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Discussing a colostomy in a patient with rectal cancer

Sid Schwab, MD

September 21, 2011Sep 21, 20114

Sturdy and thickly-built, long since widowed, cheery in a sardonic sort of way, tough and opinionated, Flora's European roots ran deep; she'd been an Italian farm girl, and she'd rather be in her garden than anywhere else. The only reason…

Sturdy and thickly-built, long since widowed, cheery in a sardonic sort of way, tough and opinionated, Flora’s European roots ran deep; she’d been an Italian farm girl, and she’d rather be in her garden than anywhere else. The only reason she agreed to come inside and go to the doctor was that her bowel movements had finally gotten too painful, and too bloody to ignore. Which she had been doing, …

Health policy

Why an ACO is essentially an American product

David Harlow

September 21, 2011Sep 21, 2011

There has been a significant outcry against the proposed ACO regulations: everything's wrong and nothing's right about them, or so some would have us believe. Today's "nattering nabobs of negativism" focus on: the estimated price tag for complying with the…

There has been a significant outcry against the proposed ACO regulations: everything’s wrong and nothing’s right about them, or so some would have us believe.

Today’s “nattering nabobs of negativism” focus on: the estimated price tag for complying with the regulatory requirements (IT and other infrastructure included), the slim chance of success by ACOs in righting the wrongs of decades of bloat in the health care system, the …

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Elimination of industry support for CME

Daniel J. Carlat, MD

September 20, 2011Sep 20, 20114

Something huge happened at the American Medical Association House of Delegates meeting. Although the meaning of what happened will be spun throughout the blogosphere, twittersphere, and schmuckosphere, the bottom line is that the AMA just voted most commercial funding of…

Specifically, the delegates voted to approve a report of the AMA ethics committee that calls for a near elimination of industry support for CME. The report is …

Elimination of industry support for CME

Appropriately dejected after an annual physical

Colleen Kelly Mellor

September 20, 2011Sep 20, 2011

Print out the eye chart, cover one eye, and see how you read it from 20 feet out. I failed line 8 abysmally. I went for my annual check-up, and I must say, this doctor was thorough. In fact, he…

Print out the eye chart, cover one eye, and see how you read it from 20 feet out. I failed line 8 abysmally.

I went for my annual check-up, and I must say, this doctor was thorough. In fact, he was too thorough. He told me way more than I ever wanted to know.

During the two-hour examination, I found out I’ve gained weight (too much ice cream), my blood pressure …

Exercise can help treat fibromyalgia

William R. Yates, MD

September 20, 2011Sep 20, 20113

What is fibromyalgia and what exactly what does exercise have to do with the treatment and long-term outcome of the condition? A recent study published in Medicine & Science in Sports & Exercise is helpful in understanding the relationship between…

What is fibromyalgia and what exactly what does exercise have to do with the treatment and long-term outcome of the condition? A recent study published in Medicine & Science in Sports & Exercise is helpful in understanding the relationship between fibromyalgia and exercise and how clinicians (and patients) might find better strategies for treatment.

Fibromyalgia is a clinically defined pain syndrome estimated to affect about 5 per cent of the general population with criteria for …

Exercise can help treat fibromyalgia

Are medical students responsible for the primary care shortage?

Emily Lu

September 20, 2011Sep 20, 201122

There is a lot of speculation about why there are fewer and fewer primary care physicians joining the workforce every year. Some have focused on the choices that medical students are making when choosing residencies. Whether due to laziness, desire to make money or the drive to be perceived as “successful” in choosing a more prestigious specialty, the new generation of physicians are being blamed for …

The value of a mentor during medical training

Michael A. Zadeh, MD

September 20, 2011Sep 20, 20112

I grew up playing a variety of different organized sports. Looking back now, I notice that no matter what the sport my best performances were always on teams which were led by inspiring coaches. The same could be said about my education, with teachers replacing the coaches. Whether I knew it at the time or not, throughout my life I have had a number of mentors who have brought the …

Quitting your job and living the dream

Susan Biali Haas, MD

September 20, 2011Sep 20, 20113

Ever dream of quitting your job, moving somewhere deliciously tropical and spending the rest of your days doing what you love (and even making a good, or great, income from it)? This story isn't about me, though some of you…

Ever dream of quitting your job, moving somewhere deliciously tropical and spending the rest of your days doing what you love (and even making a good, or great, income from it)?

This story isn’t about me, though some of you may know that I spent 2004-2008 living my dream life in Mexico (Puerta Vallarta and Los Cabos), making much of my income from my writing, dancing, coaching and speaking and occasional …

Quitting your job and living the dream

J. Leonard Lichtenfeld, MD

The progress we have made in the diagnosis and treatment of cancer

September 20, 2011Sep 20, 20112

An article released by the Centers for Disease Control and Prevention in their weekly publication Morbidity and Mortality Weekly Report provides an assessment of the progress we have made in the diagnosis and treatment of cancer. Clearly, since 1971, we…

An article released by the Centers for Disease Control and Prevention in their weekly publication Morbidity and Mortality Weekly Report provides an assessment of the progress we have made in the diagnosis and treatment of cancer.

Clearly, since 1971, we have made substantial advances in the cancer treatment. We have become a larger and older …

A place for business in medical school

Jay Agarwal

September 19, 2011Sep 19, 20115

A recent article in the New York Times business section discusses an increase in the number of doctors getting M.B.A.'s in addition to their M.D. degree. In fact, there have even been many new programs that combine getting both of…

A recent article in the New York Times business section discusses an increase in the number of doctors getting M.B.A.’s in addition to their M.D. degree. In fact, there have even been many new programs that combine getting both of these degrees together. The article emphasizes the importance of seeing that “healing is an art, medicine is a profession and health care is a business.” However, is adding more …

A place for business in medical school

Why doctors should be careful with Groupon and other social coupons

Adam Banks

September 19, 2011Sep 19, 20114

I just received a Groupon for dental services. I have seen Groupon’s in the past for medical services and I can’t figure out how selling medical services via a social coupon (the generic name for Groupon like sites) is legal.…

As I run practices in New York, I will focus on the their statutes. New York has some of …

How to ask for help when chronic pain or illness strikes

Toni Bernhard, JD

September 19, 2011Sep 19, 20114

How many times have you said to a friend or relative in need, "Let me know if there’s anything I can do to help," and when you didn’t hear back, fail to follow-up? I’ve lost count of the number of…

How many times have you said to a friend or relative in need, “Let me know if there’s anything I can do to help,” and when you didn’t hear back, fail to follow-up? I’ve lost count of the number of times I did just that—fail to follow-up when I didn’t hear back from someone in need, even though I would have been happy to help in any way I could.

Yet, …

Confirmation bias in both physicians and patients

Howard Luks, MD

September 19, 2011Sep 19, 20113

We are all guilty of confirmation bias from time to time. Confirmation is something that resident physicians in particular are guilty of more so than experienced, qualified physicians. Resident physicians and attending physicians alike may quickly form a diagnosis in…

We are all guilty of confirmation bias from time to time.

Confirmation is something that resident physicians in particular are guilty of more so than experienced, qualified physicians. Resident physicians and attending physicians alike may quickly form a diagnosis in their mind during a brief discussion with a patient. Now they will try to convince themselves (sub-consciously) that the other complaints and physical exam fit that diagnosis. They …

ADHD and the lack of quality sleep

Steven Y. Park, MD

September 19, 2011Sep 19, 20117

As the new school year begins, it’s only natural that there’s more awareness about learning and behavior issues. One of the most controversial topics that came up frequently is ADHD, or Attention Deficit Hyperactivity Disorder. It’s thought that 2-4% of children have this condition, and a shocking 50% of children with this condition are on some form of prescription medication. Not only is it seen in children, but adults …

ADHD and the lack of quality sleep

What do you think caused your disease?

Shara Yurkiewicz

September 19, 2011Sep 19, 20118

Our first assignment for medical school involved reading and discussing Anne Fadiman's The Spirit Catches You and You Fall Down, which describes how a clash of two cultures (medical and recently immigrated Hmong), miscommunication, and misunderstanding led to tragedy. Poignantly…

Our first assignment for medical school involved reading and discussing Anne Fadiman’s The Spirit Catches You and You Fall Down, which describes how a clash of two cultures (medical and recently immigrated Hmong), miscommunication, and misunderstanding led to tragedy. Poignantly narrated, the book had the take-home message: if a patient does not agree with a physician’s reasoning why a disease developed and how it can be cured, then even the best …

What do you think caused your disease?

You cannot treat a patient against his will

Yann Meunier, MD

September 19, 2011Sep 19, 20118

Year: 2002 Setting: Gleneagles Hospital, Singapore Position: Private general practitioner I am the first and only non-Anglo-Saxon, foreign, private general practitioner in the city-state and the physician of reference for 14 embassies, consulates and a high commission from Europe, Asia,…

Year: 2002

Setting: Gleneagles Hospital, Singapore
Position: Private general practitioner

I am the first and only non-Anglo-Saxon, foreign, private general practitioner in the city-state and the physician of reference for 14 embassies, consulates and a high commission from Europe, Asia, South America and Africa. One afternoon, a nurse comes into my consulting room saying that an ambassador from a European country has had an accident and that he insists on being seen immediately.

I …

Health policy

Should Medicare pay for procedures that have no proven benefit?

Bob Doherty

September 18, 2011Sep 18, 201120

"Doctors, with the consent of their patients, should be free to provide whatever care they agree is appropriate. But when the procedure arising from that judgment, however well intentioned, is not supported by evidence, the nation’s taxpayers should have no…

“Doctors, with the consent of their patients, should be free to provide whatever care they agree is appropriate. But when the procedure arising from that judgment, however well intentioned, is not supported by evidence, the nation’s taxpayers should have no obligation to pay for it.”

So argues Dr. Rita Redberg, a cardiologist and professor of medicine at the University of California, in a provocative op-ed published in the New …

When professional courtesy could get physicians in trouble

Deniza Gertsberg, Esq

September 18, 2011Sep 18, 20114

More likely than not, a physician or a dentist has at one point provided discounted or free healthcare services to some patients by waiving all or part of a fee or the copayment and/or coinsurance obligations as a “professional courtesy.” According to the Office of Inspector General’s (OIG) Compliance Program For Individual and Small Group Physician Practices guidelines, however, this practice may expose a physician to an investigation.

To be sure, not all professional courtesy discounts or free …