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A stent anecdote from a former FDA Associate Commissioner

Kevin

Physician

February 4, 2011

by Peter J. Pitts

As the saying goes, the plural of anecdote isn’t data. That is unless the anecdote supports your theory. Here’s a personal anecdote — a story of how the system works.

Being adopted, I have no family history, so when I suffered through some late night chest pains I figured I’d better act on the warning signals. I called my GP and got a same-day consultation, resulting in a next-day referral …

Bioethics and bedside communication in daily patient interaction

Kevin

Patient

February 4, 2011

by Zakari Tata, MD

Biomedical ethics and bedside communication is currently taught to medical students in a classroom mainly in the first two years. In residency it is not usually given a lot of attention. This is leading to a situation where a very basic part of daily patient interaction is not addressed. This leads to many complex problems in the hospital that lead to moral dilemmas and conflicts.

The idea needs …

Why is there a gender gap in physician salaries?

Emily Lu

Physician

February 3, 2011

Some research studies just contain too many revelations to not share with the world. The Health Affairs study on the pay gap between newly-trained male and female physicians is just such a study, demonstrating conclusively that:

1. The gender gap in physician salaries is not related to specialty choice or work hours. No matter where women are choosing to work (solo practice vs. hospital, city vs. rural), which specialty they choose …

Can posting ER wait times be dangerous to patients?

Brian Goldman, MD

Physician

February 3, 2011

You’ve probably experienced that age-old ritual of cooling your heels in an ER waiting room hoping that it won’t be too many hours before a nurse lets you inside the sliding doors.

Simon Bradley tweeted this to my Twitter Account @WCBADoctorBrian: “My buddy had a deep laceration between the thumb and the index finger – a full layer of skin. Took 10 hours at (name of hospital withheld), fastest in town.”

A …

Kids with allergies can die in school

Gina, RN

Conditions and Diseases

February 3, 2011

Like many other parents of kids with allergies, I was very dismayed to see this article, titled, Allergic boy, 7, suffers two heart attacks after teacher hands him chocolate nut in class, last week. It seems a boy of 7 was accidentally given a chocolate candy containing a hazelnut, to which he is allergic. After biting into the candy, he realized immediately that he shouldn’t have it and …

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Kids with allergies can die in school

Food is an essential part of a doctor’s success strategy

Susan Biali Haas, MD

Physician

February 3, 2011

Nutrition fascinates me – I’ve been studying it for over twenty years and have a university degree in Dietetics. These days I’m particularly interested in the secrets of high-performance eating; the busier and bigger my life gets, the more I need to be on the ball. Food is an essential part of my success strategy. Put another way: if I didn’t know how to eat right for my brain, I’d …

Confidence in a student’s ability to become a competent physician

Timothy Dempsey, MD, MPH

Medical Education

February 3, 2011

by Timothy Dempsey

Looking in the mirror before heading out the door for my first patient encounter, I slouched. Something looked off. I had on my new, absurdly short white coat complemented nicely by the equally as new black stethoscope draped around my neck; yet the way I looked wasn’t the problem. It was the way I felt. No matter how well I dressed the part …

Why the time is right for collaborative care

Kevin

Patient

February 3, 2011

by John Mooney

A recent study conducted by Dove Press Patient Intelligence Journal asked this question of patients: “Have you ever asked your physician to prescribe something different than the original recommendation?” Thirty-four percent of the respondents indicated that in fact they had. Perhaps even more interesting: of that 34 percent, 69 percent of the doctors agreed to prescribe the alternative drug when asked. Why is this important? The health …

Alternatives to NSAIDs, pros and cons

Kevin

Medications

February 3, 2011

by Marianna Rakovitsky, RPh

Recently, I have talked about the concerns with the use of NSAIDs and their effects on the heart. All medications carry a risk of adverse effects. NSAIDs are usually very effective in controlling pain especially muscle and bone pain, but they also carry a potential risk of side effects such as stomach and kidney problems, increased risk of bleeding and adverse effects …

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Alternatives to NSAIDs, pros and cons

Can President Obama and the GOP agree on improving health reform?

Bob Doherty

Health Policy

February 2, 2011

Everything seems to be pointing toward two years of partisan and ideological confrontations over health reform. The leadership of an emboldened Republican party has made it clear that it will use its newfound House majority to seek to “repeal and replace” the Affordable Care Act (ACA), and if that doesn’t work, to “defund” it. Huge GOP gains in statehouses make it likely that more states will resist implementation. Meanwhile, President …

Ethics of the individual mandate

Kevin

Health Policy

February 2, 2011

by Raymond Raad, MD, MPH

There is a remarkable inconsistency between the ethics of medical practice and the discussion about the health care reform law passed this past March, especially the individual mandate.

In medicine, it is considered unethical to force a patient to do something against his will. Patients are allowed to disagree with their doctors and to decide for themselves whether they want to heed their advice. Patients are even …

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Ethics of the individual mandate

Should doctors give marriage advice?

Randall S. Bock, MD

Patient

February 2, 2011

Doctors have no trouble or compunction giving these good pieces of advice:

stop smoking
lose weight
eat less saturated fat
wash your hands
vaccinate
schedule your mammogram
get a colonoscopy

These all likely can augment both life quality and expectancy.

Do doctors, then, (in appropriate situations obviously) go the extra mile and tell a patient to get married? There are reasonable reports church-going adds to longevity, but with sensitivity to broaching religious beliefs, doctors may be reluctant to suggest …

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Should doctors give marriage advice?

Change health behavior with a gentle nudge

Howard Luks, MD

Patient

February 2, 2011

Gentle nudges is a concept termed recently to describe a micro-choice movement that is beginning to carve out a sizable niche in the healthcare start-up space, and is gaining a lot of well deserved national attention. The secret ingredient relates to the power of a gentle nudge; verbal, text or otherwise to accomplish a change in the behavior of the person who receives the nudge. We are just starting to …

The threat of malpractice means doctors cannot acknowledge their fallibility

Maggie Kozel, MD

Physician

February 2, 2011

An excerpt from The Color of Atmosphere: One Doctor’s Journey In and Out of Medicine (Chelsea Green Publishing, 2011).

We all make mistakes. To err is human—unless you are a doctor. This is a lesson that began in med school. If something went wrong, someone else was to blame. Attending physicians blamed the residents, who blamed the interns, who blamed whomever else was within range—med student, nurse, patient. We gave …

Patient-physician relationships in medical malpractice

Kathleen Clark, PhD

Physician

February 2, 2011

I recently read a post from Jan Gurley, MD on here on KevinMD.com.

Her opinion is that medical malpractice lawsuits are a “crap-shoot”; she notes that “malpractice lawsuits fail when it comes to medical errors-in both directions. People who’ve suffered from errors both don’t sue, and lose suits, in the same percentages that people who sued have no suffered from errors.”

Assuming that information is correct for purposes of this …

Treating a patient in a small town versus a big city

StorytellERdoc, MD

Conditions and Diseases

February 1, 2011

I usually work two or three shifts a month at a small, rural hospital about two hours from where I live. Why? Mainly, the small hospital is less than ten miles from my childhood home, where my widowed father still resides, and thus provides me an opportunity to catch up with Dad as well as four of my siblings and their families, all who live within five miles of Dad.

I …

Mass shootings is a symptom of our nation’s broken health care system

Kevin

Patient

February 1, 2011

by Dora Calott Wang, MD

There will be more shooting rampages, like that which targeted Congresswoman Gabrielle Giffords in Tucson recently-as long as it is easier to get a gun than mental health care. Our current epidemic of mass shootings is but a symptom of our nation’s broken health care system. Poor access to medical care jeopardizes an individual’s health. But when the mentally ill or the seriously distressed can’t access …

Laryngopharyngeal reflux disease and a complex case or chronic cough

Steven Y. Park, MD

Conditions and Diseases

February 1, 2011

Chronic cough is a common condition that’s seen by many doctors, and in most cases, after a thorough history and exam, an answer can usually be found. However, just because a physician followed all the accepted guidelines and evidence based medicine principles to successfully address and treat a condition, it doesn’t mean that it was the right thing to do. Let me explain.

A 49 year old healthy woman presented to …

Health reform repeal will lead to single payer, Medicare for all

Kevin Pho, MD

KevinMD

February 1, 2011

In a guest post last year, physician-author Richard Reece commented that the individual mandate may collapse health reform.

Those words came to mind as Judge Vinson not only ruled the individual mandate unconstitutional, but the entire Affordable Care Act, as well.

Nobody likes to be mandated to do anything, least of all purchase health insurance, and this was always the sticking point with the current iteration of health reform.

So, what …

Praise nurses without comparing them to physicians

Shara Yurkiewicz

Physician

February 1, 2011

Doctors vs. nurses (or doctors vs. nurse practitioners, or doctors vs. physician assistants, or what have you). The debate is old, tired, unimaginative, divisive, and wrong-headed–for reasons that are too obvious even to list. Does it get perpetuated because it garners comments (175 of them, to be exact)? Snarkniess is not appreciated by this reader, at least.

The New York Times recently ran a column by one of its editors, “Read more…

Praise nurses without comparing them to physicians