KevinMD.com

May 18, 2010May 18, 2010

by Crystal Phend When children with complex chronic diseases have do-not-attempt-resuscitation orders in place, schools should honor them, the American Academy of Pediatrics urged. More children with diseases that may involve sudden and potentially fatal attacks are attending school due…

by Crystal Phend

When children with complex chronic diseases have do-not-attempt-resuscitation orders in place, schools should honor them, the American Academy of Pediatrics urged.

More children with diseases that may involve sudden and potentially fatal attacks are attending school due to legal and societal trends over the past decade, according to a statement in the May issue of Pediatrics.

While these requests are honored in hospitals and nursing homes, schools may find it …

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Medical education

Burnout is common to teaching violin and practicing medicine

Lisa Chu, MD

May 18, 2010May 18, 20108

I went to medical school and know something about what it’s like to work in clinical environments. I’ve recently started reading blogs and articles about “physician burnout” and I can’t help but notice that there’s a lot of blame being…

I went to medical school and know something about what it’s like to work in clinical environments.

I’ve recently started reading blogs and articles about “physician burnout” and I can’t help but notice that there’s a lot of blame being placed on “the system”. Doesn’t this kind of storytelling just reinforce that physicians are victims? I’d like to see physicians adopt a way of thinking that will enable them to create …

Blood tests in hospitals may be unnecessary

John Schumann, MD

May 17, 2010May 17, 20107

I’ve just finished a month “on-service” as a teaching attending for a general medicine team here at GlassHospital. This means I served as the physician of record for every patient admitted to the team. You might find it interesting to…

You might find it interesting to know that patients admitted to the hospital’s general medicine service get assigned to their teams by random assortment. Since there are five teams, one team takes call every fifth day. In …

Doctors may be forced to accept Medicare rates to stay licensed

Chris Rangel, MD

May 17, 2010May 17, 201034

Massachusetts has a problem. In April 2007, they became the first state to require residents to have health insurance. Reportedly this has resulted in 300,000 newly insured patients and lowered the uninsured population to 5%. But of course, given the…

Massachusetts has a problem.

In April 2007, they became the first state to require residents to have health insurance. Reportedly this has resulted in 300,000 newly insured patients and lowered the uninsured population to 5%. But of course, given the relatively poor reimbursement rates for primary care providers, especially when it comes to government insurance, the state is facing a growing shortage of primary care providers.

Without an adequate supply of primary …

Physician assistant not associate: Reasons against a name change

Paul Dorio, MD

May 17, 2010May 17, 20109

In reference to the seemingly “simple” name change being proposed for Physician Assistants to Physician Associates, I take great exception to the commentary offered by Dr. Zilberberg in her recent article entitled, Physician assistant name change rubs doctors the wrong…

She states: “Physicians have been only too successful at becoming the final word in health, at the exclusion of all others.”

Physicians are the highest and most extensively trained group …

Conditions and diseases

Body mass index (BMI) may not measure obesity accurately

May 17, 2010May 17, 20109

by Kristina Fiore The scale of the obesity epidemic may be much worse than currently believed, because the usual measure, body mass index (BMI), is a very insensitive measure of excess body fat, researchers said. In a single-center study, 66%…

by Kristina Fiore

The scale of the obesity epidemic may be much worse than currently believed, because the usual measure, body mass index (BMI), is a very insensitive measure of excess body fat, researchers said.

In a single-center study, 66% of patients classified as obese on the basis of DEXA scanning had BMI values in the nonobese range, according to Eric Braverman, MD, of New York Presbyterian Hospital/Weill Cornell Medical Center.

Among more …

Patient wants an apology, not money, after medical malpractice

Tricia Pil, MD

May 16, 2010May 16, 201049

This is the true story of a hospitalization as told from three points of view: first, the recollections of the patient (who happens to be a physician); second, events as recorded in the medical charts by doctors and nurses; and…

FRIDAY

Patient:
It is fall 2005, and I am nine months pregnant. A healthy 33-year-old pediatrician, I am a longtime patient of Doctor A and …

Conditions and diseases

Pediatricians have a role in reporting domestic violence

May 16, 2010May 16, 20104

by Crystal Phend One of the most effective ways to prevent child abuse may be for pediatricians to identify domestic violence against a child's caregiver, according to a report from the American Academy of Pediatrics. Intimate partner violence in the…

by Crystal Phend

One of the most effective ways to prevent child abuse may be for pediatricians to identify domestic violence against a child’s caregiver, according to a report from the American Academy of Pediatrics.

Intimate partner violence in the home has a profound effect on kids, Jonathan D. Thackeray, MD, of Columbus Children’s Hospital in Columbus, Ohio, and colleagues wrote in the May issue of Pediatrics.

They pointed to elevated risk of …

Drugs and prescribing

Crucial public health issues facing legalizing marijuana

Jan Gurley, MD

May 16, 2010May 16, 201010

So what do I know about this issue? As the physician and City public health administrator tasked with the initial implementation of Proposition 215 (legalizing medical marijuana) – I learned a lot. On the data side, I compiled every bit…

So what do I know about this issue? As the physician and City public health administrator tasked with the initial implementation of Proposition 215 (legalizing medical marijuana) – I learned a lot.

On the data side, I compiled every bit of published research about marijuana (positive and negative) from the previous thirty years, researching every conceivable symptom and/or adverse event. The results were published and widely cited. I also …

Health technology

EHR notes and the cut and paste documentation problem

Jaan Sidorov, MD

May 15, 2010May 15, 201010

"Detritus." Not only was that a chance for the Disease Management Care Blog to refamiliarize itself with an underused noun (and, er, its spelling), that was the telling term used today by a DMCB colleague to describe the output from…

“Detritus.”

Not only was that a chance for the Disease Management Care Blog to refamiliarize itself with an underused noun (and, er, its spelling), that was the telling term used today by a DMCB colleague to describe the output from a local health system’s electronic health record (EHR).

He had received a copy of a lengthy consultant-physician’s documentation involving one of his patients and was astonished by the blob of past …

Brainstorming other income opportunities for doctors

Michael Woo-Ming, MD

May 15, 2010May 15, 2010

Once you’ve decided that you want to explore other income opportunities, then it’s time to do some preliminary brainstorming. The goal here is to create a list of business ideas that you would find success in and be happy with.…

Once you’ve decided that you want to explore other income opportunities, then it’s time to do some preliminary brainstorming.

The goal here is to create a list of business ideas that you would find success in and be happy with. As a physician, you have a distinct advantage if your business plan involves the medical field. However, you do not need to limit yourself to this field as there are enumerable …

Endocrinologists may improve surgical care in diabetic patients

May 15, 2010May 15, 20104

by Kristina Fiore Shorter hospital stays and lower costs were the result when surgical patients with diabetes and dysglycemia received endocrinology consults, researchers said. Adding endocrinologists to surgical care teams for patients with abnormal blood glucose readings cut total length…

by Kristina Fiore

Shorter hospital stays and lower costs were the result when surgical patients with diabetes and dysglycemia received endocrinology consults, researchers said.

Adding endocrinologists to surgical care teams for patients with abnormal blood glucose readings cut total length of stay among patients in a single center by 1,342 days and saved the hospital $1.15 million, according to Arthur Chernoff, MD, of Albert Einstein Medical Center in Philadelphia.

Chernoff presented his findings …

Conditions and diseases

Pediatricians need to wonder when dealing with behavior problems

Claudia M. Gold, MD

May 15, 2010May 15, 201010

Last week, I again had the privilege of teaching pediatricians in training. These students were very bright, challenging and asked excellent questions. They all agreed about the limit of the pediatric model of “giving advice.” One resident, who had young children of her own, spoke of new mothers using blogs for emotional support. Many of these mothers speak less than kindly about their pediatricians, who they perceive as “not getting …

How doctors can reduce unnecessary tests and treatments

Kenneth Lin, MD

May 14, 2010May 14, 201017

Several years ago, when my wife directed the third-year Family Medicine clinical clerkship at a highly ranked medical school, she developed a popular workshop on the cost of health care that presented students with scenarios of patients who were either uninsured or underinsured and challenged them to provide cost-conscious health care by selecting medications and tests that were clinically appropriate and financially affordable.

Many students remarked that it was the only …

Doctors are focusing on lifestyle when practicing medicine

Richard Reece, MD

May 14, 2010May 14, 20102

An interview with Elizabeth Chase, MD, obstetrician-gynecologist in Dover, New Hampshire Elizabeth Chase, better known as Betsy, is a close and enduring college friend of my son, Spencer. She is a solid, pragmatic, hard working obstetrician-gynecologist, with two sons, and…

An interview with Elizabeth Chase, MD, obstetrician-gynecologist in Dover, New Hampshire

Elizabeth Chase, better known as Betsy, is a close and enduring college friend of my son, Spencer. She is a solid, pragmatic, hard working obstetrician-gynecologist, with two sons, and an architect husband, who spends his time caring for their children and their house in Dover, New Hampshire. She represents many of changes that occur when women become full-time physicians. The …

Drugs and prescribing

Fight against salt needs consumer help

Fight against salt needs consumer help

May 14, 2010May 14, 201013

by Cole Petrochko As a person who has handled salt in cooking, is prone to headaches from sodium, and has written an article on legislating salt content in prepared and packaged foods, let me tell you about salt, because I…

by Cole Petrochko

As a person who has handled salt in cooking, is prone to headaches from sodium, and has written an article on legislating salt content in prepared and packaged foods, let me tell you about salt, because I know a thing or two.

Well, it would be hard to not know much about salt after the recent string of attention paid to the “white shaken one” — eat too …

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