KevinMD.com | Page 477 of 541 | Social media's leading physician voice

The problem with home health care communication

Leslie Kernisan, MD, MPH

Physician

January 6, 2015

Home health care is in many ways a fantastic service, especially for those Medicare beneficiaries who are essentially homebound due to frailty or illness.

But it often feels surprisingly hard to synergize with home health care.

The main problem, as I see it, is that home health care agencies have set themselves up to provide only administratively required communication with the ordering doc. (There are rules governing home health care, you know!)

Now, …

Read more…

The hardest and often worst part of medicine: The waiting

Sarah Mongiello Bernstein, MD

Conditions

January 5, 2015

My brother wears a scar around his neck. It represents his second surgery for papillary thyroid cancer. The first started off the same way. Ugly, red and angry. Curving like an ominous smile around his neck, like a noose. That’s how it felt too — the lump in his throat growing as he sat quietly, alone in a doctor’s office. It’s interesting how physical scars are a visual manifestation of …

Read more…

A prescription to treat polyprovider syndrome

P. J. Parmar, MD

Physician

January 4, 2015

In the United States, we train health care providers on poor people. This is no secret — most medical schools and residencies are in lower income areas. If you have Medicaid or no insurance, you are more likely to find care in an office or hospital where medical students, residents, nursing students, and other trainees rotate; Blue Cross patients don’t let interns watch their childbirth. Even though my residency emphasized …

Read more…

You could get fat from eating healthy foods. Here’s how.

Conditions

January 2, 2015

shutterstock_145891655

Have you ever eaten a healthy meal, maybe some brown rice and stir-fried veggies, and found yourself ready for another meal just a short while later? Or, more often couldn’t overcome a hankering for a satisfying dessert to top off (and undermine the healthiness of) that meal?

As it turns out, this lack of satiety is not merely a function of the …

Read more…

How the kind, humble physician met his demise

Jordan Grumet, MD

Physician

December 30, 2014

shutterstock_44805883

There once was a kind, humble physician who worked for years in an office building across the street from the hospital, toiling day to day to take exceptional care of his patients. He was open and deliberate, calm and thoughtful. He himself hired every secretary and medical assistant, every nurse, and biller. His staff formed a protective family who fiercely advocated …

Read more…

Dear HMO, I don’t want your money

Victoria Dooley, MD

Physician

December 24, 2014

shutterstock_20992963

Dear HMO,

As I prepare to #getcovered or #staycovered, I realize that as a physician, I have an advantage in that I know what specific types of insurance plans would best fit my needs. Unfortunately, this is not the case for many Americans. Most importantly, I know to avoid signing up for certain health maintenance organizations (HMOs). Although I am a strong …

Read more…

Should ACLS certification be mandatory?

Deep Ramachandran, MD

Physician

December 22, 2014

I can recall, though it seems quite long ago, my first basic life support (BLS) course as a first-year medical student. The instructor dutifully demonstrated on a mannequin to eager young medical students what to do if someone is found unresponsive. Shaking the unmoving mannequin she said loudly, “Sir, are you OK?” Then hearing no response she showed us how to …

Read more…

Should radiologists discuss results with patients?

Skeptical Scalpel, MD

Physician

December 22, 2014

Radiologists discussing test results with patients, a subject that has been lurking under the radar for a while, recently came to light because of an article in the New York Times. The idea is that patient anxiety while waiting to find out a test result could be alleviated by an immediate discussion with a radiologist.

That would be very nice, but there are …

Read more…

Don’t pay specialists for being on call. Here’s why.

Physician

December 21, 2014

Every ER has its call roster, that sacred list of oracles, laying out who we can call when our patients need some service that we cannot provide. If I need a cardiologist, or a neurosurgeon or even a dermatologist for some acute emergency condition, all I need to do is ring up the operator and tell them, “This is the ER …

Read more…

A day in the life of a hospitalist

Joshua Allen-Dicker, MD, MPH

Physician

December 20, 2014

I am a young hospitalist who is 16 months into my role at an urban academic medical center. Unlike many of my more senior colleagues who found their way to hospital medicine by circumstance, luck, or as a second career path, I have been planning my career in hospital medicine since the beginning of my residency training.

The things that drew me …

Read more…

Hospital credentialing is one giant mess

Christopher Johnson, MD

Physician

December 19, 2014

Everyone wants to be sure their physician is competent and appropriately trained. The way this is done is through credentialing. A new applicant for privileges to practice at a hospital or other health care facility fills out an application and submits a curriculum vitae that details when and where a physician trained and the certifications obtained, such as specialty boards, and a work …

Read more…

Don’t quit medicine. Here are 5 reasons why.

Suneel Dhand, MD

Physician

December 18, 2014

There’s been a lot of talk recently about low morale and disgruntlement among doctors. A recent article on focused on a list of reasons when doctors know it’s time to quit. I found the article a bit sad and unfortunate, but I’m sure the feelings behind it were sincere.

Another excellent article in the Wall Street Journal last week extensively discussed the factors behind …

Read more…

Tongue cancer in an elderly patient: Thinking of my grandmother

Bruce Campbell, MD

Conditions

December 17, 2014

Old age is no place for sissies.
-Bette Davis

“I want the surgery today!” She started to cry. “I’m ninety-four years old. I’ll accept any risk. Just take this thing out!”

She looked back and forth between the anesthesiologist and me. Her golf-ball sized tongue cancer had been growing over the past six months. It wasn’t changing from day-to-day, but it had increased over the course of the three weeks since we had …

Read more…

How to introduce palliative care to patients

Robert Centor, MD

Physician

December 15, 2014

Did I tell you that I was a big fan of palliative care? Palliative care started around 15 years ago at the VA where I worked. We saw the service evolve. We saw how the palliative care approach improved the quality of both life and death.

Many physicians have not yet accepted or at least understood palliative care. Many physicians use some palliative care principles and believe palliative care is superfluous. …

Read more…

She died thirsty! Ice chips matter when it comes to patient satisfaction.

David Klein, MD

Physician

December 15, 2014

“My wife died uncomfortable and alone. She died thirsty!”

The man who spoke those words came in to the emergency room recently where I was working a shift. He was accompanied by his wife, a 70-year-old with high sugar, weakness, and nausea. The team worked to get her seen under the presumption that her diabetes needed control. Once she was brought back to …

Read more…

Medicine is complex, but doctoring is viewed as being simple

Hans Duvefelt, MD

Physician

December 14, 2014

I keep six honest serving-men
(They taught me all I knew);
Their names are What and Why and When
And How and Where and Who.
– Rudyard Kipling

Medicine has become a very complex, multifaceted science, ranging from pharmacogenetics to psychoneurobiology. Doctoring, however, is increasingly viewed as so simple that you don’t actually have to be a doctor to know how it should be done.

What else could explain why IT people tell doctors what “workflows” …

Read more…

A child psychiatrist: Whether I choose to be one or not

Physician

December 14, 2014

Dr. Kenneth Azar, a mentor of mine at the old Georgia Regional Psychiatric Hospital in Augusta, Georgia, told me something once that has always stuck with me.

He told me that in the early years of his practice, when he was living and working out in Idaho, that he was one of a very small handful of psychiatrists who served the whole state. If an adult with psychosis needed to be …

Read more…

A doctor goes networking, and is horrified by what she finds

Abigail Schildcrout, MD

Physician

December 11, 2014

I was invited to a “networking party.” I went. I was horrified by what transpired there. And disgusted. And felt blindsided. And angry. And blown away by the prevalence of what I couldn’t decide was greed, ignorance, or an unseemly combination of the two. And what magnified the intensity of my repulsion was the fact that a large proportion of the people involved have the …

Read more…

Health care’s future: An interview with a hospital CEO

Trudy Lieberman

Policy

December 10, 2014

Not long ago I interviewed Dr. Todd Sorensen, the CEO of Regional West Medical Center, a 184-bed facility serving a large swath of rural western Nebraska. I’ve known Dr. Sorensen since junior high school, and we’ve kept in touch over the years to discuss the health care system from his perspective as a physician and administrator and mine as a health …

Read more…

A cardiologist undergoes knee surgery. Read what he learned.

Physician

December 10, 2014

The phone rang one evening and a pleasant voice was on the other end. “Hi, my name is nurse so-and-so and I’m the educational coordinator for your upcoming knee surgery. Do you want to go to the patient orientation session?” she asked. “It’s very helpful to go over things before and after your surgery and to answer any questions you might …

Read more…

541

pages

dc-ftr