Health policy and public health

My battle against the nurse’s cap

Debbie Moore-Black, RN

February 10, 2019Feb 10, 201917

Florence Nightingale was among the first nurses who started wearing a nurse’s cap. The cap was derived by nuns and represented those caring for the sick. Hair was neatly tightened into a bun and covered by the cap. Back then…

Florence Nightingale was among the first nurses who started wearing a nurse’s cap.

The cap was derived by nuns and represented those caring for the sick. Hair was neatly tightened into a bun and covered by the cap.
Back then becoming a nurse was typically seen as a female profession, but men were allowed to become nurses too. In 1930, only one percent of RNs nationwide were male.

Growing up in the 1950s …

My battle against the nurse’s cap

The true cost of being uninsured in America

Michael Weiss, MD

February 8, 2019Feb 8, 201913

In a New York Post article dated January 23, 2019, the author states how Americans without health care insurance hit 13.7 percent. This 2.8 percent increase means an additional seven-million Americans lack health coverage as noted by the Gallup survey…

This is not far behind the 18 percent recorded just before the Obamacare mandate in 2014.

Everyone is blamed in this article except the culprits. Do you think for one moment …

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American College of Physicians & Philip A. Masters, MD

Practice at the top of your license: What does that really mean?

February 5, 2019Feb 5, 2019

A guest column by the American College of Physicians, exclusive to KevinMD.com. Much has been discussed in recent years around the concept of “practicing at the top of your license.” But what does this really mean? The most common definition…

A guest column by the American College of Physicians, exclusive to KevinMD.com.

Much has been discussed in recent years around the concept of “practicing at the top of your license.” But what does this really mean?

The most common definition is that each medical professional’s routine activities should utilize the full extent of their education, training, and experience, and that their time should not be spent doing …

Why would any woman discourage a man’s advocacy or support?

Agnieszka Solberg, MD

February 4, 2019Feb 4, 20195

A male interventional radiologist who is active in the #HeForShe campaign recently told me that he is being pressured to stop advocating for women. My first instinct was the biggest sigh and eyeroll of my life followed by thoughts of…

But the criticism did not just come from men; many women are asking him to stop. That they don’t need a knight …

How one insurer’s mistake wrecked a practice’s quality score

Fred N. Pelzman, MD

February 3, 2019Feb 3, 20197

To do the math right, you have to get your numerator and denominator correct, or else things just don't work. Recently, in the midst of a large patient safety and quality improvement project trying to bridge gaps in breast cancer…

To do the math right, you have to get your numerator and denominator correct, or else things just don’t work.

Recently, in the midst of a large patient safety and quality improvement project trying to bridge gaps in breast cancer screening among our patients, we discovered that one of the large databases of patients who were attributed to us contained innumerable …

Imagine viewing health care from space

Praveen Suthrum

February 1, 2019Feb 1, 2019

Instead of driving on the highway, let’s imagine you drove upwards from wherever you are. You’ll reach space in about an hour. On your way up, you’ll begin to see everything differently. Cities, roads, and trees slowly blur out to…

Instead of driving on the highway, let’s imagine you drove upwards from wherever you are. You’ll reach space in about an hour.

On your way up, you’ll begin to see everything differently. Cities, roads, and trees slowly blur out to make way for a new kind of reality. Converging. Diverging. Both at the same time.

What appears dissimilar on the ground (trees and shrubs) will appear similar (green). What unites on the …

Imagine viewing health care from space

Quality is more than documentation designed to meet billing and data metrics

Austin Cannon, MD

February 1, 2019Feb 1, 2019

As I walk into the well-upholstered elevator lobby of the hospital and make my way toward the stairs for another night of covering the ICU, I am again inundated with plaques, advertisements and a six-foot-tall cardboard cutout depicting an executive in a suit reminding us that this hospital is among the best in the nation in providing “value.” As I was previously made aware during a resident education session sandwiched …

What advocacy means to this physician

Deborah L. Benzil, MD

January 28, 2019Jan 28, 20192

Patients first Patient care brings me enormous satisfaction. Nearly 40 years ago, when I chose medicine as a career, this was a driving force. Within moments of patients coming into my office, they often share aspects of their life history…

Patients first

Patient care brings me enormous satisfaction. Nearly 40 years ago, when I chose medicine as a career, this was a driving force. Within moments of patients coming into my office, they often share aspects of their life history known only to their closest friends and family. Bestowing this trust is a huge honor that I cherish beyond words. I have the opportunity to help them at a time of …

What advocacy means to this physician

Are clinically integrated networks a cure for checkbox medicine?

Jaan Sidorov, MD

January 28, 2019Jan 28, 20196

Years ago, I was contacted by a health plan about an elderly nursing home patient who had not been screened for osteoporosis. While brittle bones are a big problem in skilled nursing settings, the real problem for this health plan was its low HEDIS score for “osteoporosis testing and management.” Because of the underlying financial stakes and the marketing advantages that …

Get ready for health care disruption

Praveen Suthrum

January 27, 2019Jan 27, 20192

Just like you, I'm trying to make sense of the world around me. But there are no templates for the bridge that health care's building for its future. All we can do is listen to weak signals and amplify them.…

Just like you, I’m trying to make sense of the world around me. But there are no templates for the bridge that health care’s building for its future.

All we can do is listen to weak signals and amplify them.

Recently (and finally), CVS bought Aetna for $69 billion. I spoke to someone intimately familiar with the deal. He called it “vertical stacking” — to expand what CVS customers can get — …

Get ready for health care disruption

My garden has taught me a lot about health care

Jeffrey A. Oster, DPM

January 24, 2019Jan 24, 2019

Sustainability is a bit of a buzz word these days. To be sustainable means that you only use what you need, leaving the rest to be used by you or others in the future. Sustainability is a popular topic in environmental sciences and refers to renewable agriculture, good stewardship of natural resources and recycling of waste. What about sustainability in health care?

In health care, we often describe The United States …

Drugs and prescribing

How hospitals are taking advantage of the 340B Drug Pricing Program

Peter Ubel, MD

January 23, 2019Jan 23, 2019

Sometimes it is hard for hospitals to provide expensive care to poor patients. When a low-income patient needs $20,000 of chemotherapy, a hospital loses money if that patient cannot pay for the medicine, or pays through Medicaid, with its relatively stingy reimbursement. Fortunately, the federal government created a program for hospitals that care for a disproportionate share of low-income patients, whereby they can purchase those medicines at a discount. The program …

Let’s insure our kids instead of building a wall

Sonali Saluja, MD, MPH

January 22, 2019Jan 22, 201916

President Trump wants $5 billion for his border wall — right now — and another $7 billion (or maybe $13 billion) later on to finish the project. What else could we do with that kind of money? Here’s an idea: with $12 billion we could cover ALL 3.9 million American children who are uninsured today, and still have a couple billion left over. Put another way: …

#ThisIsOurLane: Can the movement to end gun violence succeed without addressing racism?

Brian H. Williams, MD

January 20, 2019Jan 20, 2019

The movement fueling #ThisIsOurLane may fail Black Americans who endure a significant burden of gun violence. Responding to a tweet from the National Rifle Association (NRA) demanding we “stay in [our] lane” the medical community rose to the challenge. A new hashtag gained traction, thousands signed an open letter, and many shared graphic photos and stories from treating victims of gun violence.

While laudable in its medical unity, as an African-American …

Social media in medicine

Academic media: Don’t criticize your colleagues for “dumbing it down”

Shari Graydon

January 18, 2019Jan 18, 20193

Are you a media whore? Or do you worry you might be labeled one by your colleagues – if not to your face, then behind your back? In the process of delivering hundreds of media engagement workshops, I’ve heard dozens…

Are you a media whore? Or do you worry you might be labeled one by your colleagues – if not to your face, then behind your back?

In the process of delivering hundreds of media engagement workshops, I’ve heard dozens and dozens of you express this fear, using precisely this language. You’ve made it clear that the mild put-down of “microphone hog” I was familiar with has now been replaced with …

Health technology

How Google is quietly influencing medicine

Michael L. Millenson

January 18, 2019Jan 18, 20192

With nearly 80 percent of internet users searching online for health-related information, it’s no wonder the catchphrase “Dr. Google” has caught on, to the delight of many searchers and the dismay of many real doctors. What’s received little attention from…

What’s received little attention from physicians or the public is the company’s quiet

…

Take ownership of our broken health care system now

John Corsino, DPT

January 18, 2019Jan 18, 20192

In health care, we enjoy a unique opportunity to create special relationships with our work. Few enter these professions for practical reasons, and fewer still survive rigorous training without genuine belief in what they might accomplish. And cliched though they…

But to even for the naïve, spending enough time around health care produces a certain …

Caroline King, MPH & Kelsey C. Priest, PhD, MPH

Addressing gender violence in medicine

January 16, 2019Jan 16, 20192

In medical school, we learn about Broca’s area, the region of the brain that when injured prevents a person from translating their thoughts into spoken word. When this area is damaged, from a stroke or traumatic injury, the person can hear a partner declare their love or a child cry, but are unable to vocalize a response. Silenced by their injury, their voice is trapped.

In a similar way, as medical …

Addressing gender violence in medicine