Deep Ramachandran, MD

June 17, 2013Jun 17, 20138

I’ve written several times before about my love/hate status with my EMR. While I enjoy using mine, I long for it’s usefulness to get to the next level. While the EMR is useful at tracking data, it’s greatest handicap right now, is that it can’t talk to other systems. Data is still locked in individual systems and can’t be shared across platforms. This lack of interoperability has thus far been …

Doctors: Pronounce the names of your patients correctly

March 13, 2013Mar 13, 201311

I have it on good authority that it’s not easy being green. But I’m willing to wager that it’s a whole lot easier when you have a lovable name like “Kermit.” Imagine being green (or brown) with a name like “Ramachandran”? Growing up with a name like mine certainly had its disadvantages. While most neighborhoods have a local bully who kicks ass and takes names, in my case, he would …

Should medical school deans have ties to pharma?

February 5, 2013Feb 5, 20138

One of the first posts I wrote was a about how pharmaceutical reps provide lunch for physicians while presenting information about a medication that they are promoting. The post, and others like it, have generated visceral reactions on the part of the public. A similar article to the one that I wrote prompted comments like “Get over yourself and buy your own lunch” and “I’m certainly glad …

The closing of a mental health facility in Newtown

January 26, 2013Jan 26, 20137

I wrote in a previous post about what life was like growing up in Newtown, Connecticut. It truly is a picturesque New England town. But what might be surprising is that within that town sat a gem. A hundred acres of wooded rolling hills within which sat an inner campus of professionally landscaped and meticulously manicured grounds crowned with stately and handsome brick buildings in a colonial architectural style. These …

Offer hospice patients a smile

January 2, 2013Jan 2, 20132

Hospitals are busy places to work. The work is fast paced, and never seems to stop. For most physicians, the work ends when the work is done, or until you fall over, whichever comes first. So as a consultant, when I am seeing a patient wherein there is no longer anything that I am contributing to a patient’s care it’s routine that a physician would “sign off” the case, meaning …

Offer hospice patients a smile

Drugs and prescribing

10 advances that have changed medicine forever

December 4, 2012Dec 4, 20123

I’ve been thinking lately about all the great advances in medicine over the years. There have been lots of them. And despite everything you’ve heard about looming cuts in healthcare, I have no doubt that the hits will keep on coming. Since I seem to be on this Top 5 thing lately, I figured I would continue this ride and rank my top 10 medical advances over the years. There …

Why doctors should care about fracking

October 20, 2012Oct 20, 20122

Let’s all agree on two things. First, that energy independence is good for our country. Second that clean drinking water is also good for the country. The development of America’s huge stores of natural gas, have given us a remarkable…

Let’s all agree on two things.

First, that energy independence is good for our country. Second that clean drinking water is also good for the country.

The development of America’s huge stores of natural gas, have given us a remarkable opportunity to accomplish the former. In particular, the process of “fracking” has made it possible to increasingly tap those huge natural gas stores. Natural gas sits in rock formations, but releasing it …

Why doctors should care about fracking

Medical education

5 pieces of advice nobody tells you before starting residency

October 11, 2012Oct 11, 2012

Since medical school, I’ve gone through an additional 6 years of training, read countless volumes of medical literature, and had the fortune of having some great teachers. Through it all, experience has been the greatest teacher, which I suppose is what training is about. I’ve watched with interest as advice has been hashed out on the web around this time of year to new trainees on all matter of subjects. …

Drugs and prescribing

Should doctors stop prescribing inhalers for smokers?

September 18, 2012Sep 18, 20128

I’ve always had a tough relationship with cigarettes and the people who love them. As a lung doctor I hate cigarettes, and I hate that patients I see everyday continue to use them. But I also understand that vilifying smokers seems to be in vogue right now. I figure that if someone does something that is not considered socially palatable, and that does them harm, even as they strive to …

Conditions and diseases

Is CT lung cancer screening worth it?

June 14, 2012Jun 14, 20123

In 2011 The National Cancer Institute published results from their study of low dose CT lung cancer screening of individuals identified as at risk for lung cancer. The investigators enrolled those between 55 to 74 years of age who had at least 30 pack years of smoking under their belt (number of packs per day multiplied by number of years smoked). These people were then randomly assigned to either a …

Is CT lung cancer screening worth it?

How academic press releases are being used for free advertising

May 26, 2012May 26, 20126

You may have noticed the rash of medical news spewing from your favorite news outlets with greater frequency. As a medical professional you probably cringe as you envision the calls that are about to flood your office, “Doctor Smith, I heard a report on the news that this drug you prescribed to help me quit smoking is bad for my health!” or, “I want a referral to The Hoffenheimer Institute …

A Hindu physician in a Christian hospital

April 17, 2012Apr 17, 201215

As I enter the hospital in which I work, I am struck by a number of signs that denote that my place of employment is a Christian hospital, with Christian values, and a Christian "vision" of health care. I don’t…

As I enter the hospital in which I work, I am struck by a number of signs that denote that my place of employment is a Christian hospital, with Christian values, and a Christian “vision” of health care. I don’t have the vaguest clue as to what that means. And I don’t really mind either, it’s not like they’re paying me with Jesus biscuits and Christmas ornaments, nor does it seem …

Health policy

How state governments are addicted to tobacco revenue

October 31, 2011Oct 31, 201111

Few things smell worse to me than the stank of a cigarette while trying to trying to load up on cholesterol via awesome blossom. Perhaps one such thing is the beguiling tale of what perverse fate has befallen the gobs…

This seemingly righteous pursuit was fought by brave attorneys general of 46 various states to regain money we dished out to pay …

Getting insurance to cover a test requires guessing the diagnosis

August 8, 2011Aug 8, 20114

We had an interesting dilemma in the office. You see, being pulmonologists we treat people with asthma, and one of the more useful drugs we have in the ammunition belt is a medication called omalizumab (Xolair). Among patients in whom…

Among patients in whom it’s indicated, particularly those with severe allergic asthma, the effects can be dramatic and life altering. The problem with this drug is the cost. Actually also the administration. And the anaphylaxis. Not to mention all the …

Dangers of the hospital press release

August 7, 2011Aug 7, 20112

Dangers of the hospital press release

Health technology

The loss of eloquence in EMR notes

August 2, 2011Aug 2, 20116

Much has been made of the downside of the increasing use of EMR systems by physicians. But I am not going to dwell on those pervasive complaints concerning the cost and complexity of setting up the systems. Nor shall I rehash the well known issue of what I call “doc blocking” … wherein a computer (or other entity) stands between the patient and physician, slowing the exchange of information to however many words can be typed per …

The loss of eloquence in EMR notes

Drugs and prescribing

Lunch money Pharma spends on physicians

May 16, 2011May 16, 201182

Actually I’ll take a Ford Shelby GT500 Convertible, thank you very much ... Today’s stream of socially conscious thinking comes to you after having feasted on a tasty lunch paid for by a drug company (and no, it wasn’t Pfizer).…

Actually I’ll take a Ford Shelby GT500 Convertible, thank you very much …

Today’s stream of socially conscious thinking comes to you after having feasted on a tasty lunch paid for by a drug company (and no, it wasn’t Pfizer).

It has spurred me to contemplate the ever increasing scrutiny paid to the relationship between the pharmaceutical industry …