KevinMD.com

June 30, 2011Jun 30, 2011

Arriving in anatomy lab there was an obvious discontent in the air. People were slower to arrive than usual and then they were even slower to get changed in the locker room. Girls would start casual conversation, or would wait for 15 minutes for others to move from in front of their locker, just in the hopes that they would get 5 more minutes …

Health policy

A monetary value on each life saved

Benjamin Geisler, MD, MPH

June 30, 2011Jun 30, 20114

by Benjamin P. Geisler, MD, MPH A recent New York Times article on how to value a life drew almost two-hundred heavy-handed comments. It discussed how different governmental agencies such as the Food and Drug Administration (FDA), the Environmental Protection…

by Benjamin P. Geisler, MD, MPH

A recent New York Times article on how to value a life drew almost two-hundred heavy-handed comments. It discussed how different governmental agencies such as the Food and Drug Administration (FDA), the Environmental Protection Agency (EPA) or the Department of Transportation (DoT) place a monetary value on each life saved.

In many public policy areas, cost-benefit Analysis (CBA) is being used to assess whether an investment …

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A monetary value on each life saved

Physician voices

When you close an abdomen after a failed rescue, the OR is silent

Sid Schwab, MD

June 30, 2011Jun 30, 201115

I didn't know her name until it was over, much too late. What I knew was she was thirteen and that on this winter day someone in her family had been pulling her behind their car, on a sled. No…

I didn’t know her name until it was over, much too late.

What I knew was she was thirteen and that on this winter day someone in her family had been pulling her behind their car, on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled as …

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Conditions and diseases

Summer palpitations

Katherine Ellington

June 30, 2011Jun 30, 2011

It was early Saturday morning, I was making my plans for the day, crossing-off a few items that seemed unreasonable with others that had been accomplished. As I moved toward the kitchen, a voice from the living room bellowed "the…

Turning my head I could see bright rays of sunshine making a visible path through the open front door. My morning greeting followed …

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Summer palpitations

Health technology

Online physician access is key to future patient communications

Aaron George, DO

June 30, 2011Jun 30, 20117

Imagine using Skype to contact your physician for a consult. In the midst of this rapidly progressing technologic era, our delivery of medical services is being transformed by health information technology (HIT), electronic medical records (EMR), and advanced telecommunications. In…

Imagine using Skype to contact your physician for a consult.

In the midst of this rapidly progressing technologic era, our delivery of medical services is being transformed by health information technology (HIT), electronic medical records (EMR), and advanced telecommunications. In meeting criteria for “meaningful use,” physicians are driven to use these technologies to empower patients with communication through electronic medical records. A primary goal is to allow patients to …

Drugs and prescribing

Pharmacies selling prescription information to data mining companies

David Harlow

June 30, 2011Jun 30, 20114

Walgreens is being sued by customers who are not happy that their prescription information – even though it has been de-identified – is being sold by Walgreens to data-mining companies. The data privacy and security concerns surrounding the transfer of…

Walgreens is being sued by customers who are not happy that their prescription information – even though it has been de-identified – is being sold by Walgreens to data-mining companies.

The data privacy and security concerns surrounding the transfer of de-identified data are significant. To “de-identify” what is otherwise protected health information under HIPAA, some outfits will simply strip data of 18 types of identifiers listed in …

Physician voices

The decision point psychiatrists faced with psychotherapy

Daniel J. Carlat, MD

June 29, 2011Jun 29, 20118

There's been plenty of buzz about a recent New York Times story, "Talk Doesn't Pay, So Psychiatry Turns Instead to Drug Therapy" by Gardiner Harris. The story is essentially a profile of Dr. Donald Levin, a 68 year old psychiatrist…

There’s been plenty of buzz about a recent New York Times story, “Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy” by Gardiner Harris. The story is essentially a profile of Dr. Donald Levin, a 68 year old psychiatrist who has a private practice in Doylestown, Pa.

It is a poignant example of a common situation in psychiatry. Older psychiatrists were trained during a time when …

Patient voices

Using gender as sole determinant for a choice of doctor

Colleen Kelly Mellor

June 29, 2011Jun 29, 201111

It happened 25 years ago and I never forgot it. I’d been in the forefront of women’s consciousness-raising; I recognized that women had been professionally downtrodden for years (in certain fields), and hoping to do my part to balance the…

But using gender as sole determinant for my choice of doctor would prove to be a huge mistake … as I’d learn.

At …

Conditions and diseases

How autism affects social interaction

William R. Yates, MD

June 29, 2011Jun 29, 20114

One of the problems with understanding the natural history of autism is the lack of well-designed outcome studies in the disorder. Outcome studies tend to be expensive and grant agencies commonly do not fund studies longer than a few years. However, given the increased interest and funding in autism, I suspect there will be more research in this area.

An example of how outcome studies help in understanding the natural …

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How autism affects social interaction

Health technology

Google Health failed because consumers did not see the value of a PHR

Kent Bottles, MD

June 29, 2011Jun 29, 201117

To measure is to know. -Lord Kelvin If you can not measure it, you can not improve it. -Lord Kelvin Versus: Asking science to explain life and vital matters is equivalent to asking a grammarian to explain poetry. -Nassim Nicholas…

To measure is to know.

-Lord Kelvin

If you can not measure it, you can not improve it.
-Lord Kelvin

Versus:

Asking science to explain life and vital matters is equivalent to asking a grammarian to explain poetry.
-Nassim Nicholas Taleb

Technology is at its best when it is invisible.
-Nassim Nicholas Taleb

How can technology help us live healthier lives? Why did Google Health fail? Why are Klout and Twitter Grader publicly issuing a number to me …

Health policy

Reverse our attitudes and values to control health costs

John Kaegi

June 29, 2011Jun 29, 201110

by John Kaegi We all complain about the cost of health care and health insurance. Ours is by far the most expensive health care system in the world. And for the money, our health isn’t so hot either. On the…

by John Kaegi

We all complain about the cost of health care and health insurance. Ours is by far the most expensive health care system in the world. And for the money, our health isn’t so hot either. On the world stage, the U.S. ranks 37th in health care efficiency (a measure of health outcomes such as infant mortality, incidence of chronic disease, etc.) as reported by the World Health Organization. America …

Patient voices

Patients are often intimidated and confused by the medical experience

Dr. Peripatetic, MD

June 29, 2011Jun 29, 201116

As a recently minted physician, I am often on the receiving end of the gripes and grouses about the medical profession. Often I get complaints of office visits that are too short, doctors who seem too preoccupied to hear their…

As a recently minted physician, I am often on the receiving end of the gripes and grouses about the medical profession.

Often I get complaints of office visits that are too short, doctors who seem too preoccupied to hear their patients’ complaints, medical bills that are too high and medications that do nothing but cause adverse effects. On the other hand, I can’t count the number of times I have …

Medical education

Examining medicine through the lens of women’s rights

Emily Lu

June 28, 2011Jun 28, 201112

I’ve always had a hard time identifying myself as a feminist. I work for healthcare equality and human rights. Women’s rights seemed to me a part of human rights work (and as Hilary Clinton and others have said, woman’s rights…

I’ve always had a hard time identifying myself as a feminist.

I work for healthcare equality and human rights. Women’s rights seemed to me a part of human rights work (and as Hilary Clinton and others have said, woman’s rights are human rights). Tying myself to the feminist movement then seemed to be looking backwards – clinging to a term that was anachronistic, divisive and too narrowly defined in what activism …

Physician voices

How ordering tests sometimes have consequences for patients

Stewart Segal, MD

June 28, 2011Jun 28, 20114

Sometimes, you just can’t win! In medicine, sometimes is way too often. "Doc, do I need that test?" reviewed the issues surrounding screening colonoscopy exams. The dilemma is always the same. Do I order a test or don’t I? If…

Sometimes, you just can’t win! In medicine, sometimes is way too often. “Doc, do I need that test?” reviewed the issues surrounding screening colonoscopy exams. The dilemma is always the same. Do I order a test or don’t I?

If I order a test, there are consequences. Some are obvious; some are not. Tests cost money and money is in short supply. One consequence of ordering a test …

Physician voices

Why doctors shouldn’t leave their emotions behind

Michael A. Zadeh, MD

June 28, 2011Jun 28, 201110

Part of the reason I became a physician was because I got tired of watching those close to me as they suffered through illness and eventually died, while I stood helplessly by, unable to do a thing. Throughout my training…

Part of the reason I became a physician was because I got tired of watching those close to me as they suffered through illness and eventually died, while I stood helplessly by, unable to do a thing.

Throughout my training I watched as my mentors interacted with their patients, displaying a political correctness matched with just enough outward emotion so that there was no telling the difference between the good news and the bad.

“Don’t …

Patient voices

Avoiding confrontations and the difficulty of standing up for yourself

Susan Biali Haas, MD

June 28, 2011Jun 28, 20118

When I was 8, my mom went to a parent-teacher night at school. When she sat down with my teacher, the teacher smiled and said: "So how are Susan’s swimming lessons going?" My mom frowned, confused. "Susan isn’t taking swimming…

When I was 8, my mom went to a parent-teacher night at school. When she sat down with my teacher, the teacher smiled and said: “So how are Susan’s swimming lessons going?”

My mom frowned, confused. “Susan isn’t taking swimming lessons – perhaps you’ve confused her with someone else?”

“No, I’m sure,” my teacher insisted. “Susan told me that she has to leave at 3 o’clock every afternoon, right when the bell …

Physician voices

How to review the performance of your office staff

Rosemarie Nelson

June 28, 2011Jun 28, 20112

Your staff members are your most important (and costliest) resource. Have you invested in them? Do they know what is expected of them? Have you asked them if they have what they need to do their jobs? Optimizing staff performance…

Optimizing staff performance is a process. It starts with a plan, not the formal performance review.

You can’t do a successful performance evaluation without establishing accurate standards against which the employee’s performance can be …

Patient voices

How positive thinking affects patients with serious illnesses

Dr. Martin Young

June 28, 2011Jun 28, 201117

I was sick the other day. A bout of gastroenteritis that had me vomiting with diarrhea for 24 hours and feeling weak for another 48. I felt rough for a while, but got over it pretty quickly. My family gave me just the right amount of care, and avoided me appropriately because I get grumpy when I am sick.

Had they dared approach me with the suggestion that my state of …

Physician voices

Surgeons with depression and suicidal thoughts don’t get the care they need

Brian Goldman, MD

June 28, 2011Jun 28, 201112

When you think of surgeons, you likely picture heroes deftly using scalpels to pull patients back from the brink. But sometimes, as much as surgeons want to save someone, they simply can’t. A new survey finds that some of the men and women doing amazing feats of medicine in the OR don’t think quite so highly of themselves.

Suicidal thoughts could be the result of depression and job burnout. …

Real physician voices, twice a week

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