KevinMD.com

August 12, 2011Aug 12, 20118

Patients want to know why they can't get a return call from their doctor's office – here are six reasons why the calls have increased and physician offices are having trouble meeting the needs of their patients. 1. Medication questions…

Patients want to know why they can’t get a return call from their doctor’s office – here are six reasons why the calls have increased and physician offices are having trouble meeting the needs of their patients.

1. Medication questions and requests for a prescription change. The average number of retail prescriptions per capita increased from 10.1 in 1999 to 12.6 in 2009 (Kaiser Family Foundation calculations using data from …

Conditions and diseases

An apology to patients with chronic fatigue syndrome

Toni Bernhard, JD

August 12, 2011Aug 12, 201116

I've been sick since 2001 when I failed to recover from what appeared to be an acute viral infection. It has left me mostly house-bound, often bed-bound. In effect, I've had the flu without the fever for almost ten years:…

I’ve been sick since 2001 when I failed to recover from what appeared to be an acute viral infection. It has left me mostly house-bound, often bed-bound. In effect, I’ve had the flu without the fever for almost ten years: the aches and pains, the dazed sick feeling, the low grade headache, the severe fatigue. It cost me my career as a law professor; it cost me the ability to …

Physician voices

There is no such thing as a complete physical examination

Lucy Hornstein, MD

August 12, 2011Aug 12, 2011

A reader writes, "Can you do a post on what procedures constitute a thorough physical, in your opinion? I haven’t had one in several years and thinking of making an appointment now. The last doctor I went to didn’t even…

A reader writes, “Can you do a post on what procedures constitute a thorough physical, in your opinion? I haven’t had one in several years and thinking of making an appointment now. The last doctor I went to didn’t even listen to my heart or go though the motions with feeling my belly and that stuff. And of the last 3 doctors I went to, I realized they didn’t …

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Physician voices

Do patients accept hurried, fragmented, disconnected care?

Steve Balt, MD

August 12, 2011Aug 12, 2011

A cover story by Gardiner Harris in the New York Times spotlights the changes in modern psychiatry, from extensive, psychotherapy-based interaction to brief, medication-oriented “psychopharm” practice. The article shares nothing new, particularly to anyone who has paid any attention to…

A cover story by Gardiner Harris in the New York Times spotlights the changes in modern psychiatry, from extensive, psychotherapy-based interaction to brief, medication-oriented “psychopharm” practice.

The article shares nothing new, particularly to anyone who has paid any attention to the rapid evolution of the psychiatric profession over the last ten years (or who has been a patient over the same period). While the article does a nice …

Conditions and diseases

How a nephrologist assesses your kidney function

Michael Aaronson, MD

August 12, 2011Aug 12, 2011

Doctors use laboratory values to interpret your medical condition. With respect to kidney disease, the BUN and the creatinine help your nephrologist (as well as your internist and family physician) determine if your kidneys are working correctly. These two tests are commonly ordered for many reasons and are invaluable tools to help your doctor assess your condition. Let’s define what BUN (pronounced by spelling out the letters “B”, “U”, …

Health technology

Are our privacy rules robust enough to protect our patients?

Dan McCoy, MD

August 12, 2011Aug 12, 20115

Ok, imagine this. You take a video of your little girl's soccer practice with your iPhone. Within moments it's posted on YouTube for the grandparents to see. Minutes later search engines called spiders begin to crawl across the data set…

Ok, imagine this.

You take a video of your little girl’s soccer practice with your iPhone. Within moments it’s posted on YouTube for the grandparents to see.

Minutes later search engines called spiders begin to crawl across the data set of images on your upload. Face recognition technology identifies a face on the video and, with some assistance from the geo-tagging of the built in GPS metadata that accompanied the upload, …

Physician voices

What this doctor learned when he was a patient

Doctor D, MD

August 11, 2011Aug 11, 201122

Doctor D has been blogging about the doctor-patient relationship for a while now. It’s sort of the thing I’m known for. I’ve usually been on the doctor side of this equation. Most of my blogging, however, is to help patients…

Doctor D recently found himself on the patient side of a nasty injury.

Even as Doctor D looked down and realized his leg wasn’t …

Health technology

AMA working to improve e-prescribing incentives and help physicians adopt health IT

American Medical Association & Cecil B. Wilson, MD

August 11, 2011Aug 11, 2011

A guest column by the American Medical Association, exclusive to KevinMD.com. Health IT holds the promise of improving the efficiency of a physician’s practice, but physicians can easily become overwhelmed by the broad range of products and the multiple, varying…

A guest column by the American Medical Association, exclusive to KevinMD.com.

Health IT holds the promise of improving the efficiency of a physician’s practice, but physicians can easily become overwhelmed by the broad range of products and the multiple, varying federal incentive and penalty programs currently underway. The American Medical Association (AMA) continues to be in close contact with the Centers for Medicare and Medicaid Services (CMS), advocating for changes to the …

Conditions and diseases

Women with these 5 pelvic symptoms should call their doctor

Neil Baum, MD

August 11, 2011Aug 11, 2011

For most women, a couple of irregular menstrual cycles or an occasional yeast infection are just a part of life -- nothing that time or simple treatment won’t cure. However, there are a few symptoms that warrant a call to…

For most women, a couple of irregular menstrual cycles or an occasional yeast infection are just a part of life — nothing that time or simple treatment won’t cure.

However, there are a few symptoms that warrant a call to the doctor. This article will cover when you should call your doctor for problems “down there”?

1. Pelvic pain. Pain at the time of ovulation is referred to as Mittelschmerz. However, if …

Patient voices

Caregiver burnout is just a fancy term for exhaustion

Maria Basso Lipani

August 11, 2011Aug 11, 20113

Are there moments when caregiving makes you want to scream? Any number of things related to caring for your aging parent can cause you to feel like you’re at the end of the proverbial rope including: your relationship with your…

Are there moments when caregiving makes you want to scream?

Any number of things related to caring for your aging parent can cause you to feel like you’re at the end of the proverbial rope including:

your relationship with your parent
elements of your work life/family life which are separate from, but inextricably linked to, your caregiving
the myriad experiences inside the elder care maze

But here’s where things get a bit dicey: While …

Health technology

How to choose a better health app

Alexander V. Prokhorov, MD, PhD

August 11, 2011Aug 11, 20113

From helping you wake up rested to getting couch potatoes ready for a 5K, there really is an app for everything. But when it comes to health apps, many don’t get the job done. Companies are often in such a…

From helping you wake up rested to getting couch potatoes ready for a 5K, there really is an app for everything.

But when it comes to health apps, many don’t get the job done.

Companies are often in such a hurry to sell their app that they don’t conduct a study to see if users will adopt real, lasting change. And, app stores don’t have medical reviewers who make sure health …

Read more…

How to choose a better health app

Patient voices

The problem with I Heart Boobies bracelets worn by middle school students

Ann Silberman

August 11, 2011Aug 11, 20119

Many of you know that a judge in Pennsylvania has determined that the popular "I Heart Boobies" bracelets worn by middle school students are a form of free speech intended to raise awareness of breast cancer and cannot be restricted…

Many of you know that a judge in Pennsylvania has determined that the popular “I Heart Boobies” bracelets worn by middle school students are a form of free speech intended to raise awareness of breast cancer and cannot be restricted by schools.

As much as I love a good double-entrendre, I find the entire situation to be sad, particularly the misinformed comments I’ve seen made by parents of …

Health policy

Health reform and the iron triangle of health care

Aaron E. Carroll, MD

August 11, 2011Aug 11, 201112

When I was in medical school, we had a class on health economics taught by William Kissick. I didn’t pay as close attention as I should have (especially given what I do now). But I remember one thing he stressed.…

There are three aspects of health care systems that are essential: quality, cost, and access (thus the triangle). The …

Conditions and diseases

Fever in children: 5 facts you must know

Natasha Burgert, MD

August 11, 2011Aug 11, 20116

A recent issue of Pediatrics includes a new report detailing the need for doctors to improve patient teaching about fever and fever-reducing drugs. Many parents fear their child getting a fever or have "fever phobia." I certainly can understand why.…

A recent issue of Pediatrics includes a new report detailing the need for doctors to improve patient teaching about fever and fever-reducing drugs.

Many parents fear their child getting a fever or have “fever phobia.” I certainly can understand why. Kids can do crazy things when they get fevers. They don’t sleep well, eat poorly, and behave strangely. Some children …

Medical education

Why work hour restrictions won’t improve patient safety

Kevin Pho, MD

August 11, 2011Aug 11, 20115

Darshak Sanghavi recently wrote an excellent piece in the New York Times summarizing the controversy over resident work hours. The topic has been discussed here frequently, with ramifications ranging from the fact that errors arising from patient handoffs negate any…

Darshak Sanghavi recently wrote an excellent piece in the New York Times summarizing the controversy over resident work hours.

The topic has been discussed here frequently, with ramifications ranging from the fact that errors arising from patient handoffs negate any benefit gained from restricting work hours, to surgeons not accumulating enough experience during their work hour-restricted training.

I’ve often …

Health technology

Google gave up on electronic personal health records, but we shouldn’t

Ross Koppel, PhD

August 11, 2011Aug 11, 20117

Which will improve a person’s health more? Running around the block for 20 minutes or sitting at a computer entering their cholesterol and blood pressure readings? The answer is one reason why Google’s decision to end its electronic personal health…

Which will improve a person’s health more? Running around the block for 20 minutes or sitting at a computer entering their cholesterol and blood pressure readings?

The answer is one reason why Google’s decision to end its electronic personal health record (PHR) service offers important lessons about health IT and will affect the way patients get their health information and the way physicians communicate with their patients.

A recent survey …

Patient voices

Explaining an abnormal pap smear is no longer simple

Nicholas Fogelson, MD

August 10, 2011Aug 10, 20115

As I look back over my 10 year career in obstetrics and gynecology, I am sometimes struck at how many things have been discovered in this time period. When I started the origin of pre-eclampsia was unknown, and now we…

As I look back over my 10 year career in obstetrics and gynecology, I am sometimes struck at how many things have been discovered in this time period.

When I started the origin of pre-eclampsia was unknown, and now we know that it likely originates in an overabundance of a molecule called Soluble FMS-Like Tyrosine Kinase, a competitive inhibitor to natural angiogenesis in the placenta. Ten years ago the origins of …

Medical education

Why the third year is the greatest year of medical school

Robert Centor, MD

August 10, 2011Aug 10, 2011

This post is dedicated to the many 3rd year students whom I have had the privilege to teach over the past 35 years. They continue to inspire me to help them become great physicians. They care. The third year of…

This post is dedicated to the many 3rd year students whom I have had the privilege to teach over the past 35 years. They continue to inspire me to help them become great physicians. They care.

The third year of medical school is wonderful, but it is a year of great change. Those readers who are physicians will completely understand, and I will try to explain to the non-physicians.

During the third …

Patient voices

Why don’t simple messages convince people to take action?

Christina Zarcadoolas, PhD

August 10, 2011Aug 10, 2011

It’s hard to find anyone who would argue against keeping things "plain and simple." Or would they? Is it possible that the imperative to create simple health information has over-promised – hasn’t lived up to its billing? What if the…

It’s hard to find anyone who would argue against keeping things “plain and simple.” Or would they?

Is it possible that the imperative to create simple health information has over-promised – hasn’t lived up to its billing? What if the complexity of health, science and technology information in the first half of the 21st century requires more than simple simplicity?

Think back to swine flu.

Dateline November 2009: We were awash in …

Patient voices

Every new scientific finding to be nothing more than a first draft

Dave deBronkart

August 10, 2011Aug 10, 2011

A recurring theme on e_Patients.net is the need for empowered, engaged patients to understand what they read about science. It’s true when researching treatments for one’s condition, it’s true when considering government policy proposals, it’s true when reading advice based…

A recurring theme on e_Patients.net is the need for empowered, engaged patients to understand what they read about science. It’s true when researching treatments for one’s condition, it’s true when considering government policy proposals, it’s true when reading advice based on statistics. If you take any journal article at face value, you may get severely misled; you need to think critically.

Sometimes there’s corruption (e.g. the fraudulent vaccine/autism data reported …

Real physician voices, twice a week

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