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Physician voices

Atul Gawande’s The Checklist Manifesto reviewed

7

Every now and then, I read and enjoy a book, but only later fully appreciate it as its lessons and insights slowly become apparent. Judging by the number of times I’ve said, “That reminds me of Gawande’s observations about ___”…

Every now and then, I read and enjoy a book, but only later fully appreciate it as its lessons and insights slowly become apparent. Judging by the number of times I’ve said, “That reminds me of Gawande’s observations about ___” over the past month, The Checklist Manifesto is one such book.

In this short, deceptively simple volume, Atul (who I count as both friend and inspiration) discusses the …

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Atul Gawande’s The Checklist Manifesto reviewed

Patient voices

Why being President of the United States is a health hazard

Originally published in MedPage Today by Liz O'Brien Exactly whom are we honoring on Presidents (or is it President's) Day? A. George Washington B. George Washington and Abraham Lincoln C. All presidents The answer is more complicated than you'd ever…

Originally published in MedPage Today

by Liz O’Brien

Exactly whom are we honoring on Presidents (or is it President’s) Day?

A. George Washington
B. George Washington and Abraham Lincoln
C. All presidents

MedPage Today The answer is more complicated than you’d ever expect. Probably A is most correct, but if it were up to me, I’d pick C.

Certainly every one of these 43 men has earned the …

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Why being President of the United States is a health hazard

Health technology

Is Google Android or the iPhone the future of mobile smartphones?

6

Over the last few months, a great deal of time has been expended on the “hot competition” between Apple and Google in relation to smart phones. Much of this interest probably had to do with a partially imagined story of…

Over the last few months, a great deal of time has been expended on the “hot competition” between Apple and Google in relation to smart phones.

Much of this interest probably had to do with a partially imagined story of a once close friendship between Apple and Google, founded on their mutual enmity of Microsoft, now fractured on the rocks of competition and greed. While the truth probably isn’t as dramatic, …

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Is Google Android or the iPhone the future of mobile smartphones?

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Physician voices

Some hospitals tube feed patients with advanced dementia

Originally published in MedPage Today by John Gever, MedPage Today Senior Editor Tube-feeding patients with advanced dementia -- a practice whose effectiveness has been questioned by two widely cited literature reviews -- is most common in larger hospitals and those…

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Tube-feeding patients with advanced dementia — a practice whose effectiveness has been questioned by two widely cited literature reviews — is most common in larger hospitals and those run for profit, researchers said.

MedPage Today The odds of a feeding-tube insertion in a hospitalized patient with advanced dementia were about 50% greater …

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Some hospitals tube feed patients with advanced dementia

Physician voices

How the ER is now used to triage every patient

17

The ER is the portal of entry to our hospitals now, for better and for worse. On the plus side, this means that most patients being admitted to general medical and surgical services have a workup at least started and…

The ER is the portal of entry to our hospitals now, for better and for worse.

On the plus side, this means that most patients being admitted to general medical and surgical services have a workup at least started and are triaged appropriately to their destination.

A good ER evaluation should answer the following questions:

1. What’s the nature of the illness?

Are we dealing with the heart, the brain, or an abdominal organ? …

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How the ER is now used to triage every patient

Conditions and diseases

What doctors do when they don’t know the answer

10

Part two of a series. See also part one. Previously I’d discussed how most of the time diagnoses are relatively straightforward. But what do doctors do when a diagnosis isn’t immediately clear to them? Likely one or more of the…

Part two of a series. See also part one.

Previously I’d discussed how most of the time diagnoses are relatively straightforward. But what do doctors do when a diagnosis isn’t immediately clear to them?

Likely one or more of the following:

1. Revert to “novice” thinking. Which, in fact, is completely appropriate. We’re taught in medical school that approximately 90% of all diagnoses are made from the history, so if we can’t …

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What doctors do when they don’t know the answer

Patient voices

End-of-life decisions and making advance directive choices

2

Originally published in MedPage Today by Crystal Phend "I do not want my life to be prolonged if, to a reasonable degree of medical certainty, my situation is hopeless." "I want my life to be prolonged as long as possible…

Originally published in MedPage Today

by Crystal Phend

“I do not want my life to be prolonged if, to a reasonable degree of medical certainty, my situation is hopeless.”

“I want my life to be prolonged as long as possible within the limits of generally accepted medical standards, even if this means that I might be kept alive on machines for years.”

MedPage Today Check …

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End-of-life decisions and making advance directive choices

Medical education

Forcing residents to nap may not improve patient care

6

Originally published in MedPage Today by Emily P. Walker, MedPage Today Washington Correspondent More that a year after the Institute of Medicine (IOM) issued a report calling for mandatory naps for medical residents, the organization responsible for implementing -- or…

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

More that a year after the Institute of Medicine (IOM) issued a report calling for mandatory naps for medical residents, the organization responsible for implementing — or rejecting — the IOM’s controversial recommendation has yet to make a decision.

MedPage Today The Accreditation Council for Graduate Medical Education (ACGME), which has …

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Forcing residents to nap may not improve patient care

Health policy

Op-ed: Health reform requires listening to doctors

7

The following op-ed was published on January 29th, 2010 in The New York Times’ Room for Debate blog. With health reform’s future in peril, President Obama noted in his State of the Union address that the process has “left most…

The following op-ed was published on January 29th, 2010 in The New York Times’ Room for Debate blog.

With health reform’s future in peril, President Obama noted in his State of the Union address that the process has “left most Americans wondering what’s in it for them.”

For reform to succeed, the problems facing most patients today, ranging from their deteriorating relationship with doctors to the consequences of medical malpractice, have …

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Op-ed: Health reform requires listening to doctors

Health policy

Does your cardiologist deserve his salary?

35

Conflicted am I on reading of the strategy of a group of South Miami cardiologists who have written their patients complaining of the cuts to reimbursement, primarily cuts in imaging procedures. A tension emerges from within upon reading the following…

Conflicted am I on reading of the strategy of a group of South Miami cardiologists who have written their patients complaining of the cuts to reimbursement, primarily cuts in imaging procedures. A tension emerges from within upon reading the following quote from a “healthcare expert.”

“I’m not at all sympathetic with the cardiologists,” said Robert Berenson, a doctor who was once in charge of Medicare payment policy and now is a …

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Does your cardiologist deserve his salary?

Health policy

Why Medicare and health care should be deregulated

44

Should health care be controlled or provided by the government? I believe that years of answering 'yes' to this question has been at the root of most of the problems in the American health care system. Let's explore a few…

Should health care be controlled or provided by the government?

I believe that years of answering ‘yes’ to this question has been at the root of most of the problems in the American health care system. Let’s explore a few of these ‘yes’ answers:

Health care for the elderly must be provided by the government. By creating Medicare, the US government has massively and deleteriously affected medicine. The immediate effect …

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Why Medicare and health care should be deregulated

Drugs and prescribing

Medical marijuana has doctors asking questions

8

Originally published in HCPLive.com In January, New Jersey became the 14th state in the nation to legalize marijuana use for certain chronic illnesses. Other states where the use of medical marijuana is permitted include Alaska, California, Colorado, Hawaii, Maine, Michigan,…

Originally published in HCPLive.com

In January, New Jersey became the 14th state in the nation to legalize marijuana use for certain chronic illnesses. Other states where the use of medical marijuana is permitted include Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and Washington; around a dozen more states are weighing pending bills.

The New Jersey …

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Medical marijuana has doctors asking questions

Physician voices

Laparoscopic procedures injure the surgeons that perform them

Originally published in MedPage Today by John Gever, MedPage Today Senior Editor Four out of five surgeons agree: Laparoscopic procedures cause substantial discomfort and pain for the surgeons who perform them. More than 80% of surgeons completing an online questionnaire…

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Four out of five surgeons agree: Laparoscopic procedures cause substantial discomfort and pain for the surgeons who perform them.

MedPage TodayMore than 80% of surgeons completing an online questionnaire reported pain or stiffness in the hands, neck, back, or legs after performing minimally invasive surgeries, according to Adrian Park, MD, of the …

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Laparoscopic procedures injure the surgeons that perform them

Medical education

ACP: Resident work hours – Managing a precarious balance

13

The following is part of a series of original guest columns by the American College of Physicians. by Steven Weinberger, MD, FACP In December 2008 the Institute of Medicine (IOM) released its report entitled “Resident Duty Hours: Enhancing Sleep, Supervision,…

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

In December 2008 the Institute of Medicine (IOM) released its report entitled “Resident Duty Hours: Enhancing Sleep, Supervision, and Safety,” in which it proposed a number of changes to the current regulations developed and enforced by the Accreditation Council for Graduate Medical Education (ACGME).

Since the time …

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ACP: Resident work hours – Managing a precarious balance

Physician voices

Texting and cell phone use are becoming more common in hospitals

9

The cell-phone is a wonderful device. Even I, somewhat Luddite about certain technologies, find it delightfully useful for things like calling my wife when I lose the grocery list, calling my wife for directions and calling my wife to remind…

The cell-phone is a wonderful device. Even I, somewhat Luddite about certain technologies, find it delightfully useful for things like calling my wife when I lose the grocery list, calling my wife for directions and calling my wife to remind me of what I was supposed to be doing. I’m not really a fan of texting, though my wife and oldest son seem to communicate that way quite effectively. It’s …

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Texting and cell phone use are becoming more common in hospitals

Conditions and diseases

Treating ADHD may not improve kids’ school grades

3

Originally published in MedPage Today by Kristina Fiore, MedPage Today Staff Writer Adhering to guidelines when treating children with attention deficit hyperactivity disorder (ADHD) relieved symptoms but had no effect on kids' performance in school or in their relationships with…

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Adhering to guidelines when treating children with attention deficit hyperactivity disorder (ADHD) relieved symptoms but had no effect on kids’ performance in school or in their relationships with others, researchers found.

MedPage Today Although parents and teachers noted significant improvements in symptoms among ADHD kids (P<0.001) in a special treatment program, there …

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Treating ADHD may not improve kids’ school grades

HIMSS 2010 Better Health social media coverage

This year, the Better Health team will be offering live coverage of healthcare’s largest tech conference: HIMSS in Atlanta, March 1-4. Three medical bloggers, Dr. Val Jones, Dr. Mike Sevilla, and Dr. Nick Genes will interview over 40 different exhibitors…

This year, the Better Health team will be offering live coverage of healthcare’s largest tech conference: HIMSS in Atlanta, March 1-4.

Three medical bloggers, Dr. Val Jones, Dr. Mike Sevilla, and Dr. Nick Genes will interview over 40 different exhibitors and stream their interviews live via UStream.

You can ask questions of the interviewees by submitting questions to @drval during …

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HIMSS 2010 Better Health social media coverage

Conditions and diseases

Treating atrial fibrillation with catheter ablation on TV may not be ethical

4

Mauricio Arruda performed a live atrial fibrillation ablation at University Hospitals in Cleveland on the Today Show recently. The 6-minute segment was relentlessly upbeat. The TV producers pulled every trick in the book to overcome the inherent difficulty of portraying…

Mauricio Arruda performed a live atrial fibrillation ablation at University Hospitals in Cleveland on the Today Show recently.

The 6-minute segment was relentlessly upbeat. The TV producers pulled every trick in the book to overcome the inherent difficulty of portraying a hard-to-explain disease like atrial fibrillation and an even harder-to-explain procedure like catheter ablation. Instead of making any effort to truly educate their viewers, the producers took the easy …

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Treating atrial fibrillation with catheter ablation on TV may not be ethical

Conditions and diseases

Magnetic resonance imaging (fMRI) for persistent vegetative state

Originally published in MedPage Today by Michael Smith, MedPage Today North American Correspondent Researchers in England are reporting they have been able to establish limited communication with a man in a persistent vegetative state by using functional magnetic resonance imaging…

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Researchers in England are reporting they have been able to establish limited communication with a man in a persistent vegetative state by using functional magnetic resonance imaging (fMRI).

MedPage Today The 34-year-old man was able to answer simple Yes or No questions by imagining different types of activity, which caused changes …

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Magnetic resonance imaging (fMRI) for persistent vegetative state

Conditions and diseases

Don’t fall into the dementia trap when treating a developmental disability

5

by Lockup Doc In addition to correctional psychiatry, I spend about half of my professional time treating patients with developmental and intellectual disabilities (mental retardation). The majority of my patients have severe or profound mental retardation and are completely nonverbal.…

by Lockup Doc

In addition to correctional psychiatry, I spend about half of my professional time treating patients with developmental and intellectual disabilities (mental retardation). The majority of my patients have severe or profound mental retardation and are completely nonverbal.

Over the years I have observed that when many of them are admitted to the hospital for acute medical or surgical problems, because they are severely cognitively and functionally impaired, they are …

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Don’t fall into the dementia trap when treating a developmental disability

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