KevinMD.com

August 15, 2010Aug 15, 2010

Raising children in a world full of accessible opinion is a funny thing. Everyone seems to have an idea about how to do this right. Stay home, work full time, work part time, return to work, cry to sleep, not…

Raising children in a world full of accessible opinion is a funny thing.

Everyone seems to have an idea about how to do this right. Stay home, work full time, work part time, return to work, cry to sleep, not cry to sleep, pacifier, no pacifier … the recipe for each of us is different, of course. Often we’re all right in what we’re doing from picking out baby food to …

Physician voices

Practicing medicine as a single parent requires finding balance

Katherine Chretien, MD

August 14, 2010Aug 14, 2010

A couple of months before my son was born 2 1/2 years ago, we were notified that my husband, an active duty member of the Navy, was getting deployed to Iraq. His date of departure was exactly one week after…

A couple of months before my son was born 2 1/2 years ago, we were notified that my husband, an active duty member of the Navy, was getting deployed to Iraq.

His date of departure was exactly one week after my due date. To any wife or family member of a service member, this would be difficult news — a loved one going into a war zone. But, to me, 8-months …

Patient voices

Hospice care and what patients and their families can expect

Aldebra Schroll, MD

August 14, 2010Aug 14, 20104

I often find, when I talk with patients and families about hospice care, there is a palpable sense of relief; relief that there is another option when facing a terminal diagnosis or end stage disease process. Families who have participated…

Families who have participated in caring for their loved one at the end of life are grateful for the guidance provided in hospice care. Patients in turn are grateful to spend their last days at …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Health policy

Comparative effectiveness research (CER) in patient care

Kent Bottles, MD

August 14, 2010Aug 14, 20104

Recently, I was lucky to be invited to a New England Healthcare Institute discussion entitled "From Evidence to Practice: Making CER Findings Work for Providers and Patients" in Washington, DC. How to disseminate and implement Comparative Effectiveness Research (CER) so…

Recently, I was lucky to be invited to a New England Healthcare Institute discussion entitled “From Evidence to Practice: Making CER Findings Work for Providers and Patients” in Washington, DC.

How to disseminate and implement Comparative Effectiveness Research (CER) so that patient care is really improved was the first topic tackled by the expert panel and the moderator, Clifford Goodman of The Lewin Group.

The target audiences for CER findings include: patients, …

Health technology

Apple’s iPad on medical rounds, a hands on physician review

Felasfa Wodajo, MD

August 13, 2010Aug 13, 20103

Recently, we had the chance to check in with Dr. Henry Feldman. He had posted a detailed summary of his experiences using the iPad as his main interface while rotating on service for a week as a hospitalist at Beth Israel Deaconess hospital (BIDMC) in Boston. Dr. Feldman is also Chief Information Architect for the Harvard Medical Faculty Physicians.

The summary of the following report includes …

Health policy

Can a health insurer provide affordable care when its CEO makes millions?

Roy Poses, MD

August 13, 2010Aug 13, 201061

In 2005, we entitled a post, "How Can a $124.8 Million a Year CEO Make Health Care More Affordable?" At that time, we contrasted the enormous compensation given to the then CEO of UnitedHealth, Dr. William McGuire, with the stated…

In 2005, we entitled a post, “How Can a $124.8 Million a Year CEO Make Health Care More Affordable?”

At that time, we contrasted the enormous compensation given to the then CEO of UnitedHealth, Dr. William McGuire, with the stated mission of his corporation. Since then, we have traced the travails of UnitedHealth and its leadership. Dr. McGuire was eventually accused of receiving backdated stock options (which at one time …

Medical education

Will the new resident duty hour rules improve patient safety?

Robert Wachter, MD

August 13, 2010Aug 13, 20104

One of the mantras of performance improvement is that caregivers and provider organizations should learn from their experiences. That’s all well and good, but how about policy-setting organizations? Recently, in the New England Journal of Medicine, two of the Biggest…

Recently, in the New England Journal of Medicine, two of the Biggest Kahunas in the safety and quality worlds – the Joint Commission (TJC) and the Accreditation Council for Graduate Medical Education (ACGME) – announced bold new policies. To their credit, both organizations …

Conditions and diseases

Depressed elderly at risk for dementia or Alzheimer’s disease

MedPage Today

August 13, 2010Aug 13, 2010

by John Gever Elderly people who are depressed may be at twice the risk of developing dementia or Alzheimer's disease over time -- but it's unclear whether depression causes dementia or vice versa, researchers said. Among more than 900 participants…

by John Gever

Elderly people who are depressed may be at twice the risk of developing dementia or Alzheimer’s disease over time — but it’s unclear whether depression causes dementia or vice versa, researchers said.

Among more than 900 participants in the original Framingham Heart Study, almost 22% of those who were depressed when screened between 1990 to 1994 were diagnosed with dementia over 17 years of follow-up, compared with 16.6% of …

Physician voices

Pelvic exam etiquette that doctors need to know

Kathy Kastner

August 13, 2010Aug 13, 201014

I was in a room full of Family Doctors – who call themselves everything but Family Docs: Family Physicians (FPs) Primary Care Physicians (PCPs) General Practitioners (GPs). It was the Society of Teachers of Family Medicine (STFM) Spring Conference, at…

Two men amongst 20 women, all interested in learning more about being Politically Correct (PC) whilst conducting a pelvic exam. Session leaders Drs …

Drugs and prescribing

Why DTC drug marketing still clings to TV

Richard Meyer

August 13, 2010Aug 13, 20102

Top of mind positioning has been replaced with top of page positioning. The old ad model of informing, persuading and reminding are being replaced by involvement, community and empowerment. So why are the nightly network newscasts still being subsidized by…

From all the latest research that I have done, coupled with the research from other sources like Manhattan Research, Pew and Rodale, it’s quite clear …

Medical education

The 80 hour resident work week balances fatigue and independence

Danielle Ofri, MD, PhD

August 12, 2010Aug 12, 201013

How many hours can a doctor work? The residency regulators are back. About ten years ago, the national organization that accredits residency programs (ACGME) set out its first guidelines about how many hours a doctor-in-training can work. Interns and residents…

How many hours can a doctor work?

The residency regulators are back. About ten years ago, the national organization that accredits residency programs (ACGME) set out its first guidelines about how many hours a doctor-in-training can work. Interns and residents finally achieved the vaunted 80-hour workweek. New York State was 15 years ahead on this, having mandated an 80-hour work week in 1989, stemming from the Libby Zion case.

Every patient wants …

Health policy

Medicare needs to take the lead for health care cost control

David Williams

August 12, 2010Aug 12, 20102

One of the big complaints about the recently enacted health care reform law is that it does little to control costs. There is some truth to that because the major focus is on increasing access to insurance. And yet there…

First, with many of the access issues settled, stakeholders can focus directly on cost matters rather than cost-shifting and finger pointing
Second, health

…

Health technology

AMA: A roadmap to qualifying for EHR incentives

American Medical Association & Steven J. Stack, MD

August 12, 2010Aug 12, 2010

A guest column by the American Medical Association, exclusive to KevinMD.com. by Steven J. Stack, MD The high cost of an electronic health record (EHR) system, the often challenging process of implementing new technology into a physician practice, and the…

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

by Steven J. Stack, MD

The high cost of an electronic health record (EHR) system, the often challenging process of implementing new technology into a physician practice, and the difficulty in deciding which system best meets a practice’s needs have deterred many physicians from embracing EHRs.

But with the recent release of the final …

Physician voices

Being admitted to the ICU over the weekend increases risk of dying

MedPage Today

August 12, 2010Aug 12, 20105

by Nancy Walsh Patients admitted to an intensive care unit (ICU) over the weekend face a greater likelihood of dying compared with those admitted on a weekday, a meta-analysis suggested. The meta-analysis, encompassing more than 180,000 weekend and weekday ICU…

by Nancy Walsh

Patients admitted to an intensive care unit (ICU) over the weekend face a greater likelihood of dying compared with those admitted on a weekday, a meta-analysis suggested.

The meta-analysis, encompassing more than 180,000 weekend and weekday ICU admissions, found that even after adjusting for disease severity, the odds ratio for death among those admitted to an ICU over a weekend was 1.08 (95% CI 1.04 to 1.13, P<0.001), according …

Conditions and diseases

Draw a Person test to help with pain management diagnosis

Leonard R. Friedman, MD

August 12, 2010Aug 12, 20102

In diagnosing areas of chronic pain for adult pain management, I have come across a helpful test which I have unable to peer review. It is the Draw a Person test. Pain management physicians have not used this easily identifiable…

In diagnosing areas of chronic pain for adult pain management, I have come across a helpful test which I have unable to peer review.

It is the Draw a Person test. Pain management physicians have not used this easily identifiable test to evaluate the subconscious of the patient. This is done by asking the patient to draw a male and a female, with clothes, on a sheet …

Conditions and diseases

How to prevent and treat mosquito bites in children

Roy Benaroch, MD

August 11, 2010Aug 11, 20102

Summer has already begun, and LeeAnn has already had enough of mosquitoes. She wants to know, “Does taking Vitamin B1 really help keep mosquitoes from biting? How much is safe for children?” I remember a trip to the Florida Everglades…

Summer has already begun, and LeeAnn has already had enough of mosquitoes. She wants to know, “Does taking Vitamin B1 really help keep mosquitoes from biting? How much is safe for children?”

I remember a trip to the Florida Everglades as a child with school—surrounded by mosquitoes, alligators, and miles of swamp, our teachers told us that mosquitoes are a vital part of the food chain, and essential to the ecosystem.

I …

Medical education

Fighting AIDS compelled this student to become a doctor

Timothy Dempsey, MD, MPH

August 11, 2010Aug 11, 20102

by Timothy Dempsey One thing changes everything. While this may be a poor paraphrase of the cheesy slogan ESPN used for the recently finished World Cup, in my life this statement has revealed itself as a universal truth. For me,…

by Timothy Dempsey

One thing changes everything.

While this may be a poor paraphrase of the cheesy slogan ESPN used for the recently finished World Cup, in my life this statement has revealed itself as a universal truth. For me, one book changed everything. It would lead me into research labs, on a trip to disease-riddled Gaborone, Botswana, and pique my interest into an epidemic whose global …

Conditions and diseases

New osteoporosis screening guidelines from the USPSTF

MedPage Today

August 11, 2010Aug 11, 2010

by Todd Neale Postmenopausal women of any age with a 10-year fracture risk equal to or greater than that of a 65-year-old woman and no other osteoporosis risk factors should be screened for the disease, according to draft guidelines from…

by Todd Neale

Postmenopausal women of any age with a 10-year fracture risk equal to or greater than that of a 65-year-old woman and no other osteoporosis risk factors should be screened for the disease, according to draft guidelines from the U.S. Preventive Services Task Force (USPSTF).

The 2002 USPSTF guidelines recommended routine screening only for women ages 65 and older, as well as women ages 60 to 64 with an increased …

Conditions and diseases

Colonoscopy and other screening options for colon cancer

Erin Marcus, MD

August 11, 2010Aug 11, 20102

It’s exceedingly uncommon for a healthy middle-aged man to walk into his doctor’s office and demand a colonoscopy. But even though he lacked a family history, Stanley Thornton, an African-American engineer who was then in his mid-40’s, wouldn’t take no…

“I was concerned that African-Americans do get colorectal cancer earlier, and I said, ‘hey, let me lead by example,’” he said recently. “We argued about it for a …

Health policy

Can HSAs restore the doctor patient relationship?

Charles W. Patterson, MD

August 11, 2010Aug 11, 201011

Is it possible that some do not understand that to promote Healthcare Savings Accounts is the most effective thing we could do to preserve traditional medical practice? In a true doctor-patient relationship only doctors and patients discuss the options agree…

If everyone had a HSA it would be just like the good old days, only better. Everyone …

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular