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A surgeon on those who understand murderers, rapists and child molesters

bongi, MD

Physician

March 21, 2011

(Editor’s note: reader discretion advised)

Recently I was involved in a discussion with a guy that was explaining how we should understand criminals. The emphasis was on farm murders but we touched on murderers in general, rapists and child molesters. My point of view was that I did not understand them and felt that he was justifying their actions. In the end I was informed that I was smug. Apparently that …

Family physicians who care for underserved patients

Kenneth Lin, MD

Physician

March 21, 2011

One of the ugliest incidents in my career occurred during my faculty development fellowship year, when I spent two days each week seeing patients at several federally qualified community health centers in inner city Washington, DC. Midway through the year, I was transferred from a health center that served an African-American population to one serving a mostly Spanish-speaking clientele.

Nearly all of the permanent Read more…

Family physicians who care for underserved patients

How obesity is like alcoholism

Arya M. Sharma, MD

Conditions and Diseases

March 21, 2011

Recently, I attended a scientific symposium on addictions.

One of the books I picked up at that conference, and read on my flight to Montreal, is A. J. Adams’ Undrunk: A Skeptic’s Guide to AA.

While this book is a very quick and highly readable introduction to AA (Alcoholics Anonymous), about which I knew very little, today’s post is not about this book.

The definition reads as follows:

Alcoholism is a primary chronic disease …

Read more…

How obesity is like alcoholism

Prostate cancer from a patient perspective

Kevin

Conditions and Diseases

March 21, 2011

by Dan Zenka

As a patient, I feel for anyone who is given a diagnosis of prostate cancer. Hearing the “Big-C” word can be upsetting enough. But the complexity of the disease—diagnosing it, trying to characterize it and selecting the appropriate treatment—can feel like insult upon injury. We need to talk about prostate cancers. With 24 known sub-types of this cancer—from …

Concierge and primary care medical home hybrid model of care

Mark W. Browne, MD

Health Policy

March 21, 2011

As a consultant, I spend a lot of time on airplanes and subsequently get to meet a new “person in the next seat” almost every week. Once the small talk is over, the conversation is nearly the same every time. “Oh, you work in healthcare! What do you think about all of this reform stuff anyway? Is there an answer?” I’m always very cautious how I frame my answer. As those …

Evaluating dizziness in the cardiologist’s office

Eric Van De Graaff, MD

Conditions and Diseases

March 20, 2011

I see a lot of patients who are sent to me for evaluation of dizziness. On the surface you wouldn’t think a cardiologist would have much to do with a symptom that relates more to the head than the heart, but there is some logic to it—poor blood flow to the brain could lead to dizziness and, since blood flow starts in …

Uncertainty in the diagnostic methods of the obstetrician

Kevin

Physician

March 20, 2011

by Henry Dorn, MD

In 1974, the noted obstetrician Marcus Filshie published a review of the relatively new electronic fetal monitoring in the British Journal of Hospital Medicine. He stated, somewhat fatefully:

Now that the appropriate technology is available, the obstetrician may virtually eliminate intrapartum stillbirths and reduce morbidity to a minimum.

Similar statements were made in the United States by leaders in the obstetrical …

Huge holes exist in the health reform law

Richard Reece, MD

Health Policy

March 19, 2011

Huge holes exist in the health reform law you can drive an 18-Wheeler through. These holes are not “devils in the details.” They are so obvious nobody talks about them. They are the proverbial elephants in the room. I suppose this makes sense. It takes an 18-wheeler to transport …

Slowing health costs requires answering 3 simple questions

Donald H. Taylor, PhD

Health Policy

March 19, 2011

If we ever slow health care cost inflation to a sustainable pace, it will be because we learn how to ask 3 simple questions when thinking about a medical treatment.

Does it improve quality of life for the patient?
Does it extend the patient’s life?
How much does it cost?

Asking the questions are of course much simpler than figuring out the …

A global view on effectiveness research

Christopher Johnson, MD

Health Policy

March 18, 2011

We badly need effectiveness research — which medical treatments work and which ones don’t. After all, some reasonable estimates are that a third or so what we spend on medical treatments is for things that aren’t known to work, or worse, don’t work. Effectiveness research means comparing two competing therapies to see which works better; if both work the same, our preference …

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A global view on effectiveness research

Osteopathic medicine and the growth of D.O. graduates as physicians

Tayson DeLengocky, DO

Physician

March 18, 2011

by Tayson DeLengocky, DO

The landscape of healthcare delivery has changed so drastically over the past three decades with the proliferation of allied health professions, increased in medical specialization, managed health care, and technology advancement.

The direct doctor-patient relations have been relegated to the relations between healthcare providers and patients, in which doctors are only participants among other healthcare givers. A healthcare consumer, patient, can be easily further confused when visiting medical …

Rules to help you during medical school

Mary L. Brandt, MD

Medical Education

March 18, 2011

Medical school is a wonderful, but at times difficult experience. As you start this fantastic journey, there are a few “rules” I think might help.

1. You can drink from a fire hydrant, but you’ll need to learn how. The amount of information you are going to be exposed to in medical school is logarithmically more than you had to learn in …

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Rules to help you during medical school

Emotional issues that come with cancer during the teenage years

Stephen C. Schimpff, MD

Patient

March 18, 2011

When Clarissa was 13 she entered Johns Hopkins Hospital to be treated for relapsed acute leukemia knowing full well that she had only a 40% chance of survival. Today she is 16 and in excellent health. But it took 2 1/2 years of incredibly rigorous treatments to get there. Equally importantly it meant riding an emotional roller coaster for her and her parents.

Clarissa had …

Supportive physicians and management to implement an EHR

Ron Sterling

Health Technology

March 18, 2011

From Medicare/Medicaid incentives to EHR industry ads, it is hard to cut through the hype and determine if your practice is even ready to try to select and implement an EHR.

Implementing an EHR is a transformational exercise for any practice that requires redesigning every aspect of charting, clinical workflow and interaction with patients. However, in too many cases, practices approach EHR …

Cancer patients get better care than patients in primary care

Shantanu Nundy, MD

Physician

March 17, 2011

Why do my patients with cancer get better care than my patients in primary care? As the senior resident on my hospital’s inpatient leukemia service recently, this question troubled and intrigued me daily.

Despite the sheer complexity of treating leukemia (administration of chemotherapy, bone marrow biopsies, stem cell transplantation), the resources required (transplantation routinely costs $1 million), and the severity of the illness …

The next generation of public health won’t involve the medical world

Jay Parkinson, MD

Health Policy

March 17, 2011

I received my Masters in Public Health from Johns Hopkins in 2006. I took a course on transportation safety where we focused on designing roads for safety, making airlines safer, and decreasing the risk of medical helicopter crashes.

In 2007, I worked for Public Citizen, Ralph Nader’s consumer advocacy group. Ralph’s book, Unsafe at Any Speed, forced the automobile industry to focus on converting their cars from …

Match Day 2011: Family medicine grows, but enough to save primary care?

Kevin Pho, MD

KevinMD

March 17, 2011

Match Day marks one of the most important days in a medical student’s career.

A computer algorithm “matches” prospective doctors with the residency program they’re destined go to.

It’s also a look at the future trends for various specialties. With a major part of health reform about to be implemented, one naturally gravitates towards primary care, where there currently is a …

The National Health Service Corps impact on primary care doctors

Kohar Jones, MD

Physician

March 17, 2011

Before I had even begun medical school, I already knew that I would enter primary care when I finished. I had successfully applied for and received a scholarship from the National Health Service Corps Scholars program. By the time I graduated, I knew that after my three years of residency training, I would practice in an underserved area for at least four years, one year of service to America for …

Label the interaction as difficult, not the patient

Maria Yang, MD

Patient

March 17, 2011

Kevin Pho, at KevinMD.com, posted a commentary about encounters with “difficult patients.” He correctly notes that physicians themselves contribute to these interactions. To reduce the likelihood of these encounters, he suggests that physicians would benefit from more training in “psychosocial skills.”

Kudos to Kevin for adjusting his own language by the second sentence of his post: He makes the distinction between difficult patient and difficult encounter.

A vital step in decreasing …

When doctors take time off to become parents

Kevin

Physician

March 17, 2011

by Dawn Barker, MD

Until recently, it was easy to reply when an inquisitive acquaintance asked, “What do you do?” I would answer that I was a child and adolescent psychiatrist. Easy.

The most difficult part was trying to explain that yes, a psychiatrist is a medical doctor, and no, I’m not a psychologist and there is a difference. But when …

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