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Stop the patient leakage in primary care practices

Physician

August 24, 2017

Yesterday, we had a meeting about leakage.

No, it was not about urinary or fecal incontinence, but it was about care that could have been provided within our institution that ended up, for a multitude of reasons, happening with providers beyond the walls of our institution.

Representatives from our accountable care organization had requested a meeting to go over some issues they’ve been having with our practice, including low levels of usage …

This doctor sings to her patients. And the results are beautiful.

Jessica Jameson, MD

Physician

August 22, 2017

I am an interventional pain physician. I spend most of my days doing spine injections with a fair amount of kyphoplasties and spinal cord stimulators thrown in as well. It seems to me that these are minor procedures that shouldn’t evoke anxiety in patients, but they do. Patients get nervous. They get anxious.

I am also a singer. I had the privilege of being classically trained through my college years. Like …

A letter from a parent to her child’s pediatrician

Tracy Asamoah, MD

Physician

August 21, 2017

I am a child psychiatrist who is also a patient, a mother of patients and the wife of a patient. I have lived all sides of health care and appreciate the complexity that is our American health care system. After a recent move to a different part of town, we decided to find a new pediatrician for our daughters.

I knew that we had several good options near our home. When …

Online physician reviews: Patients are the ones who will suffer

Kaci Durbin, MD

Physician

August 20, 2017

The rise of the Internet has changed many things in the world of the customer. Now, in the age of the online consumer, a person can search for not only the exact item or service he or she wants, but read hundreds of reviews on that particular item or service. Thanks to Yelp and a host of other online rating sites, a person can find a reputable painter or contractor …

We look at the same picture but see different things

Nonye Aghanya, FNP-C

Physician

August 19, 2017

As you look at the above image, please let me ask you a simple question: “What do you see?”

Do you see a sick man lying on a bed with a friendly looking doctor standing by his bedside?

Do you see only men in the picture and wonder, “Why not women?”

Do you see a clinical setting of an engaging sketch of a doctor and …

Doctors: Don’t emotionally detach

Sasha K. Shillcutt, MD

Physician

August 18, 2017

“He is the best physician who is the most ingenious inspirer of hope.”
– Samuel Taylor Coleridge

I was a third-year medical student on a Sunday morning when the reality of what I had chosen as my life career truly hit me in the gut. At that moment, I realized how intimate the practice of medicine was and that I would have to bring not only my brain and skills to work …

Read more…

Doctors: Don’t emotionally detach

Doctors: Are you employees, business owners or entrepreneurs?

Pamela Wible, MD

Physician

August 17, 2017

Hate your job? You may be in the right profession, but the wrong position for your personality. Want to love your life and career? Step one: discover whether you are an employee, a business owner or an entrepreneur.

Here’s how to figure it out:

Employees are risk averse and like to know the rules. They thrive on structure and predictability. They need clear instructions …

Is it OK for a physician to retire early?

Dads Dollars Debts, MD

Finance

August 17, 2017

This is a tough post to write. I struggle with this issue daily. Is it OK for a physician to retire early? The obvious answer is: yes. Each individual should live their life as they see fit. But with a continued shortage of physicians (granted this is more in rural areas and not big metropolitan cities), and the time, money and resources required for training physicians, is it selfish to …

We must make the word “diagnostician” the most prestigious term in medicine

Robert Centor, MD

Conditions

August 16, 2017

The Society to Improve Diagnosis in Medicine has on its website this quote:

1 in 10 diagnoses are incorrect.
Diagnostic error accounts for 40,000-80,000 U.S. deaths annually — somewhere between breast cancer and diabetes.
Chances are, we will all experience diagnostic error in our lifetime.

The current focus on diagnostic error raises an interesting question: Is this a larger problem in 2017 than in the 1970s and 1980s?

In this post, I …

Why pediatricians should not kick out unvaccinated children

Michael D. Pappas, MD

Physician

August 15, 2017

We in the medical community believe wholeheartedly in the prevention of all illness, especially by vaccination. Science and history continue to show that vaccination dramatically decreases both the mortality (death rate) and morbidity (severity of illness) of infectious diseases. And, more than 98 to 99 percent of the general population (non-medical) agrees with those statements as well.

Yes, it is absolutely frustrating when parents refuse to follow our advice and protect …

The problem with the free market in health care

Roy Benaroch, MD

Policy

August 14, 2017

Competition often works. Competing dry cleaners or donut shops must either improve the quality of their product or keep their prices low, or customers will go somewhere else for their cruller fix. In time, the better businesses — the ones that provide tastier pastries at a lower price — will thrive, and less-good, more-expensive businesses will go away. In the long run, all customers benefit from competition between businesses.

That’s how …

A code in the cath lab that was unlike anything I had ever seen

Daniel Mishkin, MD

Conditions

August 14, 2017

An excerpt from The Other Side of the Bed: What Patients Go Through and What Doctors Can Learn.

As soon as I’d opened my mouth, I regretted it. In the hospital, it’s bad luck to say “It looks quiet,” or anything to that effect. At the sound of those words, …

Residents need to learn medicine, not how to pass a test

Eric W. Toth, DO

Education

August 14, 2017

In his famous novel, Moneyball, Michael Lewis illustrates the phenomenon of professional baseball scouts focusing on all the wrong characteristics when looking at players. He describes how scouts focus on fastball velocity as a way to compare pitchers, despite the lack of correlation between fastball speed and the quality of a pitcher. As it turns out, the most important factor in a pitcher is deception, not a high-velocity fastball. The …

A nurse was attacked in the emergency department. This is her story.

Debbie Moore-Black, RN

Conditions

August 14, 2017

Victim: Female nurse, age 25

Time: circa 1980

Place: A hospital in a sleepy Southern town with fifty beds, six emergency department beds, one nurse, one doctor and one secretary.

It was an unusually quiet Friday night in this small emergency department.

We all knew Friday was “party day”: pay day, play day, alcohol, pills, drugs, loud music and lots of really bad decisions.

Not only did we cover the entire city, but we also …

As a physician, you will fail at your job in these different ways. Learn from them.

Binh Phung, DO

Physician

August 11, 2017

To me, five years ago:

Right now you are 28, seated at the top of everything: chief resident of the entire pediatric department. You are in charge of 19 other interns and residents. You are resilient, kind, funny and determined. You seem to have the solution for everything, yet you don’t actually have the answer to anything. At least that’s how you’ll feel on most days in your new leadership role. …

Turn physicians into powerful health care influencers

Kevin Pho, MD

KevinMD

August 11, 2017

Physicians have so many tools available to us that can turn them into powerful health care influencers.

A KevinMD keynote video excerpt. I’m currently considering opportunities for 2018: Please visit my physician keynote speaking page to find out more.

Turn physicians into powerful health care influencers

Doctors: You’re just as unhealthy as your patients. Here’s why.

Shane C. Quinonez, MD

Conditions

August 8, 2017

Most people reading this would love to lose weight, feel better and live longer. Doctors are a smart and motivated group of people. Unfortunately, that intellect and drive has not prevented us from avoiding an increasing incidence of obesity, diabetes, and hypertension identical to the general population.

While this article may have started out sounding like an infomercial, I promise it will not end like one. …

Why I got into medical school and chose not to go

Armando Quintana

Education

August 8, 2017

Imagine taking the MCAT, applying to schools, getting interviews and even being accepted into medical school. How would it feel knowing your dedication has paid off? I felt great, as I had studied hard and made sacrifices others were unwilling to make. As I saw the finish line for what would be the beginning of medical school, I began to ask myself, “Should I continue onwards toward medical school or …

Love something other than medicine? It’s OK.

Mary Barber

Education

August 8, 2017

When I entered college, I wanted to be a chemistry major. I had no idea what college chemistry would be like, but it was the class I loved most in high school and something I was pretty good at. The town I grew up in had little more than 3,000 people and more gas stations than stop lights. My school didn’t have Advanced Placement classes or partnerships with local hospitals …

How long should I take antibiotics? Exploring the Goldilocks problem.

Robert Centor, MD

Physician

August 5, 2017

Antibiotics save lives, but antibiotics can have negative effects. When patients have bacterial infections, we want to treat them to prevent complications of the bacterial infection, but not treat them for an excessive duration. So we have a Goldilocks problem — we want antibiotic duration to be just right — neither too short or too long.

Some clinical conditions have adequate research to define the Goldilocks duration. Community acquired pneumonia only …