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Personalized health records and genomic tests for patients

Patient

April 18, 2011

Two articles recently highlighted two very different areas of medicine that are quickly colliding and pointing to a new direction for health delivery.

The first, published in the Wall Street Journal, discusses the steady rise of personalized health records through companies like Google, Microsoft, and WebMD. The second, published in USA Today, examines genetic tests and the disconnect between what is available and what physicians understand about …

Patient centered care and the family physician’s brain

Richard Young, MD

Physician

April 18, 2011

Paul Grundy is IBM’s Director of Healthcare, Technology and Strategic Initiatives for IBM’s Global Well Being Services and Health Benefits.

He has led the development of the Patient-Centered Primary Care Collaborative, which is leading the way to create a more efficient and responsive healthcare system. Before I go any further, let me be very clear by saying that his work is hugely important and I agree with 90% of what this …

Your child is a picky eater, and what to do about it

Melissa Arca, MD

Physician

April 18, 2011

Having a picky eater seems to be the norm these days. I’d almost dare to say that children between the ages of 2-7 more often than not wind up in the picky eater category.

Why the sharp jump in membership of The Picky Eaters Club during this time? Researchers believe it could be evolutionary. That way young “cave toddlers” wouldn’t walk around tasting every potentially dangerous thing in sight. Can you imagine?

Still, there …

To sell your practice or not: The decision facing most physicians today

Philippa Kennealy, MD, MPH

Health Policy

April 17, 2011

I took my eye off the ball for just a little while, and guess what happened? When I looked again, I discovered that familiar solo practitioner or small group physician medical practices are on the verge of disappearing. Going the way of the dinosaur.

At least, that’s what the pundits are saying.

In a recently published nifty newsletter, STAT Monthly, I read:

Primary care physicians and other specialists will continue to be the …

Read more…

To sell your practice or not: The decision facing most physicians today

Data overload and the pace of genomic science

Kevin

Health Technology

April 17, 2011

by W. Gregory Feero, MD, PhD

Articles in several major journals (Nature, Science, etc.) have noted that genomics research has entered an era of data measured in petabytes.

For readers who are not used to thinking on the scale of Avogadro’s number, peta refers to a number with 15 zeros tagging along. A petabyte is a lot of data—think 250,000 four-gigabyte thumb drives. Now, are you ready …

How an EMR emotionally disengages physicians from their patients

Richard Barager, MD

Health Technology

April 16, 2011

“See me, feel me.”

Yes, that’s right, the title of a song played at Woodstock by The Who—at sunrise of the third day, no less—is the title of my post. The song begins with those very words sung in dramatic refrain, followed by four more: Touch Me/Heal Me.

The same four imperatives succinctly describe the essence of what patients want from their doctors. But in the age of the EHR (Read more…

How an EMR emotionally disengages physicians from their patients

MKSAP: 63-year-old woman with a 4 week history of fatigue

mksap

Conditions and Diseases

April 16, 2011

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

A 63-year-old woman is evaluated during a follow-up visit for a 4-week history of fatigue; pain in the proximal interphalangeal joints, knees, and hips; and low-grade fever.

She has not had joint swelling, chest pain, or shortness of breath. Over the past 4 years, she has …

Is health care ready for the iPad and other new technology?

Gary Oftedahl, MD

Health Technology

April 16, 2011

I think I may have a problem, but it’s not clear exactly what it is, or if it even truly is a concern.

I’m not a “techie” so to speak. I have trouble figuring out how to enter the code for my garage door opener without making some fundamental mistake, due to a deficit embedded in my cerebral cortex at some level. But that is not coupled with an associated lack …

Judicious use of complex medical procedures

Kevin

Physician

April 15, 2011

by Shanti Bansal, MD

In the cardiac catheterization lab one Tuesday morning, I encountered a situation that made me reflect on a bit of 18th-century British history.

At that time, the British government was overburdened with prisoners. A plan was hatched for sea captains to transport many of them to Australia. Due to poor conditions, up to one third died on the voyage. Politicians and clergy members …

Where an adult can get low cost vaccines

Leslie Ramirez, MD

Patient

April 15, 2011

At LesliesList.org we get many emails asking where an adult can get low cost vaccines.

It appears the answer is… nowhere. They don’t exist– unless you are an established patient in one of the county-funded or low-cost clinics in your metropolitan area. However, you can save a little money by comparison shopping. I think your best bet is to try one of the walk-in …

Should older doctors be allowed to opt out of EMR?

Mike Koriwchak, MD

Health Technology

April 15, 2011

A fair amount has been written on EMR for the individual physician facing retirement.

But I have come across a more complicated variation of the question. What if a multi-physician group has one physician approaching retirement who is the “lone hold-out,” opposing EMR while the rest of the docs in the group are ready to take the plunge?

The older physician has a …

Can doctors learn surgical skills on YouTube and Facebook?

Dr. Martin Young

Physician

April 15, 2011

I am a self-taught bass guitarist in a church band, and, to be honest, it sometimes shows. I know I need to improve my skills, but time commitments make formal lessons difficult. So two days ago I opened up YouTube and entered “bass guitar lessons” into the search box.

19,000 hits registered. I selected a few that looked good on …

True Grit and sharing decisions on health care with our doctors

Jessie Gruman, PhD

Patient

April 15, 2011

In the recent Coen brothers’ remake of the 1969 movie True Grit, Mattie Ross, an intrepid 14-year-old, is determined to hunt down and kill the man who murdered her father.

To accomplish this, she hires U.S. Marshal Rooster Cogburn, (played by a mumbling Jeff Bridges) a rough, one-eyed veteran of many such quests – then announces that she plans to come along. She figures she is prepared.

After all, she and her …

Natural forces within us are the true healers of disease

Hans Duvefelt, MD

Physician

April 14, 2011

In my forays into the history of medicine I came across these six little words by Hippocrates.

They seem strangely modern, almost like something you might find on a Hallmark-card for today’s medical school graduates. I don’t know how old the translation is and I couldn’t understand the original text if I tried – but these simple words really touched me when I …

AMA: Getting the best value for our health care dollars

Cecil B. Wilson, MD

Physician

April 14, 2011

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

As physicians, many of us realize on some level that our practices contribute to our state and national economies – we just lacked the empirical evidence to understand how much.

That changed last month, when the American Medical Association released a report that studied the economic impact of office-based physicians. While a handful of states have previously studied the economic impact …

How to sabotage a doctor’s appointment

Diana E. Lee

Patient

April 14, 2011

by Diana E. Lee

None of us really wants to sabotage a doctor’s appointment through our own behavior. But it’s easy to do just that by not paying attention to the factors within our control that affect the quality of our appointments.

These are some behaviors to avoid at all costs:

1. Show up late for appointments. It’s an unfortunate …

Read more…

How to sabotage a doctor’s appointment

A healthy plan for dining out

Kevin

Patient

April 14, 2011

by Sally Scroggs, RD

About 130 million Americans will eat out on any given day this year. While dining out shouldn’t mean “pigging out,” picking a salad over cheese fries can sometimes be difficult.

According to the American Cancer Society, making healthy food choices is one of the most important things you can do to reduce your cancer risks. But nutritional experts say many of us don’t make good …

Read more…

A healthy plan for dining out

How an ACO will affect physicians and Medicare patients

Benjamin Geisler, MD, MPH

Health Policy

April 14, 2011

by Benjamin P. Geisler, MD, MPH

Everybody is talking about Accountable Care Organizations or ACOs these days.

The reason being that the Centers for Medicare and Medicaid Services or CMS has released the rules for shared savings between ACOs and CMS.

The complete proposed rule is 429 pages long and they’re seeking comments on it now until early June.

What is an ACO?

ACOs will take care of …

Sixteen stab wounds, seriously delivered

Sid Schwab, MD

Physician

April 13, 2011

She was a Korean woman, spoke passable English. We always exchanged pleasantries, and she called me “doctor” when I picked up my laundry. This time she was notably quiet, distant.

I didn’t figure it out until I got home and hung up my jacket, on the inside of which I noticed she’d pinned an envelope. It contained a photo I’d taken months ago, left and forgotten in one of my pockets. …

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