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 6

Conditions and diseases

New cholesterol guidelines: The statin decision lies with patients

Kevin Pho, MD

November 13, 2013Nov 13, 20138

The release of the new cholesterol guidelines from the ACC/AHA is big news. It represents a fundamental shift in how we prescribe statin drugs. As with many sweeping changes, there are some good, and some controversial ideas. I like removing…

The release of the new cholesterol guidelines from the ACC/AHA is big news. It represents a fundamental shift in how we prescribe statin drugs.

As with many sweeping changes, there are some good, and some controversial ideas.

I like removing non-statin cholesterol drugs from the recommendations, such as Zetia. Many haven’t been shown to save lives or decrease cardiovascular events.

Also, removing LDL targets can simplify …

Health technology

Google Helpouts will bring telehealth to the masses

Kevin Pho, MD

November 6, 2013Nov 6, 20133

Google Answers was a service that was launched in 2002 where users would pay money to ask questions, and a Google-vetted researcher answer them. As many who have seen me speak know, I was a Google Answers researcher, where I…

Google Answers was a service that was launched in 2002 where users would pay money to ask questions, and a Google-vetted researcher answer them.

As many who have seen me speak know, I was a Google Answers researcher, where I answered health-related questions.

Google Answers closed in 2006, but recently, version 2.0 of Google Answers was announced: …

Health policy

HealthCare.gov doesn’t need a tech surge, it needs better primary care

Kevin Pho, MD

October 25, 2013Oct 25, 201316

The Affordable Care Act is off to a rocky start, to say the least. Attention has been focused on HealthCare.gov, where those without employer-provided insurance can shop for health plans. Finger pointing abounds, with the Centers for Medicare & Medicaid…

The Affordable Care Act is off to a rocky start, to say the least.

Attention has been focused on HealthCare.gov, where those without employer-provided insurance can shop for health plans. Finger pointing abounds, with the Centers for Medicare & Medicaid Services and contractors blaming each other.

A story in the Wall Street Journal chronicles the debacle:

The contractors said each of their pieces worked more

…

Health policy

Corporate wellness programs fail both companies and patients

Kevin Pho, MD

September 19, 2013Sep 19, 201314

This column was published in USA Today on September 9, 2013. More patients are coming to my primary care clinic with forms from their employer, asking me to measure their blood pressure, or check their sugar and cholesterol levels. Companies…

This column was published in USA Today on September 9, 2013.

More patients are coming to my primary care clinic with forms from their employer, asking me to measure their blood pressure, or check their sugar and cholesterol levels. Companies requesting medical data drive employee wellness programs, a booming $6 billion business, with approximately half of large employers offering such plans.

Coaching and financial incentives are often offered to help employees meet certain health metrics, …

Physician voices

Should doctors separate their personal and professional identities?

Kevin Pho, MD

August 17, 2013Aug 17, 201311

Most social media guidelines for physicians, most recently from the American College of Physicians and Federation of State Medical Boards, suggest that doctors separate their personal and professional identity. Until physicians are better educated on how best to act professionally…

Until physicians are better educated on how best to act professionally on social networks, keeping their online personal lives private is more likely to keep them out of trouble.

But is it time for that recommendation to be revised?

In a recent JAMA perspective …

Health policy

Drug store retail clinics for primary care? Not so fast

Kevin Pho, MD

August 14, 2013Aug 14, 2013123

USA Today on July 3, 2013. One recent day in my primary care clinic, I had a full schedule and was unable to see a patient for her cough. She instead sought medical care at a local drugstore, where she…

A version of this column was published in USA Today on July 3, 2013.

One recent day in my primary care clinic, I had a full schedule and was unable to see a patient for her cough. She instead sought medical care at a local drugstore, where she was treated for bronchitis. Normally housed in pharmacies and department stores like Target or Walmart, …

Physician voices

Atul Gawande provides clues on how to change doctor behavior

Kevin Pho, MD

August 13, 2013Aug 13, 201313

We're spending an inordinate amount of time and effort trying to convince doctors to change the way they practice. Most recently, for instance, a study came out saying that doctors aren't following back pain guidelines. Or from a broader perspective,…

We’re spending an inordinate amount of time and effort trying to convince doctors to change the way they practice.

Most recently, for instance, a study came out saying that doctors aren’t following back pain guidelines. Or from a broader perspective, consider the Choosing Wisely campaign, which lists scores of tests and treatments that are ordered too frequently.

Various carrots and sticks have been used to steer …

Health policy

Complicated Obamacare clears a very low bar

Kevin Pho, MD

July 2, 2013Jul 2, 20134

The following column was published on May 29th, 2013 in the New York Times’ Room for Debate blog, which asked the question, "Is Obamacare too complicated to succeed?" Is the Affordable Care Act complicated? Of course it is. Even one…

The following column was published on May 29th, 2013 in the New York Times’ Room for Debate blog, which asked the question, “Is Obamacare too complicated to succeed?”

Is the Affordable Care Act complicated? Of course it is. Even one of its architects concedes that it is phenomenally complex. Why? To pass, it had to be contorted to satisfy a number of special interest groups.

As its major reforms are implemented …

Health policy

To improve patient safety, lawyers need to embrace transparency too

Kevin Pho, MD

June 6, 2013Jun 6, 201314

How do we reduce medical errors? It’s a question at the forefront of the minds medical and policy leaders today. Entire books have been devoted to the subject, and there is no shortage of suggestions to improve patient safety. Internist…

How do we reduce medical errors?

It’s a question at the forefront of the minds medical and policy leaders today. Entire books have been devoted to the subject, and there is no shortage of suggestions to improve patient safety.

Internist Danielle Ofri recently wrote a New York Times op-ed on the issue, where she reflected on a “near miss” she had during …

Physician voices

How I would end the war between nurse practitioners and doctors

Kevin Pho, MD

May 16, 2013May 16, 201380

One of the more contentious topics on my site is the scope of practice for non-physician providers, such as nurse practitioners. This echos the debate on the national stage where leaders of physician organizations, who want to protect their scope of practice, conflict with those of nurse practitioners’, who want to perform the tasks that physicians traditionally have.

Simply Google “nurse practitioner” on this site, for instance, and you’ll see …

Drugs and prescribing

Curb prescription drug abuse by following Mayor Bloomberg

Kevin Pho, MD

April 20, 2013Apr 20, 20135

Prescription drug abuse is a growing national tragedy. One of the biggest culprits is opioid painkillers, such as Oxycontin and Percocet. Shockingly, more than 200 million of these types of drugs are prescribed annually, and they account for more than…

A version of this column was published in USA Today on April 1, 2013.

Health policy

Health reformers should learn from doctor-owned hospitals

Kevin Pho, MD

April 18, 2013Apr 18, 201310

As part of the health reform movement, hospitals that meet various quality measures, like reduced readmission rates or improved patient satisfaction measures, get financially rewarded. Those that don’t will be penalized. How’s it going so far? Well, it appears that…

How’s it going so far?

Well, it appears that safety net hospitals that can least afford a financial hit are getting dinged, while doctor-owned hospitals are getting rewarded.

Oops.

According to Kaiser Health …

Boston rises in the wake of tragedy

Kevin Pho, MD

April 15, 2013Apr 15, 20132

“Daddy, a bomb blew up in Boston!” That was how my 4-year old greeted me when I came home this evening. Of course, I already knew about the horrific attacks during the Boston Marathon, first on Twitter, then realizing the…

“Daddy, a bomb blew up in Boston!”

That was how my 4-year old greeted me when I came home this evening.

Of course, I already knew about the horrific attacks during the Boston Marathon, first on Twitter, then realizing the gravity of the event as mainstream media caught up.

I practice in Nashua, NH, which is about 45 minutes north of Boston. But …

Read more…

Boston rises in the wake of tragedy

Health policy

Health reform faces tension with integrated health systems

Kevin Pho, MD

April 13, 2013Apr 13, 20134

Room for Debate blog. In the coming years, health care reform will drive consolidation in the industry. Reformers, including the president himself, point to integrated health systems like Kaiser Permanente as the future of health care delivery. While this movement…

The following column was published on March 26th, 2013 in the New York Times’ Room for Debate blog.

In the coming years, health care reform will drive consolidation in the industry. Reformers, including the president himself, point to integrated health systems like Kaiser Permanente as the future of health care delivery. While this movement may improve patient care, whether it will shield …

Health policy

Walgreens moves into primary care, and it’s our own damn fault

Kevin Pho, MD

April 12, 2013Apr 12, 2013204

Will your next primary care appointment be at a drugstore? Yes, if Walgreens can help it. It was recently announced that the drug chain will have its nurse practitioners and physician assistants begin to diagnose and manage chronic conditions, such…

Will your next primary care appointment be at a drugstore?

Yes, if Walgreens can help it.

It was recently announced that the drug chain will have its nurse practitioners and physician assistants begin to diagnose and manage chronic conditions, such as hypertension and diabetes.

“We’re not trying to take over primary care, but we think we can help support physicians and transform …