KevinMD.com

August 26, 2011Aug 26, 20112

I worked with Joe over a year ago and now he returned to see me with a new problem. He had just been diagnosed with a rare degenerative disorder that would eventually rob him of the use of his limbs as his muscles weakened over time. Joe wanted to talk about how he could prepare himself for this decline.

Joe is in his sixties and has worked in high tech for …

Patient voices

Hurricane tips that patients and health professionals should know

Katherine Ellington

August 26, 2011Aug 26, 2011

If you’ve seen the news recently, you know that emergencies can happen unexpectedly in communities just like yours, to people like you. We’ve seen tornado outbreaks, river floods and flash floods, historic earthquakes, tsunamis, and even water main breaks and power outages in U.S. cities affecting millions of people for days at a time and now Hurricane Irene is coming. Health care professionals should be ready too.

I was …

Patient voices

Talk to your patients before sending them home from the ED

Charles A. Pilcher, MD

August 26, 2011Aug 26, 2011

So you’re not having a heart attack like your wife thought. That’s the good news. But what is wrong, what did cause that pain, and what should you do from here on out? That’s the purpose of discharge instructions, and…

So you’re not having a heart attack like your wife thought. That’s the good news. But what is wrong, what did cause that pain, and what should you do from here on out?

That’s the purpose of discharge instructions, and it’s not enough for the ED staff to just print out some forms, say “sign here,” and send you on your way.

What constitutes good discharge instructions, and why are they critical …

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Health policy

Why specialists should join primary care to end the RUC

Paul Fischer, MD

August 25, 2011Aug 25, 20112

The old doctors know. The practice of medicine has changed in a very basic way over the last 20 years. Physician relationships have lost their civility and have been replaced by a level of tension that takes the fun out of collegial interactions. I remember my first year of family medicine as the only doctor in Weeping Water, Nebraska. My personal medical community had gone from an entire medical …

Health technology

Will patients trust sociable humanoid robots?

Kent Bottles, MD

August 25, 2011Aug 25, 20115

Within in five years primary care providers will begin being replaced by sociable humanoid robots, avatars, and computer programs. Within ten years you will no longer hear any complaints about medical students choosing specialty residencies over family practice because the role of the physician will be completely redefined to complement a rules based approach to the diagnosis and treatment of many diseases. This transformation is inevitable because of demographics, economics, and …

Physician voices

Converting a practice to a no insurance accepted model

Robert Tomsett, PA-C

August 25, 2011Aug 25, 201157

Not long ago, I was working for a pain management firm with 19 clinics scattered throughout three states. I was fast approaching my three year mark as the travel PA and more recently, the compliance officer. Little did I know that my career path was about to go off-road, into a new world of clinic ownership coupled with the unchartered territory of no-insurance accepted.

What a difference a few months can …

Patient voices

Top 10 musts for your hospital visit

Mitchell Brooks, MD

August 25, 2011Aug 25, 20114

Whether you are going to the hospital for an outpatient procedure or whether you will be admitted to the hospital for medical illness or surgical procedure, there are certain things you must know and certain things you must do in…

You must become informed about the terms and limits of your health insurance policy. See if the fees you are being

…

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Top 10 musts for your hospital visit

Health policy

Implementing the Affordable Care Act will increase physician tension

Jeffrey Hall Dobken, MD, MPH

August 25, 2011Aug 25, 20113

It's really quite an ancient debate: 400 to 500 years before the birth of Christ, on the island of Kos (home of Hippocrates) originates the myth of Aesculapius, god of healing, son of Apollo and the nymph Coronis. As is…

It’s really quite an ancient debate: 400 to 500 years before the birth of Christ, on the island of Kos (home of Hippocrates) originates the myth of Aesculapius, god of healing, son of Apollo and the nymph Coronis.

As is not unusual in Greek mythology, Coronis meets a violent death, but the infant Aesculapius is saved. He is raised by a wise centaur, becomes skilled in healing arts, and succeeds in …

Patient voices

Why technology should never takeover the patient encounter

Neil Baum, MD

August 25, 2011Aug 25, 2011

Today, healthcare is criticized by the public as too high on technology and too low in touch. Computers take patients histories, provide differential diagnoses, and even supply educational materials to patients. A new specialty, tele-medicine, offers healthcare services to rural…

A humorous story about technology occurred when a patient’s secretary called to say that her boss was too …

Patient voices

Patient advocacy groups should help support research

Christopher Johnson, MD

August 25, 2011Aug 25, 2011

I was a medical researcher for several decades, investigating an unusual, but not rare, condition called infective endocarditis. I found the disease fascinating, primarily because of how understanding it could unlock many secrets of the endothelial cell, the cells lining all our blood vessels. I chose my research subject because it interested me and I thought I could do some good studying it. This is the case for …

Patient voices

Medicare patients should bring a companion to office visits

James Haddad

August 25, 2011Aug 25, 20117

When a patient shows up for a doctor’s appointment with a companion, I often find myself studying (and later, interacting with) them as much as I do the patient. Most times, a quick review of body language is all I need to make an assessment – is this person looking out for the interests of the patient? Are they here begrudgingly, or out of concern? Are they indifferent, or …

Physician voices

Should pediatricians be punished for asking about guns in the home?

Ricky Choi, MD

August 24, 2011Aug 24, 201144

Far be it for me, a Bay Area pediatrician, to tell Floridians about how to keep their kids safe. But having spent half of my life in the south (and I don't mean LA), perhaps I am only partially carpetbagging.…

Far be it for me, a Bay Area pediatrician, to tell Floridians about how to keep their kids safe. But having spent half of my life in the south (and I don’t mean LA), perhaps I am only partially carpetbagging.

Florida’s Governor Scott has signed a law that penalizes doctors for asking about guns in the home. It shockingly included a $5 million fine and a five year prison sentence if …

Patient voices

An ER specifically built for older patients

Brian Goldman, MD

August 24, 2011Aug 24, 20112

Seniors spend a lot of time at hospital ER's. Now, a small but growing number of hospitals in the US have built ER's especially for the aging patient - with wider hallways, motion detectors, hearing and visual aids. To me,…

Seniors spend a lot of time at hospital ER’s. Now, a small but growing number of hospitals in the US have built ER’s especially for the aging patient – with wider hallways, motion detectors, hearing and visual aids. To me, this is long overdue.

Older patients are avid consumers of emergency medical services. Older people make up a significant percentage of the total population of ER patients. A 2008 …

Conditions and diseases

Navigating the path of contradictory medical opinions

Ralph Gordon, MD

August 24, 2011Aug 24, 2011

With the advancement in healthcare and technology we are able to greatly extend the life expectancy of the population. For the healthcare provider that means that more elderly patients and patients with multiple chronic medical conditions are being admitted to the hospital. Some “complex” patients require a multidisciplinary approach with the involvement of multiple consultants.

As a primary attending physician for the patient you often have to deal with contradictory …

Medical education

How medical residents should spend their time off

Mary L. Brandt, MD

August 24, 2011Aug 24, 2011

Here’s the scenario. It’s Friday evening. You’ll be back at work on Sunday. You’re sleep deprived because you are a resident. You haven’t spent any quality time with your significant other, friends or family because you haven’t had any real time off. Next week has plenty of call and it would really help if you planned out good food for the week and cooked something. And, by the way, …

Health policy

Adapting the medical home for cancer care

Richard Just, MD

August 24, 2011Aug 24, 2011

It was 1967. I was an intern in the UCLA-Wadsworth VA Rotating Internship Program when I reported for my physical as part of the Berry Plan deferment. For the younger set, physicians and dentists could elect to delay military service until completion of their first year of residency training, and we could elect our branch of service we preferred to serve in. I chose the Air Force. On the History …

Conditions and diseases

Checking blood sugar is a habit that must be formed

Trey Stephens

August 24, 2011Aug 24, 20115

If you don’t know there is a problem how can you fix it? Checking blood sugar for a diabetic is mandatory. This applies to both Type I and II diabetics. I check my blood sugar at least 8 times per day. I do this to allow me to closely monitor my blood sugar level. As a disciplined diabetic, I run the risk of low blood sugar episodes more frequently …

Patient voices

Personal responsibility is needed to treat drug addiction

Randall S. Bock, MD

August 24, 2011Aug 24, 201134

A 44-year-old man came to my office to begin Suboxone in hopes of stopping his injecting heroin. He was raised well by married parents, whose other four children have not indulged in narcotics. He lives with a friend, unable to…

A 44-year-old man came to my office to begin Suboxone in hopes of stopping his injecting heroin. He was raised well by married parents, whose other four children have not indulged in narcotics.

He lives with a friend, unable to contribute to rent while “not working” yet somehow he affords $50 per day for narcotics through (self-admitted) hustling (comprising: working as one tentacle of the drug-dealers’ network, shoplifting, borrowing with no …

Physician voices

Why medicine actively and legally stifles innovation

Jay Parkinson, MD

August 23, 2011Aug 23, 201117

Upon finishing my second residency at Hopkins in Baltimore in September of 2007, I moved back to Williamsburg to start a new kind of practice: Patients would visit my website See my Google calendar Choose a time and input their…

Upon finishing my second residency at Hopkins in Baltimore in September of 2007, I moved back to Williamsburg to start a new kind of practice:

Patients would visit my website
See my Google calendar
Choose a time and input their symptoms
My iphone would alert me
I would make a house call
They’d pay me via paypal
We’d follow up by email, IM, videochat, or in person

It was simple, elegant, and affordable for me to start. But …

Health policy

How Medicare undermines primary care

Kohar Jones, MD

August 23, 2011Aug 23, 20118

When I was a family medicine intern, I met a diabetic patient in the hospital who had stopped seeing his regular doctor after he lost his job and his health insurance. His untreated diabetes made his feet go numb. He…

He spent thousands of dollars on the surgery and subsequent hospital stay—far …

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How Medicare undermines primary care

Real physician voices, twice a week

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