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A critique of interoperability, big data, and AI in medicine

Tech

March 27, 2022

Today medical records are developed for a single encounter (an outpatient visit or hospital stay). The medical records for an encounter are signed off at the end of the encounter and cannot be changed. An addendum medical record can be added later to correct misinformation in the encounter medical records, but this is seldom done.

This process enables medical documents to be legal recordings of what happened during each encounter. But …

Health care and the Latinx experience [PODCAST]

The Podcast by KevinMD

Podcast

March 26, 2022

“Knowing that an important number of Latinx are not yet fully vaccinated and understanding the health care gaps and social disparities that affect this group, it is reasonable to assume that the Latinx community will be disproportionately affected by the pain and sorrow of the new wave of the …

The true story of morphine milligram equivalents

Charles Dinerstein, MD, MBA

Meds

March 26, 2022

They are the foundation of the CDC’s 2016 opioid guidelines, resulting in legislation limiting opioid prescribing in 36 states. Morphine milligram equivalents, or MMEs, are used to set arbitrary prescribing limits for opioids by physicians since many state legislators fail to understand — and translate into policy and law — the ’16 guidelines. If we had all known the history of MMEs, perhaps we would not have been so eager …

Doctor, why don’t you care?

Anne M. Miller, DO

Physician

March 26, 2022

“Doctor, why don’t you remember when I was last hospitalized? I told you about that two months ago. You obviously don’t care if you can’t remember. Is all of psychiatry like this? Maybe I need to see someone else. Why won’t you prescribe Ambien for my insomnia during pregnancy along with all the other medications I am on? My last doctor had no problem giving me Ambien during pregnancy.”

This was …

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Doctor, why don’t you care?

Restoring the value of primary care

Robert Pearl, MD

Physician

March 26, 2022

In most professions, the pecking order is clear, even when there’s no formal designation.

Take pro football. Although nothing in the rulebook grants status or authority to certain players, everyone knows the starting quarterback is the most valuable person on the field. That’s because no other player can do more to win (or lose) a game.

You might assume the same type of logic applies to medicine. If saving …

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Restoring the value of primary care

Patients need palliative care to manage the pain of sickle cell disease [PODCAST]

The Podcast by KevinMD

Podcast

March 25, 2022

“Sickle cell disease (SCD) affects about 100,000 Americans as an inherited genetic disorder with intermittent exacerbations requiring hospitalization. SCD is also a painful and complicated disease with no single physician specialist that can provide pain relief. While SCD pain is similar in severity to cancer pain, patients struggle to find …

Food allergies are a growing public health concern, not a joke

Lianne Mandelbaum, PT

Conditions

March 25, 2022

I was truly gutted when watching the recent Saturday Night Live that joked about nut allergies. My son Joshua, who is 16 years old, has an anaphylactic peanut allergy. I found the segment to be insensitive to the millions of people globally who live each day with food allergies, an invisible but potentially fatal disease.

How do I explain to my son that it is OK to make …

Financial infidelity: It’s not about the money, it’s about trust

Shane Tenny, CFP

Finance

March 25, 2022

If you have never heard the term “financial infidelity,” it doesn’t mean you don’t know what it is. In fact, according to a recent creditcards.com survey, 32 percent of respondents have financially cheated on their partners. Both finances and cheating can be complex subjects to discuss, even with and, sometimes especially with, those closest to you. Not surprisingly, this topic is pertinent to physicians and dentists because they tend to …

Concerns about the generic formulations of ADHD medications

Jolene Won

Meds

March 25, 2022

I love generic brand products. I will fight to the last breath for my Shoppers’ Choice Adhesive Bandages rather than pay an extra $0.49 for Band-Aids. So why, then, have I been paying up to $395 every month for brand-name medication for the last two years instead of getting the generic version for $7.56? After all, aren’t generic drugs the same as their brand-name counterparts?

Let’s go back to November 2019, …

We’re failing people with opioid use disorder [PODCAST]

The Podcast by KevinMD

Podcast

March 24, 2022

“We know regulators can move quickly to confront a health crisis because we have seen it in action. During COVID, the nation eased regulatory burdens at all levels of government to help health systems and doctors leverage technology and change the way they deliver care and to drive vaccine …

We are not defined by what we eat

Wendy Schofer, MD and Erin Schofer

Conditions

March 24, 2022

Throughout history, ancient tribes practiced cannibalism with the intent of bolstering their own courage or energy by consuming their defeated enemies. They wanted to be what they ate: full of courage and vigor. They would even eat their enemies to vanquish their energetic spirits before they ascended to the afterlife.

Christian Communion also practices the consumption of the figurative blood and body of Christ. It serves as a remembrance …

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We are not defined by what we eat

Understanding consent-to-settle in your malpractice insurance policy

Jennifer Wiggins

Policy

March 24, 2022

Arguably one of the most overlooked yet incredibly important aspects of your malpractice insurance policy is the Consent to Settle Provision. You’re paying thousands of dollars a year for your malpractice insurance; you should have a say in how your claims are handled, don’t you think? Today we’re going to talk about the consent to settle provision – why it’s important, how carriers can limit you, and what you can …

Human beings are more than their genes

Dustin Grinnell

Conditions

March 24, 2022

An excerpt from The Empathy Academy.

It might be tempting to choose an easier path, Monty thought, but amid the stress, pain, and tragedy, there were also triumphs: A patient’s seizures stop. A CT scan is clear. He remembered resuscitating Mrs. Caldwell and feeling a wave of relief upon …

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Human beings are more than their genes

A body part that fills me with a roller coaster of emotion [PODCAST]

The Podcast by KevinMD

Podcast

March 23, 2022

“Their absence makes me feel sad,
I look around at my peers, envious and curious,
Obsessing over when they will show up.
When they do, they never seem to live up to expectations,
Too small, too uneven, but what’s sure is it’s a sign I’m no longer a child.

It adds to my wardrobe …

A neurosurgeon and patient satisfaction scores

Barbara Lazio, MD

Physician

March 23, 2022

Over coffee each morning, I quickly skim the headlines on my laptop before heading to work. It is Washington winter, it is dark outside, and the headlines in health care news are grim. Health care workers are burned out. Doctors are working hard all day and coming home to find scathing reviews on online rating sites. Some have their compensation tied to the results of patient surveys. Patients are trusting …

A photographic exploration of the physician’s inner life

Nina Shevzov-Zebrun

Physician

March 23, 2022

I entered my Manhattan apartment around midnight, roughly an hour after observing a transplant team recover kidneys and a liver from a young patient newly pronounced dead. Still wearing scrubs, I sat down on my bed, and, like a ghostly twin or guardian angel, watched myself spill tears.

The scene I witnessed in the operating room that evening as a second-year medical student was at once grotesque and hallowed, shocking and …

5 ways that health IT can improve health equity

Robert Murry, MD

Tech

March 23, 2022

On March 10, I had the distinct privilege of presenting to the ONC Health IT Advisory Committee at their meeting titled “Health Equity by Design.” The presentation highlighted five areas of focus for health IT in reducing health disparities: health equity data collection, actionable analysis of the data, integration of health care and social service providers, the special role that health information exchanges (HIEs) can play, and access to health …

The invisibility of mental illness

William Lynes, MD

Conditions

March 23, 2022

While the mental illness patient is afflicted by very real and painful feelings, these feelings are internal and not visible to others. The indications of the condition then, whether those of depression, anxiety, or even hallucinations, can be said to be invisible to observers — family, doctor, etc. — in fact, to everyone other than that individual sufferer of mental illness.

A constellation of signs and symptoms is often used to …

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The invisibility of mental illness

To my patient who is going to lose her hair from chemotherapy [PODCAST]

The Podcast by KevinMD

Podcast

March 22, 2022

“I understand that the biggest fear you have about going through chemotherapy is losing your hair. I just want to tell you. You will be fine. Trust me.

I know it’s barbaric. Why don’t we have medicines to treat cancer that will not make you lose your hair in this …

A primary care physician’s gut feelings

Gerald P. Corcoran, MD

Physician

March 22, 2022

To spend an entire college year (two semesters) studying epistemology seemed like a colossal waste of time when I was 19. We had no choice; we had to take it, and I got a pretty good mark, as I recall. It took a half year to find out what it was about, but it seemed to concern itself with how we obtain knowledge. There is inductive reasoning and deductive reasoning …

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A primary care physician’s gut feelings

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