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A confident, independent, empowered woman is a force to be reckoned with

Physician

April 5, 2011

I am infinitely blessed by The Girl Effect. As I look back through the generations of my family, I see it rolling toward me, through me like a wave.

I am sure it started even before my grandmother stole her parents’ car with intent to drive by herself from Austin to Chicago to see the World’s Fair in 1924; I just don’t have much history to work with prior to that. …

A medical student goes back to the anatomy lab before residency

Kevin

Medical Education

April 5, 2011

by Christopher Bayne

I still remember the first time I entered the anatomy lab. Heck, I remember the first time I entered the hallway leading to the anatomy lab.

I wouldn’t say an anatomy lab “smells.” That is, an anatomy lab doesn’t smell “bad”: the odor can’t be defined as good or bad. Really, it’s neither. But the scent is distinctive. If you’ve been …

The Relative Value Scale Update Committee (or RUC) impact on health care

Brian Klepper, PhD

Health Policy

April 5, 2011

On Kaiser Health News, Barbara Levy MD, the Chair of the AMA’s Relative Value Scale Update Committee (or RUC), published a glowing defense of the RUC’s activities.

Her article extols the work of the 29 physician volunteers who, “at no cost to taxpayers … generously volunteer their time, supported by advisers and staff from more than 100 national medical specialty societies and health care professional organizations.”

She fails to mention that the …

Patients can lift doctors up during a challenging day

Linda Pourmassina, MD

Patient

April 4, 2011

I will be leaving my current practice in a couple months and starting work at a different clinic in a different city. This type of transition really brings to light how much I had really gotten to know patients on a personal level. This became surprisingly clear not too long ago.

One day, I saw a patient on my schedule that had historically required more of my emotional energy. We often …

After the ACO regulations: Accountable care organization answers

Kevin

Health Policy

April 4, 2011

by Jeffrey L. Cohen

Patient centeredness, fragmentation and value based purchasing are just a few of the terms that are peppered throughout the newly proposed regulations for accountable care organizations (ACOs).

The healthcare reform law established the Medicare Shared Savings Program for Read more…

After the ACO regulations: Accountable care organization answers

Doctors are trained to prevent death, but not deal with death

S. Irfan Ali, MD

Physician

April 4, 2011

It was a dimly lit room, up on the sixth floor. I am not sure why they would not fix the light in that corridor. Even during the day, I would find this area poorly lit.

Maybe it was not the light but the grim atmosphere of oncology floor. Some of the patients there had terminal illnesses but they would still act like they had decades to live. You would be …

Treatment of chronic pain puts doctors in a no win situation

Edward Pullen, MD

Physician

April 4, 2011

First do no harm.

Treat every patient with respect and dignity.

These are values I try to live by and incorporate into my daily work. Treatment of chronic pain is the scenario that puts me and every practicing primary care physician in a no-win situation regularly in the office. To try to make physicians feel more comfortable treating pain most states have tried …

Cyberchondria repackaged as new local TV health news

Gary Schwitzer

Patient

April 4, 2011

So I’m watching the 6 pm local news last night and see a piece on KARE-11, my local NBC affiliate, about “a new buzzword called ‘cyberchonrdria'” — used to describe people who “Google their symptoms online and then worry over the multitude of results and possible diagnosis …”

But it’s clear from what they posted online that this was not …

How to make money off the mentally ill

Dennis Grace

Patient

April 3, 2011

by Dennis Grace

Recognize the title? It’s from Steve Martin’s 1978 stand-up album, Wild and Crazy Guy. Martin lists How to Make Money Off the Mentally Ill as one of the many books he’s written. The joke is supposed to be on Martin himself, inviting us to ask, “What kind of disreputable jerk takes advantage of the mentally ill?”

But it’s just a …

Read more…

How to make money off the mentally ill

How academic physicians are being used as live bait for journalists

Larry Husten, PhD

Physician

April 3, 2011

Here’s something little known outside of the small circle of industry marketers, academic docs, PR flacks, and medical journalists: pharmaceutical and device companies (or their PR agencies) regularly offer to arrange interviews with well-known academic physicians to talk about new trials, drug approvals, and other items of obvious interest to the companies involved.

I receive these sort of invitations all …

Can ACOs curb health costs and improve quality of care?

Robert Rowley, MD

Health Policy

April 2, 2011

Accountable Care Organizations (ACOs) have received considerable attention recently, and are the new “hot topic” in healthcare delivery policy circles. They are the latest response to the need to do something to stem the runaway inflation of healthcare costs, while maintaining or improving measurable health care quality.

According to a …

MKSAP: 28 year old woman with easy bruising and bleeding gums

mksap

Conditions and Diseases

April 2, 2011

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

A 28-year-old woman has a 3-month history of easy bruising and bleeding gums. She feels otherwise well. Medical and family histories are unremarkable, and she takes no medications.

On physical examination, temperature is normal, blood pressure is 110/70 mm Hg, pulse rate is 64/min, and respiration rate …

The futility of prolonging life and the benefit to patients

ER Stories, MD

Physician

April 2, 2011

In case you have not heard about it, there is a very gut wrenching court case St Louis Park, MN. A doctor in the hospital system is going to court to replace a patient’s wife, Lana Barnes, with a substitute decision maker, claiming that she is making futile and reckless decisions to prolong her near-vegetative husband’s life.

He has …

Debt prevents health insurance from providing more health care access

WhiteCoat, MD

Health Policy

April 1, 2011

I read an article in the New York Times that underscores my argument that health care insurance does not and never will equal health care access.

Our federal and state governments are being crushed by debt. There are many reasons for that debt, and addressing the reasons for the debt are a necessary aspect of decreasing the debt. For example, if a family household had overdrawn its checking account by …

Dangers of strict adherence to clinical guidelines

Douglas Perednia, MD

Physician

April 1, 2011

Medical guidelines are well on their way to becoming the Law of the Land. Dr. Rich over at The Covert Rationing Blog featured a recent post that highlighted this point.

When a study published in the Journal of the American Medical Association showed that nearly 23% of patients receiving implantable cardioverter-defibrillators (ICDs) received them under circumstances that did not match up with the recommended “guidelines” for doing so, this breach of …

Why medical education needs to evolve away from memorization

Josh Herigon, MPH

Medical Education

April 1, 2011

Skeptical Scalpel writing at KevinMD.com in a post giving some advice to second year medical students nails the problem with medical education on the head:

Rather than forcing [medical students] to memorize information, we should be teaching you how analyze and synthesize it as it relates to your patient.

Our increasingly sophisticated and robust understanding of the pathophysiology of human disease processes coupled with the growth in diagnostic testing power …

Artificial intelligence and capturing quality information into your EHR

Kevin

Health Technology

April 1, 2011

by Janet Dillione

Are we ready to deliberate on how artificial intelligence will be used in healthcare? While the future role of innovation as part of healthcare is certain, it’s critical that we first focus on achieving what is possible and absolutely necessary today.

There’s been tremendous attention on IBM’s work with Nuance to bring Watson (supercomputer) to healthcare, and rightfully so, it’s a fascinating application of technology. However, …

The relationship between parents and pediatricians

Yolanda Wong, MD

Physician

April 1, 2011

It’s strange being on the other side for a change. I remember bringing my son to his first doctor’s appointment. A new mom. No stethoscope around my neck. No patient schedule, replaced instead by the constant grind of breastfeeding.

I knew it was just another routine newborn check for our pediatrician, but every maternal fiber in me believed that my son must be the cutest baby that ever walked through that clinic. …

Diagnostic errors and their role in patient safety

Charles A. Pilcher, MD

Physician

March 31, 2011

American Medical News published an informative essay by Kevin B. O’Reilly on December 13, 2010, about errors in diagnosis and why doctors make them.

According to Gordon Schiff, MD, associate director of the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital, “The problem of diagnostic errors has gotten short shrift in the broader patient safety movement.” The article focused on …

How an EMR can be shockingly inconvenient for prescription refills

Paul Sax, MD

Health Technology

March 31, 2011

Let me start by confessing I’m something of a gadget freak. I was an early Palm Pilot adopter, loved the iPod from the get-go, and need to avoid CNET, Engadget, Gizmodo, and David Pogue’s columns for the New York Times when deadlines loom.

Not surprisingly, I embraced the shift to electronic medical records (EMRs) enthusiastically. While I acknowledge that sometimes EMRs …