Pediatricians have a role in reporting domestic violence

Conditions and Diseases
May 16, 2010

by Crystal Phend

One of the most effective ways to prevent child abuse may be for pediatricians to identify domestic violence against a child’s caregiver, according to a report from the American Academy of Pediatrics.

Intimate partner violence in the home has a profound effect on kids, Jonathan D. Thackeray, MD, of Columbus Children’s Hospital in Columbus, Ohio, and colleagues wrote in the May issue of Pediatrics.

They pointed to elevated risk of …

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Pediatricians have a role in reporting domestic violence

Crucial public health issues facing legalizing marijuana

Medications
May 16, 2010

So what do I know about this issue? As the physician and City public health administrator tasked with the initial implementation of Proposition 215 (legalizing medical marijuana) – I learned a lot.

On the data side, I compiled every bit of published research about marijuana (positive and negative) from the previous thirty years, researching every conceivable symptom and/or adverse event. The results were published and widely cited. I also …

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Crucial public health issues facing legalizing marijuana

EHR notes and the cut and paste documentation problem

Health Technology
May 15, 2010

“Detritus.”

Not only was that a chance for the Disease Management Care Blog to refamiliarize itself with an underused noun (and, er, its spelling), that was the telling term used today by a DMCB colleague to describe the output from a local health system’s electronic health record (EHR).

He had received a copy of a lengthy consultant-physician’s documentation involving one of his patients and was astonished by the blob of past …

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EHR notes and the cut and paste documentation problem

Brainstorming other income opportunities for doctors

Physician
May 15, 2010

Once you’ve decided that you want to explore other income opportunities, then it’s time to do some preliminary brainstorming.

The goal here is to create a list of business ideas that you would find success in and be happy with. As a physician, you have a distinct advantage if your business plan involves the medical field. However, you do not need to limit yourself to this field as there are enumerable …

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Brainstorming other income opportunities for doctors

Endocrinologists may improve surgical care in diabetic patients

Physician
May 15, 2010

by Kristina Fiore

Shorter hospital stays and lower costs were the result when surgical patients with diabetes and dysglycemia received endocrinology consults, researchers said.

Adding endocrinologists to surgical care teams for patients with abnormal blood glucose readings cut total length of stay among patients in a single center by 1,342 days and saved the hospital $1.15 million, according to Arthur Chernoff, MD, of Albert Einstein Medical Center in Philadelphia.

Chernoff presented his findings …

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Endocrinologists may improve surgical care in diabetic patients

Pediatricians need to wonder when dealing with behavior problems

Conditions and Diseases
May 15, 2010

Last week, I again had the privilege of teaching pediatricians in training. These students were very bright, challenging and asked excellent questions. They all agreed about the limit of the pediatric model of “giving advice.” One resident, who had young children of her own, spoke of new mothers using blogs for emotional support. Many of these mothers speak less than kindly about their pediatricians, who they perceive as “not getting …

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Pediatricians need to wonder when dealing with behavior problems

How doctors can reduce unnecessary tests and treatments

Health Policy
May 14, 2010

Several years ago, when my wife directed the third-year Family Medicine clinical clerkship at a highly ranked medical school, she developed a popular workshop on the cost of health care that presented students with scenarios of patients who were either uninsured or underinsured and challenged them to provide cost-conscious health care by selecting medications and tests that were clinically appropriate and financially affordable.

Many students remarked that it was the only …

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How doctors can reduce unnecessary tests and treatments

Doctors are focusing on lifestyle when practicing medicine

Health Policy
May 14, 2010

An interview with Elizabeth Chase, MD, obstetrician-gynecologist in Dover, New Hampshire

Elizabeth Chase, better known as Betsy, is a close and enduring college friend of my son, Spencer. She is a solid, pragmatic, hard working obstetrician-gynecologist, with two sons, and an architect husband, who spends his time caring for their children and their house in Dover, New Hampshire. She represents many of changes that occur when women become full-time physicians. The …

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Doctors are focusing on lifestyle when practicing medicine

Fight against salt needs consumer help

Medications
May 14, 2010

by Cole Petrochko

As a person who has handled salt in cooking, is prone to headaches from sodium, and has written an article on legislating salt content in prepared and packaged foods, let me tell you about salt, because I know a thing or two.

Well, it would be hard to not know much about salt after the recent string of attention paid to the “white shaken one” — eat too …

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Fight against salt needs consumer help

AMA legal battle a victory for fair pay from insurers

Health Policy
May 13, 2010

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

Physicians filing claims in $350M UnitedHealth Settlement can get help from new AMA guide

by J. James Rohack, MD

In mid-April, the first of 18 million people around the country began receiving legal notices containing details of a record-breaking settlement reached last January in a historic court challenge …

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AMA legal battle a victory for fair pay from insurers

Added sugars worsen cholesterol levels

Patient
May 13, 2010

Added sugars hit a new low this week. A study published in JAMA found that people who consume higher quantities of added sugars have worse cholesterol profiles than those who consume less.

First of, what are added sugars? Added sugars simply put are sugars that are added into foods (in contrast to naturally-occurring sugars that you find in fruits). The JAMA article writes that added sugars are “defined as caloric sweeteners …

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Added sugars worsen cholesterol levels

Medical practice success depends on a strong clinical team

Physician
May 13, 2010

Although every day can bring surprises in a medical practice, you can develop a clinical team that can optimize the efficiencies of your operation and make it easier for you to see your patients.

There are three key areas that lead to provider frustration in daily operations: preparation and anticipation; the daily dance; and being in the moment. Address these, and your days should go more smoothly.

Preparation and anticipation

Are your charts …

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Medical practice success depends on a strong clinical team

Bartering and whether doctors should be paid with chickens

Potpourri
May 13, 2010

Generally, I find my practice works best when I get paid in dollars. They’re convenient. They can be transmitted electronically between bank accounts. Mary and Annie like them. I can spend them by swiping a credit card.

But, in a remarkable effort to win the “Let’s See How Stupid I Can Sound” award, a Nevada candidate for U.S. Senate has proposed ditching the idea of paying doctors in money, and going …

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Bartering and whether doctors should be paid with chickens

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Declining autopsy rate, and how that impacts doctors

Conditions and Diseases
May 12, 2010

The role of autopsy in the medical profession is difficult to overestimate. Western medicine takes its roots from comparative studies between patient’s symptoms and the findings on autopsy.

Participation in an autopsy was one of the most valuable lessons from medical school and residency. If you participated in the patient’s care, there is no greater educational tool than witnessing the postmortem exam. It is especially true if the cause of death …

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Declining autopsy rate, and how that impacts doctors

Apple Store is demonstrating iPhone EMR apps to physicians

Health Technology
May 12, 2010

When I recently walked into my local Apple store to buy an iPad accessory, I saw a group of about 20 people huddled around a large LCD screen while an Apple employee was giving a workshop.

When I saw the LCD screen full of medical applications, I was shocked.  This wasn’t your run of the mill “how to use your iPhone” workshop.

The people gathered for the workshop consisted of healthcare professionals …

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Apple Store is demonstrating iPhone EMR apps to physicians

Activities for family members with dementia

Conditions and Diseases
May 12, 2010

There is a lot of focus on what elders with dementia can’t do. But what about more discussion of what they can do?

When you see a patient with dementia, how do you help family members maintain meaningful interactions with their loved ones? I am sad to admit that I don’t do this nearly as well as I should. After all, this is not the type of thing we are taught …

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Activities for family members with dementia

C-section rates as a marker for obstetric care quality

Conditions and Diseases
May 12, 2010

by Michael Smith

When cesarean section rates are lower than expected, adverse maternal or neonatal outcomes are higher, researchers said.

But the converse isn’t true — higher-than-expected C-section rates aren’t associated with a protective effect, according to Sindhu Srinivas, MD, of the University of Pennsylvania, and colleagues.

The finding comes from an attempt to see if the risk-adjusted C-section rate can be used as a marker for the quality of obstetric care, Srinivas …

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C-section rates as a marker for obstetric care quality

Outpatient internal medicine needs a consultant track

Physician
May 12, 2010

I have spent most of the past 2 weeks on the road – first at ACP and this week at SGIM. I have talked with many internists, but several conversations have contributed to writing this post. Each of several leaders contributed to these ideas, but I will keep them anonymous so the innocent are protected.

Here are the main assumptions:

1. Internists by training excel in the care of complexity
2. Pursuing the …

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Outpatient internal medicine needs a consultant track

Physician assistant name change rubs doctors the wrong way

Health Policy
May 11, 2010

Much like many other news items, I came upon the one about the proposed name change for Physician Assistants quite by accident: it came to me as an e-mail notification of a new topic being discussed on one of the physician only discussion boards that I am a part of. Apparently, after 40+ years of the profession’s existence, there is a grassroots effort afoot to upgrade the name, and presumably …

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Physician assistant name change rubs doctors the wrong way

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