KevinMD.com

Why team based primary care won’t help evidence based medicine soon

Kevin Pho, MD

KevinMD

March 11, 2011

Despite the advances in evidence-based medicine, not every patient benefits.

In a recent column from the New York Times, Pauline Chen looks at a study showing exploring the issue:

For many patients, evidence-based medicine isn’t working. Two-thirds of patients with diabetes, a disease with some of the strongest evidence-based guidelines available, continue to have trouble controlling their blood sugar levels; and only half of all …

Read more…

Why team based primary care won’t help evidence based medicine soon

Prevention of disease and monitoring of chronic diseases in a yearly physical

PalMD

Physician

March 11, 2011

When I go to the doctor for my yearly physical (OK, not quite yearly, but…) he puts me through the ringer. He asks me dozens of questions, follows up with more questions, and does a (thorough!) physical exam. Then he takes some blood, and sometimes runs some other tests. The big question is “why”? What are …

What should we expect of a physician leader today?

Stephen C. Schimpff, MD

Physician

March 11, 2011

What should we expect of a physician leader today? I believe it should be something much different than what leaders do now.

Today, a hospital physician CEO might be expected to develop new or improved clinical programs, in part by recruiting the best and the brightest, by building new wings, and by purchasing new technologies. The measure of success would be improved finances as a result of added …

Japan earthquake and tsunami first hand physician account

Kevin

Potpourri

March 11, 2011

An international ACEP member has been giving real-time updates to the ACEP Disaster Section about the developing situation in Japan. He agreed to share the information with the emergency medicine community and will try to continue to provide updates when he can.

by Dr. Takashi Nagata

Friday, March 11, 2011 1:13 AM CST

Hello. I am Dr. Takashi Nagata, …

Challenge the constitutionality of EMTALA

Lucy Hornstein, MD

Health Policy

March 11, 2011

Here is a letter to the editor in a recent Philadelphia Inquirer:

… In 1986, Congress passed and President Ronald Reagan signed the Emergency Medical Treatment and Active Labor law, which requires hospitals to admit all who arrive at the emergency room and treat them without regard for their ability to pay.

In essence, we had federally mandated national health care – signed …

Read more…

Challenge the constitutionality of EMTALA

Making sense of colorectal cancer headlines

Kevin

Conditions and Diseases

March 11, 2011

by Robert Bresalier, MD

Did you hear the one about the cancer-sniffing dogs?

Sounds crazy, right? This is just one of many recent headlines that may leave you scratching your head.

Not every study you read in the news is the final word. But recent research can provide interesting new insight on colorectal cancer — the second leading cause of cancer death in the United States.

Here’s some insight to help you make sense …

What will prevent the iPad from dominating health care IT?

Jared Sinclair, RN

Health Technology

March 11, 2011

iMedicalApps reviewed some recent news articles regarding business/enterprise adoption of the iPad as a legitimate alternative to Windows machines in the workplace, taking it as a sign that healthcare IT is poised to adopt it, too: “All in all, these developments bode well for the adoption of the iPhone and iPad as a mainstream, IT-blessed mobile healthcare solution.”

iPad …

Aspects of psychiatry this doctor appreciates

Jeffrey Knuppel, MD

Physician

March 10, 2011

Working as a psychiatrist is very rewarding. It’s stressful in a unique way, and some people may look at me strangely for having an unusual job. But overall I really enjoy it. Here are some of the aspects of psychiatry that I really appreciate.

1. Being trusted. Psychiatrists meet people when they are at their most vulnerable points, and we are entrusted with extremely …

AMA push against Medicare recovery audit overreach

Cecil B. Wilson, MD

Physician

March 10, 2011

A guest column by the American Medical Association, exclusive to KevinMD.com.

The Centers for Medicare and Medicaid Services (CMS) has pushed back the April 1 deadline for states to implement their Medicaid recovery audit contractor (RAC) programs until an unspecified time later this year. The implementation delay was welcomed by the American Medical Association (AMA) and other national physician organizations who have vocally urged CMS to improve its proposed Medicaid RAC …

Taking Chantix to help smokers quit may be worth the risk

Michael Aaronson, MD

Medications

March 10, 2011

I decided to dedicate a medical blog on smoking cessation after realizing that too many people in Douglas County (Omaha, Nebraska) smoke. Did you know that despite a smoking ban in restaurants and bars, 18.3% of people in Nebraska are smokers? That’s one in five people. And this number contributes to Omaha’s health ranking of 142 out of 182 cities in …

High rate of surgical site infections (SSIs) in our nation’s hospitals

David B. Nash, MD, MBA

Physician

March 10, 2011

By now, most healthcare professionals — and many well-read consumers — are aware of the disturbingly high rate of surgical site infections (SSIs) in our nation’s hospitals.

Each year, approximately 500,000 surgical patients develop SSIs. In some types of operations, such as colorectal surgery, the rate is close to 10%.

Many hospitals submit information about SSIs in their institutions through the …

Gout is a common cause for episodic joint pain and swelling

Dr. Irwin Lim

Conditions and Diseases

March 10, 2011

For Christmas Eve dinner, our family congregated at Café Opera, in the Intercontinental Hotel for a scrumptious seafood buffet. Going to a buffet is a little bit evil, as you know that you’re about to commit the sin of gluttony.

I usually tell my patients who suffer with gout to avoid buffets. That 3rd mountain of prawns may precipitate an acute episode of gout. Christmas party season is a dangerous time.

Overindulgence …

What is a difficult patient, and how doctors may be responsible

Kevin Pho, MD

KevinMD

March 9, 2011

What, exactly, is a difficult patient?

Doctors can tell many tales of what they term as a difficult encounter. Just as many patients can recall doctors whom they would say are difficult to work with as well.

According to a study from the Journal of General Internal Medicine, here’s a definition:

Patients deemed difficult included those with more than five symptoms, severe symptoms or an underlying mental disorder or were less functional. These …

Signs that your practice is ready for EMR

Mary Pat Whaley

Health Technology

March 9, 2011

My current practice is getting ready to go live on Electronic Medical Records (EMR), but it’s taken us over a year to get here. When I first started this job, we were supposed to go live with EMR in two months. After I’d had a chance to speak with everyone, I just knew the timing wasn’t right for the EMR. We would need to be able to run, and at …

Your laser facial rejuvenation questions answered

Anthony Youn, MD

Conditions and Diseases

March 9, 2011

Laser facial rejuvenation is one of the most popular but most confusing treatments today.

What’s the difference between a lunchtime laser and a fractionated laser? An ablative or a nonablative laser? If many plastic surgeons are confused by the plethora of lasers available, how can the average consumer or patient know what laser is best for removing their wrinkles and tightening their skin?

Lasers work by focusing energy on a certain color of the …

ABIM: Maintenance of Certification (MOC) exams assess clinical judgment

Christine K. Cassel, MD

Medical Education

March 9, 2011

A guest column by the American Board of Internal Medicine, exclusive to KevinMD.com.

KevinMD.com recently posted a blog noting that Watson, the IBM super computer who successfully beat two contestants on Jeopardy, would eventually make board certification exams obsolete. He argues that exams that rely on “memory-based curriculum” focused on recall of facts will become unnecessary. I agree. Recall …

Treatment-resistant depression is a myth

Steve Balt, MD

Conditions and Diseases

March 9, 2011

Treatment-resistant depression is one of those clinical terms that has always been a bit unsettling to me.

Maybe I’m a pessimist, but when I hear this phrase, it reminds me that despite all the time, energy, and expense we have invested in understanding this all-too-common disease, we still have a long way to go. Perhaps more troubling, the phrase also suggests an air of resignation or abandonment: “We’ve tried everything, but …