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Your medical career and the waning interest in bridal and baby showers

Physician

March 16, 2011

I think that I am missing a gene from one of my X chromosomes.

I attended my sister-in-law’s baby shower recently. I love my sister-in-law dearly and was happy to be there to support her. If only I could have supported her in another way.

I detest showers. Once I was engaged, I stated clearly to everyone I knew that I did not, under any circumstances, want a bridal shower. Naturally, everyone …

Should doctors be like workers on factory assembly lines?

Greg Smith, MD

Physician

March 16, 2011

fatigue |fəˈtēg|

noun
1 extreme tiredness, typically resulting from mental or physical exertion or illness : he was nearly dead with fatigue.
• a reduction in the efficiency of a muscle or organ after prolonged activity.

No, this post is not a part of my twenty six installment Psychiatry A to Z series.

You’ll have to wait for the next one in that group, which by the way will be looking at a “T” word. …

Gratitude from patients and their families

a medical resident, MD

Physician

March 16, 2011

It is hard to imagine that someone can emerge from intern year – 12 months of chaos, little sleep, and hours upon hours spent responding to pages and putting orders in a computer – and know something, anything, about medicine. I did not believe in this training system until now, after my first night as a supervising resident. The knowledge I have absorbed over the …

Physician reputation management in the age of social media

Neil Baum, MD

Physician

March 16, 2011

What is the physician’s most precious possession? Some might answer that it is his patients.

Others might respond it is the training and education that the physician has obtained to practice his (or her’s) craft.

But the real answer is that it’s the physician’s reputation.

Doctors live and die by their reputations. Reputations take years to …

Doctors receive no training on coding, which makes them prone to fraud

Michelle Mudge-Riley, DO

Physician

March 16, 2011

How much attention do you pay to your Evaluation and Management (E&M) Coding practices?

E&M codes represent the type, setting, and complexity of services provided and the patient status, such as new or established. Providers are responsible for ensuring that the codes they submit accurately reflect the services they provide.

According to the Office of the Inspector General (OIG), Medicare paid $25 …

Health costs need to be addressed by doctors, patients, and lawyers

Kevin Pho, MD

KevinMD

March 15, 2011

It’s no secret that our health system encourages doctors to order too many tests. Compounded with the widespread belief that more tests equates to better medicine, the reasons why health costs are spiraling out of control aren’t a secret.

In a perspective piece from the New England Journal of Medicine, physician Sean Palfrey notes our dire situation:

Recent advances …

Read more…

Health costs need to be addressed by doctors, patients, and lawyers

Do Not Resuscitate and the need for a central line

Ralph Gordon, MD

Physician

March 15, 2011

Just the other day I was called to see a patient coming up to the Intensive Care Unit with a diagnosis of pneumonia. Upon my arrival the patient is “hanging in there” with the blood pressure in the 60’ and 70’s systolic.

This is a no-brainer situation – the patient is in sepsis and septic shock.

Early intravenous antibiotics and aggressive resuscitation is what this gentleman needs right now. Per the ER …

Why this medical student found primary care awesome, and boring

Suchita Shah

Physician

March 15, 2011

I recently finished another 5-week clinical rotation. This one was primary care (outpatient internal medicine +/- family medicine).

First a few words about primary care as a field: I found it to be both awesome and boring.

It was awesome because I was the “doctor.” I had essentially full responsibility for my each patient. From calling him in from the …

Why this patient recommends her family physician

WarmSocks

Patient

March 15, 2011

“Do you know a good doctor?” is a question tossed around in conversation sometimes. If the person is reasonably nice/intelligent, I’m happy to hand out my doctor’s name and phone number.

Recently, I referred more friends to my all-time favorite doctor. Instead of just taking his name and phone number, the couple wanted to know why I like him. That’s a fair enough …

How to prevent suicide in physicians

Kevin

Physician

March 15, 2011

by Zakari Tata, MD

Many articles have been written on physician suicides. Yet nothing practical has been implemented. The problem is probably much larger than reported, as families will try to avoid publicity where possible.

In medicine, just as in the rest of society, people diagnosed with depression are wrongly labeled as weak, and discrimination, especially the subtle passive …

Read more…

How to prevent suicide in physicians

Alternative medicine problems patients need to know about

Alex Lickerman, MD

Medications

March 14, 2011

Americans spend an astounding 34 billion dollars on alternative medicine annually. Given that so many of us put our faith in alternative care, I wanted to clear up some common misconceptions about it to help people make wiser choices when and if they turn to it.

What is alternative medicine?

In general, alternative medicine is used to describe practices outside the bounds of conventional medicine. …

ASA addresses drug shortages to ensure patient safety

Kevin

Medications

March 14, 2011

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

by Arnold J. Berry, MD, MPH

Drug shortages continue to impact patients across the nation. Over the past year, anesthesiologists have been faced with the challenge of finding alternatives for several unique drugs needed to safely provide anesthesia for patients having surgical, diagnostic or therapeutic procedures.

Anesthesiologists have …

How to help autistic or delayed children behave and learn

dr_som, MD

Conditions and Diseases

March 14, 2011

Here are ways doctors can help autistic or delayed children behave and learn.

I certainly do not mean to trivialize the behavior issues that erupt as typical children develop, but the problems of atypical kids are more difficult and less likely to be fully addressed by general pediatricians and society at large.

1. Understand the ABCs of behavior. Antecedent = What happened immediately before the behavior? Behavior = A description of the …

TMA: Vaccines, autism, and Andrew Wakefield’s wake

Kevin

Conditions and Diseases

March 14, 2011

by Steve Levine

The sad story of the fraud Dr. Andrew Wakefield perpetrated on the world’s autism community lies at the intersection of my personal and professional lives. Could these latest revelations be the final chapter?

As chief of communications at Texas Medical Association, I promote the …

Bullying among nurses needs to stop

Sarah Beth Cowherd, RN

Patient

March 14, 2011

I do not wish simply to use the buzz word of the hour. Nor do I wish to assert that I have all the answers.

I genuinely desire to bring to light an interesting conflict that has plagued the nursing profession for decades.

Bullying.

Why in a profession centered around the concepts of compassion, caring, and healing has a mindset of bullying permeated the culture. Even more confusing is that most often, this …

Read more…

Bullying among nurses needs to stop

Danger of multiple emergency room visits to different hospitals

Jeffrey I. Kreisberg, PhD

Patient

March 13, 2011

If you are one of the more than 100 million Americans who visit emergency rooms (ER) at least once a year, you’re not alone.

Americans, insured and not, make ample use of hospital emergency rooms. One out of every five visited an ER at least once in 2007, the latest year for which the National Center for Health Statistics …

The differences between comparative and clinical effectiveness

Kevin

Health Policy

March 13, 2011

by Peter J. Pitts

“Newspeak,” the language of Big Brother, was designed “not to extend but to diminish the range of thought.”

Some well-known examples of Newspeak are Bellyfeel (a blind, enthusiastic acceptance of an idea), Duckspeak (meaning literally to quack like a duck or to speak without thinking), Crimethink (the Newspeak word for thought crime) and Goodthink (or “political orthodoxy”).

Which brings us from the nightmare fantasy of “1984” to the health …

Achieving balance in life with cerebral palsy

Erin Breedlove

Patient

March 13, 2011

As in anyone’s life, the hardest thing to achieve in life is a balance. Whether it’s work, school, home, or play, it’s just plain tough. For those of us with challenges such as cerebral palsy, it brings a new set of challenges. Here’s why.

Task execution takes longer. Where it might take my sister thirty minutes to get herself ready and out the door in the mornings, it will take me …

Withholding liver transplants for Medicaid recipients in Arizona

Gary Levin, MD

Health Policy

March 12, 2011

Governor Brewer’s decision to withhold liver transplants for Medicaid recipients in Arizona should serve as a loud warning to the electorate regarding governmental intrusions into health care financing and health care operations.

The decision was ill advised on the basis of multiple factors. The survival rates differ from one facility to another.

What is the liver transplant survival rate and what information needs to be considered when looking at such numbers?

For example, …

Humility in medicine and our academic training environments

Ken Covinsky, MD

Medical Education

March 12, 2011

I sometimes wonder if we spend too much time talking about professionalism.

It is not that I don’t think we should promote professionalism. Of course we should. But many discussions of professionalism descend into overly academic and scholarly treatises that end up obscuring rather than clarifying the values such discussions hope to promote. It may be a mistake to overly …

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