KevinMD.com

March 30, 2011Mar 30, 2011

I received a phone call from the Broward Sheriff’s Office Police Athletic League Youth Boxing Program asking if I would help them out and be the fight physician at their upcoming youth boxing tournament. Their usual physician, a member of…

Their usual physician, a member of the Boxing Hall of Fame, had another commitment. However, he was willing to train me in advance and show me the ropes on the day of the event.

State law and the …

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A boxing fight physician experience

Health policy

Accountable Care Organizations and the need to innovate

Kunmi Sobowale, MD

March 30, 2011Mar 30, 20116

There is a lot of buzz over the creation of Accountable Care Organizations (ACOs) under the Patient Protection and Affordable Care Act (PPACA). An ACO is a network of health care providers and hospitals that collaboratively manage patient care and…

There is a lot of buzz over the creation of Accountable Care Organizations (ACOs) under the Patient Protection and Affordable Care Act (PPACA).

An ACO is a network of health care providers and hospitals that collaboratively manage patient care and prospective budgets. Perhaps the biggest draw of ACOs is the potential to create innovative ways to improve quality and decrease costs. To …

Health technology

Why some EMR programmers think physicians are stupid

Chris Rangel, MD

March 29, 2011Mar 29, 201135

Every major industry is now computerized with one glaring exception; health care delivery. Thirty years after Steve Jobs began selling personal computers out of his garage, far less than 50% of physician practices and hospitals have converted to any form…

The vast majority of medical documentation is still done via paper and writing utensil just as it …

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Physician voices

How physician practices can compete with retail clinics

Brandon Betancourt

March 29, 2011Mar 29, 201123

A reader recently wrote to me: "Brandon, in our area, we’ve seen a few retail clinics pop up. What can we do as a practice to let patients know that visiting retail clinics is not in their best interest?" We…

A reader recently wrote to me: “Brandon, in our area, we’ve seen a few retail clinics pop up. What can we do as a practice to let patients know that visiting retail clinics is not in their best interest?”

We had along discussion. So I put together a summary of our conversation. Below is a rundown, more of less, of what I …

Conditions and diseases

What is stuttering, how is it treated, and The King’s Speech

Michele R. Berman, MD

March 29, 2011Mar 29, 20113

One of the "Crown Jewels" of the 2010 holiday movie season may be The King’s Speech. The film centers on Colin Firth, who plays King George VI of Britain, and Geoffrey Rush as Lionel Logue, the speech therapist who helps…

One of the “Crown Jewels” of the 2010 holiday movie season may be The King’s Speech. The film centers on Colin Firth, who plays King George VI of Britain, and Geoffrey Rush as Lionel Logue, the speech therapist who helps the king deal with his stutter.

Born Albert Frederick Arthur George, the second son of King George V, he spent most of his early years out of the spotlight, which centered …

Patient voices

Does empathy mean giving patients what they want?

Steve Wilkins, MPH

March 29, 2011Mar 29, 20116

Recently, KevinMD.com picked up my post on empathy or should I say the lack of it. I received some engaging comments. One comment in particular caught my attention. The contributor for some reason equated “being empathetic” with “giving in” to…

Recently, KevinMD.com picked up my post on empathy or should I say the lack of it. I received some engaging comments.

One comment in particular caught my attention.

The contributor for some reason equated “being empathetic” with “giving in” to patient requests presumably during routine office visits. Here’s a direct quote:

Give the patients what they want! Antibiotics are OK for colds. The patients want them. So

…

Medical education

Why medical education needs to be more affordable

Edwin Leap, MD

March 29, 2011Mar 29, 201112

I was talking to a young man who is starting medical school this fall. His tuition at one of South Carolina’s newer schools will be $40,000 per year. That’s admittedly on the high end. On the low end, it runs…

And this is all after college, of course. He and others like him are taking out loans to the tune of $240,000 to pay for their …

Patient voices

Implications of the surgical buy in when discussing informed consent

Jeffrey Parks, MD

March 28, 2011Mar 28, 2011

Pauline Chen had a post in the New York Times recently about surgical informed consent. Informed consent is an important part of the surgeon/patient communication transaction. Surgeon reviews the proposed operation, the rationale behind it, and the possible complications. For…

Pauline Chen had a post in the New York Times recently about surgical informed consent. Informed consent is an important part of the surgeon/patient communication transaction.

Surgeon reviews the proposed operation, the rationale behind it, and the possible complications. For example— a patient comes in with biliary colic. We describe the anatomy and pathology. We aver that surgical resection will lead to …

Physician voices

Calling in sick serves as a reminder for compassion for this doctor

Anesthesioboist T., MD

March 28, 2011Mar 28, 20114

One of my Facebook updates on my private account was that I "have a love-hate relationship with interleukin-6. Yes, macrophages and T cells, I know you are doing your job, but how many proinflammatory cytokines does it really take to…

One of my Facebook updates on my private account was that I “have a love-hate relationship with interleukin-6. Yes, macrophages and T cells, I know you are doing your job, but how many proinflammatory cytokines does it really take to fight this thing? What’s that? Be grateful you guys are even working? Oh, all right. I’ll shut up and eat my soup now.”

Yes, I’ve been sick this week. It started …

Conditions and diseases

How astroturfing disease affects patients

Marya Zilberberg, MD, MPH

March 28, 2011Mar 28, 20115

One of the top hits that comes up on the Oracle of Googlius for "astroturf" is for the original company, now renamed SYNLawn, but still proudly stating, "We invented synthetic grass," which is what astroturf is. More recently, this already…

One of the top hits that comes up on the Oracle of Googlius for “astroturf” is for the original company, now renamed SYNLawn, but still proudly stating, “We invented synthetic grass,” which is what astroturf is. More recently, this already synthetic term has become a verb, as in “astroturfing.”

My favorite of all credible information sources on the web, Wikipedia, has this to say about it:

Astroturfing denotes political, advertising, or public relations campaigns that are formally

…

Health policy

ACP: Benefits, harms, and quality in high value, cost conscious care

American College of Physicians

March 28, 2011Mar 28, 2011

A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP Last month, my KevinMD.com column introduced a concept paper published in the Annals of Internal Medicine by Owens and colleagues titled High-Value,…

A guest column by the American College of Physicians, exclusive to KevinMD.com.

by John Tooker, MD, MBA, MACP

Last month, my KevinMD.com column introduced a concept paper published in the Annals of Internal Medicine by Owens and colleagues titled High-Value, Cost-Conscious Health Care: Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions. This month, I’ll take a closer look at value, the …

Physician voices

Reductionism and daily medical practice

George Lundberg, MD

March 28, 2011Mar 28, 20116

The results of the application of reductionism in modern biomedical research and practice has been nothing short of miraculous, but while wondrous for some things, reductionism alone is incomplete. The basic premise of reductionism is that by breaking down (or…

The results of the application of reductionism in modern biomedical research and practice has been nothing short of miraculous, but while wondrous for some things, reductionism alone is incomplete.

The basic premise of reductionism is that by breaking down (or “reducing”) complex biological or medical phenomena into their many parts, one is much more likely to understand a single cause and devise a cure.

Historically, the invention of the microscope, the defining …

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Reductionism and daily medical practice

Patient voices

Life at a needle exchange

Jan Gurley, MD

March 27, 2011Mar 27, 20113

I went to needle exchange to hang out. You may be asking yourself what a soccer mom from the burbs is doing perched on a folding chair in the parking garage of 101 Grove on a dark November night, surrounded…

I was there as a guest observer because I’m working on a series of articles about mortality and homelessness, as part of an Annenberg California Health Journalism Fellowship I …

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Life at a needle exchange

Conditions and diseases

Overeating is a behavioral problem, not a surgical one

Dr. Joe Kosterich

March 27, 2011Mar 27, 201132

Overeating is not a surgical problem. This may seem to be a statement of the obvious, but the solution to a behavioral problem is not surgery. Overeating is not a surgical problem -- it is a behavioral one. The problem…

Overeating is not a surgical problem.

This may seem to be a statement of the obvious, but the solution to a behavioral problem is not surgery. Overeating is not a surgical problem — it is a behavioral one. The problem is not because the stomach is too big and needs to be made smaller. It is a function of how …

Health policy

Reduce variations in cancer care that do not improve outcomes

Merrill Goozner

March 26, 2011Mar 26, 2011

Here are a few facts to enliven the next public discussion about death panels. An analysis of Medicare claims by researchers at Dartmouth University found that nationwide nearly one in three cancer patients died in hospitals or in intensive care,…

Here are a few facts to enliven the next public discussion about death panels.

An analysis of Medicare claims by researchers at Dartmouth University found that nationwide nearly one in three cancer patients died in hospitals or in intensive care, the most expensive form of end-of-life care and contrary to most patients’ wishes. Nearly half are not offered hospice …

Drugs and prescribing

Vaccination and the killers of yesterday now overcome by modern medicine

Emily Gibson, MD

March 26, 2011Mar 26, 20115

It’s only been a little over fifty years since vaccinations became routine for the childhood killers like polio, measles, mumps and whooping cough. People my age and older had no choice but to suffer through childhood infectious diseases given how…

Most of us survived, subsequently blessed with life long natural immunity. Some did not survive. …

Social media in medicine

Guiding patients online is a new physician responsibility for the digital age

Kevin Pho, MD

March 25, 2011Mar 25, 201115

The following op-ed was published on February 22nd, 2011 in AOL News. If you woke up one day with an earache, you could call your doctor's office for help. Or you could do what the majority of patients do today…

The following op-ed was published on February 22nd, 2011 in AOL News.

If you woke up one day with an earache, you could call your doctor’s office for help. Or you could do what the majority of patients do today and Google what to do first.

Type “earache” into your Web browser and the results can vary wildly. Search engines can return results saying that an earache can be from the common cold, …

Conditions and diseases

Food

Joanne Wilkinson, MD

March 25, 2011Mar 25, 2011

I have a stress test nearly every year. I do this because my mother dropped dead of a heart attack when she was thirty-six, and now I am thirty-five. They stick EKG leads on me, and for weeks I have…

I have a stress test nearly every year. I do this because my mother dropped dead of a heart attack when she was thirty-six, and now I am thirty-five.

They stick EKG leads on me, and for weeks I have blotchy red circles on my skin where it’s reacted to the adhesive. I run on the treadmill. …

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Food

Medical education

3 resident interviews for family medicine

Allen Perkins, MD

March 25, 2011Mar 25, 20115

I interview approximately 60 prospective physicians for medical school over the course of the year and 40 physicians who are applying for the residency program. The pre-med students (almost all of whom are the age of my children) tend to have pretty good interview skills and are trying very hard to get into medical school (“I’ve wanted to be a doctor for as long …

Health technology

EHR and the solo primary care physician

Margalit Gur-Arie

March 25, 2011Mar 25, 201121

Recently, I went to see a doctor about an EHR. Dr. Greene (not his real name) is a typical solo primary care physician in a typical small town in the typical middle of nowhere. Four hours from the closest airport…

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EHR and the solo primary care physician

Real physician voices, twice a week

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