KevinMD.com

January 7, 2011Jan 7, 2011100

I sat at the checkout desk in my practice last week for the first time and as always, it was a revelation. If you haven’t worked your check-in and check-out desks recently, I highly recommend it. An insured patient that…

I sat at the checkout desk in my practice last week for the first time and as always, it was a revelation. If you haven’t worked your check-in and check-out desks recently, I highly recommend it.

An insured patient that I checked out was shocked when I said the charge for her visit was $100. She said, “But he was only in …

Patient voices

Why your health insurance medical appeal was rejected

Nicholas Fogelson, MD

January 6, 2011Jan 6, 201132

One thing that many residents do not know is that there are more benefits to becoming a board certified physician than just that plaque on the wall. One of these benefits is that ability to pick up a few extra hours of work here and there doing consulting for the multitude of companies that would like the opinion or expertise of a physician.

In some cases this consulting can be about …

Health policy

Will health care melt down, like the mortgage industry?

Dan McCoy, MD

January 6, 2011Jan 6, 20116

Clearly, one issue dominated the election this past fall: the economy, and more specifically the lack of jobs. So I would like to pose a few questions and ideas on just how government actually performs in creating economic growth and…

Clearly, one issue dominated the election this past fall: the economy, and more specifically the lack of jobs.

So I would like to pose a few questions and ideas on just how government actually performs in creating economic growth and in kick starting job growth. I don’t necessarily have the answers, but I’m real good at asking questions.

Did government assisted mortgages help the economy? …

Real physician voices, twice a week

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Patient voices

Secrets of good health website design

Lisa Gualtieri, PhD

January 6, 2011Jan 6, 20115

I interviewed Tania Schlatter, one of the best designers I know and a guest-lecturer for Web Strategies for Health Communication, about color, imagery, and other aspects of health website design. Lisa: How is the design of health websites different than…

I interviewed Tania Schlatter, one of the best designers I know and a guest-lecturer for Web Strategies for Health Communication, about color, imagery, and other aspects of health website design.

Lisa: How is the design of health websites different than for other types of sites?

Tania: The design of any site goes back to the goals of an organization and what people coming to a site need. Healthcare consumers can …

Read more…

Secrets of good health website design

Conditions and diseases

MKSAP: 74-year-old man with gradually progressive dyspnea

mksap

January 6, 2011Jan 6, 2011

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 74-year-old man is evaluated for a 5-year history of gradually progressive dyspnea and dry cough without wheezing or hemoptysis. For the past 2…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 74-year-old man is evaluated for a 5-year history of gradually progressive dyspnea and dry cough without wheezing or hemoptysis. For the past 2 years he has had pain and occasional swelling in both knees. He has not had fever or lost weight. He smoked one pack …

Physician voices

Doctors can reduce malpractice by being better people

Aaron E. Carroll, MD

January 5, 2011Jan 5, 20118

My father, although retired, is a general and thoracic surgeon, triple boarded in critical care, who ran a trauma unit. My brother is a pretty successful lawyer. Whenever I visit them, inevitably at least one night ends with the three…

My father, of course, blames the lawyers; my brother …

Physician voices

Measuring health outcomes is important but needs caution

Vipan Nikore, MD

January 5, 2011Jan 5, 20114

I sat at home with a sense of relief. I had just finished my first month of residency - a grueling inpatient hospital month where I was pushed to new limits. I now finally had my first “golden weekend” (meaning…

I sat at home with a sense of relief. I had just finished my first month of residency – a grueling inpatient hospital month where I was pushed to new limits.

I now finally had my first “golden weekend” (meaning I had both Saturday and Sunday off). More importantly, I had survived my first month without any patient deaths on my service. Given how sick people are when they come to …

Health policy

An ACO primer and get started on forming an Accountable Care Organization

Donald Tex Bryant

January 5, 2011Jan 5, 20112

In early 2011 Department of Health and Human Services will be issuing guidelines for the formation of Accountable Care Organizations (ACO’s) for CMS (Medicaid and Medicare). I know of several organizations looking into this type of organization as they anticipate…

In early 2011 Department of Health and Human Services will be issuing guidelines for the formation of Accountable Care Organizations (ACO’s) for CMS (Medicaid and Medicare).

I know of several organizations looking into this type of organization as they anticipate the new guidelines. There seems to be great anticipation of the guidelines in various health care publications that I have recently read. On December 18, 2010 on the Health Affairs website …

Patient voices

How you can reduce preventable mistakes in your medical care

Neil Baum, MD

January 5, 2011Jan 5, 20118

There are nearly 1.5 million Americans who suffer each year from preventable mistakes. A report by the Institute of Medicine estimates that as many as 98,000 people die in U.S. hospitals each year as the result of medical errors. Most…

There are nearly 1.5 million Americans who suffer each year from preventable mistakes. A report by the Institute of Medicine estimates that as many as 98,000 people die in U.S. hospitals each year as the result of medical errors.

Most of these errors are related to drug mistakes. That’s the bad news. The good news is that your doctors and hospitals are trying to reduce these errors by using by using …

Health policy

Government and health insurance intrusion penalizes efficient doctors

Jordan Grumet, MD

January 4, 2011Jan 4, 20118

I wish I knew how to express myself. I wish I knew how to put this into words. How the direction of things has just become depressing. How each day makes me wonder how we got to where we are…

I wish I knew how to express myself. I wish I knew how to put this into words. How the direction of things has just become depressing. How each day makes me wonder how we got to where we are today. And I think back. Back to the beginning.

I think back to my childhood. And how I looked up to my father … the physician. How he died when I …

Patient voices

Start thinking about health literacy in a broader framework

Hilary Seligman, MD

January 4, 2011Jan 4, 20114

I have a patient who I will call Antonia. Antonia is in her early 70’s. She came to the United States from Guatemala many years ago, but never learned to speak much English. This doesn’t cause her much of a…

I have a patient who I will call Antonia.

Antonia is in her early 70’s. She came to the United States from Guatemala many years ago, but never learned to speak much English. This doesn’t cause her much of a problem; her community is small and tightly-knit, so she doesn’t have much need to speak English in her home or her neighborhood. And she has a large family—children and grandchildren and …

Patient voices

Patients will choose their medicine, based on their doctor’s advice

Dave deBronkart

January 4, 2011Jan 4, 20114

TEDMED is a truly extraordinary conference in San Diego, a fall sibling of TED talks focused on medicine. TED talks are just 18 minutes long, chosen and designed to blow your mind. They don’t all hit that level, but many…

True to form, the opening session was a mind-blower. 26 year old Charity Tillemann-Dick stepped out on stage and belted out a soprano aria. I thought that was it – an opening …

Physician voices

Pain contracts threaten the doctor-patient relationship

Kevin Pho, MD

January 4, 2011Jan 4, 201128

Doctors today are wary about treating chronic pain. One of the main worries is precipitating fatal opioid overdoses. Indeed, according to the CDC, and reported by American Medical News, "fatal opioid overdoses tripled to nearly 14,000 from 1999 to 2006…

Doctors today are wary about treating chronic pain.

One of the main worries is precipitating fatal opioid overdoses. Indeed, according to the CDC, and reported by American Medical News, “fatal opioid overdoses tripled to nearly 14,000 from 1999 to 2006 … [and] emergency department visits involving opioids more than doubled to nearly 306,000 between 2004 and 2008.”

Requiring chronic pain patients to sign pain contracts is a way to mitigate this …

Patient voices

Childhood obesity and chronic illnesses that result from being overweight

David B. Nash, MD, MBA

January 4, 2011Jan 4, 20117

Our national health status is in imminent danger from the effects of a condition that most population health experts acknowledge is out of control. I am speaking of obesity -- and, in particular, its increasing prevalence in American adolescents and…

Our national health status is in imminent danger from the effects of a condition that most population health experts acknowledge is out of control.

I am speaking of obesity — and, in particular, its increasing prevalence in American adolescents and children.

Almost every study that has been done concerning obesity shows a correlation with soda consumption. As a result, some states and municipalities have tried to implement initiatives that make it more …

Patient voices

Protecting health care professionals who act based on their conscience

Anonymous

January 4, 2011Jan 4, 201118

I recently came across an interesting article titled “Conscientious Objection Gone Awry — Restoring Selfless Professionalism in Medicine” by Julie D. Cantor, M.D., J.D., in the New England Journal of Medicine. This article argues against a rule, the Provider Refusal…

This article argues against a rule, the Provider Refusal Rule, from the United States Department of Health and Human Services (DHHS) that legally protects health care professionals who act based on their conscience when treating …

Patient voices

Medical care and airlines – should there be a difference?

angienadia, MD

January 3, 2011Jan 3, 20115

A recent article by Pauline Chen features a group of primary care physicians at Tufts Medical Center in Boston, who have created a concierge practice that funnels income into the traditional general medical practice that sees less-advantaged patients. Surveys (performed…

Surveys (performed by the medical center itself) found that patients rated the quality of interactions with their doctors similarly regardless of their affiliation. The only significant differences in responses had to …

Physician voices

An automated call center for your medical practice

Peter J. Polack, MD

January 3, 2011Jan 3, 2011

Having an answering service is essential for the typical medical practice. But what about your regular call center? Do your front desk personnel answer the phone? Do you have a dedicated receptionist? Or a formal call center? Outsourcing services seem…

Outsourcing services seem to be on the rise and medical practices are beginning to realize some cost savings just like other businesses.

The trade-off of course can be the perception of less personalized service. Some …

Health technology

ACP: Clinical decision support – is it time?

American College of Physicians

January 3, 2011Jan 3, 20113

A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP The recently enacted American Recovery and Reinvestment Act (ARRA, 2009) and Patient Protection and Affordable Care Act (PPACA, 2010) contain provisions that,…

A guest column by the American College of Physicians, exclusive to KevinMD.com.

by John Tooker, MD, MBA, MACP

The recently enacted American Recovery and Reinvestment Act (ARRA, 2009) and Patient Protection and Affordable Care Act (PPACA, 2010) contain provisions that, if implemented, will fundamentally change the way that medicine will be practiced in the future.

As I indicated in a prior post, the new Center for Medicare …

Patient voices

Is the media responsible for childhood eating disorders?

Claire McCarthy, MD

January 3, 2011Jan 3, 20119

I really don’t want my children to be overweight. I know this because I see the consequences every day in my practice, consequences like high blood pressure, impending diabetes, or poor self-esteem. At the same time, I really, really don’t…

At the same time, I really, really don’t want my children to have an eating disorder. I know this because I had one.

In college, I suffered from anorexia nervosa. I’m a little more than 5 feet 9 inches tall, …

Real physician voices, twice a week

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