KevinMD.com

July 14, 2010Jul 14, 20103

Psychiatrists treating patients who can’t talk. Sounds fishy, doesn’t it? Well, I do it 2-3 days per week, and as strange as it may sound, it makes perfect sense. Let me explain. I provide psychiatric consultation services in a facility…

Psychiatrists treating patients who can’t talk. Sounds fishy, doesn’t it?

Well, I do it 2-3 days per week, and as strange as it may sound, it makes perfect sense.

Let me explain.

I provide psychiatric consultation services in a facility for people with intellectual and developmental disabilities. (Intellectual disability is the newer term for mental retardation). Some of my patients are short-term admissions from the community, and others are long-term residents of the …

Physician voices

Fire in the OR and how hospitals should report medical mistakes

Maggie Mahar

July 14, 2010Jul 14, 20107

Did you know that if there is a fire in the OR during surgery hospitals in some states don’t have to report the event to anyone? When I read a recent story in the Cleveland Plain Dealer headlined, “Reporting Surgical…

Did you know that if there is a fire in the OR during surgery hospitals in some states don’t have to report the event to anyone?

When I read a recent story in the Cleveland Plain Dealer headlined, “Reporting Surgical Fires Could Improve Patient Safety in Ohio, Experts Say,” I was stunned.

The piece begins:

When fire breaks out and burns a patient during surgery in Pennsylvania, the hospital is required by law

…

Health policy

Free clinics need more government funding

MedPage Today

July 14, 2010Jul 14, 201010

by Cole Petrochko The nation's free clinics provide medical service to 1.8 million patients annually -- more than half of those clinics operate without government funding and serve patients who are almost all uninsured -- according to the first census…

by Cole Petrochko

The nation’s free clinics provide medical service to 1.8 million patients annually — more than half of those clinics operate without government funding and serve patients who are almost all uninsured — according to the first census of free clinics in 40 years.

Responses to a national mail survey by 764 free clinics in the U.S., reported in the June issue of the Archives of Internal Medicine, revealed that …

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Conditions and diseases

Pregnant with triplets, and a premature delivery

Jennifer Gunter, MD

July 14, 2010Jul 14, 20104

An excerpt from The Preemie Primer. There’s a well-entrenched theory that OB/GYNs have the most complicated pregnancies. In reality most of us probably do not, but doctors remember complications most vividly when they happen to people they know and love.…

An excerpt from The Preemie Primer.

There’s a well-entrenched theory that OB/GYNs have the most complicated pregnancies.

In reality most of us probably do not, but doctors remember complications most vividly when they happen to people they know and love. My pregnancy was, unfortunately, a good example of that old adage. Many of my colleagues who looked after me during that time have said, “It was the worst night of my …

Health technology

Final meaningful use rules for electronic health records reaction

MedPage Today

July 14, 2010Jul 14, 20109

by Joyce Frieden The Department of Health and Human Services has released its final rule on "meaningful use" of electronic health records with the goal of making it easier for physicians to comply. "We want these objectives to be ambitious…

by Joyce Frieden

The Department of Health and Human Services has released its final rule on “meaningful use” of electronic health records with the goal of making it easier for physicians to comply.

“We want these objectives to be ambitious but achievable,” David Blumenthal, MD, MPP, the department’s National Coordinator for Health Information Technology, said at a press conference on Tuesday announcing the release of the …

Medical education

What residents and medical students should wear in the hospital

Shalini Reddy, MD & Vineet Arora, MD

July 13, 2010Jul 13, 201017

At a recent meeting I attended, a vigorous discussion broke out about what medical students, residents and attendings should wear, and more importantly what they should not wear. Interestingly, patients have been asked to weigh in on this discussion. What…

At a recent meeting I attended, a vigorous discussion broke out about what medical students, residents and attendings should wear, and more importantly what they should not wear.

Interestingly, patients have been asked to weigh in on this discussion. What to wear is also on the mind of many current second year medical students who may find themselves trying to take study breaks from USMLE 1 to go buy …

Physician voices

Cancer in a transplant kidney, is it the doctor’s fault?

Amy Tuteur, MD

July 13, 2010Jul 13, 20102

May you never be an interesting case. That's a cautionary proverb familiar to medical professionals. While it's bad to get sick, it's much worse to get sick with something uncommon or unusual. The more fascinating a case is for doctors,…

May you never be an interesting case.

That’s a cautionary proverb familiar to medical professionals. While it’s bad to get sick, it’s much worse to get sick with something uncommon or unusual. The more fascinating a case is for doctors, the more difficult it is for patients. Difficult to diagnose, difficult to treat, and often difficult to survive.

Kenneth Liew was doubly unfortunate. He was an interesting medical case and an interesting …

Health policy

The individual mandate and the impending Supreme Court challenge

Roger Collier

July 13, 2010Jul 13, 201054

The individual mandate is the single most controversial feature of the Patient Protection and Affordable Care Act (PPACA). Everyone who can afford coverage—unless an undocumented immigrant or exempted on religious grounds—is required to have it or pay a penalty of…

The rationale is straightforward: without a mandate, many people would wait until they needed care before buying insurance, driving up premiums for those with ongoing …

Drugs and prescribing

Ecstasy overdose is becoming more frequent at rave parties

MedPage Today

July 13, 2010Jul 13, 2010

by Crystal Phend Overdoses of the "club drug" ecstasy at all-night rave dance parties may be a rising but under-reported public health problem, the CDC said. What may be the first public health investigation into the epidemiology of ecstasy overdose…

by Crystal Phend

Overdoses of the “club drug” ecstasy at all-night rave dance parties may be a rising but under-reported public health problem, the CDC said.

What may be the first public health investigation into the epidemiology of ecstasy overdose revealed that 18 patients landed in hospital emergency departments for illness related to the hallucinogenic stimulant within 12 hours after a Los Angeles New Year’s Eve rave.

This cluster of events was accompanied …

Health policy

Healthcare reform: Who’s getting stuck with the bill?

Shelly Towns

July 13, 2010Jul 13, 20102

by Shelly Towns Many people have the mistaken idea that “socialized healthcare” means that medicine and care will now be free for everyone, but in all actuality, nothing could be further from the truth. The new healthcare bill represents one…

by Shelly Towns

Many people have the mistaken idea that “socialized healthcare” means that medicine and care will now be free for everyone, but in all actuality, nothing could be further from the truth.

The new healthcare bill represents one of the largest, most sweeping domestic policy changes in a generation, and aims to provide an estimated $940 billion in healthcare to over 32 million uninsured Americans (and that’s only for the …

Patient voices

When the doctor is the patient, humanism and competency matter

Wendy Sue Swanson, MD

July 13, 2010Jul 13, 201011

Over the past few weeks I’ve had ample opportunity to be on the other side. Not like some parents with chronically ill children or those with children who have suffered tragic illness. No, not like that; I am fortunate that hospitals aren’t a part of my family’s everyday (except for work). My children have had amazing fortune and I remain in awe of good health. Lately though, we’ve had some …

Drugs and prescribing

Will Avandia survive the FDA advisory panel?

MedPage Today

July 13, 2010Jul 13, 2010

by Crystal Phend and Emily Walker Despite hints that the FDA may be leaning toward pulling rosiglitazone (Avandia) from the market, it's going to be a tough decision for the advisory committee slated to begin meeting on Tuesday, and things…

by Crystal Phend and Emily Walker

Despite hints that the FDA may be leaning toward pulling rosiglitazone (Avandia) from the market, it’s going to be a tough decision for the advisory committee slated to begin meeting on Tuesday, and things could still go either way, leading endocrinologists predict.

“I think the FDA advisory committee is going to struggle with this because none of the data is conclusive,” …

Physician voices

How this OB/GYN handled her unexpected maternity leave

Anonymous

July 12, 2010Jul 12, 2010

About 3 weeks after my son was born I read this post and I was extremely jealous as I read about the author’s extended leave. As I began to consider my "maternity leave" I realized that I could quite possibly…

About 3 weeks after my son was born I read this post and I was extremely jealous as I read about the author’s extended leave. As I began to consider my “maternity leave” I realized that I could quite possibly have a truly unique situation on my hands.

I work in private practice and my husband is an amazing stay at home Dad. We had been waiting to adopt a …

Health policy

AMA health insurer report card finds need for more accuracy

American Medical Association & Cecil B. Wilson, MD

July 12, 2010Jul 12, 2010

A guest column by the American Medical Association, exclusive to KevinMD.com. There has been some notable progress in just two years since the American Medical Association's first National Health Insurer Report Card evaluated the claims processing performance of the nation’s…

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

There has been some notable progress in just two years since the American Medical Association’s first National Health Insurer Report Card evaluated the claims processing performance of the nation’s largest insurers. Health plans have made improvements in the efficiency and transparency of their claims processes, but there is still a lot of room for improvement – and the AMA …

Physician voices

Not all pain patients in the ER are drug seekers

MedPage Today

July 12, 2010Jul 12, 201018

by Melissa Velez-Avrach About eight years ago, I was in an accident that left me with chronic lower back pain and muscle spasms. Then, about a year and half ago, I was in a car accident. Bad combo for the…

by Melissa Velez-Avrach

About eight years ago, I was in an accident that left me with chronic lower back pain and muscle spasms.

Then, about a year and half ago, I was in a car accident. Bad combo for the pain. I’ve been to chiropractors, orthopedic spine specialists, had MRIs, the works and am following my doctor’s recommendations, doing yoga, deep breathing and physical therapy when needed. It has all helped me …

Why technology and the Internet may not be good for patients

Kent Bottles, MD

July 12, 2010Jul 12, 20102

Paro the robot baby harp seal was the final straw. I had vowed to myself not to think about or write about “the internet makes you smarter, the internet makes you dumber” argument. Even when some of my favorite authors…

Paro the robot baby harp seal was the final straw.

I had vowed to myself not to think about or write about “the internet makes you smarter, the internet makes you dumber” argument. Even when some of my favorite authors (Steven B. Johnson, Clay Shirky, Nicholas Carr, and Jonah Lehrer) weighed in, I thought it best not to participate.

And then I read about Paro, either “a disturbing turn in our treatment …

Drugs and prescribing

Is health care experience mandatory for a pharmaceutical CEO?

Roy Poses, MD

July 11, 2010Jul 11, 2010

A persistent theme for Health Care Renewal has been how concentration and abuse of power in health care trap patients and heath care professionals in a maze of bureaucracy, perverse incentives, deception, and conflicts of interest. To anyone who has…

A persistent theme for Health Care Renewal has been how concentration and abuse of power in health care trap patients and heath care professionals in a maze of bureaucracy, perverse incentives, deception, and conflicts of interest.

To anyone who has to make the transition from person to patient, some of these problems become immediately obvious.

Consider, for example, this account of “going into a hospital for a minor procedure”:

The very idea of

…

Conditions and diseases

How H1N1 influenza is similar to the influenza A virus

MedPage Today

July 11, 2010Jul 11, 2010

by Todd Neale The pandemic H1N1 influenza virus is similar to seasonal influenza A viruses in terms of viral shedding, symptoms, and household transmission, researchers in Hong Kong found. The researchers prospectively followed 99 patients testing positive in rapid diagnostic…

by Todd Neale

The pandemic H1N1 influenza virus is similar to seasonal influenza A viruses in terms of viral shedding, symptoms, and household transmission, researchers in Hong Kong found.

The researchers prospectively followed 99 patients testing positive in rapid diagnostic tests for influenza A virus and found 45 had the H1N1 pandemic virus and 54 were infected with a seasonal influenza A virus, H3N2, but the two strains did not differ significantly, …

Health technology

iPhone, Android or Blackberry? The right smartphone for doctors

Iltifat Husain, MD

July 11, 2010Jul 11, 20109

Lately, I’ve often been asked the question, “What type of smartphone should I get?” by my medical peers. I’ve been asked this by physicians, residents, medical students, and others. Many of my friends are entering residency and plan on upgrading…

The answer to this question is not easy. Rather, as Facebook nomenclature would demand, “it’s complicated”. …

Drugs and prescribing

Be skeptical of natural and herbal supplements

Danielle Ofri, MD, PhD

July 10, 2010Jul 10, 201010

A good chunk of every medical visit is spent writing prescriptions. Before we had an electronic medical record, this was often an arduous task, leading to serious writer’s cramp. Now the computer makes it easier on the doctor, but it…

A good chunk of every medical visit is spent writing prescriptions.

Before we had an electronic medical record, this was often an arduous task, leading to serious writer’s cramp. Now the computer makes it easier on the doctor, but it doesn’t seem to have much effect on the patient.

A recent article in the Journal of General Internal Medicine highlighted what most doctors have suspected all along, that a good chunk for …

Real physician voices, twice a week

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