KevinMD.com

January 23, 2017Jan 23, 2017

“When companies start unbundling costs, it is a sign of increasing consumer power and weakening market power.” This is what CEO David Goldhill and author of Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong told…

“When companies start unbundling costs, it is a sign of increasing consumer power and weakening market power.”

This is what CEO David Goldhill and author of Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong told me once. Airlines have unbundled everything that used to be included in a plane ticket. No longer do tickets include meals, in-flight entertainment, and the ability to check in baggage. Today, …

Physician

Patient death by data: A poem

Ellen Kemper, MD

January 23, 2017Jan 23, 2017

“Afternoon,” the doctor says. “What brings you here today?” A cough? A cold? A belly ache? Some feelings of dismay? Well, tell me just what ails you, and I’ll try to do my best, To sort through all your problems…

“Afternoon,” the doctor says. “What brings you here today?”
A cough? A cold? A belly ache? Some feelings of dismay?
Well, tell me just what ails you, and I’ll try to do my best,
To sort through all your problems and put your fears to rest.

But give me just a moment — my computer must get started.
Without attention to its needs, your visit goes uncharted.
You say your chest is hurting? And you’re really …

Read more…

Patient death by data: A poem

Physician

Let’s leave clerical work to administrators

Hans Duvefelt, MD

January 23, 2017Jan 23, 2017

On an ordinary day last month, I saw patients for eight and a half hours. I addressed a dozen computer messages, took four or five calls from outside providers and held innumerable curbside conversations with medical assistants, case managers and…

I didn’t get to any of the 100+ lab results or 50+ documents in my electronic inboxes. Consequently, the care for several dozens of my patients didn’t move forward.

Many of …

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Conditions and Diseases

There’s absolutely no way to stop a cough. Here’s why.

Roy Benaroch, MD

January 23, 2017Jan 23, 2017

Coughing is one of the most common reasons parents bring their children to see me. And I can understand why. Coughing is noisy and uncomfortable and gets kids dirty looks in schools and subways. Even worse, coughing keeps kids and…

But coughing is there, usually, for a reason. Almost all coughs are from upper respiratory infections (that’s fancy …

Health Technology

Meaningful use: A view from the penalty box

Niran S. Al-Agba, MD

January 23, 2017Jan 23, 2017

The Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program -- also known as meaningful use (MU) -- initially provided incentives to accelerate the adoption of electronic health records (EHRs) to meet certified program requirements. Many physicians were mandated…

The Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program — also known as meaningful use (MU) — initially provided incentives to accelerate the adoption of electronic health records (EHRs) to meet certified program requirements. Many physicians were mandated to change over to electronic records at the cost of tens of thousands of dollars. Electronic records have never been shown to improve patient care or outcomes with statistical significance, …

Physician

It’s time to ask patients about spirituality

Veronica J. Meawad, MD

January 22, 2017Jan 22, 2017

From the first year of medical school, we are trained in probing into the most personal aspects of patients’ lives; but when it comes to spirituality, we shy away. In a survey of the U.S. general public, the 2008 Gallup Report demonstrated that 78 percent of people believed in God and an additional 15 percent believed in a higher power. Other studies have shown that religious beliefs and …

Physician

Welcome to the world of post-truth medicine

Eric Beam, MD

January 22, 2017Jan 22, 2017

During this recent emotional and divisive election cycle, much ink was devoted to analyzing the brave new political world we now live in, a world in which just about anyone with an audience and a platform can issue statements that…

I’m talking, of course, about the world of Read more…

Welcome to the world of post-truth medicine

Physician

What National Women Physicians Day means to me

Hala Sabry, DO, MBA

January 22, 2017Jan 22, 2017

"What do you want to be when you grow up?” It’s a common question we ask our youth, and I remember as young child sharing my aspirations with family members. When I answered "I want to be a doctor when…

“What do you want to be when you grow up?”

It’s a common question we ask our youth, and I remember as young child sharing my aspirations with family members. When I answered “I want to be a doctor when I grow up”, I received positive feedback and praise. As an innocent little girl, I had no idea that there were people in the world who wouldn’t be as supportive of a woman in medicine.

Later …

Health Technology

Why are Americans wary of advances in biotechnology?

Samir Shah

January 22, 2017Jan 22, 2017

We are truly living in a remarkable era of biotechnological progress. Emerging nanotechnologies and immunotherapies offer the possibility of the targeted destruction of cancerous cells. 3-D printing of living cells is on the horizon, engendering the hope of a future with fully printed organs. And simultaneous advances in neuroscience and bioengineering have given rise to promising research and development of “electrocueticals” (neuromodulatory devices that may alleviate the symptoms …

Physician

What a psychiatrist learned when she tried to connect with her colleagues

Tracy Asamoah, MD

January 21, 2017Jan 21, 2017

Over the past couple of months, I have had the privilege of meeting with several colleagues in my community. When I contacted them, I offered to bring them lunch if they would give me a few minutes to share an idea about a project that I am really excited about. However, what I really wanted was a chance to engage with physicians who I knew little more than their name …

Physician

A bloody baptism into emergency medicine

Zahir Basrai, MD

January 21, 2017Jan 21, 2017

It’s the first day on my 4th-year elective in the emergency department. I had orientation in the morning and just my luck I am scheduled for a night shift. I had the good fortune of finding an emergency physician in New York who let me shadow him before my rotation, but the truth of the matter is, I had no idea that what I was getting myself into. I guess …

Physician

Confessions of a former TV doctor

Michael Breen, MD

January 21, 2017Jan 21, 2017

I was the "TV doctor" at the CBS, NBC, and ABC affiliates in Minnesota and Chicago for 25 years. I was on air several times a day and anchored my own news block. I did some good. I organized a…

I was the “TV doctor” at the CBS, NBC, and ABC affiliates in Minnesota and Chicago for 25 years. I was on air several times a day and anchored my own news block.

I did some good. I organized a colon cancer early detection campaign while presenting a series on the illness. One-hundred thousand viewers picked up Hemoccult tests, 25,000 sent them in, and I received a plaque that says, “Thank you for …

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Confessions of a former TV doctor

Conditions and Diseases

MKSAP: 24-year-old woman with sickle cell anemia

mksap

January 21, 2017Jan 21, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 24-year-old woman undergoes routine evaluation. She is pregnant at 12 weeks' gestation. Medical history is notable for homozygous sickle cell anemia (Hb SS).…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 24-year-old woman undergoes routine evaluation. She is pregnant at 12 weeks’ gestation. Medical history is notable for homozygous sickle cell anemia (Hb SS). She has had multiple uncomplicated painful crises treated at home with hydration, nonopioid analgesia, and incentive spirometry. She requires hospital management for these episodes approximately twice per year. She has declined …

Medical Education

I demand you consider us humans: A medical student poem

Anonymous

January 20, 2017Jan 20, 2017

Slave, I am not Servant, I may be Arrogant, I am not Ignorant, I may be Un-engaged, I am not However, Quiet, I may be. Your coat is long, mine short Your knowledge mile deep, mine mile wide You have…

Slave, I am not
Servant, I may be

Arrogant, I am not
Ignorant, I may be

Un-engaged, I am not
However, Quiet, I may be.

Your coat is long, mine short
Your knowledge mile deep, mine mile wide
You have seen 100 patients this week, I have seen 10
You trained for 10 years, this is my first

If I look scared, it’s because I am
If I seem intimidated, I indeed am
If I appear confused, I in fact am
If I …

Physician

What this physician learned from being a doughnut waitress

Anne McTiernan, MD, PhD

January 20, 2017Jan 20, 2017

In high school and college, I waitressed in a Dunkin’ Donuts shop that sat between Boston Common and the Combat Zone’s porn shops, strip clubs, and bars. The wages paid for school, clothes, rent, and food. At the time, I didn’t realize this job would provide useful skills for my later medical career, an early pre-med training of sorts.

Look the part. I donned the bubblegum pink polyester uniform that clearly identified …

Physician

Patients are evaluated for assisted suicide the wrong way

Michel Accad, MD

January 20, 2017Jan 20, 2017

Laws that allow assisted suicide restrict the provision of “aid-in-dying” drugs to patients whose mental status is not impaired and who are capable of sound judgment. Medscape recently featured a video interview of Timothy Quill, the palliative-care specialist and long-term…

Laws that allow assisted suicide restrict the provision of “aid-in-dying” drugs to patients whose mental status is not impaired and who are capable of sound judgment.

Medscape recently featured a video interview of Timothy Quill, the palliative-care specialist and long-term assisted suicide activist. He is interviewed by the ethicist Arthur Caplan, and the two discuss the psychological evaluation of terminally ill patients who request physician-assisted suicide (PAS).

Several points …

Conditions and Diseases

How to practice mindful nursing

Carmel Sheridan

January 20, 2017Jan 20, 2017

An excerpt from The Mindful Nurse: Using the Power of Mindfulness and Compassion to Help You Thrive In Your Work. Do you ever feel panic at the end of a long weekend or vacation, wondering where the time went? Do…

An excerpt from The Mindful Nurse: Using the Power of Mindfulness and Compassion to Help You Thrive In Your Work.

Do you ever feel panic at the end of a long weekend or vacation, wondering where the time went? Do your days, weeks, and months blend into one another, each day bringing you more of the same?

At work, you move through a series of tasks so that …

Read more…

How to practice mindful nursing

Patient

Who coordinates patient care? Maybe no one.

Bonnie Friedman

January 20, 2017Jan 20, 2017

“Who’s in charge of the case?” the doctor asked a bit impatiently. My husband was in the hospital, and his care seemed disjointed and fragmented. I was concerned and called his primary care physician (PCP) to ask advice. He hadn’t…

“Who’s in charge of the case?” the doctor asked a bit impatiently.

My husband was in the hospital, and his care seemed disjointed and fragmented. I was concerned and called his primary care physician (PCP) to ask advice. He hadn’t known my husband was in the hospital again and seemed frustrated.

I thought about his question for a minute and answered, “I guess I am. I am the one who talks to …

Health Policy

How health care could crash the U.S. economy

Ron Howrigon

January 19, 2017Jan 19, 2017

An excerpt from Flatlining: How Healthcare Could Kill the U.S. Economy. In recent history, the U.S. economy has experienced the near catastrophic failure of two major market segments. The first was the auto industry and the second was the housing…

An excerpt from Flatlining: How Healthcare Could Kill the U.S. Economy.

In recent history, the U.S. economy has experienced the near catastrophic failure of two major market segments. The first was the auto industry and the second was the housing industry. While each of these reached their breaking point for different reasons, they both required a significant government bailout to keep them from completely melting down.

What is also true about …

Physician

Physicians! 7 steps to financial freedom

Pamela Wible, MD

January 19, 2017Jan 19, 2017

I grew up studying my physician parents. My dad, a pathologist, was a hard-working hospital employee with multiple odd jobs on the side. He always worried about whether he’d have enough for retirement, though he never really wanted to retire. My mom, a psychiatrist, is more of an entrepreneurial businesswoman. She had her own private practice (even though all the other employed doctors warned she’d never make …

Real physician voices, twice a week

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