KevinMD.com

September 16, 2010Sep 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…

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 …

Conditions and diseases

Can scientific knowledge overcome uncontrollable food behavior?

Susan Biali Haas, MD

September 16, 2010Sep 16, 20107

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…

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

Physician voices

Physicians love their work but are frustrated

Aldebra Schroll, MD

September 15, 2010Sep 15, 201064

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…

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 …

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Physician voices

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

Kent Bottles, MD

September 15, 2010Sep 15, 20108

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…

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

…

Conditions and diseases

Health decisions are not entirely based on evidence based data

Kathy Kastner

September 15, 2010Sep 15, 201026

“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.…

“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 …

Health policy

Emergency department utilization and its impact on health care reform

James P. Davison, DO

September 15, 2010Sep 15, 20104

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…

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 …

Health technology

How CPOE violated medical ethics

Anonymous

September 14, 2010Sep 14, 201027

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…

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 for …

Read more…

How CPOE violated medical ethics

Conditions and diseases

Does the DSM-5 medicalize normal behavior?

MedPage Today

September 14, 2010Sep 14, 20107

by John Gever Just about everyone catches colds, and just about everyone who gets one is able to go to work and cook their meals, and they nearly always recover within a few days whether or not they take anything…

by John Gever

Just about everyone catches colds, and just about everyone who gets one is able to go to work and cook their meals, and they nearly always recover within a few days whether or not they take anything for it. That’s normal.

So, is the advice to take aspirin “medicalizing normal behavior”? Are drug companies that market decongestants and fever reducers “medicalizing normal behavior”?

The answer …

Patient voices

Talk to your own doctor when hearing advice on the radio

Adam Linker

September 14, 2010Sep 14, 20103

A doctor at Sloan-Kettering Cancer Center recently advised that I submit to genetic testing without ever having met me. It turns out I may harbor a gene that increases my risk of developing prostate cancer. This unsolicited advice was delivered…

This unsolicited advice was delivered via National Public Radio after a story on the JAMA study of preventive breast and ovarian surgery in women with BRCA1 or BRCA2 genes. Dr. Kenneth Offit …

Medical education

Social science requirements for pre-medical students

Robert Wachter, MD

September 13, 2010Sep 13, 20109

I thought I was an oddball in college. I've only recently learned that I was avant garde. Right before beginning college in 1975, I decided I wanted to be a doctor. Being the first-born son – with decent SATs –…

I thought I was an oddball in college. I’ve only recently learned that I was avant garde.

Right before beginning college in 1975, I decided I wanted to be a doctor. Being the first-born son – with decent SATs – of an upwardly mobile Long Island Jewish family, I had relatively little choice in the matter. Notwithstanding this predestiny, I felt confident that medicine was a good fit for my interests …

Physician voices

Is health care shifting towards convenient retail clinics?

David Williams

September 13, 2010Sep 13, 201022

Mark Perry provides an interesting inference from two news stories: a WSJ article that suggests consumers are using less health care and another that reports a big jump in MinuteClinic volumes. Consumers aren’t necessarily consuming less health care like the…

Mark Perry provides an interesting inference from two news stories: a WSJ article that suggests consumers are using less health care and another that reports a big jump in MinuteClinic volumes.

Consumers aren’t necessarily consuming less health care like the WSJ suggests; rather, they are shifting their demand for health care away from expensive, conventional physician offices with limited hours to affordable and convenient retail clinics. Especially

…

Patient voices

A primary care physician who knows history and can relate to people

MedPage Today

September 13, 2010Sep 13, 20105

by Marianne Mattera Recently, a press release from Mount Sinai School of Medicine in New York City landed in my e-mail inbox. "Students with Humanities Background Equally Successful in Medical School as Traditional Students", the headline read. The press release…

by Marianne Mattera

Recently, a press release from Mount Sinai School of Medicine in New York City landed in my e-mail inbox. “Students with Humanities Background Equally Successful in Medical School as Traditional Students”, the headline read.

The press release summarized the findings of a study published in the August issue of Academic Medicine. David Muller, MD, and Nathan Kase, MD, reviewed data on the Mount Sinai …

Patient voices

All patients will soon become e-patients

Daphne Swancutt

September 13, 2010Sep 13, 201040

by Daphne Swancutt I’m having a weird, visceral reaction to all of the recent brouhaha surrounding the term “e-patient.” For some reason, semantically speaking, the term is slipping in to derogatorium. Up there with “cyberchondriac,” which definitely is derogatory. It’s…

by Daphne Swancutt

I’m having a weird, visceral reaction to all of the recent brouhaha surrounding the term “e-patient.”

For some reason, semantically speaking, the term is slipping in to derogatorium. Up there with “cyberchondriac,” which definitely is derogatory. It’s kind of like research—one day, omigod, it’s Mecca; the next day, it’s the scab on a rotting wound.

Whatever.

I have a chronic condition—I’m not dying, it’s not …

Physician voices

“A Pediatric Surgeon in Iraq” does not disappoint

911Doc, MD

September 12, 2010Sep 12, 2010

by 911Doc, MD I can't help but stand in awe of surgeons. I thought I was going to be one when I went to medical school, but my short attention span and my lack of true interest in the procedures…

by 911Doc, MD

I can’t help but stand in awe of surgeons. I thought I was going to be one when I went to medical school, but my short attention span and my lack of true interest in the procedures spelled doom for that. Still, when I work in the ER and I have a surgical patient, I especially want to dot my i’s and cross …

Conditions and diseases

Why you need the pertussis vaccine, especially if you have children

Roy Benaroch, MD

September 12, 2010Sep 12, 20103

A reader wrote, “A friend sent me a link to information regarding the pertussis vaccine for adults. I have a 6 month old. What are your thoughts?” I wrote about vaccines for parents of newborns last year, but recent news…

A reader wrote, “A friend sent me a link to information regarding the pertussis vaccine for adults. I have a 6 month old. What are your thoughts?”

I wrote about vaccines for parents of newborns last year, but recent news about several outbreaks of pertussis make this question especially important. It’s time for an update.

Pertussis, also called “whooping cough,” is bad news. For children …

Physician voices

Doctors and family members often push for futile, aggressive care

Erin Marcus, MD

September 12, 2010Sep 12, 201013

Every once in a while, there's a magazine piece that so encapsulates the key moral issues -- and irrationality -- of 21st Century medicine that it warrants designation as mandatory reading for anyone who interacts with patients. Atul Gawande has…

Every once in a while, there’s a magazine piece that so encapsulates the key moral issues — and irrationality — of 21st Century medicine that it warrants designation as mandatory reading for anyone who interacts with patients. Atul Gawande has written some of these; so too has Slate medical columnist, Darshak Sangavi.

The latest entry on the required reading list is Katy Butler’s “My Father’s Broken Heart,” which appeared …

KevinMD.com in the New York Times and New York Post and other recent media mentions

Kevin

September 12, 2010Sep 12, 2010

I’d like to thank various media outlets for recently citing KevinMD.com. In her New York Times diagnosis column, The heat of the night, Lisa Sanders discusses the case where a patient live-blogged his hospital stay, crowd sourcing his diagnosis: Schumann…

I’d like to thank various media outlets for recently citing KevinMD.com.

In her New York Times diagnosis column, The heat of the night, Lisa Sanders discusses the case where a patient live-blogged his hospital stay, crowd sourcing his diagnosis:

[Physician blogger John] Schumann was worried, too. He lived nearly a thousand miles away — too far to come and see his friend. Besides, the patient was posting all his test

…

Health policy

Patients don’t believe the evidence, blame our healthcare system

Trisha Torrey

September 11, 2010Sep 11, 201020

Health Affairs reports on a study that finds Evidence That Consumers Are Skeptical About Evidence-Based Health Care. According to the abstract, We found many of these consumers’ beliefs, values, and knowledge to be at odds with what policy makers prescribe…

Health Affairs reports on a study that finds Evidence That Consumers Are Skeptical About Evidence-Based Health Care.

According to the abstract,

We found many of these consumers’ beliefs, values, and knowledge to be at odds with what policy makers prescribe as evidence-based health care. Few consumers understood terms such as “medical evidence” or “quality guidelines.” Most believed that more care meant higher-quality, better care. The gaps in

…

Health technology

10 tips for troubleshooting complex EHR infrastructure problems

John Halamka, MD

September 11, 2010Sep 11, 2010

I recently joined my team while troubleshooting a complex infrastructure problem affecting our community EHR hosting private cloud. From years of experience doing this, here are my lessons learned. 1. Once the problem is identified, the first step is to…

I recently joined my team while troubleshooting a complex infrastructure problem affecting our community EHR hosting private cloud.

From years of experience doing this, here are my lessons learned.

1. Once the problem is identified, the first step is to ascertain the scope. Call the users to determine what they are experiencing. Test the application or infrastructure yourself. Do not trust the monitoring tools if they indicate all is well but the …

Real physician voices, twice a week

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