KevinMD.com

January 17, 2011Jan 17, 20113

Obesity is now increasingly recognized as the "natural" consequence of societal changes that have occurred over the past decades to foster an increasingly obesogenic environment. Yet, rather than focus on the root causes of these societal drivers of obesity, governments…

Obesity is now increasingly recognized as the “natural” consequence of societal changes that have occurred over the past decades to foster an increasingly obesogenic environment.

Yet, rather than focus on the root causes of these societal drivers of obesity, governments apparently prefer to make obesity prevention a personal matter, with a strong emphasis on trying to get individuals to change their lifestyles.

It is clearly far easier to simply tell people to …

Patient voices

Fetal ultrasound and our image oriented society

Randi Hutter Epstein, MD, MPH

January 17, 2011Jan 17, 20115

An excerpt from Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank published by W. W. Norton & Company, 2010 (paperback January 2011). On eBay, you can buy a fetal ultrasound scrapbook that…

An excerpt from Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank published by W. W. Norton & Company, 2010 (paperback January 2011).

On eBay, you can buy a fetal ultrasound scrapbook that has a poem on the first page that begins, “I loved you from the start.” It comes with Care Bear stickers. One of them is a pregnant rabbit …

Physician voices

Save time and money with your visit with healthcare providers

Stephen Meyers, MD

January 17, 2011Jan 17, 20117

Have you ever been frustrated by an unproductive or inopportune visit with your doctor that wasted your time and money? Here are a few tips to keep that from happening again. The problem Many visits with healthcare providers are poorly…

Have you ever been frustrated by an unproductive or inopportune visit with your doctor that wasted your time and money?

Here are a few tips to keep that from happening again.

The problem

Many visits with healthcare providers are poorly timed and less productive than they could be. Why? Because nobody is looking out for you between visits. It’s not that your doctor doesn’t care. He or she is simply too busy with …

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Physician voices

Are malpractice lawsuits really responsible for the rise in C-sections?

Louise Marie Roth, PhD

January 16, 2011Jan 16, 201161

by Louise Marie Roth, PhD About one third of all births in the contemporary United States occur via c-section. Physicians and the public at large often attribute this to a "malpractice crisis," whereby obstetricians perform c-sections routinely to avoid malpractice…

by Louise Marie Roth, PhD

About one third of all births in the contemporary United States occur via c-section. Physicians and the public at large often attribute this to a “malpractice crisis,” whereby obstetricians perform c-sections routinely to avoid malpractice litigation. Over the last couple of years, I have been conducting research on obstetric practices and malpractice.

One of the things that I have learned …

Drugs and prescribing

How cocaine can be used in sinus surgery

Christopher Chang, MD

January 16, 2011Jan 16, 20116

Many people are already aware that marijuana is now legal in some states in the US with a medical prescription. What many people may not realize is that cocaine is also used in medical care, especially in the ENT world.…

Many people are already aware that marijuana is now legal in some states in the US with a medical prescription.

What many people may not realize is that cocaine is also used in medical care, especially in the ENT world.

Cocaine is one of the most potent anesthetic and vasoconstrictor. These two characteristics make it an ideal medication for use during sinus surgery as well as any nasal procedure where bleeding and …

Drugs and prescribing

Why doctors should profit from dispensing medications

Richard Reece, MD

January 15, 2011Jan 15, 201162

Hold onto your hats. I am about to enter dangerous territory. I am about to suggest maybe doctors should profit from dispensing medications from their office to offset declining reimbursements and rising expenses by using prescriptions as a source of…

Why dangerous? For a number of reasons.

One, physicians still grapple with the perception that it is improper for a physician to make money from …

Health policy

What health reform compromise could look like

Donald H. Taylor, PhD

January 15, 2011Jan 15, 20114

While the rhetoric around health reform has been incendiary from day one, in policy terms, a compromise between Democrats and Republicans using the outline of the Affordable Care Act (ACA) has always been available. The two primary problems with the health care system are costs and lack of coverage. The ACA does pretty well on the second, and is a start on the first, but much more is needed. It …

Medical education

Alternative medicine and osteopathic medical education

Tayson DeLengocky, DO

January 14, 2011Jan 14, 201118

by Tayson DeLengocky, DO There has been a growing public interest in complementary and alternative medicine (CAM) in recent years. Osteopathic manipulative therapy, a form of physical manipulation of the body for improvement of health and body function, has been…

by Tayson DeLengocky, DO

There has been a growing public interest in complementary and alternative medicine (CAM) in recent years. Osteopathic manipulative therapy, a form of physical manipulation of the body for improvement of health and body function, has been designated as complementary and alternative medicine (CAM) by the National Institutes of Health (NIH).

According to data reported in 2007 by the National Institutes of Health’s National Center for Complementary and Alternative …

Medical education

Using failure as motivation for medical residents

Mary L. Brandt, MD

January 14, 2011Jan 14, 20113

Dear Dr. Brandt, As a second year medical student, I know that my peers and I all struggle with what we view as "failure" at some point or another. I imagine this problem doesn’t stop (... ever), especially since medicine…

Dear Dr. Brandt,

As a second year medical student, I know that my peers and I all struggle with what we view as “failure” at some point or another. I imagine this problem doesn’t stop (… ever), especially since medicine seems to attract people who hold themselves to extremely high, if not impossible, standards. If you’re looking for topics, I wonder if you might have some insight to offer on how

…

Conditions and diseases

What is a concussion, and what does it mean for the child?

Christopher Johnson, MD

January 14, 2011Jan 14, 2011

When it comes to football season, it’s time to think about sports injuries. We frequently have children admitted to the PICU (or to what we call the intermediate or step-down unit) for observation, typically overnight, who have struck their head.…

The term itself is centuries old, but even thirty-five years ago, when I was in …

Conditions and diseases

Obesity and the crossroads between relative health and medical illness

Shantanu Nundy, MD

January 14, 2011Jan 14, 20117

At the end of a busy afternoon, Mrs. MJ was exactly the kind of case I needed. Two of my patients had come in late but needed to be seen and another was acutely short of breath and refusing to…

At the end of a busy afternoon, Mrs. MJ was exactly the kind of case I needed.

Two of my patients had come in late but needed to be seen and another was acutely short of breath and refusing to be admitted to the hospital. The chaos had put me almost an hour behind schedule, and I still had to return to the wards to round on my cancer patients. Fortunately …

Drugs and prescribing

How the vaccine and autism scare was a fraud to make money

Toni Brayer, MD

January 13, 2011Jan 13, 20116

Most parents and all pediatricians are aware of the 1998 study published in The Lancet by Dr. Andrew Wakefield that mentioned a causal link between measles, mumps, rubella (MMR) vaccine and the increased incidence of childhood autism. It shook the…

Most parents and all pediatricians are aware of the 1998 study published in The Lancet by Dr. Andrew Wakefield that mentioned a causal link between measles, mumps, rubella (MMR) vaccine and the increased incidence of childhood autism. It shook the medical community and created an international movement of parents questioning the extensive combination of immunizations that are given to children. Could these immunizations be the cause of the increase in …

Health policy

Legal tobacco and illegal marijuana are historical accidents costing billions

Kohar Jones, MD

January 13, 2011Jan 13, 20115

"What do you think of medical marijuana?" my mother, who has never smoked a thing in her life, of the tobacco or cannabis variety, asked me one day as we drove through beautiful upstate New York woods. We had just…

“What do you think of medical marijuana?” my mother, who has never smoked a thing in her life, of the tobacco or cannabis variety, asked me one day as we drove through beautiful upstate New York woods. We had just passed a sign saying “We will destroy your crops,” with a marijuana leaf beneath. “It has its place,” I said. “No reason to be against it.” “But isn’t marijuana a …

Physician voices

Kind and thoughtful words from a fellow physician colleague

Jennifer Middleton, MD

January 13, 2011Jan 13, 20117

I was sitting on one of the hospital's nursing units having a difficult telephone conversation. Anyone working nearby could have easily discerned the situation from my end of the call. Patient's family member wants to keep aggressive care going for…

I was sitting on one of the hospital’s nursing units having a difficult telephone conversation. Anyone working nearby could have easily discerned the situation from my end of the call.

Patient’s family member wants to keep aggressive care going for a comatose, terminally ill family member against the best advice of the medical team.

Having never had to make such a decision in my own life, I am left to imagine how …

Physician voices

Do satisfaction scores really measure quality care?

William Sullivan, DO, JD

January 13, 2011Jan 13, 20117

Does patient satisfaction matter? The answer is a resounding "yes." In fact, as the director of an emergency department, feedback from dissatisfied patients has provided both me and our group with an early warning about several physicians who were not…

Does patient satisfaction matter? The answer is a resounding “yes.”

In fact, as the director of an emergency department, feedback from dissatisfied patients has provided both me and our group with an early warning about several physicians who were not performing up to our standards. Studies show a clear correlation between decreased patient satisfaction and increased medical malpractice risk, so meeting our patients’ needs is not only in their best interests, …

Health policy

Optimization of the new PCMH neighborhood

Matt Adamson

January 13, 2011Jan 13, 20115

by Matt Adamson There are a number of care models now being explored to improve the manner in which healthcare can be delivered. Let’s take a quick look at a few of the well known options: Accountable Care Organization (ACO):…

by Matt Adamson

There are a number of care models now being explored to improve the manner in which healthcare can be delivered. Let’s take a quick look at a few of the well known options:

Accountable Care Organization (ACO): The ACO model has the ability to provide, and manage with patients, the continuum of care across different institutional settings, including at least ambulatory (outpatient) and inpatient …

Patient voices

Caregiving and living with those who have mental illness

Greg Smith, MD

January 12, 2011Jan 12, 20113

Your mother has been up all night. She has Alzheimer's Disease and now it has progressed to that inevitable stage of the dementing process where she is paranoid, agitated, and confused. She fidgets and paces and walks all day. She…

Your mother has been up all night.

She has Alzheimer’s Disease and now it has progressed to that inevitable stage of the dementing process where she is paranoid, agitated, and confused. She fidgets and paces and walks all day. She gets out of bed multiple times each night. She has gone out the door into the back yard and tried to escape to the street, wearing only her night clothes. Sometimes …

Patient voices

How much we should try to help patients who do not want our help?

a medical resident, MD

January 12, 2011Jan 12, 201111

I recently completed a long stretch of night shifts in the emergency department. I have done a myriad of things – spent over twenty minutes trying to convince a patient to take a pill that she needed to treat her psychosis, sutured a facial laceration for a young gentleman who kept insisting that he wanted to leave AMA (against medical advice) and just place a …

Medical education

How surgery is a team sport, and in awe of neurosurgery

Suchita Shah

January 12, 2011Jan 12, 20116

I recently finished my 10 weeks in Internal Medicine and have moved on to 1 week each of Ophthalmology, Neurosurgery, Anesthesiology, and Otolaryngology. This week: brain surgery. (Tomorrow, the world.) In 3rd grade, I wrote “I want to be a…

In 3rd grade, I wrote “I want to be a brain surgen [sic].” Ever since, it’s been a goal of mine to be a neurosurgeon. Well, until college … when other interests and the anticipated reality of a 7+ year residency …

Real physician voices, twice a week

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