KevinMD.com

April 12, 2011Apr 12, 201123

Recently, I attended a conference on integrative medicine. It was a lovely conference and I learned a lot: about Chinese therapies used for cancer, about osteopathic manipulation, and about the growing community of doctors that respect the value of complimentary…

I also left with a sense of dissatisfaction with what …

Physician voices

Palliative care and medical interventions are not mutually exclusive

Neha Jain, MD

April 12, 2011Apr 12, 20112

Think back to your first memory of death. Was it a loved one? A stranger? A pet? Were you sad, happy, or just curious? My grandmother, Nani, died unexpectedly. During the wake, my cousins and I played together in the…

Think back to your first memory of death.

Was it a loved one? A stranger? A pet? Were you sad, happy, or just curious?

My grandmother, Nani, died unexpectedly. During the wake, my cousins and I played together in the bedroom where we had been restricted. All through that memory, there’s a strange, dark, terrible sound.

It’s the sound …

Patient voices

Ordering tests may take food out of the mouths of our patients

Tarcia Edmunds-Jehu

April 11, 2011Apr 11, 201116

Sitting in an exam room I am watching my patient struggling to ask a difficult question that she clearly does not want to ask. After several attempts at starting and a few half finished sentences she finally manages to mumble…

Sitting in an exam room I am watching my patient struggling to ask a difficult question that she clearly does not want to ask.

After several attempts at starting and a few half finished sentences she finally manages to mumble a request for help with obtaining food for herself and her two daughters. She is a 41-year-old woman, 32 weeks pregnant with her third child, and …

Real physician voices, twice a week

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Patient voices

When a patient evokes an emotional reaction from a physician

Brian Goldman, MD

April 11, 2011Apr 11, 201111

When it comes to caring for the sick, it's often assumed that health professionals and their patients usually get along. But that's not always true. Sales people call some of their customers difficult. Turns out that doctors do exactly the…

When it comes to caring for the sick, it’s often assumed that health professionals and their patients usually get along.

But that’s not always true. Sales people call some of their customers difficult. Turns out that doctors do exactly the same thing with theirs. An article in the current issue of the journal Neurology provides a catalog of difficult …

Physician voices

Stop and really think about what you want from life

Susan Biali Haas, MD

April 11, 2011Apr 11, 201114

A friend and I made a pact today. No more hanging out halfway, it’s all or nothing. Each of us has a dream for our lives. Our respective dreams are almost the same, and they’re dreams that we’d almost cast…

A friend and I made a pact today. No more hanging out halfway, it’s all or nothing. Each of us has a dream for our lives.

Our respective dreams are almost the same, and they’re dreams that we’d almost cast aside or given up on. Why? Because they require so much faith, dedication, focus and endurance to pull off. Neither of us had wholeheartedly committed to the dream.

I’ve had a small …

Physician voices

If you want good pediatric care, stay away from retail clinics

Roy Benaroch, MD

April 11, 2011Apr 11, 201179

They’re everywhere, all of a sudden: little medical kiosks tucked into the back of drug stores, grocery stores, and big box outlets. With names like “Minute Clinic” or “RediClinic,” they stress speedy, in-and-out service. And of course, you’re already there…

They’re everywhere, all of a sudden: little medical kiosks tucked into the back of drug stores, grocery stores, and big box outlets.

With names like “Minute Clinic” or “RediClinic,” they stress speedy, in-and-out service. And of course, you’re already there in the store, ready to buy whatever has been prescribed. A win-win, no?

No.

Everyone knows that if you’re …

Physician voices

Physician characteristics that are universally appreciated

Michael A. Zadeh, MD

April 11, 2011Apr 11, 20116

The relationship a physician has not only with their patients, but also with their patient’s families, has long been the foundation of the medical system. Over the course of time this once valued bond has had its ups and downs;…

The relationship a physician has not only with their patients, but also with their patient’s families, has long been the foundation of the medical system.

Over the course of time this once valued bond has had its ups and downs; however today with the internet, Obama healthcare reform, and Medicare cuts to name a few, the doctor-patient relationship finds itself in its …

Health policy

Physicians referring patients to a diagnostic facility they own

Bob Doherty

April 10, 2011Apr 10, 201119

Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue - a practice called "self-referral" - unless the facility is located in their own practice. This exemption exists to…

Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue – a practice called “self-referral” – unless the facility is located in their own practice.

This exemption exists to allow patients with access to a laboratory test, x-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less …

Physician voices

Federal workers worried about a shutdown should do what doctors do

Edwin Leap, MD

April 10, 2011Apr 10, 20119

I have a suggestion for all of those federal workers who were concerned about a government shutdown. To all those who already have better insurance and better benefits than most in the private sector; for all those whose jobs pay…

I have a suggestion for all of those federal workers who were concerned about a government shutdown.

To all those who already have better insurance and better benefits than most in the private sector; for all those whose jobs pay more than equivalent private sector jobs for the same activities. Do what hospitals do. ‘Go to your jobs, and do the necessary work anyway.’

It is ironic, but hardly surprising, that the

…

Patient voices

Why patients seek a second opinion

Howard Luks, MD

April 10, 2011Apr 10, 20117

This has been a very busy week already. I have seen many second opinions and I am always very interested in the reason why the patient initiated the second opinion. In many situations it was simply to see if I…

This has been a very busy week already. I have seen many second opinions and I am always very interested in the reason why the patient initiated the second opinion.

In many situations it was simply to see if I would perform the surgery. After I spent a while listening to the patient, examining them and coming up with an appropriate …

Read more…

Why patients seek a second opinion

Social media in medicine

Talking social media and health reform with medical students

Kevin Pho, MD

April 9, 2011Apr 9, 20115

I recently concluded a trip down to Nashville, TN where I gave my talk on the health care-social media intersection at Vanderbilt University School of Medicine. My audience normally consists of physicians and hospital staff, so talking to students was…

I recently concluded a trip down to Nashville, TN where I gave my talk on the health care-social media intersection at Vanderbilt University School of Medicine.

My audience normally consists of physicians and hospital staff, so talking to students was a refreshing change.

I had the opportunity to have dinner the night before, and breakfast and lunch the day …

Conditions and diseases

Are memory loss and mood disorders actually diabetes of the brain?

Larry McCleary, MD

April 9, 2011Apr 9, 20113

An excerpt from Feed Your Brain Lose Your Belly. by Larry McCleary, MD As diseases, memory loss and mood disorders appear to have very little in common. But could memory loss (even severe memory loss such as that which occurs…

An excerpt from Feed Your Brain Lose Your Belly.

by Larry McCleary, MD

As diseases, memory loss and mood disorders appear to have very little in common. But could memory loss (even severe memory loss such as that which occurs in Alzheimer’s disease) and mood illnesses such as depression and bipolar disorder, actually be treated much the same …

Conditions and diseases

7 procedures that can affect the way you breathe and sleep

Steven Y. Park, MD

April 9, 2011Apr 9, 20112

Millions of surgical operations are performed every year to improve your health, beauty, and even your smile, but there’s a hidden danger in some of the most common procedures that can aggravate if not actually cause obstructive sleep apnea. Sleep…

Sleep apnea happens when your jaws are too narrow, which constricts the internal soft tissue layer that lines your upper breathing passageways, from …

Patient voices

What your patient appreciates, and what causes hurt and confusion

Shara Yurkiewicz

April 9, 2011Apr 9, 20116

Listening to patients for the past two weeks, we learned quite a bit about what patients appreciated about their doctors and what had left them hurt and confused. The good: M., an elderly lady with a very close relationship with…

Listening to patients for the past two weeks, we learned quite a bit about what patients appreciated about their doctors and what had left them hurt and confused.

The good:

M., an elderly lady with a very close relationship with her primary care physician, said she had been to many bad doctors in her life. She knew right away that her current doctor …

Patient voices

Becoming the official caregiver to your sick parent

StorytellERdoc, MD

April 8, 2011Apr 8, 20115

I imagine the world as a vast, boundless frontier weathered by our swirling human emotions and complicated energies -- hurricanes of intense heartbreak and tornadoes of joyous, unbridled celebrations, with every weather pattern in between. Sunshine and rain included. If…

I imagine the world as a vast, boundless frontier weathered by our swirling human emotions and complicated energies — hurricanes of intense heartbreak and tornadoes of joyous, unbridled celebrations, with every weather pattern in between. Sunshine and rain included.

If I could gather this world, foolishly believing that I could sweep my arms and hands through the unsuspecting air to collect a smaller, more-contained version of reality, I know with absolute …

Physician voices

Maintaining private space when patients share trying times with you

Yann Meunier, MD

April 8, 2011Apr 8, 20112

Year: 1987 Setting: Pitie-Salpetriere Hospital in Paris, France Position: Specialist in tropical diseases I am a consultant in tropical diseases at the Pitie-Salpetriere Hospital in Paris in professor Marc Gentilini’s department, which has been receiving HIV/AIDS patients from all parts…

Year: 1987

Setting: Pitie-Salpetriere Hospital in Paris, France
Position: Specialist in tropical diseases

I am a consultant in tropical diseases at the Pitie-Salpetriere Hospital in Paris in professor Marc Gentilini’s department, which has been receiving HIV/AIDS patients from all parts of the world since the onset of the pandemic.

Indeed, in the early days most patients came from Haiti and Africa and were seen primarily in tropical disease …

Drugs and prescribing

The FDA does not approve the uses of drugs

George Lundberg, MD

April 8, 2011Apr 8, 20115

Many people believe that the Food and Drug Administration (FDA) of the United States approves uses of drugs. It does not. This confusion comes from insufficient clarity of language. The FDA does approve whether or not a prescription drug can…

Many people believe that the Food and Drug Administration (FDA) of the United States approves uses of drugs. It does not.

This confusion comes from insufficient clarity of language.

The FDA does approve whether or not a prescription drug can be manufactured, marketed, and sold, the language on the label, and the claims of advertising.

Drug manufacturers must use an elaborate, detailed, lengthy, and very …

Conditions and diseases

Treating patients with pre-diabetes: Weight loss and carbohydrate restriction

David B. Nash, MD, MBA

April 8, 2011Apr 8, 20114

What physician has not stifled a groan when a patient presents with a chief complaint of "I just don't feel right, Doc." About this time last year, I had that "not quite right" feeling and vague, seemingly unrelated symptoms ...…

What physician has not stifled a groan when a patient presents with a chief complaint of “I just don’t feel right, Doc.”

About this time last year, I had that “not quite right” feeling and vague, seemingly unrelated symptoms … sweating, mid-morning headaches, and frequent feelings of hunger, which I was accustomed to satisfying with a muffin.

Like most people — patients and clinicians alike — I ignored these subtle signals.

One evening, …

Health policy

Overhauling America’s Healthcare Machine, an excerpt

Douglas Perednia, MD

April 8, 2011Apr 8, 20114

An excerpt from Overhauling America’s Healthcare Machine: Stop the Bleeding and Save Trillions, published by Financial Times Press (2011). Reprinted with permission of FT Press, and imprint of Pearson. In recent years, more and more of the revenue collected by…

An excerpt from Overhauling America’s Healthcare Machine: Stop the Bleeding and Save Trillions, published by Financial Times Press (2011). Reprinted with permission of FT Press, and imprint of Pearson.

In recent years, more and more of the revenue collected by U.S. healthcare facilities ends up paying for costs that have nothing to do with providing actual healthcare goods and services: things such as administration, billing, documentation, and the cost …

Medical education

Think about medical school tuition debt before becoming a doctor

Skeptical Scalpel, MD

April 7, 2011Apr 7, 201125

Recently, I received a call from the son of some old friends. This 30-year-old man has been an elementary schoolteacher for the past few years and recently decided that he would like to go to medical school and eventually become…

Suppressing the urge to tell him not to even consider …

Real physician voices, twice a week

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