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Should academic physicians have the final word on acceptable practice?

Physician

June 15, 2011

The New York Times recently published an opinion editorial entitled “Squandering Medicare’s Money“in which Dr. Rita Redberg, professor of cardiology at UCSF, proposes that much of Medicare’s financial deficit could be reduced if the government did not spend “a fortune each year on procedures that have no proven benefit.”

To support her contention, Redberg cites several studies which indicate that many routinely performed tests and treatments …

Medication reconciliation brings the ER back to 1960

Chris Rangel, MD

Medications

June 14, 2011

What a blessing and a curse it must have been to practice medicine fifty years ago.

Most internists had only about twenty or so medications that they used regularly. It was a curse not to have effective medications to treat many common ailments but somewhat of a blessing not to have the modern medical nightmare of having patients on 15-20 chronic medications with all the logistical problems of keeping track of …

Why the word “drug” promotes a public bias in chronic pain treatment

Kevin

Medications

June 14, 2011

by Jack Cain

In the United States, there is a heated debate at all levels over the increased use of narcotic pain relievers, especially as part of a long-term treatment regimen for chronic pain. Part of that debate is fueled by the pejorative use of the term “drug” instead of “medication” in conjunction with the legal prescribing, dispensing and consumption of these substances.

Bias is …

A history of smallpox in America

Michele R. Berman, MD

Conditions and Diseases

June 14, 2011

This past Presidents’ Day, I thought it would be a good idea to talk briefly about the role that smallpox played in the life of our first president and it’s important role in the American Revolution. For those who would like to learn about this in greater detail, I would highly recommend the book, Pox Americana: The Great Smallpox Epidemic of 1775-82, written by Elizabeth A. Fenn.

In 1751, when George …

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A history of smallpox in America

Insurance companies cutting corners puts patients at risk

Vipan Nikore, MD

Physician

June 14, 2011

My patient, whom I’ll call Jane, had a neurologic disorder that prevented her from emptying her bladder properly.

She required a permanent urinary foley catheter to help her urinate. Jane landed back at the hospital with yet another urinary tract infection – her third in one month. She had pus draining from her catheter and was infected with a multi-drug resistant strain of the bacteria Proteus. Our lab ran tests (sensitivities) …

Hospital inefficiencies observed during a surgery rotation

Kevin

Health Technology

June 14, 2011

by Anar Mikailov

I recently finished my surgery rotation at a Level 1 Trauma Hospital in Philadelphia and amidst the ephemeral eight weeks I quickly realized the immense demands of a surgical residency. So, as an avid technology enthusiast and a team member, I took note of inefficient workflows with potential for technology driven solutions. By discussing the observed inefficiencies and potential solutions I hope …

Physicians and their staff need to put on a consistent show

Brandon Betancourt

Physician

June 13, 2011

This past summer, I had a few parents complain to me about our staff. The parents wanted to let me know that they were treated nicely by the staff, but they had noticed things from the employees that they didn’t appreciate. They mentioned that the staff seemed annoyed and irritated, even bored at times and a bit disingenuous.

I wanted to investigate the issue before I reprimanded the staff. Things …

Letting the states decide healthcare reform

Kevin

Health Policy

June 13, 2011

by Terry O’Keefe

The State of Vermont just passed the nation’s first single-payer universal healthcare system. While there are still some bureaucratic hurdles to cross, Vermont will soon install the kind of system that healthcare progressives have been drooling about for decades.

And whether you think that puts Vermont on the high road to healthcare nirvana, or the low road to socialized medicine, I think we …

MRI overuse is widespread, and dangerous to patients

Angry Orthopod, MD

Physician

June 13, 2011

MRI overuse and misuse really make me angry.

Did you know that a growing number of doctors don’t even read the tests themselves? Another shocking aspect of this industry is that some doctors will order an MRI because it’s quicker than doing a full examination. Rushing to an MRI can oftentimes erase clinical correlation, that is, connecting the dots between pain and what the MRI shows.

MRI is unnecessarily overused. In …

How physicians derive evidence for their practices needs to change

Marya Zilberberg, MD, MPH

Physician

June 13, 2011

I like to poke fun at real estate agents (please, forgive me if you are one, it is all in good fun).

My experience has been that, despite what I describe as my preferences, they always end up showing me what they have, even if it does not bear the remotest resemblance to what I need. This holds true for politicians, with this cardinal rule: always answer the question you want …

Social media ROI for one practicing physician

Howard Luks, MD

Social Media in Medicine

June 13, 2011

This is a message that should resonate loud and clear with providers, institutions or members of the healthcare enterprise world who are ruminating over the upsides — and potential downsides — of a wide reaching, multiple digital property: social media presence.

As Ted Eytan found out when he questioned the (anonymous) physicians on Sermo, many physicians are simply not interested in establishing an online presence.

“Risk” is the overwhelming variable they’re …

More healthy eating tips to add to the USDA food plate

James Haddad

Conditions and Diseases

June 13, 2011

The USDA has recently released it’s new concept, the food plate, to replace the iconic food pyramid it introduced in 1992 (and modified in 2005).

At its release, Agriculture Secretary Tom Vilsack criticized the food pyramid for being “too complex to serve as a quick and easy guide for American families” – I completely agree, and have always felt this way. The food pyramid was the …

The last exam of a first year medical student

Samyukta Mullangi

Medical Education

June 13, 2011

Recently, the Harvard class of 2014 took its last exam of the year.

We filled our usual amphitheater, took a 60 multiple choice question test on viruses, parasites and fungi, and went to go see X-men in the afternoon. I told my mom last night that I expected people to exit the lecture hall in hysterics, falling to their knees on our marble floors and weeping at being 25% closer to …

Why doctors shouldn’t have to choose between medicine and family

Kevin Pho, MD

KevinMD

June 12, 2011

For the past few Sundays, the New York Times has published provocative op-eds involving physicians.

The first tackled physician bullying. Next was the cost of medical education. And, most recently, the phenomenon of part-time, mostly female, physicians.

This is obviously a live-wire topic, sure to generate passionate commentary.

In the piece, anesthesiologist Karen S. Sibert goes over ramifications of part-time physicians. …

Hospital bullying requires everyone to share in the blame and solution

Kevin Pho, MD

KevinMD

June 12, 2011

The following column was published on May 28, 2011 in FoxNews.com.

Theresa Brown’s New York Times op-ed, Physician, Heel Thyself, recently introduced hospital bullying into the national health care conversation.

In it, she recounted a hospital vignette while working as an oncology nurse. A patient asked a doctor who should he blame for a late test result. The …

Doctors don’t take snow days

Anesthesioboist T., MD

Physician

June 12, 2011

Editor’s note: This post was originally written this past winter.

Boston had another blizzard today. I was really worried about this one. It was supposed to snow hard, about three inches an hour from 3 a.m. to 12 p.m. with poor visibility, impassable roads, etc. I’ve driven home in snow like that, and I find it terrifying. Your car won’t do what you want it to, and worse, other people can’t …

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Doctors don’t take snow days

The Golden Moment in medical malpractice

Kathleen Clark, PhD

Physician

June 12, 2011

As Kevin Pho pointed out in his piece, “How malpractice hurts doctors and their future patients,” physicians who have been through trial are often never quite the same.

Physicians who have been sued in medical malpractice case are often referred to as the “Second Victim,” a term that says it all. When a mistake is made and a patient is injured, the physician also suffers, often in silence and …

Why children are getting fatter

Dr. Joe Kosterich

Patient

June 12, 2011

Children are getting fatter because they are not allowed to run around and play. This comes from parents wanting to wrap kids in cotton wool — also known as helicopter parenting.

There is a new push to get children to walk to school. This is something which previous generations just did but has largely disappeared over the last 25 years. There are many reasons for this but one of them …

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Why children are getting fatter

How to take care of your health during difficult economic times

Jan Gurley, MD

Conditions and Diseases

June 11, 2011

Studies show that many people faced with home loss and housing uncertainty can take a tremendous hit to their health. If you’re going through difficult times, and worried you too may lose your home, what can you do to try to buffer or reclaim your health?

Here are some tips for ways to counteract some of the toll that constant stress (and the insomnia, distraction and desperation that go with …

MKSAP: 50-year-old woman with advanced multiple myeloma

mksap

Conditions and Diseases

June 11, 2011

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

A 50-year-old woman with advanced multiple myeloma diagnosed 6 months ago undergoes a follow-up visit. Treatment includes daily oral thalidomide and pulse dexamethasone. The patient now feels well.