KevinMD.com

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 …

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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 …

Physician voices

How physicians can endure the trauma of a malpractice lawsuit

Philippa Kennealy, MD, MPH

September 11, 2010Sep 11, 20109

Several clients have endured the trauma of malpractice law suits, Medicare audits and stinging accusations or criticisms from patients or colleagues that leave them reeling. These clients have shared feelings of: shame despair depression loss of self-worth disillusionment confusion hurt…

Several clients have endured the trauma of malpractice law suits, Medicare audits and stinging accusations or criticisms from patients or colleagues that leave them reeling.

These clients have shared feelings of:

shame
despair
depression
loss of self-worth
disillusionment
confusion
hurt
defeat

Oddly enough, one of the least common feelings they’re able to get in touch with is anger.

Maybe it’s because my clients are self-selected, and many tend to be goal-oriented strivers with a perfectionistic streak. They were, as was I, …

Physician voices

Primary care needs more than 15 minutes for patients

Hans Duvefelt, MD

September 10, 2010Sep 10, 201012

Psychotherapy appointments have traditionally lasted 50 minutes with 10 minutes for paperwork. This has lead to the expression, “the 50-minute hour”. More recently there has been talk of incorporating psychotherapy techniques in brief visits in primary care. The provoking title…

Psychotherapy appointments have traditionally lasted 50 minutes with 10 minutes for paperwork. This has lead to the expression, “the 50-minute hour”.

More recently there has been talk of incorporating psychotherapy techniques in brief visits in primary care. The provoking title “The Fifteen Minute Hour” is from a book about addressing the emotional aspects of disease in primary care during brief appointments. The title and the concept seem relevant to much of

…

Physician voices

How doctors can cope with stress

Walter van den Broek, MD, PhD

September 10, 2010Sep 10, 20102

Often I ask my residents that if you can’t take care of yourself, how do you expect to take care of your patients? Or in another way: the only difference between God and a doctor is that God knows he’s…

Often I ask my residents that if you can’t take care of yourself, how do you expect to take care of your patients?

Or in another way: the only difference between God and a doctor is that God knows he’s not a doctor. These sound like cliches but there is some truth in them. In short, doctors are just ordinary people with ordinary problems who can …

Read more…

How doctors can cope with stress

Conditions and diseases

Contraceptive pill prices have a huge price range

Leslie Ramirez, MD

September 10, 2010Sep 10, 2010

Do you know that the price of a contraceptive pill in Chicago pharmacies varies from $9 (Trinessa, aka generic Tricyclen, at Target pharmacy) to $84 (Loestrin 24 at Kmart pharmacy) a month? That means, over the course of the year, depending on what pill you take and where you shop, you could drop as little as $84 or — let me get my calculator here — $1008! These prices are if you pay out …

Health technology

Beyond the final Medicare and Medicaid EHR incentive rules

Brian Klepper, PhD & David C. Kibbe, MD, MBA

September 10, 2010Sep 10, 20105

by David C. Kibbe, MD, MBA and Brian Klepper, PhD Finally, we have a Final Rule on the Medicare and Medicaid EHR incentive programs. The rules and criteria are simpler and more flexible, and the measures easier to compute. But…

by David C. Kibbe, MD, MBA and Brian Klepper, PhD

Finally, we have a Final Rule on the Medicare and Medicaid EHR incentive programs.

The rules and criteria are simpler and more flexible, and the measures easier to compute. But they are still an “all or nothing” proposition for physicians, who will have to meet all of the objectives and measures to receive any incentive payment. Doctors …

Conditions and diseases

What is an adequate trial of an antidepressant?

Dheeraj Raina, MD

September 10, 2010Sep 10, 20105

Since there are many antidepressants with varying dosage ranges, and many more degrees of variations between individual responses to particular antidepressants, psychiatrists have been unable to agree upon an operational definition of an "adequate trial" of an antidepressant. However, it's…

However, it’s worth looking at some guidelines.

A 2003 study from the Journal of American Medical Association found that only 21.7% of Americans diagnosed with depression received “minimally adequate treatment” in the past 12 …

Patient voices

Bringing a friend or family member on doctor’s appointments

Diana E. Lee

September 9, 2010Sep 9, 201016

by Diana E. Lee Most of the resources I've read about how to prepare for a doctor's appointment recommend bringing a loved one with you so that person can help you remember what the doctor said and make sure you…

by Diana E. Lee

Most of the resources I’ve read about how to prepare for a doctor’s appointment recommend bringing a loved one with you so that person can help you remember what the doctor said and make sure you get your questions and concerns addressed.

But when I read Paula Kamen’s book All in My Head: An Epic Quest to Cure an Unrelenting, Totally Unreasonable and …

Health policy

Working with industry requires building a culture of trust

Thomas Sullivan

September 9, 2010Sep 9, 20109

Howard Brody, a family physician, recently wrote an article in the Annals of Family Medicine discussing, “Professional Medical Organizations and Commercial Conflicts of Interest: Ethical Issues.” The article focused on how AAFP has “recently been criticized for accepting a large…

Howard Brody, a family physician, recently wrote an article in the Annals of Family Medicine discussing, “Professional Medical Organizations and Commercial Conflicts of Interest: Ethical Issues.”

The article focused on how AAFP has “recently been criticized for accepting a large corporate donation from Coca-Cola to fund patient education and materials on obesity prevention,” and how this money has been called a “conflict of interest.” To that effect, Dr. Brody defines such …

Health technology

Physician resistance to EMR and why CPT should be replaced

Mike Koriwchak, MD

September 9, 2010Sep 9, 201021

After 5 successful years with electronic medical records (EMR), I am convinced that the promise of EMR to improve physician practices and to improve the health care system is real. If that is true, why is adoption of EMR currently…

After 5 successful years with electronic medical records (EMR), I am convinced that the promise of EMR to improve physician practices and to improve the health care system is real.

If that is true, why is adoption of EMR currently limited to only 5-10% of medical practices? Why is there so much resistance? As folks who work in heath care IT so often ask, why don’t doctors “get it?” I don’t …

Health policy

Why are most physicians writing their prescriptions by hand?

Bob Doherty

September 8, 2010Sep 8, 201034

Is the pen mightier than the PC? When it comes to prescribing, it appears so. A new report from the Center for Studying Health System Change finds that most physicians write their RX scripts by hand, despite financial incentives for…

Is the pen mightier than the PC?

When it comes to prescribing, it appears so. A new report from the Center for Studying Health System Change finds that most physicians write their RX scripts by hand, despite financial incentives for physicians to adopt electronic prescribing. Even those who have e-RX systems do not always use them, and when they do, they may not to use the features that were …

Real physician voices, twice a week

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