KevinMD.com

July 6, 2011Jul 6, 20119

Although Jack Kevorkian was only a few years older than I was, and we both practiced pathology in southern California for many of the same years, I never met Dr. Kevorkian. I found him from a distance to be a…

Although Jack Kevorkian was only a few years older than I was, and we both practiced pathology in southern California for many of the same years, I never met Dr. Kevorkian.

I found him from a distance to be a deeply odd character, and a profoundly flawed messenger but with a profoundly correct message.

I can’t improve on the quick summary of Jack Kevorkian by an unnamed author that the New …

Patient voices

Use the National Cancer Institute’s Cancer Information Service

Erin Marcus, MD

July 5, 2011Jul 5, 2011

Brenda Bryant learned she had breast cancer while she was sitting alone in her car in the parking lot of her grandson's day care center. It was early evening on a Friday two years ago, and her surgeon called to…

Brenda Bryant learned she had breast cancer while she was sitting alone in her car in the parking lot of her grandson’s day care center. It was early evening on a Friday two years ago, and her surgeon called to tell her the results of a biopsy. “He just gave me my results and that was it,” says Bryant, who lives in Northern Virginia. “It was like there was …

Health policy

Cost of care is related to the advancements in medicine

Doc B, MD

July 5, 2011Jul 5, 201125

Much is being written about the ever increasing cost of health care in the US, especially compared to the rest of the developed world. As a nation, we spend nearly 16% of our GDP on health care. All estimates predict…

Much is being written about the ever increasing cost of health care in the US, especially compared to the rest of the developed world.

As a nation, we spend nearly 16% of our GDP on health care. All estimates predict that this amount will continue increasing unless costs can be controlled now. Hence the passage of the Affordable Care Act. Not only was it designed to extend coverage to more …

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Drugs and prescribing

Using genomic data to understand disease entities

Douglas Elwood, MD, MBA

July 5, 2011Jul 5, 2011

Three recent studies point to the continued presence and increasing importance of genomic information to improving health care. We have discussed the power of personalized medicine in multiple posts and highlighted the potential of genomics and though this movement is…

Three recent studies point to the continued presence and increasing importance of genomic information to improving health care.

We have discussed the power of personalized medicine in multiple posts and highlighted the potential of genomics and though this movement is really still in its infancy it is a burgeoning component of medicine.

The first study, published in the American Journal of Gastroenterology, explores Helicobacter pylori, a common …

Drugs and prescribing

Vaccines to prevent or treat non-infectious chronic illnesses

Stephen C. Schimpff, MD

July 5, 2011Jul 5, 2011

A major megatrend in medicine will be the use of vaccines to prevent or treat (non infectious) chronic illnesses. Although we tend to think of vaccines for preventing infections there are now two vaccines that prevent cancer (via preventing the…

A major megatrend in medicine will be the use of vaccines to prevent or treat (non infectious) chronic illnesses.

Although we tend to think of vaccines for preventing infections there are now two vaccines that prevent cancer (via preventing the infections that are in part causative), one vaccine on the market to treat residual cancer and many vaccines in development to prevent or treat other cancers …

Physician voices

Why HB 155 undermines the trust doctors have with patients

James Logan, MD

July 5, 2011Jul 5, 201125

Do doctors have any business asking patients about whether or not they own a handgun? Like many other paternalistic inquiries with which doctors routinely harass their patients (car seats, bicycle helmets, smoke alarms, etc), my answer to this question is…

Do doctors have any business asking patients about whether or not they own a handgun?

Like many other paternalistic inquiries with which doctors routinely harass their patients (car seats, bicycle helmets, smoke alarms, etc), my answer to this question is “no.’”

There is a fairly well delineated sphere of knowledge which is medical in nature and in which I have some expertise and other topics which are purely personal, moral, or lifestyle considerations and in …

Physician voices

Death is inevitable, but it is almost always seen as tragic

Rob Lamberts, MD

July 4, 2011Jul 4, 201111

Everyone liked him. Though his later years (the only ones in which I knew him) took away his ability to do most things, and though he was in great pain every day, it was easy to see the mischief in his eyes. The subtle humor was still there, coming out of a man who was weak, in pain, dying.

She lived for him. She was always telling me of his pain, …

Physician voices

Not engaging in end of life discussions is grounds for malpractice

Barry Massie, MD

July 4, 2011Jul 4, 201111

by Barry Massie, MD It’s not that I am fixated on death, but recently, the CMS (Medicare) has decided not to pay for discussions with patients about prognosis and planning end of life care. Reimbursement for such discussions was a…

by Barry Massie, MD

It’s not that I am fixated on death, but recently, the CMS (Medicare) has decided not to pay for discussions with patients about prognosis and planning end of life care.

Reimbursement for such discussions was a key aspect of the health care reform legislation passed this year, and was widely mischaracterized as establishing “death panels.” I cannot imagine a legitimate justification …

Conditions and diseases

Medicare should stop paying for prostate cancer screening in men over age 75

Kevin Pho, MD

July 3, 2011Jul 3, 201129

The following op-ed was published on June 1st, 2011 in the New York Times’ Room for Debate blog. Medicare should stop paying for prostate cancer screening in men over the age of 75. You may be surprised to hear that,…

The following op-ed was published on June 1st, 2011 in the New York Times’ Room for Debate blog.

Medicare should stop paying for prostate cancer screening in men over the age of 75.

You may be surprised to hear that, especially coming from a primary care doctor. But evidence is mounting that screening for prostate cancer is not only ineffective in older men, but may actually be harmful.

The cornerstone of …

Health technology

Medicine and the examples of unintended effects of technology

Mike Koriwchak, MD

July 3, 2011Jul 3, 20114

The interaction of humans and technology will always be unpredictable. A few months ago this thought was driven home to me in a rather malodorous manner. I have obstructive sleep apnea (OSA) and use a CPAP machine every night to…

The interaction of humans and technology will always be unpredictable. A few months ago this thought was driven home to me in a rather malodorous manner.

I have obstructive sleep apnea (OSA) and use a CPAP machine every night to sleep comfortably. With OSA your airway collapses when you fall asleep. A CPAP machine is a small technological marvel, quietly delivering heated, humidified air under gentle pressure through a …

Conditions and diseases

MKSAP: 69-year-old woman with pain and swelling in the knee

mksap

July 2, 2011Jul 2, 2011

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 69-year-old woman is evaluated for a 5-day history of pain and swelling in the right knee that developed after a prolonged period of…

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

A 69-year-old woman is evaluated for a 5-day history of pain and swelling in the right knee that developed after a prolonged period of gardening in her backyard. Her pain worsens when she walks and is relieved with rest. She has no morning stiffness.

On physical examination, …

Drugs and prescribing

What do hospice nurses and teenage heroin addicts have in common?

Richard Barager, MD

July 1, 2011Jul 1, 201127

What do hospice nurses and teenage heroin addicts have in common? One may be an unintended consequence of the other. A pair of articles published recently in two prestigious medical journals help make the case. The Lancet reported that 47…

What do hospice nurses and teenage heroin addicts have in common? One may be an unintended consequence of the other.

A pair of articles published recently in two prestigious medical journals help make the case.

The Lancet reported that 47 million of the 58 million deaths occurring annually worldwide take place in developing countries, and that of these, fully 27 million die without having received proper palliative care. The article attributes …

Patient voices

Measuring physician trust in patients

Jessie Gruman, PhD

July 1, 2011Jul 1, 20115

Members of the American public are frequently surveyed about their trust in various professionals. Doctors and nurses usually wind up near the top of the list, especially when compared to lawyers, hairdressers and politicians. Trust in professionals is important to us: they possess expertise we lack but need, to solve problems ranging from the serious (illness) to the relatively trivial (appearance).

How much professionals trust us seems irrelevant: our reciprocity is …

Read more…

Measuring physician trust in patients

Conditions and diseases

Analyzing the reporting of lung cancer CT screening

Gary Schwitzer

July 1, 2011Jul 1, 2011

It's been another challenging week for journalists covering various screening stories. First the new analysis of Swedish mammography studies: Some familiar flaws surfaced in some stories. Then came the followup analysis of the National Lung Screening Trial - first reported…

It’s been another challenging week for journalists covering various screening stories.

First the new analysis of Swedish mammography studies: Some familiar flaws surfaced in some stories.

Then came the followup analysis of the National Lung Screening Trial – first reported last fall.

This week various headlines announced:

More evidence CT scans better at detecting lung cancer
Study bolsters evidence that screening reduces lung cancer deaths
Nat’l Study Shows Long-Term Smokers Should Get Lung

…

Conditions and diseases

Dwyane Wade and the NBA’s insensitivity to his migraines

Diana E. Lee

July 1, 2011Jul 1, 20115

by Diana E. Lee Sports journalists recently discussed discussing Dwyane Wade's migraines and his decision to try wearing goggles to deal with light sensitivity. News outlets like ESPN proved once again they know how to treat migraine disease as a…

by Diana E. Lee

Sports journalists recently discussed discussing Dwyane Wade’s migraines and his decision to try wearing goggles to deal with light sensitivity.

News outlets like ESPN proved once again they know how to treat migraine disease as a serious, burdensome medical issue in reporting on Wade’s health situation. But somehow at the eleventh hour the story got way more complicated and the NBA revealed they don’t …

Physician voices

How direct primary care reduces primary care costs

Dave Chase

July 1, 2011Jul 1, 201127

In an age of family physicians literally not being able to give away their practices, Brian Forrest has built a successful model that is similar to the age of Marcus Welby where there was a direct relationship between a patient and their doctor. Practices such as Forrest’s Access Healthcare in North Carolina run unencumbered by insurance hassles.

As word of Dr. Forrest’s …

Conditions and diseases

Sometimes the treatment is worse than the disease

Hans Duvefelt, MD

June 30, 2011Jun 30, 20115

To do nothing is sometimes a good remedy. -Hippocrates Edna Frost is 88 years old, a slender, slow-talking woman with a dry sense of humor and a blood pressure that’s all over the place. At best, she runs ten points…

To do nothing is sometimes a good remedy.
-Hippocrates

Edna Frost is 88 years old, a slender, slow-talking woman with a dry sense of humor and a blood pressure that’s all over the place. At best, she runs ten points higher than any of her previous doctors wanted to put up with. At worst, she flirts with systolics over 200, but that doesn’t seem to be a common occurrence.

Edna has been my …

Real physician voices, twice a week

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