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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 …

Activities for family members with dementia

Ken Covinsky, MD

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 …

C-section rates as a marker for obstetric care quality

MedPage Today

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 …

Outpatient internal medicine needs a consultant track

Robert Centor, MD

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 …

Causes of Beau Biden’s stroke

Kevin

Conditions and Diseases

May 11, 2010

Beau Biden, son of Vice President Joe Biden, suffered a stroke today.

He is 41-years old, and is expected to make a full recovery according to the medical director of the Center for Heart and Vascular Surgery at Christiana Care Health System:

Biden has what the doctors “believe to be a mild stroke,” according to Gardner. “[He is] “fully alert, …

Read more…

Causes of Beau Biden’s stroke

Physician assistant name change rubs doctors the wrong way

Marya Zilberberg, MD, MPH

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 …

Intern: A Doctor’s Initiation, an audiobook excerpt

Kevin

Medical Education

May 11, 2010

An audiobook except from Intern: A Doctor’s Initiation, now available for download on iTunes.

Intern: A Doctor’s Initiation — Click to play audioclip

by Sandeep Jauhar, MD

Chapter one

I had been an intern less than an hour, and already I was running late. The sloping footpath leading up to the hospital was paved with gray cobblestones. My feet ached as my oversize leather …

Health insurance will be reformed by a little known department

MedPage Today

Health Policy

May 11, 2010

by Joyce Frieden

In one of those “important but little noticed” announcements that government officials are prone to put out, the Department of Health and Human Services recently let the world know – via the Federal Register — that it has created an Office of Consumer Information and Insurance Oversight to assist with implementation of the newly passed health insurance reform law.

This new office has four divisions. Here are a …

Treating cancer needs to be an individual patient decision

Bruce Campbell, MD

Conditions and Diseases

May 11, 2010

The heresy of one age becomes the orthodoxy of the next.
-Helen Keller

The patient returned to my clinic several years after her original thyroid cancer surgery. “The cancer blood test never went completely back to zero,” she told me. “We knew there was cancer in there somewhere. Finally, the new ultrasound machine found it! I guess it is time for more surgery!”

I guess. In my patient’s situation, the latest high resolution diagnostic …

ABIM: Quality medical care needs more than strong systems

Christine K. Cassel, MD

Physician

May 10, 2010

A guest column by the American Board of Internal Medicine, exclusive to KevinMD.com.

Imagine a sub-par doctor at a vibrant health system with care delivered and coordinated by skilled teams, using robust EHRs and other vital supports for physicians and patients. Now imagine an extremely talented, knowledgeable doctor at an underfunded community clinic. This clinic has no real computer system, …

Transparent medical pricing lowers health costs

Michael Kirsch, MD

Health Policy

May 10, 2010

My friend, the Buckeye Surgeon, has resisted reforms in medical residency training programs, that have eased some of the inhumane exhaustion on young interns and residents.

I have a different view on the subject. This issue generates spirited debate in the blogosphere and in teaching hospitals across the country.

Not all medical education reforms, however, provoke controversy. I learned recently from an Ohio medical student that they are now being taught …

Children with fever may not receive antibiotics in the ER

MedPage Today

Physician

May 10, 2010

by John Gever

Up to one-third of children with febrile bacterial infections failed to receive antibiotics in a large emergency department, while 20% of youngsters without such infections received antibiotics unnecessarily, Australian researchers said.

A computer algorithm based on standard test results could do a better job of assigning feverish children to the correct treatment sooner, Jonathan C. Craig, MBChB, PhD, of the University of Sydney, and colleagues reported online in BMJ.

Although …

False patient contact information worsens emergency care

Kevin

Physician

May 10, 2010

One of the biggest emergency room problems is contacting patients after they leave.

Patients sometimes leave false contact information — which makes it difficult for the emergency room staff should problems arise after the visit.

The issue was illustrated in a piece from msnbc.com. Many times, results like blood cultures or x-ray findings take time to return. And if there’s something that needs to be acted upon, contacting the …

Medical malpractice deposition survival tips for doctors

Kevin

Physician

May 9, 2010

An excerpt from How to Survive a Medical Malpractice Lawsuit: The Physician’s Roadmap for Success.

by Ilene R. Brenner, MD

The most important part of your case is upon you: the pretrial deposition. If you do a poor job, you can ruin your case and make a defensible lawsuit become indefensible.

So what is a deposition? It is the sworn testimony of a witness taken before trial, in a location …

Online dermatology visits for acne can be effective

MedPage Today

Physician

May 9, 2010

by Chris Emery

Acne patients who received online treatment from dermatologists had similar outcomes to patients who were treated in the doctor’s office, a new study found.

Patients who participated in “e-visits” with dermatologists experienced similar reductions in inflammatory lesions as those who had office visits, Alice J. Watson, MBChB, MRCP, MPH, of the Center for Connected Health in Boston, and colleagues wrote in the report, published online April 19 in the …

How PCOS can be diagnosed and treated in primary care

Jill of All Trades, MD

Conditions and Diseases

May 9, 2010

Hypothetical case scenario

27-year old female presents to the office with a complaint of irregular periods. Menarche was at age 15, and periods occur about 1-2 times a year. Breast development began at age 9, followed shortly by axillary & pubic hair. Growth spurt was at age 13. She’s been trying to get pregnant for the last one year now, and has never been seen before for her irregular periods.

On physical …

MKSAP: A 21-year-old man is evaluated for painful mouth sores

Kevin

Conditions and Diseases

May 8, 2010

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

A 21-year-old man is evaluated for painful sores in his mouth. Episodes of these sores have occurred two to three times yearly since he was 16 years old, and he believes they are associated with stress. They usually appear on the inside of his mouth as a single, round, painful lesion, lasting for 5 …

Hiatal hernia in women can present with heartburn

Kevin

Conditions and Diseases

May 8, 2010

by David Edelman, MD

Heartburn and acid reflux disease are common problems affecting women of all ages. The problem develops when acid in the stomach backs up into the esophagus. There is a muscle known as the diaphragm that separates the chest from the abdominal cavity. When you eat or drink, the food goes from the mouth down the esophagus, through the diaphragm and into the stomach. …

Indoor tanning can be an addictive behavior

MedPage Today

Conditions and Diseases

May 8, 2010

by John Gever

“Jersey Shore” wannabes beware: some people crave the indoor tanning experience so much that it qualifies as an addiction, researchers said.

Among 229 college students completing a survey, 39.3% met DSM-IV criteria for addiction, reported Catherine E. Mosher, PhD, of Memorial Sloan-Kettering Cancer Center in New York City, and Sharon Danoff-Burg, PhD, of the State University of New York at Albany, in the April issue of Archives of Dermatology.

Participants …

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