We often speak of the importance of continuity of care, but there is confusion about what this really means.
When I first joined our small clinic twenty-five years ago, continuity was the reason every medical group in the five town area had its own night-call roster. This way, patients who called after hours could reach a doctor from their own doctor’s office. Even if the covering physician didn’t know the patient, …
Continuity of care starts with caring
by Walter van den Broek, MD, PhD
In normal every day life with face to face contact, the physical characteristics and knowledge about social background form the identity of your contact.
It’s stable and three dimensional. You know that person, it’s therefor very difficult for the other to claim another identity or create impressions inconsistent with how you know him or her. Online identity is a different …
Facebook, narcissism and low self esteem
The commonly prescribed breast cancer drug, Arimidex, was released as a generic in June 2010. The generic name is anastrozole. I called several local pharmacies last week to find out how much this medicine would cost for a one-month supply. I found some very surprising results:
Costco: $27
Walgreens (with Saver Card): $325 (without Card): $380
CVS: $361
Walmart: $347
Target: $340
These are not typos. Costco is selling a one-month supply of generic Arimidex for $27, …
Arimidex price markup at major pharmacy chains
by June Parker Beck
At age 73 I have definitely seen the evolution of the whole “doctor” experience, from Ob/Gyn, to pediatrician (have 5 children) to specialist, to internist.
I’ve learned to accept the fact that in this high tech age, we aren’t going to be chatting with our doctor about the grade school bake sale. The biggest lesson learned, however, was that if you are treated …
Doctors need to be aware of their office staff behavior
This month of my intern year, I am covering night float for the private hospital. Compared to the massive county hospital teeming with laboring patients, churning at all hours of the day and night, the private practice pace is meant to be a luxury for interns seeking respite. And for the most part, life has been pretty nice.
This week however, has been nothing less than hell. One night, I was …
Medical resident superstition and black clouds
New concepts need gimmicks. Proven concepts do not.
The phenomenon of using the internet to gather and share health information is now mainstream. It’s time to change how we talk about it, revising and maybe even retiring certain terms.
Some history to build our case:
In 1998, only about one-third of American adults had access to the internet. Harris Interactive published pioneering research about how internet users gather health information online, dubbing these …
Using the internet for health information is not the exception
A guest column by the American Medical Association, exclusive to KevinMD.com.
As physicians, we prioritize the health of others often at the expense of our own health. Our patients’ health is our priority and why we chose the profession of medicine. The International Conference on Physician Health, held earlier this month in Chicago, gave physicians the opportunity to make their health a priority and provided them with tools to make …
AMA makes physician health a priority
by Diana E. Lee
Minnesota Vikings wide receiver Percy Harvin has been struggling with chronic migraines.
If you don’t follow football you may not have heard of him. But let me assure you he is a high profile player in the National Football League and an important component of the Minnesota Vikings’ offense. Harvin has dealt with migraines since childhood (like me), but almost …
How Percy Harvin struggles with chronic migraines
In addition to outlining patient’s medications, and teaching them what times of day to take the drugs that will help control their specific disease, pharmacists are now taking on a new role to address the growing healthcare needs and demands of Americans, according to a recent article in the New York Times.
For example, at Barney’s Pharmacy in Augusta, Ga., the pharmacy offers classes at the store for patients …
How pharmacists address the healthcare needs of patients
by Thomas Goetz
Enough about patients: What is a doctor to do?
In the past few months, since The Decision Tree book came out, I’ve had the privilege to talk with many doctors about the opportunity and challenge of engaging patients in their own health. Some physicians, not surprisingly, have been suspicious, and even hostile to the idea that patients have a …
How can doctors successfully engage their patients?
by Travis G. Bias, DO
Throughout my involvement in organized medicine, I’ve met friends who I hold in high regard, and colleagues for whom I hope to one day work. One of my favorites, a neurosurgery resident buddy of mine, claims specialists should be paid more than primary care physicians. But, I am a third-year family medicine resident, preparing to enter the practicing world. And …
How to meet the primary care demand in the next decade
by Timothy Dempsey and Pamela Savitz
Last month, the National Football League inducted seven of its all-time great players into its Hall of Fame in a ceremony filled with nostalgia and memories of legendary careers long-finished.
While this was going on, there was another type of induction ceremony taking place around the country. Yet, these celebrations lacked recollections of past achievements by retired legends finally receiving …
The White Coat Ceremony and its effect on medical students
Learn the art of observation.
“The whole art of medicine is in observation… but to educate the eye to see, the ear to hear and the finger to feel takes time, and to make a beginning, to start a man on the right path, is all that you can do.”
– Wiliam Osler
One of my favourite books as a medical student was Michael Zatouroff’s Physical Signs in General Medicine, a book brimming …
The art of medicine is in observation
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Recent rules issued by the Accreditation Council for Graduate Medical Education (ACGME) for resident work hours have further limited the consecutive and total number of hours that medical trainees may work. These measures, originally created because of safety concerns, are intended to decrease the number of fatigue-related errors made by physicians in training. They have received broad support within the medical community.
A recent story published by Mike Lillis in The …
Should OSHA create work rules for physicians in training?
by Ruben J. Rucoba, MD
Has it come to this? Do we really need, as a profession, to measure ourselves against others like a bunch of schoolboys? After reading Dr. Son’s article, “Does being a lawyer or journalist stack up with being a physician?”, I feel compelled to reply.
As a practicing pediatrician, I, too, feel the nobility and privilege of my profession, and count myself lucky …
A physician’s worth doesn’t need a professional hierarchy
One of the more effective criticisms of the health reform law (Affordable Care Act, or ACA) is that it hurts Medicare. It also is wrong.
Effective, in that it has been widely reported that seniors are more likely to express negative views of the ACA than other age groups. (Although the Kaiser Family Foundation’s Drew Altman, citing the group’s most recent tracking polls, writes that seniors’ opposition to …
How the Affordable Care Act helps Medicare
One of the most difficult family decisions can be whether to move an aging parent(s) out of their own home and into assisted living or even a nursing home. I’ve seen families face this dilemma numerous times. (After my psychiatry residency, I completed a geriatric psychiatry fellowship and also spent the first few years in practice consulting at nursing homes.)
Nobody wants to face this situation.
In fact, I’ve seen repeated instances …
Technology can help your aging parents
An excerpt from Doctor Guilt?
by Everett Winslow Lovrien, MD
This is the story of a boy who had hemophilia, a bleeding disorder that resulted in pain, disability and death before adulthood. A new medicine was developed which brought an end to suffering and increased longevity in persons with hemophilia. The effect of the new medicine was like magic. It was a remarkable revolutionary advancement …
A drug to treat hemophilia was polluted with hepatitis viruses and HIV
When I was a resident in internal medicine many years ago, I saw an elderly woman who came to the ER complaining of chest pain and shortness of breath. She had a history of heart disease. When I listened to her chest, the crackles I heard emanating from her wet lungs told me she had congestive heart failure. I treated her chest pain and gave her diuretics to help her get rid of the water that was making …
Reduce medical malpractice and create a culture of patient safety
It would be difficult today to be connected to medicine as either a provider or a consumer and not be aware of the existence of free-standing ambulatory care centers.
Their usual habitat is along a suburban commercial strip, and their presence is generally announced by a well-lit sign displaying a hyphenated medical name, corporate-logo style. The ambulatory care center, known to much of the public as the “walk-in clinic,” is less …
Doctors working in an ambulatory care clinic
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