KevinMD.com

June 23, 2008Jun 23, 2008

The following op-ed was published on May 4th, 2008 in the Nashua Telegraph. Communication in medicine grows worse by the day. What should be a pillar of quality health care is instead a resounding failure. Patients are rushed through office…

The following op-ed was published on May 4th, 2008 in the Nashua Telegraph.

Communication in medicine grows worse by the day. What should be a pillar of quality health care is instead a resounding failure.

Patients are rushed through office visits and often leave without having their questions answered. Labyrinthine barriers have to be overcome before speaking with a physician. Reaching a medical provider via the …

Op-ed: Shortage of primary care threatens health care system

June 20, 2008Jun 20, 2008

The following op-ed was published on March 13th, 2008 in the USA Today. Crippling health care bills, long emergency room waits and the inability to find a primary care physician just scratch the surface of the problems that patients face…

The following op-ed was published on March 13th, 2008 in the USA Today.

Crippling health care bills, long emergency room waits and the inability to find a primary care physician just scratch the surface of the problems that patients face daily.

Surveys suggest that health care is a top domestic priority in the presidential election, and there is no lack of ideas on how to fix our system. …

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Doctors are not gods: a surgeon on empathy with patients

Sid Schwab, MD

June 15, 2008Jun 15, 2008

There's an old joke about a guy waiting in line at the Pearly Gates, slowly working his way forward to sign in with St. Peter. Wearing a white coat, carrying a black bag and with a stethoscope slung around his…

There’s an old joke about a guy waiting in line at the Pearly Gates, slowly working his way forward to sign in with St. Peter. Wearing a white coat, carrying a black bag and with a stethoscope slung around his neck, a man walks past those in line and is waved right into Heaven. “Hey, what’s up with that?” asks the guy in line. “How come that person gets to …

Tim Russert and the limits of a normal stress test

June 14, 2008Jun 14, 2008

WSJ Health Blog: "Russert's doctor Michael Newman said the tough-questioning but congenial host of NBC's 'Meet the Press' had been under treatment for asymptomatic coronary disease, but that it was under control with medication. He was carrying excess weight, Newman…

WSJ Health Blog: “Russert’s doctor Michael Newman said the tough-questioning but congenial host of NBC’s ‘Meet the Press’ had been under treatment for asymptomatic coronary disease, but that it was under control with medication. He was carrying excess weight, Newman observed, but he got regular exercise and he performed well on an exercise stress test in April.”

GruntDoc: “I therefore propose a new sign in …

Humor in medicine: why laughter helps patients open up

Rob Lamberts, MD

April 25, 2008Apr 25, 2008

The following is a reader take by Dr. Rob.I don't remember why he came to see me on that day. He was anxious on most of his office visits, so I had to spend most of my time dealing with…

The following is a reader take by Dr. Rob.

I don’t remember why he came to see me on that day. He was anxious on most of his office visits, so I had to spend most of my time dealing with his surplus of symptoms. As I walked in to see him on this day, he started rapidly hitting two fingers of against the top …

Op-ed: Cut Medicare payments for doctors, you’ll have fewer doctors

August 6, 2007Aug 6, 2007

The following op-ed was published on August 6th, 2007 in the New Hampshire Union Leader. Medicare is planning to cut physician payment rates by 10 percent in 2008. These reductions will continue annually, and it is predicted that the total…

The following op-ed was published on August 6th, 2007 in the New Hampshire Union Leader.

Medicare is planning to cut physician payment rates by 10 percent in 2008. These reductions will continue annually, and it is predicted that the total cuts will be about 40 percent by 2016.

The topic of physician compensation generally elicits little public sympathy. After all, the average primary care physician salary in 2006 …

Meds

What “take 2 tablets twice daily” really means on a label

July 31, 2007Jul 31, 2007

What does that mean to you? More patients than you think are confused by drug labels:Did that mean a total of two, or a total of four? A third of patients who were deemed literate got confused. A more clear…

What does that mean to you? More patients than you think are confused by drug labels:

Did that mean a total of two, or a total of four? A third of patients who were deemed literate got confused. A more clear instruction would be: “Take two tablets in the morning and two tablets at night.”

The fix is not complicated. When I write a prescription, I spell out how …

How too much muscle cream caused a fatal overdose

June 9, 2007Jun 9, 2007

Overuse of muscle cream led to this teen's death:A medical examiner blamed a 17-year-old track star's death on the use of too much muscle cream, the kind used to soothe aching legs after exercise.Arielle Newman, a cross-country runner at Notre…

Overuse of muscle cream led to this teen’s death:

A medical examiner blamed a 17-year-old track star’s death on the use of too much muscle cream, the kind used to soothe aching legs after exercise.

Arielle Newman, a cross-country runner at Notre Dame Academy on Staten Island, died after her body absorbed high levels of methyl salicylate, an anti-inflammatory found in sports creams such as Bengay and Icy Hot,

…

Social media

How an anonymous doctor blog surfaced in a malpractice trial

May 31, 2007May 31, 2007

Stunning news. The Boston Globe on Flea, his trial and how his blogging ultimately led from a possible victory to settlement:As Ivy League-educated pediatrician Robert P. Lindeman sat on the stand in Suffolk Superior Court this month, defending himself in…

Stunning news. The Boston Globe on Flea, his trial and how his blogging ultimately led from a possible victory to settlement:

As Ivy League-educated pediatrician Robert P. Lindeman sat on the stand in Suffolk Superior Court this month, defending himself in a malpractice suit involving the death of a 12-year-old patient, the opposing counsel startled him with a question.

Was Lindeman Flea?

Flea, jurors in the case

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Policy

What is defensive medicine, and why do doctors practice it?

April 4, 2007Apr 4, 2007

What is defensive medicine? Defensive medicine is the deviation from sound medical practice to avoid the threat of malpractice litigation. According to a 2005 study in JAMA, over 90 percent of physicians surveyed admitted to practicing defensive medicine. This can…

What is defensive medicine?

Defensive medicine is the deviation from sound medical practice to avoid the threat of malpractice litigation.

According to a 2005 study in JAMA, over 90 percent of physicians surveyed admitted to practicing defensive medicine. This can range from “positive” defensive medicine, like ordering unnecessary tests, referring to consultants, or performing unneeded procedures; to “negative” defensive medicine, like avoiding high-risk patients or procedures. …

4 reasons doctors order unnecessary tests at checkups

May 20, 2006May 20, 2006

I'm happy that this study is getting some play in the media. Essentially, many of the "routine" tests done on a physical are not recommended (the whole concept of a "routine physical" is controversial - but that's for another discussion).…

I’m happy that this study is getting some play in the media. Essentially, many of the “routine” tests done on a physical are not recommended (the whole concept of a “routine physical” is controversial – but that’s for another discussion). Merenstein concludes:

# 37 percent of checkups included a urinalysis.

# 9 percent of checkups included an electrocardiogram.

# 8 percent of checkups included an

…

Is the physical exam dying in American medicine?

February 8, 2006Feb 8, 2006

I have written before that the physical exam is useless in American medicine:This is why the physical exam is useless in American medicine - it cannot hold up in court. Clinical evaluation and judgment skills now needs to be supported…

I have written before that the physical exam is useless in American medicine:

This is why the physical exam is useless in American medicine – it cannot hold up in court. Clinical evaluation and judgment skills now needs to be supported with objective, and often expensive, tests. Here we have a case of three separate physicians who, in their clinical opinion, did not feel a CT scan was warranted.

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Patent foramen ovale and Tedy Bruschi’s 2005 stroke

March 15, 2005Mar 15, 2005

It was just reported that Tedy Bruschi is undergoing surgery for a hole in his heart:New England Patriots linebacker Tedy Bruschi -- who once played for the University of Arizona - is back in the hospital tonight, according to sources…

It was just reported that Tedy Bruschi is undergoing surgery for a hole in his heart:

New England Patriots linebacker Tedy Bruschi — who once played for the University of Arizona – is back in the hospital tonight, according to sources in Tucson and Boston.

The team isn’t confirming this news yet, but KOLD News 13 has learned Bruschi is undergoing surgery to repair a hole in his heart.

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Tedy Bruschi’s 2005 stroke and what causes a brain bleed

February 17, 2005Feb 17, 2005

As has been reported, Patriots linebacker Tedy Bruschi has been hospitalized with some kind of intracerebral bleed. As one can imagine, this is big news here in New England.Here's what we know so far:Patriots linebacker Tedy Bruschi will remain hospitalized…

As has been reported, Patriots linebacker Tedy Bruschi has been hospitalized with some kind of intracerebral bleed. As one can imagine, this is big news here in New England.

Here’s what we know so far:

Patriots linebacker Tedy Bruschi will remain hospitalized while he undergoes additional tests after suffering a broken blood vessel in his head, a Patriots team source told The Boston Globe on Thursday.

Bruschi,

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Why testicular cancer is diagnosed without a biopsy