KevinMD.com

What do hospice nurses and teenage heroin addicts have in common?

Medications

July 1, 2011

What do hospice nurses and teenage heroin addicts have in common? One may be an unintended consequence of the other.

A pair of articles published recently in two prestigious medical journals help make the case.

The Lancet reported that 47 million of the 58 million deaths occurring annually worldwide take place in developing countries, and that of these, fully 27 million die without having received proper palliative care. The article attributes …

Measuring physician trust in patients

Jessie Gruman, PhD

Patient

July 1, 2011

Members of the American public are frequently surveyed about their trust in various professionals. Doctors and nurses usually wind up near the top of the list, especially when compared to lawyers, hairdressers and politicians. Trust in professionals is important to us: they possess expertise we lack but need, to solve problems ranging from the serious (illness) to the relatively trivial (appearance).

How much professionals trust us seems irrelevant: our reciprocity is …

Read more…

Measuring physician trust in patients

Analyzing the reporting of lung cancer CT screening

Gary Schwitzer

Conditions and Diseases

July 1, 2011

It’s been another challenging week for journalists covering various screening stories.

First the new analysis of Swedish mammography studies: Some familiar flaws surfaced in some stories.

Then came the followup analysis of the National Lung Screening Trial – first reported last fall.

This week various headlines announced:

More evidence CT scans better at detecting lung cancer
Study bolsters evidence that screening reduces lung cancer deaths
Nat’l Study Shows Long-Term Smokers Should Get Lung …
Read more…

Analyzing the reporting of lung cancer CT screening

Dwyane Wade and the NBA’s insensitivity to his migraines

Diana E. Lee

Conditions and Diseases

July 1, 2011

by Diana E. Lee

Sports journalists recently discussed discussing Dwyane Wade’s migraines and his decision to try wearing goggles to deal with light sensitivity.

News outlets like ESPN proved once again they know how to treat migraine disease as a serious, burdensome medical issue in reporting on Wade’s health situation. But somehow at the eleventh hour the story got way more complicated and the NBA revealed they don’t …

How direct primary care reduces primary care costs

Dave Chase

Physician

July 1, 2011

In an age of family physicians literally not being able to give away their practices, Brian Forrest has built a successful model that is similar to the age of Marcus Welby where there was a direct relationship between a patient and their doctor. Practices such as Forrest’s Access Healthcare in North Carolina run unencumbered by insurance hassles.

As word of Dr. Forrest’s Read more…

How direct primary care reduces primary care costs

Google Circles may be why physicians will embrace Google+

Kevin Pho, MD

KevinMD

June 30, 2011

After playing around with Google+ today, I’ve come away on a more positive note than my speculative post on Google’s social network recently.

Before experiencing Google+, I asked whether doctors can separate their personal and professional relationships, and how the Google Circles feature would help.

Well, if Google+ ever takes off for physicians, it will be because of Circles.

Tech blogs, …

Sometimes the treatment is worse than the disease

Hans Duvefelt, MD

Conditions and Diseases

June 30, 2011

To do nothing is sometimes a good remedy.
-Hippocrates

Edna Frost is 88 years old, a slender, slow-talking woman with a dry sense of humor and a blood pressure that’s all over the place. At best, she runs ten points higher than any of her previous doctors wanted to put up with. At worst, she flirts with systolics over 200, but that doesn’t seem to be a common occurrence.

Edna has been my …

The first brain a medical student sees in anatomy lab

Jessica Gold

Medical Education

June 30, 2011

Arriving in anatomy lab there was an obvious discontent in the air. People were slower to arrive than usual and then they were even slower to get changed in the locker room. Girls would start casual conversation, or would wait for 15 minutes for others to move from in front of their locker, just in the hopes that they would get 5 more minutes …

A monetary value on each life saved

Benjamin Geisler, MD, MPH

Health Policy

June 30, 2011

by Benjamin P. Geisler, MD, MPH

A recent New York Times article on how to value a life drew almost two-hundred heavy-handed comments. It discussed how different governmental agencies such as the Food and Drug Administration (FDA), the Environmental Protection Agency (EPA) or the Department of Transportation (DoT) place a monetary value on each life saved.

In many public policy areas, cost-benefit Analysis (CBA) is being used to assess whether an investment …

Read more…

A monetary value on each life saved

When you close an abdomen after a failed rescue, the OR is silent

Sid Schwab, MD

Physician

June 30, 2011

I didn’t know her name until it was over, much too late.

What I knew was she was thirteen and that on this winter day someone in her family had been pulling her behind their car, on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled as …

Summer palpitations

Katherine Ellington

Conditions and Diseases

June 30, 2011

It was early Saturday morning, I was making my plans for the day, crossing-off a few items that seemed unreasonable with others that had been accomplished. As I moved toward the kitchen, a voice from the living room bellowed “the coffee is ready.”

Turning my head I could see bright rays of sunshine making a visible path through the open front door. My morning greeting followed …

Read more…

Summer palpitations

Online physician access is key to future patient communications

Aaron George, DO

Health Technology

June 30, 2011

Imagine using Skype to contact your physician for a consult.

In the midst of this rapidly progressing technologic era, our delivery of medical services is being transformed by health information technology (HIT), electronic medical records (EMR), and advanced telecommunications. In meeting criteria for “meaningful use,” physicians are driven to use these technologies to empower patients with communication through electronic medical records. A primary goal is to allow patients to …

Pharmacies selling prescription information to data mining companies

David Harlow

Medications

June 30, 2011

Walgreens is being sued by customers who are not happy that their prescription information – even though it has been de-identified – is being sold by Walgreens to data-mining companies.

The data privacy and security concerns surrounding the transfer of de-identified data are significant. To “de-identify” what is otherwise protected health information under HIPAA, some outfits will simply strip data of 18 types of identifiers listed in federal …

The decision point psychiatrists faced with psychotherapy

Daniel J. Carlat, MD

Physician

June 29, 2011

There’s been plenty of buzz about a recent New York Times story, “Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy” by Gardiner Harris. The story is essentially a profile of Dr. Donald Levin, a 68 year old psychiatrist who has a private practice in Doylestown, Pa.

It is a poignant example of a common situation in psychiatry. Older psychiatrists were trained during a time when there …

Using gender as sole determinant for a choice of doctor

Colleen Kelly Mellor

Patient

June 29, 2011

It happened 25 years ago and I never forgot it. I’d been in the forefront of women’s consciousness-raising; I recognized that women had been professionally downtrodden for years (in certain fields), and hoping to do my part to balance the inequity, I opted for female doctors whenever possible.

But using gender as sole determinant for my choice of doctor would prove to be a huge mistake … as I’d learn.

At …

How autism affects social interaction

William R. Yates, MD

Conditions and Diseases

June 29, 2011

One of the problems with understanding the natural history of autism is the lack of well-designed outcome studies in the disorder. Outcome studies tend to be expensive and grant agencies commonly do not fund studies longer than a few years. However, given the increased interest and funding in autism, I suspect there will be more research in this area.

An example of how outcome studies help in understanding the natural …

Read more…

How autism affects social interaction

Google Health failed because consumers did not see the value of a PHR

Kent Bottles, MD

Health Technology

June 29, 2011

To measure is to know.

-Lord Kelvin

If you can not measure it, you can not improve it.
-Lord Kelvin

Versus:

Asking science to explain life and vital matters is equivalent to asking a grammarian to explain poetry.
-Nassim Nicholas Taleb

Technology is at its best when it is invisible.
-Nassim Nicholas Taleb

How can technology help us live healthier lives? Why did Google Health fail? Why are Klout and Twitter Grader publicly issuing a number to me …

Reverse our attitudes and values to control health costs

Kevin

Health Policy

June 29, 2011

by John Kaegi

We all complain about the cost of health care and health insurance. Ours is by far the most expensive health care system in the world. And for the money, our health isn’t so hot either. On the world stage, the U.S. ranks 37th in health care efficiency (a measure of health outcomes such as infant mortality, incidence of chronic disease, etc.) as reported by the World Health Organization. America …

Google+ for doctors, and why physicians should be careful

Kevin Pho, MD

KevinMD

June 29, 2011

Google has announced its social networking product, Google+.

I haven’t received an invite yet, so I don’t have first-hand experience with the service. But reading the major tech blogs’ take from Engadget, TechCrunch and Mashable, you have a pretty good idea of what to expect.

What should doctors know about Google+?

Obviously, this is Google’s last, best attempt to combat …