As if medical practices don’t have enough to worry about with EMR implementation, now they have to decide what kind of EMR system to get: a client-server-based system or a web-based system. The former is the kind that most of us are familiar with. You purchase a computer server, buy a license for the EMR software, install said software on your server, …
Pros and cons of cloud based or web based EMR systems
Recently I wrote a blog about how the American Academy of Pediatrics (AAP) thinks that otherwise healthy children with ear infections should wait a couple of days before starting antibiotics, because many will get better without them.
Now there are two articles in the New England Journal of Medicine (here and here) saying that children with ear infections who are given antibiotics are more likely …
Pediatrics is full of uncertainty, not unlike the practice of parenthood
The Theresa Brown furor has got me thinking. To be honest, I don’t think the doctor’s apparent offense was really that bad. I remember giving and taking worse.
When I was at medical school and in specialist training, there were senior doctors and nurses of legendary temper and bad disposition. Tiptoeing around them, and working to their satisfaction, however unreasonable, was an accepted part of the job. But the …
A tough disposition is required to endure physician training
Arnold Schwarzenegger’s revelation about his long-term affair with his household employee that involved a child being born is the latest in a string of powerful men with career ending flaws. Add to that the shocking arrest this week of powerful Dominique Strauss-Kahn for allegedly raping a hotel maid and we must ask, “What the heck is going on with these guys?”
I can’t count the number of heartfelt apologies that …
Why powerful men risk their family and career
I hear it all the time: “All these illegals are coming over here and they don’t pay taxes, but they get all these government handouts and they’re clogging up our health care system …”
I often point out that many undocumented immigrants actually do obtain a taxpayer identification number for the express purpose of paying taxes in hopes that if a path to …
The myth of undocumented immigrants using American health care
As 30-year-old New Yorker Carrie Donnelly began her bachelorette party in her new black open-toe five-inch heels, she fell, her foot going one way and her ankle the other.
“When I woke up the next day, my ankle was throbbing and had become extremely swollen,” she said. It was a month before her wedding—the last thing she wanted to do was to walk down the aisle in a cast.
Super-high heels like …
Prevent foot fractures while wearing heels
by Paul Rousseau, MD
Communication between physicians and patients is critical to quality care and improved outcomes, however, such discussions often seem labored and fraught with anxiety and stress.
Physicians commonly speak too much and listen too little, while patients feel swept up in an unfamiliar and frightening situation with loss of control and little-to-no input into care.
As I have …
Two words that hurt communication between physicians and patients
by Ashwin Patel
As a MD/PhD candidate, I enjoy learning how medicine interfaces with other fields. I found that MDs that have ventured into these fields have the best stories and insights to share.
I recently had the privilege of interviewing Dr. David E. Albert, MD. He’s a physician, a successful inventor with 30+ patents, and a serial entrepreneur. He has sold two of his companies, one to …
5 things I learned from a MD inventor and serial entrepreneur
Little has been written about the impact a malpractice lawsuit has on physicians.
But physicians who’ve been sued have a higher rate of suicide, and emergency physician Edwin Leap wrote about how doctors are emotionally scarred from the grueling ordeal of a trial.
A recent piece from American Medical News puts faces on the toll:
The key to surviving is having …
How malpractice hurts doctors and their future patients
Recently, an editorial from a plastic surgeon Lloyd Kreiger, MD, appeared in the Wall Street Journal entitled “ObamaCare Is Already Damaging Health Care.”
While I’m not sure I’m ready to concede that Obamacare has already damaged health care in America, I will agree the law is certainly is changing health care, aligning health care corporate interests with political interests, …
Predictions on the future of medicine after health care reform
May is National Osteoporosis Awareness Month.
Osteoporosis is a poorly understood concept amongst the general public, and perhaps the best way to explain it is the presence of an insufficient quantity of bone – the bone that is present, however, is normal (or properly mineralized). This can be contrasted with osteomalacia (or rickets, in children), …
Osteoporosis Awareness Month, and how to prevent early bone loss
by Andrew Schutzbank, MD
“He wants to go to Atlantic City for his research time?” must have been the question bouncing around my residency’s Area of Concentration (AOC) Committee.
Not that there is anything wrong with Atlantic City per se, but historically, our residency program generously grants three to six weeks of AOC time to allow residents to explore interests and …
Observations of a primary care innovator in Atlantic City
At the heart of medicine is the relationship between a doctor and a patient.
The more a doctor knows about his patients, the better. While visual changes and numbness might represent migraine symptoms for one patient, for another they could forebode a stroke. Having followed patients through the stages of life, participating in their medical experiences firsthand rather than solely reviewing those as written case-files — I can vouch that knowing …
How an ACO will affect the relationship between a doctor and a patient
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I have had the pleasure as a medical student to complete my clinical clerkships in the Baltimore area community hospitals, the Johns Hopkins Hospital, and the National Institutes of Health.
I will forever cherish these experiences and lessons as I progress through my career. With an educated and wealthy suburban population and a large disadvantaged urban population; Baltimore is symbolic of the challenges and opportunities the healthcare field faces.
There are different …
Primary care training and international medical graduates
Actually I’ll take a Ford Shelby GT500 Convertible, thank you very much …
Today’s stream of socially conscious thinking comes to you after having feasted on a tasty lunch paid for by a drug company (and no, it wasn’t Pfizer).
It has spurred me to contemplate the ever increasing scrutiny paid to the relationship between the pharmaceutical industry …
Lunch money Pharma spends on physicians
One aspect of religious dogma that has entered the medical world is that fee-for-service pricing of medical services is bad and should be replaced by a capitated, or global, arrangement that establishes an annual budget for care for different risk groups of patients.
Like other religious beliefs, this is often offered without rigorous analytic support. Some insurance companies are particularly pleased …
The problem with global, or capitated, payments to doctors and hospitals
I don’t know what your destiny will be, but one thing I do know: the only ones among you who will be really happy are those who have sought and found how to serve.
– Albert Schweitzer
The middle-aged Tanzanian woman lived many hours away and had traveled to the academic medical center in Moshi. She had now waited all day to see …
6 ENT physicians practicing in Tanzania, a country of 40 million people
Becoming a doctor is a long and arduous process. Between taking pre-med courses, taking the MCAT
, applying to medical schools, matriculating, then taking test after test after test until you take the big one (USMLE Step 1) before which you did questions all day long for weeks from a good USMLE question bank …
Why doctors should pursue another degree
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 26-year-old woman is evaluated for a 4-month history of amenorrhea. Menses began at age 13 years. At age 18 years, the patient was placed on an oral contraceptive pill to control heavy bleeding. She discontinued the oral contraceptive pill 4 months ago because she and …
MKSAP: 26-year-old woman is evaluated for amenorrhea
Dr. Elvira Aletta is a clinical psychologist with a unique perspective on what it’s like to live with a chronic illness. In her early twenties, she was diagnosed with nephrotic syndrome, a rare kidney disease that usually affects young boys. Then in her thirties, she came down with a chronic autoimmune condition called scleroderma.
She’d never heard of that, either. She describes her …
5 rules for living well with a chronic illness
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