KevinMD.com

June 24, 2016Jun 24, 2016

The USA trains its physicians differently from every other Western country I know. Everyone (with rare exceptions) who goes to medical school first must get a four-year undergraduate college degree in something. There are no such degrees in medicine, although the overwhelming majority of students going on to medical school major in one of the sciences, such as chemistry, biochemistry, and biology. If they don’t major in a science, they generally …

Health Technology

What went wrong with health care IT

Suneel Dhand, MD

June 24, 2016Jun 24, 2016

One of the topics’s that I’ve written most about, and also do a considerable amount of non-clinical consulting work on, is how we can improve health care information technology and electronic medical records. As they currently exist, there are unfortunately…

I’m not a technophobe by any stretch of the imagination. I embrace technologies and …

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What went wrong with health care IT

Health Technology

Where will health IT innovation come from?

John Halamka, MD

June 24, 2016Jun 24, 2016

When my father died three years ago, my comments at his funeral noted that the greatest aspiration any of us can have is to make a difference in the world. My father’s life made a difference. I’m always self-critical and…

When my father died three years ago, my comments at his funeral noted that the greatest aspiration any of us can have is to make a difference in the world. My father’s life made a difference.

I’m always self-critical and analyzing my own life. I moved to Boston 20 years ago this month. In those 20 years of service to Beth Israel Deaconess Medical Center (BIDMC), Harvard, numerous federal organizations, …

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Physician

If you are admitted to the hospital, will a specialist see you?

Gene Uzawa Dorio, MD

June 23, 2016Jun 23, 2016

Most primary care physicians (PCPs) who admit patients to a hospital are family practitioners or internists. Since medicine becomes more complex each day, PCPs must remain up-to-date on the latest treatment related to drugs, surgery, procedures, risks, complications, and costs. This might require your PCP to be a quarterback bringing together a team of consulting specialists to guide you through your hospital stay.

The economics of hospitalization are changing, and since …

Physician

A patient dies during live video surgery. Who’s to blame?

Skeptical Scalpel, MD

June 23, 2016Jun 23, 2016

"Was the delay in deciding to open influenced by the presence of an audience of 100 surgeons expecting to see a laparoscopic liver resection?" “In addition to his tumor, the patient had hepatitis and cirrhosis. Was he a good candidate?…

“Was the delay in deciding to open influenced by the presence of an audience of 100 surgeons expecting to see a laparoscopic liver resection?”

“In addition to his tumor, the patient had hepatitis and cirrhosis. Was he a good candidate? A major complication was inevitably to occur during a live broadcast.”

As I predicted last year, it had to happen sooner or later.

In that post, I wrote, “A major complication will inevitably …

Physician

The loneliness of a long-distance academic

Vic Strasburger, MD

June 23, 2016Jun 23, 2016

I love being an academic pediatrician. I didn’t start out to do that; I thought I would be writing novels and working part-time in an inner-city clinic. I wrote with Robert Penn Warren in college and my first (and only) novel was published when I was a senior in medical school. But things don’t always turn out the way you expect them to. In my case, I didn’t expect to be …

Physician

The death of a child is an abomination

Olubunmi Ode, MD

June 23, 2016Jun 23, 2016

When, aged thirteen, my best friend died of complications from sickle cell disease, her parents could not attend her funeral or find out where she was buried. My mom explained to me that in the Yoruba culture because parents are not expected to survive their children, it is considered an abomination for a parent to know where their child is buried. So, the young adults in the extended family attended …

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The death of a child is an abomination

Physician

The idealized doctor is dead. Or at least on death’s door.

Igor Shumskiy, MD

June 22, 2016Jun 22, 2016

The American medical establishment has systematically clogged his arteries with paperwork, lined his lungs with rules, and filled his intestines with, that’s right you guessed it, shit. There he lay, in a comatose state, awaiting to be pronounced. Only one…

Idealism.

Four months into my intern year and I’m just realizing how crucial maintaining my idealism — as unrealistic as it may be — is to …

Physician

They played Taps at my father’s funeral. They played it beautifully.

Kathy Stepien, MD

June 22, 2016Jun 22, 2016

They played Taps at my dad’s funeral. Two teenagers on trumpets. First, the girl, positioned to the back and left of the crowd. Ta-ta-dah, she starts boldly, without the unease of her youth. Each simple note pierces the dry winter…

Yes, you have our attention. Not another sound. Not even a breath by gathered friends and family.

In time, the second musician’s reply from the front. Ta-da-dah. And a pause. Their …

Patient

Doctors need to partner with families to save lives

Bonnie Friedman

June 22, 2016Jun 22, 2016

“Hey, doc, you’re killing me.” Or, more specifically, us. A recent report from researchers at the Johns Hopkins University School of Medicine points to medical errors as the third leading cause of death in this country. Despite the many safeguards…

“Hey, doc, you’re killing me.” Or, more specifically, us.

A recent report from researchers at the Johns Hopkins University School of Medicine points to medical errors as the third leading cause of death in this country. Despite the many safeguards put in place by the government, hospitals, and doctors, themselves, more than 250,000 people a year in the U.S. die from hospital-acquired infections, wrong-site surgeries, medication mistakes and a host of …

Physician

The superhuman efforts of the trauma surgeons at Orlando Health

Jamie Coleman, MD

June 22, 2016Jun 22, 2016

A 6-year-old boy with abnormal pupils and gasping for breath. A 26-year-old pregnant woman with a gunshot wound to her abdomen. A 54-year-old male with blood pouring from a wound in his thigh. Now add 43 more patients. Imagine you…

A 6-year-old boy with abnormal pupils and gasping for breath. A 26-year-old pregnant woman with a gunshot wound to her abdomen. A 54-year-old male with blood pouring from a wound in his thigh.

Now add 43 more patients.

Imagine you are the paramedic at this scene. Who do you take to the hospital first? Who do you have to choose to walk past and leave at the scene while you take your patient to …

Physician

How can patients accept cash-based practices?

Steven Reidbord, MD

June 22, 2016Jun 22, 2016

A primary care physician named Ashley Maltz recently discussed advantages and disadvantages of a cash-based practice. I appreciate her evenhanded tone: She prefers this model yet expressed concern for patients who can’t use it. In the comments section, several physicians extolled the virtues of cash-pay, but patients were mixed. It’s attractive for those who can afford it, while it worries, and maybe angers, those who can’t.

I enjoy the personal and patient benefits of a mostly cash-pay psychiatric practice (I …

Physician

We need to stop sugarcoating our cancer prognoses

James Wu, MD

June 21, 2016Jun 21, 2016

Mrs. Liu, who was only 58 years old, had metastatic ovarian cancer. Despite radical surgery and chemotherapy, her disease persisted. Worse yet, her PET scan from a few months ago revealed that she had carcinomatosis — numerous deposits of cancer showered throughout her abdomen. This particular night, she starting having more nausea and couldn’t eat or drink anything without vomiting. So, she came to the ED. I was called into …

Physician

Addressing racial bias in the treatment of pain

Leigh-Ann J. Webb, MD

June 21, 2016Jun 21, 2016

The opioid (painkiller) epidemic, with its seemingly indiscriminate reach, has embraced an alarming number of Americans. In the most recent statistics available, two million Americans either abuse or are dependent on prescription opioids. Even the death of internationally acclaimed artist,…

Physician

America’s civil war on doctors

Rebekah Bernard, MD

June 21, 2016Jun 21, 2016

I recently saw the movie, Captain America: Civil War. If you haven’t seen it yet (no spoilers), the United Nations decides that because of civilian fatalities during previous Avenger battles, the world would be safer if all superheroes voluntarily subjugate…

Sounds good to some of the Avengers; after all, innocent people have died, and maybe some form of supervision will minimize collateral …

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America’s civil war on doctors

Health Policy

The MACRA rule: Not what Congress ordered

Don Read, MD

June 21, 2016Jun 21, 2016

I joined physicians nationwide last year in cheering when Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Not only did it eliminate the congressional budgetary fiction known as the Sustainable Growth Rate (SGR) formula, it also promised to simplify and improve Medicare’s costly and complex programs that purport to measure the quality of care we provide to our patients.

Unfortunately, as we review the draft implementing rule, …

Medical Education

Don’t do these 5 things with your medical school personal statement

Dr. Dale

June 21, 2016Jun 21, 2016

Your medical school personal statement is one of the most important components of your application. This short essay can be the deciding factor as to whether or not you will spend the remainder of your life practicing medicine. To be…

To be honest, most personal statements will be similar enough that they’ll fit right in with the rest. There will be a handful that stand out above the majority, and if you can …

Physician

ER misuse in our instant gratification society

Kenneth Szwak, PA-C

June 20, 2016Jun 20, 2016

Those of us who work in emergency medicine have all had these patients. They present with a complaint that started two years ago and for whatever reason now deem it an issue that needs immediate attention in the ER. I had a patient like this recently who not only had the issue for two years, but also had a primary care provider. Not only did the patient have a PCP, …

Physician

Sometimes, talking to strangers is necessary

Claire McCarthy, MD

June 20, 2016Jun 20, 2016

I remember a warm September day at the playground 22 years ago. I was there with my 19-month-old daughter and newborn son. Zack was hungry, so I sat down on a bench to nurse him -- but every time I…

I remember a warm September day at the playground 22 years ago. I was there with my 19-month-old daughter and newborn son. Zack was hungry, so I sat down on a bench to nurse him — but every time I got him settled, Michaela ran away from me. Far away, out-of-view away (she was a quick little thing). The playground was fenced in, but there were lots of ways for …

Real physician voices, twice a week

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