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Is it the doctor’s fault if an obese patient cannot lose weight?

Patient

September 19, 2010

I need help. In dealing with obesity as a medical problem, that is.

I am pretty solid at arrhythmia management, but as an obesity doctor, not so much. If I was the teacher, and my obese patients were the students, I would surely be fired for poor student test performance. At least, if the core measure was the patient’s BMI.

If a student does poorly on an achievement test, is it the student’s …

DTC advertising, and its history with the FDA

Ishmael Bradley, MD

Medications

September 18, 2010

Advertising is everywhere.

That should come as no surprise to anyone who has lived in modern America. It is impossible to turn on the television, ride the subway, or even sort through the daily mail without coming across an ad for a new car, a soft drink, or the latest digital toy. These advertisements have only one goal: to entice you to buy their products. This is harmless enough when these …

Do all people with disturbing behavior have a psychiatric illness?

Jeffrey Knuppel, MD

Conditions and Diseases

September 18, 2010

“Hey Doc, this guy needs some help.”

I’ve heard that statement from countless correctional officers over the years. Its meaning is very simple: Someone is exhibiting thoughts or behaviors that the officers find disturbing and “not normal.”

I appreciate the officers expressing concern. Without their input I often would not be aware of cases where I might be able to be of assistance.

But, one of the questions that always pops into my …

Are Alzheimer’s disease screening tests ready for the public?

Naomi Freundlich

Conditions and Diseases

September 18, 2010

In April, an independent panel established by the National Institutes of Health came to the disheartening conclusion that currently, there is nothing to prevent or delay the progress of Alzheimer’s disease in those of us who are destined to join the 5 million Americans currently suffering from this dreaded ailment.

The panel found that: “Although numerous interventions have been suggested to delay Alzheimer’s disease, the evidence is inadequate to conclude that …

Radiation risks of CT scans need to be taught to patients

Paul Dorio, MD

Physician

September 17, 2010

Radiation is emitted in various forms. Recently, CT scan radiation has preoccupied (or “absorbed”) the attention of the public and media. As explained: “X rays, γ rays, and neutron beams are considered ionizing radiation. Ionizing radiation may break molecules into pieces, creating ionic free radicals that can be very damaging to tissue.”

For this reason, it is imperative that the use of radiation is only by highly trained personnel and that …

For autism, vaccination is the simple answer that is tragically wrong

Amy Tuteur, MD

Conditions and Diseases

September 17, 2010

It is a curious fact, seldom remarked upon, that all diseases purportedly caused by vaccination share certain common characteristics. Chief among these characteristics is that the cause of the disease purportedly caused by vaccination is presently unknown.

Vaccine rejectionists never claim that a particular vaccine causes heart disease, gall bladder disease, bone abnormalities or any of the myriad diseases for which causes are already known. Vaccine rejectionists always insist that vaccines …

Triage pathways make patients feel disconnected from their doctors

Wendy Sue Swanson, MD

Physician

September 17, 2010

There are things we (the providers) do to health care that are hurtful. We make protocols and rules that divide us from our patients. Protocols that sometimes make patients feel alone, distant, and disconnected from their doctors. I don’t mean algorithms of care (safe, standardized ways of how and why to treat pneumonia, for example), I mean clinic rules for helping patients schedule and get in to see doctors appropriately.

Triage …

There is no alternative medicine, only unproven medicine

George Lundberg, MD

Conditions and Diseases

September 17, 2010

There is no Alternative Medicine.

Thus sprach Phil Fontanarosa and me in a 1998 JAMA editorial in the famous theme issue dedicated to Complementary and Alternative Medicine.

So I went to Mr. Google in 2010 and entered … Alternative Medicine … and clicked — 41,200,000 results; entered Complementary and Alternative Medicine, click — 3,210,000 results; entered CAM, click — 191,000,000 results, but that’s not fair; CAM can stand for many unrelated topics.

Let’s …

Chronic prostatitis is a public health problem

Arnon Krongrad, MD

Conditions and Diseases

September 17, 2010

by Arnon Krongrad, MD

David was afraid. After years of peregrinations with pain, he had exhausted all the options. David knew he wasn’t crazy. The problem was the doctors: They had no more treatments for chronic prostatitis. The doctors did not want to see him.

Chronic prostatitis is a public health problem. Contrasted with fibromyalgia, autism, and breast cancer, however, nobody talks about it. President Obama declared …

AMA: Ensuring medical education best prepares future physicians

Kevin

Medical Education

September 16, 2010

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

by J. James Rohack, MD

This year marks the 100th anniversary of the landmark Flexner Report that standardized medical education in North America. Now, during this historic time of health system change, medical education reforms on the scale of those enacted a century ago are needed …

Powerful examples of using the iPad on the wards

Vineet Arora, MD

Health Technology

September 16, 2010

I recently completed a two week tour of duty on the wards in July with new residents, interns, and students.

Attending (serving as the supervising doctor for the team of residents, interns and students) in July can be challenging, but also one of the most rewarding clinical experiences as a faculty member. The interns and residents are eager to learn and your teaching may have a more lasting impact as the residents …

Goals when starting medicine and how some have been disillusioned

Gizabeth Shyder, MD

Physician

September 16, 2010

When I went into medicine, I had clear goals in mind. Helping people. A stable income to provide for a family. I grew up under the spotlight of my father, who is a neonatologist, and lived in awe of his work. I remember being in restaurants with my dad – people would come up to him reverently and sing his praises (to his obvious embarrassment).

Talk about their son or daughter …

Business reasons to get compliant with HIPAA

Rosemarie Nelson

Physician

September 16, 2010

In addition to providing those incentive dollars for meaningful use of a certified EHR, the Health Information Technology for Economic and Clinical Health Act (HITECH) significantly strengthened aspects of the HIPAA security rule, including the penalties imposed under HHS and the Office of Civil Rights.

If you are a “Covered Entity” (CE) or “Business Associate” (BA) it’s time to get serious, the deadline to be fully compliant with these final HIPAA …

Can scientific knowledge overcome uncontrollable food behavior?

Susan Biali Haas, MD

Conditions and Diseases

September 16, 2010

I’ve struggled almost my whole life with food. During my late teens I was obsessed with dieting and calorie-counting, which turned into compulsive eating and a powerful addiction to sugary, fatty foods in my 20’s and 30’s – even though I had both a medical degree and a degree in dietetics (human nutrition).

Obviously, having scientific knowledge about food and health isn’t enough to help someone control their uncontrollable behavior around …

Physicians love their work but are frustrated

Aldebra Schroll, MD

Physician

September 15, 2010

I recently finished reading In Their Own Words: 12,000 Physicians Reveal their Thoughts on Medical Practice in America. It is a summary of a 2008 survey from the Physicians Foundation. I vaguely remember filling out this survey. I was interested to see what my colleagues had to say.

Many physicians describe themselves as at the breaking point.

“I am so mired in this mess that I can’t see clearly enough to give …

Physicians must be aware of what they know they don’t know

Kent Bottles, MD

Physician

September 15, 2010

St. Augustine: “Fallor ergo sum”

When I was in charge of the medical residency programs in Grand Rapids, Michigan, David Leach introduced me to the expanded Dreyfus Model of how physicians can progress from beginners to masters.

I was always struck by how master physicians freely admitted their mistakes and used them as a teaching tool. As a young surgical and cytopathologist, my sanity was saved more than once by University of …

Health decisions are not entirely based on evidence based data

Kathy Kastner

Conditions and Diseases

September 15, 2010

“Science tells us nothing about the individual.”

So said Dr. Susan Pinker, psychologist and author. This perfectly articulated truth puts into perspective popular thinking: To make a decision, the most important thing is evidence-based information: all you need is science. To this I say, that’s a bunch of hooey. Science tells us nothing about the individual. Thank you Dr. Pinker.

Creating the expectation that health decisions are entirely based on evidence-based information …

Emergency department utilization and its impact on health care reform

Kevin

Health Policy

September 15, 2010

by James P. Davison, DO

Emergency department utilization and its impact on health care reform legislation has been a hot topic of conversation in healthcare journals and the blogosphere. It is a tenet of the currant legislation that ER visits and cost growth will go down, contributing to a decreased health cost growth curve.

Opponents state the newly insured will flock to the nation’s emergency rooms. Proponents …

How CPOE violated medical ethics

Kevin

Health Technology

September 14, 2010

by MedInformaticsMD

As a result of my mother’s health IT-related cerebral hemorrhage and resultant multi-month hospitalization, with transfers to nursing homes then back to acute care due to setbacks, I recently had the chance to observe her care in a small community hospital.

This was a hospital that, in her last several days there before going back to a nursing home …

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How CPOE violated medical ethics