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Your laser facial rejuvenation questions answered

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 …

Are doctors ordering too many tests, or practicing a new standard?

Kevin Pho, MD

KevinMD

March 8, 2011

Are medical students and new doctors overly reliant on tests and technology to make diagnoses?

That’s an interesting thought I had when reading the latest TIME.com piece from emergency physicians Jesse M. Pines and Dr. Zachary F. Meisel.

In their article, they give reasons why doctors order too many tests.

Of course, they cite defensive purposes, saying, “once a doctor has presented an …

Asking a doctor for their opinion on another physician

Doctor D, MD

Physician

March 8, 2011

If one of your patients asked your opinion of another doctor whom you know to be incompetent what would you tell your patient?

Incompetence in a physician is a scary thing! Doctors deal with problems of life and death and try to heal you with dangerous tools. A doc that isn’t competent can be seriously dangerous.

But how do you know who’s on their game and who’s falling down on the job? …

Is Medicare the biggest challenge to seeing the doctor of your choice?

Dan McCoy, MD

Health Policy

March 8, 2011

Medicare was touted as the social entitlement program that would forever change health care access for our seniors.

But is it becoming the biggest challenge to seeing the doctor of your choice?

For the first time in the almost 50 years of the program more and more Medicare recipients are facing the challenge of finding a doctor who will take their government sponsored insurance.

Sure, there have recently been …

5 ways I use my iPad at pediatric point of care

Natasha Burgert, MD

Health Technology

March 8, 2011

I love experimenting with different ways to use technology within my pediatric practice. The iPad has been an amazing device to adapt and use with my families.

Here are 5 different ways I use the iPad with my patients at the point-of-care.

Referring. I have entered my favorite subspecialty providers into Contacts; including their name, address, phone number, and website URL. I list providers by specialty with “pediatric” preceding each listing in …
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5 ways I use my iPad at pediatric point of care

Hospitals taking over private practices

Manoj Jain, MD, MPH

Physician

March 8, 2011

A decade and a half ago, when I moved to Memphis, I proudly hung a sign outside an office I shared with another doctor. It had my name followed by an MD. I had started my own small business as a solo practitioner in medicine.

Over the years, the practice has grown. I now have several employees and my own office, with the names of several other doctors alongside mine on …

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Hospitals taking over private practices

Mental illness in men, and how physicians can prevent suicide in males

Kevin

Patient

March 8, 2011

by Sujatha Prabhakaran, MD

Suicide is arguably the most preventable cause of death. It is also a tough thing to talk about. But talk we should, because suicide costs Americans a lot. In 2000, self directed violence cost $1 billion in medical costs and $32 billion in lost productivity. Self-directed violence affects men and women of all racial/ethnic groups. However, as highlighted in the 2011 …

EMR, a patient’s perspective

Ann Silberman

Patient

March 8, 2011

My oncologist’s office implemented a new EMR system when I was in the middle of chemo. Once the nurses learned the system, I saw no difference in the care I got from them.

Not quite so with the doctor. My experience with him changed dramatically.

Before EMR I would enter the exam room and sit on a chair, play Angry Birds on my iPhone and wait. My doctor would walk in, make …

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EMR, a patient’s perspective

Successfully appeal an insurance company reviewer decision

Nicholas Fogelson, MD

Physician

March 7, 2011

Coverage requests get rejected when the requested service does not fit within an insurance company’s initial guidelines for approval.

This happens for a number of reasons, but usually it comes down to poor documentation or inappropriate care, or in some cases care that is appropriate but can’t be supported in the literature. When a denial occurs, the physician or patient has several opportunities to appeal this decision. The first appeal is …

A primer on brand name drugs and generics

Aaron E. Carroll, MD

Medications

March 7, 2011

That there are some serious misunderstandings out there about the difference between name-brand drugs and generics, as well as some bizarre assumptions about the merits of newer drugs. So here’s a quick primer on how you (and everyone else) are sometimes not getting accurate information about your pharmaceuticals.

As a society, we’re addicted to drugs. Almost all of them are legal, and we’re not abusing them per se, but we want …

Medical error in a fertility clinic

Kevin

Patient

March 7, 2011

by Carolyn Savage

Our names will be forever connected with one of the most significant medical errors ever made inside a fertility clinic.

In February 2009, through a process referred to as a frozen embryo transfer, another couple’s embryos were mistakenly transferred into my body. Eight months later, I gave birth to a baby boy who we relinquished to his genetic parents a few minutes after …

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Medical error in a fertility clinic

Lifestyle changes to control the symptoms of prostate enlargement

Neil Baum, MD

Conditions and Diseases

March 7, 2011

Prostate enlargement, or benign prostate hyperplasia (BPH), is a common, non-cancerous condition affecting nearly 14 million men over the age of 50.

The symptoms of prostate gland enlargement include a decrease in the force and caliber of the urinary stream, frequency of urination, urgency, a feeling of not emptying the bladder despite urination and nocturia, or the need to get up at night to urinate. Although lifestyle changes will not cure …

I see dead people, an excerpt from In Stitches

Anthony Youn, MD

Physician

March 7, 2011

An excerpt from In Stitches.

I see dead people.

Eighteen bodies covered with plastic, lying on gurneys. An occasional toe protrudes to verify that beneath the shiny black tarp, a dead person lies.

I smell dead people, too.

Or at least the thick chemical stench of formaldehyde, tearing at my eyes and packing my nose, enough liquid preservative in here to float a yacht. The smell rises from the bodies and from a dozen …

Primary care physicians are rebelling against the system

Robert Centor, MD

Physician

March 6, 2011

I believe primary care docs are rebelling against the system. The system has made primary care physicians suffer emotionally and financially. The system has taken the greatest form of medical care – that consisting of continuity, comprehensiveness, complexity and completeness – and denigrated it.

Now I talk about “the system” in an anthropomorphic sense, but “the system” is virtual. “The system” has no conscious, it is not deliberate, rather it represents …

Literacy related difficulties in health settings and the written word

Kevin

Patient

March 6, 2011

by Rima Rudd, ScD

We take the written word for granted.

Signs and billboards are everywhere – offering directional information, alerts, warnings, and advertisements. Streets, public squares, buildings, agencies, and institutions are numbered and named. We are surrounded by the written word in public locations and within public and private institutions. Individual entrances and even elevators in some large buildings carry names. The lobby, the inside hallways, …

Entering the golden age of hospice care

Jordan Grumet, MD

Physician

March 5, 2011

Friday in my office is like happy hour for the oldest of the old.

They come. 90, 95, 100. Always on Fridays. Some come in wheel chairs. Others walking. Some alone. Others with family. 5,6, 7 sometimes even more in just one short morning. And we talk about life, about their children, about growing old. I apologize that at that age I really have little to offer. After all, they know …

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Entering the golden age of hospice care

How the mobile internet can transform healthcare

Dave deBronkart

Health Technology

March 5, 2011

Our colleague Susannah Fox of the Pew Internet & American Life Project has done much research about trends in mobile, particularly about health.

In contrast, Meeker focuses on overall big trends. She sees aspects I’ve never noticed, like what-all constitutes mobile: when I hear the term, I think handheld phones (iPhone, Droid, Blackberry), but she makes the case that mobile web access (and other wireless) is much more than phones.

As we …

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