KevinMD.com

August 10, 2010Aug 10, 2010

In January, I wrote a Do it Yourself presentation on meaningful use for folks to use with their Board and Senior leaders. Now that its August, there is a different kind of Do it Yourself document - a letter to…

In January, I wrote a Do it Yourself presentation on meaningful use for folks to use with their Board and Senior leaders.

Now that its August, there is a different kind of Do it Yourself document – a letter to your Board and Senior leaders outlining your plan and timeframe for certification, measurement of meaningful use, and collection of your stimulus funds. We cannot be completely certain about every detail, …

Patient voices

Doctors need to confront end of life care

Philippa Kennealy, MD, MPH

August 10, 2010Aug 10, 201011

"Avoiding those twin traps of overtreatment and therapeutic nihilism" Recognize this phrase? It's from our Hippocratic Oath, the one I took, standing beside my newly assigned cadaver, in my second year of medical school. "What Broke My Father's Heart", recently…

“Avoiding those twin traps of overtreatment and therapeutic nihilism”

Recognize this phrase? It’s from our Hippocratic Oath, the one I took, standing beside my newly assigned cadaver, in my second year of medical school.

“What Broke My Father’s Heart“, recently in the New York Times Magazine, is an exquisitely painful story of medicine and our Oath gone awry in the United States. I urge you to read it.

End-of-life care is …

Patient voices

The Empowered Patient: Finding Dr. Right

Elizabeth Cohen, MPH

August 10, 2010Aug 10, 201013

An except from The Empowered Patient. by Elizabeth Cohen, MPH Did you ever see the Seinfeld episode where Elaine gets into trouble at the doctor’s office? While she’s waiting in the examining room, she sneaks a peek at her chart…

An except from The Empowered Patient.

by Elizabeth Cohen, MPH

Did you ever see the Seinfeld episode where Elaine gets into trouble at the doctor’s office? While she’s waiting in the examining room, she sneaks a peek at her chart and notices that it says she’s “difficult.” When the doctor comes in, he whips the chart out of her hands.

DOCTOR: You shouldn’t be reading …

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Conditions and diseases

What cyberbullies have in common with their victims

MedPage Today

August 10, 2010Aug 10, 2010

by John Gever So-called cyberbullies share many of the psychosocial features as their victims -- and in fact many bullies were also victims themselves, researchers from Finland said. A population-based cross-sectional study surveyed more than 2,000 seventh- and ninth-graders in…

by John Gever

So-called cyberbullies share many of the psychosocial features as their victims — and in fact many bullies were also victims themselves, researchers from Finland said.

A population-based cross-sectional study surveyed more than 2,000 seventh- and ninth-graders in two Finnish communities and found that cyberbullies had higher than average rates of self-perceived difficulties in life, headache, feeling unsafe at school, and perceiving teachers as uncaring, among other problems, reported Andre …

Medical education

Today’s new physicians are unable to improve patient safety

David B. Nash, MD, MBA

August 10, 2010Aug 10, 201010

It has been 10 years since the landmark Institute of Medicine report "To Err is Human" uncovered disturbing deficiencies in the quality of our nation's medical care. Progress in correcting these deficiencies remains frustratingly slow, and it has become clear…

It has been 10 years since the landmark Institute of Medicine report “To Err is Human” uncovered disturbing deficiencies in the quality of our nation’s medical care.

Progress in correcting these deficiencies remains frustratingly slow, and it has become clear that achieving the quality and safety improvements we seek will require us to examine our approach to medical education.

Although today’s newly minted physicians are well prepared in the science of medicine …

Patient voices

Laugh, Sing, and Eat Like a Pig: Facing death, with hope

Dave deBronkart

August 9, 2010Aug 9, 201017

An excerpt from Laugh, Sing, and Eat Like a Pig. Last month Dave deBronkart, known on the internet as “e-Patient Dave,” released his first book, Laugh, Sing, and Eat Like a Pig: How an Empowered Patient Beat Stage IV Cancer…

An excerpt from Laugh, Sing, and Eat Like a Pig.

Last month Dave deBronkart, known on the internet as “e-Patient Dave,” released his first book, Laugh, Sing, and Eat Like a Pig: How an Empowered Patient Beat Stage IV Cancer (and what healthcare can learn from it) (www.LaughSingBook.com).

It’s his personal cancer story – excerpts from the journal he kept …

Conditions and diseases

Male hormone treatment and testosterone replacement concerns

Hans Duvefelt, MD

August 9, 2010Aug 9, 20103

One of my medical school professors was an internationally renowned subspecialist, whose ward occupied the entire top floor of the medical tower at Academy Hospital in Uppsala. He had cadres of residents working for him, and for two glorious months…

One of my medical school professors was an internationally renowned subspecialist, whose ward occupied the entire top floor of the medical tower at Academy Hospital in Uppsala.

He had cadres of residents working for him, and for two glorious months I rotated through his ward as part of my internal medicine training in medical school.

One thing that stands out in my memory, to this day, from those two months is how …

Patient voices

Sharing medical records with patients can save lives

Trisha Torrey

August 9, 2010Aug 9, 20108

Regina Holliday’s husband, Fred, age 39, died of cancer in June 2009 leaving his wife, and his two young, beautiful children behind. During their journey through the healthcare system to try to get Fred the help he needed, too many…

Among the horrors of their journey was the fact that Fred was transferred …

Conditions and diseases

Video games are linked with attention problems in children

MedPage Today

August 9, 2010Aug 9, 20104

by Michael Smith It's not just TV -- video games are also associated with an increased risk of attention problems in children, researchers said. A large study found that children who spent more than three hours in front of a…

by Michael Smith

It’s not just TV — video games are also associated with an increased risk of attention problems in children, researchers said.

A large study found that children who spent more than three hours in front of a computer or television screen — whether playing video games or watching TV — were significantly more likely to have attention problems, according to Edward Swing, MS, of Iowa State University in Ames, …

Health technology

10 EMR don’ts when choosing electronic medical record

Rosemarie Nelson

August 9, 2010Aug 9, 20106

So, you've decided to move forward and get an EMR for your practice, but studies and reports of EMR implementation failures are adding to your anxiety levels. You've probably read scores of rules on how to go about the task…

So, you’ve decided to move forward and get an EMR for your practice, but studies and reports of EMR implementation failures are adding to your anxiety levels.

You’ve probably read scores of rules on how to go about the task — some of them in this column. But today I want to share with you some important things you shouldn’t do.

Medical groups of all sizes and specialties across the country make …

Patient voices

Treating people with humility, and every patient like a V.I.P.

Anesthesioboist T., MD

August 8, 2010Aug 8, 20102

People often seem to think that members of the medical world are excessively preoccupied with, defined according to, and ruled by a status-oriented system. That may have been an accurate perception a generation ago, but I've seen enough surgeons sweeping…

People often seem to think that members of the medical world are excessively preoccupied with, defined according to, and ruled by a status-oriented system.

That may have been an accurate perception a generation ago, but I’ve seen enough surgeons sweeping O.R. floors, attending physicians socializing with interns, and doctors having deep conversations with custodians to believe that “medical people” have matured a little past the old caste systems that governed the …

Medical education

Academic medical centers need better conflict of interest policies

MedPage Today

August 8, 2010Aug 8, 20102

by John Gever Academic medical centers need comprehensive policies to manage their physicians' relationships with industry and other commercial interests, according to the Association of American Medical Colleges (AAMC). Disclosure of such relationships -- both to patients and to their…

by John Gever

Academic medical centers need comprehensive policies to manage their physicians’ relationships with industry and other commercial interests, according to the Association of American Medical Colleges (AAMC).

Disclosure of such relationships — both to patients and to their institutions — should be more detailed than is currently the case at many medical schools, an AAMC task force recommended in a new report.

In particular, significant potential conflicts should be reported annually …

Conditions and diseases

Is migraine pain comparable to torture?

Diana E. Lee

August 7, 2010Aug 7, 20102

by Diana E. Lee Last year, People published an interview with Cindy McCain, wife of U.S. Senator John McCain of Arizona. She revealed she has dealt with excruciating migraine attacks for about 15 years, including during her husband's presidential campaign.…

by Diana E. Lee

Last year, People published an interview with Cindy McCain, wife of U.S. Senator John McCain of Arizona.

She revealed she has dealt with excruciating migraine attacks for about 15 years, including during her husband’s presidential campaign. Though she has never discussed them publicly before, she has chosen to talk about her situation now to help bring awareness to this disabling condition and all the people going through what …

Read more…

Is migraine pain comparable to torture?

Physician voices

Does surgery prevent knee osteoarthritis?

MedPage Today

August 7, 2010Aug 7, 2010

by John Gever Surgery for torn knee ligaments and meniscal cartilage may have improved patients' short-term outcomes, but it did not seem to prevent the eventual development of osteoarthritis, researchers said. A study that followed 326 patients for a mean…

by John Gever

Surgery for torn knee ligaments and meniscal cartilage may have improved patients’ short-term outcomes, but it did not seem to prevent the eventual development of osteoarthritis, researchers said.

A study that followed 326 patients for a mean of 10 years found that radiographic findings shortly after the initial knee injury strongly predicted the long-term clinical course, with no significant difference seen between those who did and did not have …

Health technology

Will patients embrace Health 2.0?

Susannah Fox

August 7, 2010Aug 7, 201014

Someone going by the name "Darthmed" recently posted a comment that stopped me in my tracks: … The remaining 95% of “patients” out there are not motivated to become informed, or invest the time/energy/money in using any of these tools.…

Someone going by the name “Darthmed” recently posted a comment that stopped me in my tracks:

… The remaining 95% of “patients” out there are not motivated to become informed, or invest the time/energy/money in using any of these tools. These are the folks that know that fast food isn’t healthy, but are just too tired to choose differently. Some (emphasis on some) will do a standard Google search when they

…

Read more…

Will patients embrace Health 2.0?

Conditions and diseases

Testosterone and when should low levels be treated in older men

William R. Yates, MD

August 6, 2010Aug 6, 20102

I've been interested in the role of testosterone in physical performance, depression and aging for many years. While at the University of Iowa, I was involved in research to detect testosterone doping, the psychological effects of testosterone and the potential…

I’ve been interested in the role of testosterone in physical performance, depression and aging for many years. While at the University of Iowa, I was involved in research to detect testosterone doping, the psychological effects of testosterone and the potential for testosterone to alleviate depression in older men.

One of the difficult questions facing clinicians is when is testosterone too low in older men.

One problem with answering this question is the …

3 tips to stick with an exercise program

Jeffrey Knuppel, MD

August 6, 2010Aug 6, 20104

How many times have you started a new exercise program and been determined that this time would be different? You’d actually keep it up. You wouldn’t quit. But, a few weeks or months later, you’re back to your old ways.…

How many times have you started a new exercise program and been determined that this time would be different? You’d actually keep it up. You wouldn’t quit. But, a few weeks or months later, you’re back to your old ways. You’re busy, and you have lots of “legitimate” excuses for skipping a fitness routine.

I think most people who have tried to make regular exercise a part of their lives have …

Health policy

Patients will skip care with higher deductibles and copays

Davis Liu, MD

August 6, 2010Aug 6, 201035

The Wall Street Journal reported that overall medical use fell as patients had fewer doctor office visits, lab testing, and maintenance medications possibly due to the recession or as a result of consumer driven healthcare in the way of higher…

The Wall Street Journal reported that overall medical use fell as patients had fewer doctor office visits, lab testing, and maintenance medications possibly due to the recession or as a result of consumer driven healthcare in the way of higher deductibles and copays.

This is very worrisome. Certainly patients should have some financial responsibility for their care, but skimping on care will only result in Americans not becoming healthier, but sicker. …

Patient voices

Laughter and humor heals the soul in life’s most difficult times

MedPage Today

August 6, 2010Aug 6, 20102

by Charles Bankhead My oldest sister died recently. She spent the last three years of her life in a nursing home, trying to hold on to reality and her dignity as her mind and body betrayed her. Barely five feet…

by Charles Bankhead

My oldest sister died recently. She spent the last three years of her life in a nursing home, trying to hold on to reality and her dignity as her mind and body betrayed her.

Barely five feet tall, my sister Peggy had a big heart and a vibrant personality that made her seem much taller. I have a lot of fond memories of her, many of which involve her …

Conditions and diseases

MKSAP: A 35-year-old man with red eye and acute eye pain

mksap

August 6, 2010Aug 6, 20103

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old man is evaluated for red eye and acute onset of right eye pain. He wears contact lenses daily. Fluorescein staining is positive…

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

A 35-year-old man is evaluated for red eye and acute onset of right eye pain. He wears contact lenses daily. Fluorescein staining is positive for corneal abrasion without a dendritic, or branching, pattern. He is instructed to stop wearing the contact …

Real physician voices, twice a week

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