated several patients who had onychomycosis and had undergone the antifungal treatment. One patient declined treatment with terbinafine because …

How can doctors understand the business side of medicine?

Michelle Mudge-Riley, DO

Physician

August 17, 2011

What do you regret about your medical training or specialty selection?

Anything?

One thing I regret is not taking advantage of the Masters degree in Health Administration program at my medical school. At the time, I was focused solely on medicine and on being a doctor. I didn’t think the business side of medicine was all that important. In fact, I didn’t consider the business side of medicine at all.

I regret …

Chronic disease management through mobile health

Barbara Ficarra, RN, MPA

Health Technology

August 17, 2011

The conundrum continued behind conference doors at the American Telemedicine Association (ATA) conference in Tampa about the efficacy of mobile phone usage to improve patient health.

Lively discussions followed about the ROI for chronic disease management through mobile health and outcomes for remote patient monitoring focusing on whether telemedicine is excluded from meaningful use and reasons why telehealth should be a key component in Accountable Care Organizations (ACO).

As the debate …

Will a healthy lifestyle prevent illness?

WarmSocks

Patient

August 17, 2011

I am utterly sick of the myth that living a healthy lifestyle will prevent illness.

Granted, eating a balanced diet of nutritious food is better than grazing on ice cream and bon-bons all day.
Getting regular exercise has distinct health benefits; moving as little as possible has a detrimental impact on people’s health.
Is there anyone who isn’t aware of the health ramifications of smoking?
Excessive alcohol consumption is another no-no.

The story goes …

Accommodate people with hearing loss in the hospital

Margaret Mortz, PhD

Conditions and Diseases

August 17, 2011

Hospital care for people with hearing loss can be ineffective when people cannot communicate. Most hard-of-hearing people do not know sign language because they lost hearing later in life and remain in the oral culture. Without effective communication, quality of care is impaired and patient compliance is often reduced. The patient’s bed needs to have proper signage and chart records to alert staff of special communication needs.

Ironically, many hard-of-hearing people …

Why is it so difficult for doctors to stay on time?

Jennifer Middleton, MD

Physician

August 16, 2011

“I’m sorry.”

I said that phrase a lot last night during evening patient hours.

With an overfilled schedule, I mostly said it to patients who waited twenty, thirty, even forty-five minutes for me to see them. “I’m sorry for your wait. I appreciate your patience.” I say these sentences far more often than I should. Why is it so difficult to stay on time?

I could blame my inadequate supply of nursing staff; …

The physical and emotional costs of non-compliance

Stewart Segal, MD

Patient

August 16, 2011

There are multiple costs to non-compliance, including financial, both personal and societal, and physical-emotional. When patients fail to comply with treatment protocols, fail to get prescribed tests, or fail to stop destructive behaviors, there is a societal cost.

Today, I want to address the physical and emotional costs of non-compliance. I just read a brilliant article by Roxanne Sukol, MD. Dr. Sukol’s article discussed the fact that diabetes starts …

The majority with diabetes do not lead a disciplined diabetic life

Trey Stephens

Conditions and Diseases

August 16, 2011

“More than half of all Americans may develop diabetes or pre-diabetes by 2020, unless prevention strategies aimed at weight loss and increased physical activity are widely implemented, according to a new analysis. Diabetes is an epidemic, ” according to Denise Mann in WebMD Health News.

At 14 months old, the doctor told my parents that the disease would ultimately take my life. The doctor motioned my father into the hallway of …

Doctors sometimes fail when practicing what they preach

Dr. Peripatetic, MD

Physician

August 16, 2011

I’ve heard patients say, “How could she smoke and she’s a doctor?” Alarmed and bewildered by the fact that an agent of health could partake in one of the most harmful acts of bodily destruction. In medical school, a sizable number of my classmates smoked and I always found it so counter-intuitive, mind-boggling that they would be learning about smoker’s lung in pathology and on class breaks would huddled outside …

Medical student research and reading

Katherine Ellington

Medical Education

August 16, 2011

According to Liaison Committee on Medical Education (LCME) policy, medical education curricula should provide opportunities for and encourage medical student participation in research and scholarly activities. Some med students take the summer between first and second year while others may take elective time or a year-off to pursue more in-depth research experiences.

Med students may also choose to become the subject of research by participating in a clinical trials as patients, although …

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Medical student research and reading

Taking the time to answer patient questions

Sharon Bahrych, PA-C, MPH

Physician

August 15, 2011

I was working in the bone marrow transplant clinic of an internationally known cancer center. When I looked into the patient’s faces, I saw hope as they were being worked up for a possible transplant.

I went into see a new patient. She had leukemia and had relapsed after her remission. Her sister would be the donor.

Gretchen, age 19 came in with her mom for the appointment. She was tall, youthful …

Think about mindfulness when seeing a new patient

Steve Wilkins, MPH

Patient

August 15, 2011

I had a “wow” experience recently when I accompanied my wife to interview a new doctor for her. As some reader may know she is being seen by specialists at MD Anderson Medical Center in Houston for Stage IV lung cancer. She has not had a local oncologist for the past 6 years, but she does now. And we both love this guy!

You need to understand that I have …

Does the White Coat Ceremony encourage compassion?

a medical resident, MD

Medical Education

August 15, 2011

An article written by Dr. Sally Satel in The Wall Street Journal, Physician, Humanize Thyself, discusses the origins of the white coat ceremony. In the 1980s, as insurance companies placed increasing pressure on physicians to minimize visit time and maximize patient volume, the medical profession at large became increasingly cynical and disgruntled. A direct result of this was the White Coat Ceremony, whereby each medical student goes up on stage …

Demystifying anesthesia to put patients at ease

Kenneth Elmassian, DO

Patient

August 15, 2011

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

As patient safety advocates responsible for monitoring vital signs, managing pain and safeguarding a patient’s overall health through the surgical process, anesthesiologists are committed to informing patients about the anesthesia experience. The American Society of Anesthesiologists (ASA) and the Michigan Society of Anesthesiologists (MSA) have launched a new public education campaign to help patients better prepare and …

Doctors diagnose, sometimes we dispense, often, we teach

Greg Smith, MD

Physician

August 15, 2011

“My grandson has HDHD.”

This was intriguing. I had just asked her one of my standard psychiatric interview questions about family history of mental illness. Maybe I hadn’t heard right, but it sounded like she was telling me about a new flat screen. Had her grandson just bought a fifty-two inch LED set in time to watch the Final Four this weekend? Had he mounted it on the wall on …

Tips to care for your child with extra medical or behavioral needs

dr_som, MD

Conditions and Diseases

August 15, 2011

Lately when I ask my son to make a choice or do anything he considers difficult, he says, “Bus number twenty three. Number twenty three. Bus number seventy nine. Number seventy nine.”

He memorized not only the words but the exact cadence of how buses are announced at his school and recites this script instead of screaming. If you know David, this avoidance tactic is creative, a little annoying, and downright …

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