Kevin Pho, MD

A practicing, board-certified internal medicine physician and the founder and editor of KevinMD.

385 articles on KevinMD

About Kevin Pho, MD

Articles, page 10

Health policy

The emotional costs of malpractice mean more to doctors than money

Kevin Pho, MD

August 19, 2011Aug 19, 20117

Every year, according to a recent study from the New England Journal of Medicine, a typical physician has about a 7% chance of being sued for medical malpractice. Surgeons almost certainly will face a malpractice claim sometime during their career.…

Every year, according to a recent study from the New England Journal of Medicine, a typical physician has about a 7% chance of being sued for medical malpractice.

Surgeons almost certainly will face a malpractice claim sometime during their career. Neurosurgeons, for instance, have a 19.1% chance of being sued in a given year, while that number is 18.9% for …

Medical education

Why work hour restrictions won’t improve patient safety

Kevin Pho, MD

August 11, 2011Aug 11, 20115

Darshak Sanghavi recently wrote an excellent piece in the New York Times summarizing the controversy over resident work hours. The topic has been discussed here frequently, with ramifications ranging from the fact that errors arising from patient handoffs negate any…

Darshak Sanghavi recently wrote an excellent piece in the New York Times summarizing the controversy over resident work hours.

The topic has been discussed here frequently, with ramifications ranging from the fact that errors arising from patient handoffs negate any benefit gained from restricting work hours, to surgeons not accumulating enough experience during their work hour-restricted training.

I’ve often …

Drugs and prescribing

Should Lipitor go OTC? A cardiologist says yes, an internist says no

Kevin Pho, MD

August 4, 2011Aug 4, 201111

With the patent for Lipitor expiring, Pfizer is considering selling an OTC version of the statin. It's generated a firestorm of debate, with doctors speculating on the impact for patients. According to Pharmalot, "an OTC version would allow Pfizer to…

With the patent for Lipitor expiring, Pfizer is considering selling an OTC version of the statin.

It’s generated a firestorm of debate, with doctors speculating on the impact for patients.

According to Pharmalot, “an OTC version would allow Pfizer to capture some of the sales that will be lost when the Lipitor patent expires in November. In fact, Pfizer execs recently changed …

Physician voices

Hospitalist care is more expensive but don’t blame hospitalists

Kevin Pho, MD

August 3, 2011Aug 3, 20118

Hospitalists save money. Until the patient leaves the hospital, at least. A recent study from the Annals of Internal Medicine ignited debate over the cost effectiveness of hospitalists. Looking at Medicare patients from 2001 to 2006, researchers found that "those…

Hospitalists save money. Until the patient leaves the hospital, at least.

A recent study from the Annals of Internal Medicine ignited debate over the cost effectiveness of hospitalists. Looking at Medicare patients from 2001 to 2006, researchers found that “those who were followed by a primary care physician spent about half a day more at the hospital, costing Medicare …

Health policy

Why the debt ceiling deal is a horrific outcome for physicians

Kevin Pho, MD

August 2, 2011Aug 2, 201151

If you're a physician or hospital that relies on Medicare payments, grim times are ahead. Yes, even worse than the scheduled 29% payment cut that's scheduled to go into effect in 2013. Emergency physician Shadowfax calls the debt deal "a…

If you’re a physician or hospital that relies on Medicare payments, grim times are ahead. Yes, even worse than the scheduled 29% payment cut that’s scheduled to go into effect in 2013. Emergency physician Shadowfax calls the debt deal “a terrible deal for health care providers.”

Under the contentious debt ceiling agreement, significant cuts in Medicare dollars will be made. But …

Conditions and diseases

Advances in cancer treatment are hyped by headlines

Kevin Pho, MD

July 31, 2011Jul 31, 2011

The following op-ed was published on June 5, 2011 in USA Today. A patient recently asked me if I had heard about the new "wonder drugs" used to treat skin cancer. Indeed, I had. In a widely reported story in…

The following op-ed was published on June 5, 2011 in USA Today.

A patient recently asked me if I had heard about the new “wonder drugs” used to treat skin cancer. Indeed, I had. In a widely reported story in early June, two novel cancer drugs were found to benefit patients with advanced melanoma, a devastating form of skin cancer. These …

Medical education

Medical education cost is a health policy imperative

Kevin Pho, MD

July 28, 2011Jul 28, 201110

Whenever I talk about the cost of medical education, I like to bring up this chart. It starkly illustrates just how expensive it is to train a doctor in the United States, compared to Canada and France. New York Times…

New York Times contributor Pauline Chen wrote a column on the issue recently. Most doctors graduate with a debt exceeding $150,000, and …

Medical education

Speed dating techniques to screen medical students

Kevin Pho, MD

July 27, 2011Jul 27, 20117

Speed dating to find the next generation of doctors? Well, yes, in a way. The New York Times recently wrote about the admissions process at Virginia Tech Carilion, where students are chosen as much for their interpersonal qualities as their…

Speed dating to find the next generation of doctors? Well, yes, in a way.

The New York Times recently wrote about the admissions process at Virginia Tech Carilion, where students are chosen as much for their interpersonal qualities as their academic aptitude.

Using the so-called “multiple mini interview,” prospective medical students are ushered in a series of 9 interviews, each designed to test …

Physician voices

Why receptionists are integral to the health care team

Kevin Pho, MD

July 25, 2011Jul 25, 20112

Health care is a team sport, and one of the most important members is the office receptionist. Receptionists are often the first people patients see when the visit the clinic. And those first impressions count. In a recent piece from…

Health care is a team sport, and one of the most important members is the office receptionist.

Receptionists are often the first people patients see when the visit the clinic. And those first impressions count.

In a recent piece from the New York Times, Pauline Chen notes a study of the responsibilities of the medical receptionist, and finds they impact …

Conditions and diseases

Breast cancer screening guidelines confuse doctors and patients

Kevin Pho, MD

July 21, 2011Jul 21, 20116

The American College of Obstetricians and Gynecologists (ACOG) recently released their recommendations for breast cancer screening. Previously, they had recommended a mammogram every 1 to 2 years for women between the ages of 40 to 49. Now, they recommend more…

The American College of Obstetricians and Gynecologists (ACOG) recently released their recommendations for breast cancer screening.

Previously, they had recommended a mammogram every 1 to 2 years for women between the ages of 40 to 49.

Now, they recommend more intensive screening:

Due to the high incidence of breast cancer in the US and the potential to reduce deaths from it when caught

…

Conditions and diseases

Medicare should stop paying for prostate cancer screening in men over age 75

Kevin Pho, MD

July 3, 2011Jul 3, 201129

The following op-ed was published on June 1st, 2011 in the New York Times’ Room for Debate blog. Medicare should stop paying for prostate cancer screening in men over the age of 75. You may be surprised to hear that,…

The following op-ed was published on June 1st, 2011 in the New York Times’ Room for Debate blog.

Medicare should stop paying for prostate cancer screening in men over the age of 75.

You may be surprised to hear that, especially coming from a primary care doctor. But evidence is mounting that screening for prostate cancer is not only ineffective in older men, but may actually be harmful.

The cornerstone of …

Health policy

Should doctors be scared of government mystery shoppers?

Kevin Pho, MD

June 27, 2011Jun 27, 201182

The government is going to find out about the primary care physician shortage for themselves. They're resorting to "mystery shoppers," used frequently in other industries, to see what the wait times really are for a new primary care doctor. As…

The government is going to find out about the primary care physician shortage for themselves.

They’re resorting to “mystery shoppers,” used frequently in other industries, to see what the wait times really are for a new primary care doctor. As mentioned before, come 2014, there will be over 30 million newly insured patients looking for a doctor. This will further stress a system short of primary care resources.

Doctors, as …

Health technology

One more thing: Works for Apple, but killed Google Health

Kevin Pho, MD

June 27, 2011Jun 27, 20114

Google Health is dead. There have been plenty of post-mortems as to why, ranging from the fact that it's not social enough (uh ... no), to the realization that only a minority of practices have electronic medical records, yet alone…

Google Health is dead.

There have been plenty of post-mortems as to why, ranging from the fact that it’s not social enough (uh … no), to the realization that only a minority of practices have electronic medical records, yet alone a patient portal that can incorporate PHRs like Google Health.

I’ll chip in with my own reason — it suffered from “one more thing” syndrome.

PHRs today aren’t seamlessly incorporated into …

Health policy

Team based care in health reform needs patient involvement

Kevin Pho, MD

June 25, 2011Jun 25, 201123

The following op-ed was published on June 7, 2011 in USA Today. More than ever, I find myself fielding questions from patients about the health care reform law. The most common one is, "How will reform affect me?" It's a…

The following op-ed was published on June 7, 2011 in USA Today.

More than ever, I find myself fielding questions from patients about the health care reform law. The most common one is, “How will reform affect me?” It’s a complicated question, with a different answer for each patient. But as the law’s full effects unfold, one of the more significant changes will be in how patients interact with their …

Health policy

Physician consolidation places health reformers in an ironic dilemma

Kevin Pho, MD

June 23, 2011Jun 23, 20117

One of the major efforts of the Affordable Care Act is to consolidate physician groups, so they can be modeled after integrated health systems like the Minnesota's Mayo Clinic or California's Kaiser Permanente. According to health reformers, these integrated systems…

One of the major efforts of the Affordable Care Act is to consolidate physician groups, so they can be modeled after integrated health systems like the Minnesota’s Mayo Clinic or California’s Kaiser Permanente.

According to health reformers, these integrated systems can reduce variation in care, which improves quality, and potentially reduces costs.

There’s been a major effort to re-organize hospitals and physicians under guises of Patient Centered Medical Homes and …

Health policy

Why the AMA is in decline, and should doctors care?

Kevin Pho, MD

June 20, 2011Jun 20, 201146

The American Medical Association recently released its membership numbers, and they're declining. According to MedPage Today, the AMA "saw another steep drop in its membership in 2010 -- this time losing about 12,000 members or 5% of its total membership."…

The American Medical Association recently released its membership numbers, and they’re declining.

According to MedPage Today, the AMA “saw another steep drop in its membership in 2010 — this time losing about 12,000 members or 5% of its total membership.”

It’s been well publicized that the AMA only represents a minority percentage of physicians, depending on what you read, it’s between 20 and 30%. But it seems many physicians have little …

Physician voices

Why doctors shouldn’t have to choose between medicine and family

Kevin Pho, MD

June 12, 2011Jun 12, 201131

For the past few Sundays, the New York Times has published provocative op-eds involving physicians. The first tackled physician bullying. Next was the cost of medical education. And, most recently, the phenomenon of part-time, mostly female, physicians. This is obviously…

For the past few Sundays, the New York Times has published provocative op-eds involving physicians.

The first tackled physician bullying. Next was the cost of medical education. And, most recently, the phenomenon of part-time, mostly female, physicians.

This is obviously a live-wire topic, sure to generate passionate commentary.

In the piece, anesthesiologist Karen S. Sibert goes over ramifications of part-time physicians. …