Kevin Pho, MD

December 15, 2011Dec 15, 20115

Imagine that your neurosurgeon, during surgery, was talking on his cellphone using a headset. Unthinkable? Well, no. A recent article in the New York Times cites a case where a patient was left paralyzed and the neurosurgeon was sued, in…

Imagine that your neurosurgeon, during surgery, was talking on his cellphone using a headset.

Unthinkable?

Well, no. A recent article in the New York Times cites a case where a patient was left paralyzed and the neurosurgeon was sued, in part, for being distracted. He made 10 personal calls during the operation.

The proliferation of portable electronic devices, smartphones, tablets, and the …

Physician finance

Why doctors need to be better negotiators

November 29, 2011Nov 29, 20116

Pediatrician Rahul Parikh has a great piece in Salon, Why doctors can’t say no. You should go read it. In the piece, he cites a recent study showing that, in about 10 to 25% of cases, patients come into an…

Pediatrician Rahul Parikh has a great piece in Salon, Why doctors can’t say no. You should go read it.

In the piece, he cites a recent study showing that, in about 10 to 25% of cases, patients come into an office visit with an agenda, or something specific they request.

It can be an antibiotic, x-ray or a scan, for instance.

The kicker …

How patient satisfaction scores reward rich hospitals

November 8, 2011Nov 8, 20117

Medicare is beginning to tie financial bonuses to hospital patient satisfaction scores. Although patient satisfaction is important, I've voiced concern in the past about giving hospitals a financial incentive to cater to patient surveys. In a previous USA Today column,…

Medicare is beginning to tie financial bonuses to hospital patient satisfaction scores.

Although patient satisfaction is important, I’ve voiced concern in the past about giving hospitals a financial incentive to cater to patient surveys.

In a previous USA Today column, I wrote, “already, more than 80% of doctors … said patient pressure influenced their medical decisions. And in primary care, linking …

The malpractice risk of high deductibles

November 7, 2011Nov 7, 201117

As the cost of health insurance rises, patient deductibles are getting bigger. More doctors are reporting that patients are coming in less frequently for chronic care followups, skipping medication refills, or balking at the out of pocket costs for various…

As the cost of health insurance rises, patient deductibles are getting bigger.

More doctors are reporting that patients are coming in less frequently for chronic care followups, skipping medication refills, or balking at the out of pocket costs for various tests.

Sometimes, however, this can get physicians into trouble.

I was reading through a copy of Massachusetts Medical Law Report, and saw this …

Doctors and patients cannot win when it comes to chronic pain

November 7, 2011Nov 7, 201118

The following op-ed was published on September 18, 2011 in USA Today. A fellow physician recently shared a frustrating clinic visit with me, in which a patient had left by saying, "You doctors need to wake up and realize that…

The following op-ed was published on September 18, 2011 in USA Today.

A fellow physician recently shared a frustrating clinic visit with me, in which a patient had left by saying, “You doctors need to wake up and realize that patients (who are) in pain are in a no-win situation.”

The patient was absolutely right. This summer, the Institute of Medicine released …

Physician voices

The media’s role in educating patients about MRI overuse

November 3, 2011Nov 3, 20112

Thankfully, there have been more news stories recently illustrating the overuse of tests. Specifically with cancer screening, the PSA test and mammograms have come under increasing scrutiny. I think this type of media attention is long overdue, as the public…

Thankfully, there have been more news stories recently illustrating the overuse of tests.

Specifically with cancer screening, the PSA test and mammograms have come under increasing scrutiny.

I think this type of media attention is long overdue, as the public needs to be aware of the potential downsides of diagnostic tests.

Now comes the MRI.

A recent piece in the New …

The power of gut feeling in cancer screening

October 25, 2011Oct 25, 20112

Cancer screening has always been an emotional topic. In recent years, both prostate and breast cancer screening have come under increasing scrutiny. Studies are beginning to question the benefits of early detection, and, in the case of prostate cancer screening,…

Cancer screening has always been an emotional topic.

In recent years, both prostate and breast cancer screening have come under increasing scrutiny. Studies are beginning to question the benefits of early detection, and, in the case of prostate cancer screening, whether more harm is done than good.

In fact, the USPSTF recently downgraded their prostate cancer screening recommendation.

In a recent study from …

Physician voices

How new doctors will kill private practice

October 24, 2011Oct 24, 201128

What are new medical graduates looking for in their first job? According to American Medical News, they're looking for jobs with the following criteria: "The most important items would be the ability to show a stable, growing practice and quality…

What are new medical graduates looking for in their first job?

According to American Medical News, they’re looking for jobs with the following criteria: “The most important items would be the ability to show a stable, growing practice and quality of life … The stability would come from a practice that generates most of their collections from commercial insurance, as Medicare …

Prostate cancer screening requires patient input

October 11, 2011Oct 11, 20116

Predictably, reactions to the USPSTF's prostate cancer screening guidelines are all over the map. Consider editorials from two national newspapers, the New York Times and USA Today. USA Today wants readers to ignore the recommendations: "Here's our suggestion for the…

Predictably, reactions to the USPSTF’s prostate cancer screening guidelines are all over the map.

Consider editorials from two national newspapers, the New York Times and USA Today.

USA Today wants readers to ignore the recommendations: “Here’s our suggestion for the 50-plus male: Get tested, then get smart. Information about prostate cancer and its treatment is readily available from the National Cancer …

USPSTF prostate cancer screening guidelines need emotion to resonate

October 7, 2011Oct 7, 201113

Prostate cancer screening has always been controversial. Now, with the USPSTF is recommending against screening for prostate cancer, gas is about to be poured on the proverbial fire. Recently, the New York Times Magazine published a lengthy piece on the…

Prostate cancer screening has always been controversial.

Now, with the USPSTF is recommending against screening for prostate cancer, gas is about to be poured on the proverbial fire.

Recently, the New York Times Magazine published a lengthy piece on the issue, perhaps not coincidentally, perfectly timed with the Task Force’s announcement.

In 2009, advocates for breast cancer screening were up …

Cancer screening is plagued by dissonance

October 5, 2011Oct 5, 20118

Last year, the USPSTF was poised to meet regarding its prostate cancer screening guidelines. According the Kenny Lin, a physician who was with the Task Force at the time, the meeting was cancelled for political reasons. He points us to…

Last year, the USPSTF was poised to meet regarding its prostate cancer screening guidelines.

According the Kenny Lin, a physician who was with the Task Force at the time, the meeting was cancelled for political reasons. He points us to a New York Times story on the dueling narratives of prostate cancer screening.

It’s a topic that often appears here …

Medical education

Universal board certification can solve the Doctor Nurse controversy

October 3, 2011Oct 3, 201118

I'm going take on the Doctor Nurse controversy. This isn't a new issue, as the doctorate in nursing degree has been around for awhile. But a recent piece in the New York Times gave it new life. The topic is…

I’m going take on the Doctor Nurse controversy.

This isn’t a new issue, as the doctorate in nursing degree has been around for awhile. But a recent piece in the New York Times gave it new life.

The topic is a ripe invitation to “doctor bash,” with the predictable arguments about physicians protecting their turf, elitism, and the like.

Yawn.

To sample the …

Progressive health reformers need doctors to change the health system

October 1, 2011Oct 1, 20117

Doctors order too many tests. That's not a surprise for regular readers of this site, but even the physicians themselves think so. A recent survey reported that, "42% of the 627 respondents believed the patients in their own practice were…

Doctors order too many tests.

That’s not a surprise for regular readers of this site, but even the physicians themselves think so.

A recent survey reported that, “42% of the 627 respondents believed the patients in their own practice were getting too much care. Just 6% of doctors believed their patients were getting too little care … And 28% of the …

Doctors need celebrities to spread the vaccine message

September 20, 2011Sep 20, 201110

Presidential candidate Michele Bachmann has been in the health care headlines recently, saying the HPV vaccine was dangerous. Although doctors and other health experts, along with editorials in major newspapers, rebutted her claims immediately, they didn't stand a chance. The…

Presidential candidate Michele Bachmann has been in the health care headlines recently, saying the HPV vaccine was dangerous.

Although doctors and other health experts, along with editorials in major newspapers, rebutted her claims immediately, they didn’t stand a chance.

The damage was already done.

A piece from the New York Times explores the power both celebrities and politicians have when it comes to …

Physician voices

Patients should care about physician stress and burnout

September 15, 2011Sep 15, 20115

Physicians are human, like everyone else. And when things go wrong, like making a medical error or having a patient die, they suffer like most people would. Pauline Chen writes about Schwartz Rounds in the New York Times, where, in…

Physicians are human, like everyone else.

And when things go wrong, like making a medical error or having a patient die, they suffer like most people would.

Pauline Chen writes about Schwartz Rounds in the New York Times, where, in a confidential environment, doctors and other health professionals can discuss challenging cases.

As Dr. Chen writes, “the discussions that ensue are …

Targeting physician salaries is a poor strategy for health care costs

September 14, 2011Sep 14, 201112

A recent study from Health Affairs took aim at physician salaries. Well, not exactly their salaries, but fees. It's a subtle difference, but that nuance is lost in the mainstream media narrative. According to the study, "American primary care and…

A recent study from Health Affairs took aim at physician salaries.

Well, not exactly their salaries, but fees. It’s a subtle difference, but that nuance is lost in the mainstream media narrative.

According to the study, “American primary care and orthopedic physicians are paid more for each service than are their counterparts in Australia, Canada, France, Germany and the United Kingdom.”

Thankfully …

How not to convince doctors to embrace single payer

September 1, 2011Sep 1, 201124

What would happen to physician salaries if the United States adopted a single payer system? The concept of a single payer system is a progressive ideal, and has been vociferously pursued by some left-leaning physician groups. For a variety of…

What would happen to physician salaries if the United States adopted a single payer system?

The concept of a single payer system is a progressive ideal, and has been vociferously pursued by some left-leaning physician groups. For a variety of reasons, not least of which is the political climate in our country, I think the chances of single payer happening …

Physician finance

Doctors should learn personal finance during medical school

August 28, 2011Aug 28, 20119

I read somewhere in the comments here something to the effect of this: "Physicians are only good for one thing: doctoring." That would explain the general ineptitude of many physicians when it comes to skills outside medicine, such as political…

I read somewhere in the comments here something to the effect of this: “Physicians are only good for one thing: doctoring.”

That would explain the general ineptitude of many physicians when it comes to skills outside medicine, such as political lobbying, or business and personal finance decisions.

The New York Times has written a helpful column that’s required reading for any new …

Patient voices

How much physician guidance do patients want with medical decisions?