KevinMD.com

March 11, 2011Mar 11, 2011

When I go to the doctor for my yearly physical (OK, not quite yearly, but…) he puts me through the ringer. He asks me dozens of questions, follows up with more questions, and does a (thorough!) physical exam. Then he takes some blood, and sometimes runs some other tests. The big question is “why”? What are …

Physician voices

What should we expect of a physician leader today?

Stephen C. Schimpff, MD

March 11, 2011Mar 11, 2011

What should we expect of a physician leader today? I believe it should be something much different than what leaders do now. Today, a hospital physician CEO might be expected to develop new or improved clinical programs, in part by…

What should we expect of a physician leader today? I believe it should be something much different than what leaders do now.

Today, a hospital physician CEO might be expected to develop new or improved clinical programs, in part by recruiting the best and the brightest, by building new wings, and by purchasing new technologies. The measure of success would be improved finances as a result of added …

Japan earthquake and tsunami first hand physician account

Takashi Nagata

March 11, 2011Mar 11, 2011

An international ACEP member has been giving real-time updates to the ACEP Disaster Section about the developing situation in Japan. He agreed to share the information with the emergency medicine community and will try to continue to provide updates when…

by Dr. Takashi Nagata

Friday, March 11, 2011 1:13 AM CST

Hello. I am Dr. Takashi Nagata, …

Real physician voices, twice a week

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Health policy

Challenge the constitutionality of EMTALA

Lucy Hornstein, MD

March 11, 2011Mar 11, 201129

Here is a letter to the editor in a recent Philadelphia Inquirer: … In 1986, Congress passed and President Ronald Reagan signed the Emergency Medical Treatment and Active Labor law, which requires hospitals to admit all who arrive at the…

Here is a letter to the editor in a recent Philadelphia Inquirer:

… In 1986, Congress passed and President Ronald Reagan signed the Emergency Medical Treatment and Active Labor law, which requires hospitals to admit all who arrive at the emergency room and treat them without regard for their ability to pay.

In essence, we had federally mandated national health care – signed

…

Conditions and diseases

Making sense of colorectal cancer headlines

Robert Bresalier, MD

March 11, 2011Mar 11, 2011

by Robert Bresalier, MD Did you hear the one about the cancer-sniffing dogs? Sounds crazy, right? This is just one of many recent headlines that may leave you scratching your head. Not every study you read in the news is…

by Robert Bresalier, MD

Did you hear the one about the cancer-sniffing dogs?

Sounds crazy, right? This is just one of many recent headlines that may leave you scratching your head.

Not every study you read in the news is the final word. But recent research can provide interesting new insight on colorectal cancer — the second leading cause of cancer death in the United States.

Here’s some insight to help you make sense …

Health technology

What will prevent the iPad from dominating health care IT?

Jared Sinclair, RN

March 11, 2011Mar 11, 20118

iMedicalApps reviewed some recent news articles regarding business/enterprise adoption of the iPad as a legitimate alternative to Windows machines in the workplace, taking it as a sign that healthcare IT is poised to adopt it, too: "All in all, these…

iMedicalApps reviewed some recent news articles regarding business/enterprise adoption of the iPad as a legitimate alternative to Windows machines in the workplace, taking it as a sign that healthcare IT is poised to adopt it, too: “All in all, these developments bode well for the adoption of the iPhone and iPad as a mainstream, IT-blessed mobile healthcare solution.”

iPad …

Physician voices

Aspects of psychiatry this doctor appreciates

Jeffrey Knuppel, MD

March 10, 2011Mar 10, 20119

Working as a psychiatrist is very rewarding. It’s stressful in a unique way, and some people may look at me strangely for having an unusual job. But overall I really enjoy it. Here are some of the aspects of psychiatry…

1. Being trusted. Psychiatrists meet people when they are at their most vulnerable points, and we are entrusted with extremely …

Physician voices

AMA push against Medicare recovery audit overreach

American Medical Association & Cecil B. Wilson, MD

March 10, 2011Mar 10, 20118

A guest column by the American Medical Association, exclusive to KevinMD.com. The Centers for Medicare and Medicaid Services (CMS) has pushed back the April 1 deadline for states to implement their Medicaid recovery audit contractor (RAC) programs until an unspecified…

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

The Centers for Medicare and Medicaid Services (CMS) has pushed back the April 1 deadline for states to implement their Medicaid recovery audit contractor (RAC) programs until an unspecified time later this year. The implementation delay was welcomed by the American Medical Association (AMA) and other national physician organizations who have vocally urged CMS to improve its proposed Medicaid RAC …

Drugs and prescribing

Taking Chantix to help smokers quit may be worth the risk

Michael Aaronson, MD

March 10, 2011Mar 10, 2011

I decided to dedicate a medical blog on smoking cessation after realizing that too many people in Douglas County (Omaha, Nebraska) smoke. Did you know that despite a smoking ban in restaurants and bars, 18.3% of people in Nebraska are smokers? That’s one in five people. And this number contributes to Omaha’s health ranking of 142 out of 182 cities in …

Physician voices

High rate of surgical site infections (SSIs) in our nation’s hospitals

David B. Nash, MD, MBA

March 10, 2011Mar 10, 201110

By now, most healthcare professionals -- and many well-read consumers -- are aware of the disturbingly high rate of surgical site infections (SSIs) in our nation's hospitals. Each year, approximately 500,000 surgical patients develop SSIs. In some types of operations,…

By now, most healthcare professionals — and many well-read consumers — are aware of the disturbingly high rate of surgical site infections (SSIs) in our nation’s hospitals.

Each year, approximately 500,000 surgical patients develop SSIs. In some types of operations, such as colorectal surgery, the rate is close to 10%.

Many hospitals submit information about SSIs in their institutions through the …

Conditions and diseases

Gout is a common cause for episodic joint pain and swelling

Dr. Irwin Lim

March 10, 2011Mar 10, 20112

For Christmas Eve dinner, our family congregated at Café Opera, in the Intercontinental Hotel for a scrumptious seafood buffet. Going to a buffet is a little bit evil, as you know that you’re about to commit the sin of gluttony.…

I usually tell my patients who suffer with gout to avoid buffets. That 3rd mountain of prawns may precipitate an acute episode of gout. Christmas party season is a dangerous time.

Overindulgence …

Physician voices

What is a difficult patient, and how doctors may be responsible

Kevin Pho, MD

March 9, 2011Mar 9, 201159

What, exactly, is a difficult patient? Doctors can tell many tales of what they term as a difficult encounter. Just as many patients can recall doctors whom they would say are difficult to work with as well. According to a…

What, exactly, is a difficult patient?

Doctors can tell many tales of what they term as a difficult encounter. Just as many patients can recall doctors whom they would say are difficult to work with as well.

According to a study from the Journal of General Internal Medicine, here’s a definition:

Patients deemed difficult included those with more than five symptoms, severe symptoms or an underlying mental disorder or were less functional. These …

Health technology

Signs that your practice is ready for EMR

Mary Pat Whaley

March 9, 2011Mar 9, 20113

My current practice is getting ready to go live on Electronic Medical Records (EMR), but it’s taken us over a year to get here. When I first started this job, we were supposed to go live with EMR in two months. After I’d had a chance to speak with everyone, I just knew the timing wasn’t right for the EMR. We would need to be able to run, and at …

Conditions and diseases

Your laser facial rejuvenation questions answered

Anthony Youn, MD

March 9, 2011Mar 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…

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 …

Medical education

ABIM: Maintenance of Certification (MOC) exams assess clinical judgment

Christine K. Cassel, MD

March 9, 2011Mar 9, 20112

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…

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 …

Conditions and diseases

Treatment-resistant depression is a myth

Steve Balt, MD

March 9, 2011Mar 9, 20115

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…

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 …

Physician voices

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

Kevin Pho, MD

March 8, 2011Mar 8, 201127

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…

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 …

Physician voices

Asking a doctor for their opinion on another physician

Doctor D, MD

March 8, 2011Mar 8, 20117

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…

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? …

Real physician voices, twice a week

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