Medical jargon leads to poor communication between physicians and patients

Patient
November 16, 2010

An article in the Wall Street Journal, Taking Medical Jargon Out of Doctor Visits, emphasizes that the use of medical jargon leads to poor communication between physicians and patients, and consequently leads to ineffective medical care. Federal and state officials are now pushing healthcare professionals to use simpler language to communicate medical advice to patients.

I could not agree more with this mission. The gap …

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Medical jargon leads to poor communication between physicians and patients

What does the NYC Marathon have to do with health reform?

Health Policy
November 16, 2010

Legend tells of an Athenian named Pheidippides who, in 490 B.C., ran from the battlefield at Marathon to Athens, telling of the victory over the Persians. Proclaiming the news that Athens would be spared pillage and fire, the Athenian dropped dead. The story is a myth.

But the marathon, like most things worth doing, does offer both risks and rewards. Because it gives a chance to go beyond usual boundaries, with …

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What does the NYC Marathon have to do with health reform?

Design solutions by truly understanding how humans use tools

Health Policy
November 16, 2010

The Futurama exhibit from the 1939 World’s Fair, although pretty in exhibition form, looks like a terrible place to live. It’s a world of machines, concrete, and efficiency. How boring! Futurists have always imagined the “what can we do?” scenarios. They’ve never really asked the questions:

  • What should we do?
  • What do people want that would make them feel more alive and more happily human?

Jane Jacobs, in her excellent book The Death …

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Design solutions by truly understanding how humans use tools

How to create your medical family tree

Conditions and Diseases
November 16, 2010

The holidays are a great opportunity to ask family members about their health history.

Learning about your family’s health history can help you answer your doctor’s medical history questions. It can even help your doctor determine if you may be at risk for an inherited cancer like breast, colorectal, ovarian, prostate or endometrial cancer, which sometimes run in the family.

Keep in mind that just a small portion of cancers – about 5 …

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How to create your medical family tree

Why medical students are burning out and lacking altruism

Medical Education
November 16, 2010

by mdstudent31

Recently, AAFP News Now released an article titled, Unprofessional Conduct Among U.S. Medical Students Linked to Burnout.

It focused on an article recently released in JAMA entitled, Relationship Between Burnout and Professional Conduct and Attitudes Among US Medical Students.

I had the opportunity to be interviewed for this article and was featured on an inset within the article that shared a minority of my interview. …

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Why medical students are burning out and lacking altruism

EMTALA threatens the safety net of community care

Physician
November 15, 2010

President Bush once said something along the lines of, “We do have universal health care in this country — just go to the emergency room.”

EMTALA.  The law requiring emergency rooms to treat everyone’s emergent conditions, a well meaning act that has had disastrous consequences for hospitals’ bottom lines.  A disgustingly flawed law on many levels.

How do you prove it is not an emergency condition?  You work it up.  …

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EMTALA threatens the safety net of community care

Neoplastic epidural spinal cord compression is an oncologic emergency

Conditions and Diseases
November 15, 2010

There are very few oncologic emergencies. Neoplastic epidural spinal cord compression is one of them. The delay in diagnosis and treatment is often explained by the non-specific nature of the presenting signs and symptoms.

The patient developed urinary retention a couple of weeks prior to presentation. On the morning of admission he was fully functional. Later he sat down to have a cup of coffee and boom – he couldn’t feel …

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Neoplastic epidural spinal cord compression is an oncologic emergency

Physicians the government wants to see

Medical Education
November 15, 2010

I was talking with a pre-med student recently.  He had completed his very first medical school interview and was, understandably, excited.  But he told me the interviewer had asked him what he thought would be the outcome of the current health-care reform measures.

I laughed to myself.  After 17 years in practice, even I don’t know the outcome, though I have my suspicions.  It seemed a loaded, almost unfair question.  After …

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Physicians the government wants to see

First aid rules that everyone needs to know

Patient
November 14, 2010

First aid is defined as the immediate care given to an acutely injured or ill person.  It can literally be life-saving so it behooves all of us to know some basic principles.

What follows are some rules that cover common conditions and general practices:

  1. Don’t panic.  Panic clouds thinking and causes mistakes.  When I was an intern and learning what to do when confronted with an unresponsive patient, a wise resident advised …

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First aid rules that everyone needs to know

Medical students taking a mandatory rotation in geriatrics

Medical Education
November 14, 2010

What happens when you randomly assign medical students to either a mandatory two week rotation in specialized geriatric training or to a traditional non-geriatric clerkship that sees a lot of old people?

Will there be any difference in the knowledge of geriatric conditions, the attitudes toward older adults, or geriatric clinical skills between the two groups?  Or does mere exposure to an aging patient population give students the training they need to …

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Medical students taking a mandatory rotation in geriatrics

Side effects of medication sometimes confuse patients

Medications
November 14, 2010

Side effects.  Every medication has them.  Some are mild, some are annoying, and some are downright dangerous.

When doctors write a prescription, they mention that some people experience side effects, and if certain bizarre things happen, the patient should phone the doctor.

How do we keep track?

If you get one antibiotic to take for two weeks, it isn’t so hard.  First, because it’s for a short time period, and also because it’s …

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Side effects of medication sometimes confuse patients

How dietary guidelines can help prevent disease

Physician
November 13, 2010

Most of the illnesses that occur today are chronic like diabetes, heart disease, cancer or kidney disease.

These stay with us for the rest of our lives, are debilitating, and are expensive to treat. But in many cases they are not all that difficult to prevent. Unfortunately, our dietary guidelines are of little or no help in this regard but could be.

In 1941, following studies that demonstrated …

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How dietary guidelines can help prevent disease

Making the decision to go to medical school

Medical Education
November 13, 2010

First, this piece is not a how-to guide for getting into medical school.

But I use this ploy for good, and not for evil.  Through conversations with a number of non-medical colleagues, I’ve been forced to think a bit more about premedical and medical education.  A letter from a reader (which is presented in a highly altered version below) made me decide to more thoroughly and …

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Making the decision to go to medical school

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Get a straight answer from your doctor

Patient
November 13, 2010

How can patients get a straight answer from a doctor?

The answer is really very simple: Don’t accept a non-answer answer from a doctor on a question that really matters to you!

If you get a dodgy, vague, or useless answer don’t take it lying down. Politely insist that the doctor elaborate and clarify until you get a reply that you understand.

We doctors are totally scary, but if you have to have …

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Get a straight answer from your doctor

Preventive care as a cost saving measure is a fallacy

Health Policy
November 12, 2010

I like reading Maggie Mahar’s Health Beat.

She usually gets it, from the function of insurance to the complexities of assorted payment systems, I get the sense that she is generally rational when it comes to paying for health care. This doesn’t mean there aren’t times when she gets it wrong. Her embrace of primary care provided by nurse practitioners shows a truly spectacular …

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Preventive care as a cost saving measure is a fallacy

Help patients synchronize their prescription drugs

Medications
November 12, 2010

Here’s the scenario: on the 2nd of the month, a patient with diabetes on metformin and high blood pressure on benazepril sees her family physician for a routine follow up.

The patient’s blood pressure is elevated and the decision is made to add carvedilol to help get the blood pressure to goal. The patient’s metformin and benazepril “drop” (are renewed) at the pharmacy on the 18th of every month, a date …

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Help patients synchronize their prescription drugs

Autonomy versus supervision for residents is a fine line

Medical Education
November 12, 2010

When one is a medical student, pretty much everything one does is directly supervised.  Though a student is allowed to assess patients and make recommendations, rarely is a student given the autonomy to make decisions that will affect patients.  They practice these decisions, but there is always someone more senior ratifying them.

Once a student becomes  a resident, things start to change.  As residents are physicians, they have the power to write …

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Autonomy versus supervision for residents is a fine line

Why patients in Grand Junction, Colorado have better health outcomes

Health Policy
November 12, 2010

The New England Journal of Medicine analyzed Medicare statistics from the beloved Dartmouth Atlas of Health Care study revealing a wide disparity in the number of coronary bypass procedures in Golden Colorado compared to other areas.

The report reveals a 60% reduction in the number of procedures as compared to Miami, Florida.  The Dartmouth Atlas Study has been used to justify changes in payment systems by Medicare. The study has …

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Why patients in Grand Junction, Colorado have better health outcomes

Using the internet for health information before surgery

Patient
November 11, 2010

Diana Cole told me, “The internet saved my life,” and recounted a story about using the internet to identify a bat bite and learn about rabies in bats, leading to an emergency room trip.

She later introduced me to her sister, Carolyn Kingston, who attributed her successful outcome from hip replacement surgery to her use of the internet. I asked Carolyn about her general use of the internet for health, her …

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Using the internet for health information before surgery

AMA: Patients and physicians call on Congress to stop Medicare cut

Health Policy
November 11, 2010

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

Medicare physician payment cuts are once again looming in the immediate future, with a cut of 25 percent now threatening to hurt access to care for seniors and military families. As many doctors know all too well, the looming cut is forcing physicians to make difficult decisions about the continuing role Medicare can play in their practices.

The AMA is working on …

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AMA: Patients and physicians call on Congress to stop Medicare cut

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