KevinMD.com

September 11, 2011Sep 11, 20114

Thump. There is a strange sound emanating from the hallway. It’s more of a series of sounds, of thuds, punctuated by an odd, louder noise. The hallway is narrow, not much room for a five-year-old to create too much havoc.…

Thump.

There is a strange sound emanating from the hallway. It’s more of a series of sounds, of thuds, punctuated by an odd, louder noise. The hallway is narrow, not much room for a five-year-old to create too much havoc. I close my eyes, and as I try to visualize the corresponding sequence of events the rhythm is interrupted by a much louder sound and the house shakes. A child has fallen …

Physician voices

New HIPAA rules won’t enhance privacy, but they will burden physicians

Jared M. Rhoads

September 11, 2011Sep 11, 20116

Hospitals and physician practices are waiting with bated breath for the final changes to the HIPAA Privacy Rule, which the Department of Health and Human Services (HHS) is expected to release by the end of the year. One of the new rules could require healthcare providers to keep track of the instances in which patients’ health information is shared with third parties for reasons including treatment and managing payments. …

Patient voices

A contract for patient responsibility

Stewart Segal, MD

September 11, 2011Sep 11, 201122

I often refer to myself as a fireman pouring water on the flames that are burning my patients. Often, I view my patients as arsonists, pouring gas on the fire I am working to put out. Taking personal responsibility is a critical component of success in any of life’s ventures. While my patients are very responsible business and family men and women, they often take no responsibility for their …

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A contract for patient responsibility

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Patient voices

How elderly patients can be stubborn to their own detriment

Sharon Bahrych, PA-C, MPH

September 11, 2011Sep 11, 20114

The elderly population can be fun to take care of (they have more stories than you have time to hear), or they can be a handful in regards to all of their chronic complaints and numerous medications. But then, there are those senior citizens that come into clinic and tell us, “I don’t need to take medications, I haven’t taken medications my whole life, and look at where it’s …

Physician voices

When not to use a physician recruiter

Bo Claypool

September 11, 2011Sep 11, 20114

As a physician recruiter of prominence, a number of times during any given week I get a fair number of calls from physicians in training who, honestly, should not be calling me whatsoever and I am very frank in telling…

“Hi Bo, my name is Dr. Doe. I am finishing up my dermatology residency and I want to be there in …

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When not to use a physician recruiter

9/11 grieving in the social media era

Elias Aboujaoude, MD

September 11, 2011Sep 11, 2011

Sunday marks the tenth anniversary of the 9/11 attacks, and our keyboards, monitors and smartphones will likely play a big role as we commemorate the events. Numerous remembrance websites and videos already appear online, and people will undoubtedly take to Facebook and Twitter over the weekend to share their personal stories and express their thoughts on that tragic day.

Never before have we been so “plugged in,” and I had to …

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9/11 grieving in the social media era

Physician voices

How Jenny McCarthy became a medical thought leader

Mark Britton

September 10, 2011Sep 10, 201117

The mere mention of Jenny McCarthy gets an immediate eye roll from many physicians. The closer their practice is to autism or immunology, the more likely the eye roll turns into a lecture on why Ms. Playboy should focus on…

The problem is that “Ms. Playboy” is kicking the medical profession’s behind on thought leadership. Jenny McCarthy has become a – if not the – leading voice regarding …

Patient voices

What to ask a doctor when faced with a difficult diagnosis

Linda Pourmassina, MD

September 10, 2011Sep 10, 20112

We live in an era of medicine in America in which patients want to be involved in their healthcare. This is very satisfying to physicians like me, who prefer to educate and engage patients rather than just telling them what to do. Granted, there are some instances when a patient does need to be told what to do (ex: “You have appendicitis. You need surgery.”)

However, when faced with a …

Health technology

How an EHR will impact physician productivity

Robert Rowley, MD

September 10, 2011Sep 10, 2011

One of the big concerns about implementing an electronic health record (EHR) into a medical practice is the fear that it will slow you down. In fact, after cost, usability (and its effect on productivity) is the second-biggest perceived barrier…

Numerous studies have shown that EHR implementation actually ends up saving cost in a group practice, mainly because of reducing or eliminating the need for paper-based medical …

Conditions and diseases

MKSAP: 25-year-old man with swelling of the feet and legs

mksap

September 10, 2011Sep 10, 2011

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old man is evaluated in the emergency department for swelling of the feet and legs. He has a 5-year history of HIV infection…

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

A 25-year-old man is evaluated in the emergency department for swelling of the feet and legs. He has a 5-year history of HIV infection for which he has refused treatment.

On physical examination, temperature is normal, blood pressure is 128/74 mm Hg, pulse rate is 88/min, and …

Patient voices

The dual tragedy of suffering catastrophic illness and being uninsured

John Maa, MD

September 9, 2011Sep 9, 201118

An estimated 60% of American bankruptcies result from overwhelming medical costs. My uncle’s tale illuminates the dual tragedy of suffering catastrophic illness and being uninsured. The 2008 recession claimed my uncle’s job, health benefits, and assets, except for a small…

An estimated 60% of American bankruptcies result from overwhelming medical costs. My uncle’s tale illuminates the dual tragedy of suffering catastrophic illness and being uninsured.

The 2008 recession claimed my uncle’s job, health benefits, and assets, except for a small inheritance. By 2009 he found work (but not health coverage) as a consultant.

One day he noticed that his eyes were yellow. He emailed a photograph, and I immediately recognized jaundice. I …

Medical education

The growth of integrative medicine in academic institutions

Robert Donnell, MD

September 9, 2011Sep 9, 201114

The Atlantic published an article about the growth of quackademic medicine in our teaching institutions and it's celebratory more than critical. It profiles the integrative medicine clinic of Dr. Brian Berman. That's right, this Dr. Berman. I blogged about him…

The Atlantic published an article about the growth of quackademic medicine in our teaching institutions and it’s celebratory more than critical. It profiles the integrative medicine clinic of Dr. Brian Berman. That’s right, this Dr. Berman. I blogged about him four years ago and it seems his clinic at the University of Maryland is still going strong. Stronger, apparently.

The article, like integrative medicine itself, is a mixture of quackery …

Physician voices

The graveyard hidden in a surgeon’s mind

bongi, MD

September 9, 2011Sep 9, 20114

This is a difficult story to tell but if I am to be true to the complete experience of a surgeon, I do need to tell it. One of my seniors used to say that every surgeon has a graveyard…

This is a difficult story to tell but if I am to be true to the complete experience of a surgeon, I do need to tell it.

One of my seniors used to say that every surgeon has a graveyard hidden away somewhere in the dark recesses of his mind. He went on to say it was unfortunately normal, so long as you remember all the names engraved on the tombstones. …

Physician voices

Human capital makes doctors special

Douglas Perednia, MD

September 9, 2011Sep 9, 20113

If you’ve ever been sick, especially with anything serious, you quickly realize that doctors, nurses and their ilk are an unusual and precious resource. First you have to find smart people with personalities willing and able to put up with…

If you’ve ever been sick, especially with anything serious, you quickly realize that doctors, nurses and their ilk are an unusual and precious resource.

First you have to find smart people with personalities willing and able to put up with a lot of guff in the service of their fellow man. Then they have to be willing to (usually borrow, and) spend tens or hundreds of thousands of dollars for …

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Human capital makes doctors special

Physician voices

Patients lose if physicians are expected to practice perfect medicine

WhiteCoat, MD

September 9, 2011Sep 9, 201111

I discussed whether or not ambulances should be required to add equipment costing $12,000 in order to be able to transport 850 pound patients recently, so I won’t belabor the point here. Providing medical care to morbidly obese patients presents…

Then I read an article in the Florida Sun Sentinel about how some obstetrician-gynecologists in South Florida are refusing to provide medical care to obese women. …

Patient voices

Defining what health truly is

Stewart Segal, MD

September 9, 2011Sep 9, 20113

I read an interesting article by Jason Luban, a licensed acupuncturist, on why so many patients flock to alternative practitioners. Mr. Luban brought up an interesting question, "What is health?" Is health simply the absence of disease? If it is,…

I read an interesting article by Jason Luban, a licensed acupuncturist, on why so many patients flock to alternative practitioners. Mr. Luban brought up an interesting question, “What is health?”

Is health simply the absence of disease? If it is, there certainly aren’t very many healthy patients in my neck of the woods. Most of the patients I take care of have something that’s not quite right. I only know one perfect …

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Defining what health truly is

Health technology

The threat of technology to proper patient care

Josh Herigon, MPH

September 9, 2011Sep 9, 2011

Dr. Abraham Verghese wrote in the New York Times recently about the threat of technology to proper patient care. This is an excellent piece and although I do not disagree with the overall message, I think Dr. Verghese conflates different…

Dr. Abraham Verghese wrote in the New York Times recently about the threat of technology to proper patient care. This is an excellent piece and although I do not disagree with the overall message, I think Dr. Verghese conflates different issues currently plaguing our health care system.

Below, I provide some comments on a few of the major points Dr. Verghese writes about: “This computer record creates what I call an “iPatient” …

Physician voices

A reminder of why doctors do what they do

Gregory Bratton, MD

September 8, 2011Sep 8, 20115

Residency is hard. The hours are long, the work is grueling, and, simply put, hospital food is not good. Many days, we, as residents, walk the wards in a lifeless haze – coasting on the wings of our white coats,…

During these times, we find ourselves sitting in wheelchairs that are stored in dark remote corners, questioning whether or not all of this is worth it. For years, …

Patient voices

Asking patients about their health care financial concerns

Libertad Flores

September 8, 2011Sep 8, 20114

I remember joking with Dad about how he'd outlive us all. He had gone vegetarian 10 years before I was born, never smoked, took vitamins, and asked for a designated driver after his annual Heineken at the neighbor's Christmas shin-dig.…

I remember joking with Dad about how he’d outlive us all. He had gone vegetarian 10 years before I was born, never smoked, took vitamins, and asked for a designated driver after his annual Heineken at the neighbor’s Christmas shin-dig. He flossed, wore a seat belt, and looked forward to annual physicals. If I tried leaving our Michigan house in the winter with more than 3 inches of skin exposed, …

Physician voices

The specialty that makes doctors rich and happy

Paul Sax, MD

September 8, 2011Sep 8, 20116

A long time ago, I was very close to becoming a cardiologist. Really. Even though my fascination with ID and microbiology started in medical school — and believe me, not much fascinated me in medical school — the fact that…

A long time ago, I was very close to becoming a cardiologist. Really.

Even though my fascination with ID and microbiology started in medical school — and believe me, not much fascinated me in medical school — the fact that all the top residents in my program were going into cardiology made me feel that somehow I should be doing this too. Plus, the guy who was Chief …

Real physician voices, twice a week

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