A guest column by the American College of Physicians, exclusive to KevinMD.com.
by John Tooker, MD, MBA, MACP
There are over 11 million undocumented immigrants in the United States — about 3.7% of the U.S. population — according to a 2011 report from the Pew Hispanic Center.
Although there are many reasons why immigrants elect to come …
ACP: National immigration policy and health care
by Katherine O’Brien
Cancer patients usually say they want a cure. Well, of course, that goes without saying. But it’s also kind of annoying.
We’ve all, as children and adults, had those “What if” conversations. What if you could have anything you wanted in the whole world? Depending on the respondents’ ages, people might say anything from “a …
Cancer is a crime, and how a tumor board is the courtroom
by Justin Chang, MD
I think we can all agree — physician, payer, provider, patient, etc. — that the ultimate goal of regulations and reform should be to improve the delivery of healthcare, lowering costs and ultimately, making patients healthier and more satisfied.
Coupled with driving toward the results defined by CMS, this requires some fairly significant changes …
How the ACO model can be successful
I am a nurse practitioner committed to expert level end of life care. I a consultant for hospice and palliative care organizations, a clinical educator and a volunteer in my town on the local emergency medical service. My life is paradoxical.
It’s not a happy partnership having a palliative mind and responding to 911 emergency calls to save lives.
It’s not …
The paradoxical life of a palliative care nurse practitioner who’s an EMT
I must have missed the declaration of war on pubic hair.
It must have happened sometime in the last decade because the amount of time, energy, money and emotion both genders spend on abolishing every hair from their genitals is astronomical. The genital hair removal industry, including medical professionals who advertise their specialty services to those seeking the “clean and bare” look, …
The war on pubic hair must end
American Heart Month may be officially over, but don’t let the lack of media attention fool you into thinking heart disease isn’t a critical issue.
We still need to be mindful of the fact that heart disease is the number one killer of women.
There are simple lifestyle choices you can make to help prevent you from heart disease.
I hope after reading this post you don’t just move on, but I hope …
Tips to prevent heart disease in women
by Chris Porter, MD
“Treat your patients as you would your own loved ones,” is advice taught throughout training in health care.
Great advice. I use it constantly. Mr. Davis is dying of multiple organ failure in the ICU after exploratory abdominal surgery. His siblings and children trickle in from Florida and Montana.
I’m always sorry for the last to arrive, who visits his dying brother’s bedside minutes before …
How a family conference affects the decision for surgery
Sam was late and Ella was furious. “Now why isn’t that man back by now? He knows it’s time to leave for church.”
The hours began to pass and Ella became frightened. Sam had gone out for his usual two mile run and had simply disappeared. Ella called friends and neighbors but no one had seen him. Panic began to set in so Ella called 911 who connected her to the …
How a patient’s organs could live on and be life saving to a recipient
What medical condition is the most costly to employers? I’ll give you a hint. It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians.
If you guessed depression you are correct. If you mentioned obesity you get a gold star since that comes in right behind depression for both …
Why depression continues to go undiagnosed and untreated in primary care
I just finished another 2 weeks on service. This time, I had also had a shadower, but one of a different kind. As part of our Institute for Healthcare Improvement (IHI) Open School, we are making an effort to have collaborative learning opportunities for our medicine and health administration program students. Achieving true interprofessional learning is challenging for schools like ours without …
Social workers can reduce preventable readmissions
There was a time when Herb was living the American dream in the sunny state of California. He was married with 2 children, a big house in the suburbs, a golden Labrador retriever, and a well-paying job as an executive in a book publishing company.
His two sons were stellar athletes and students, both moving on to attend nationally ranked colleges upon graduation from high school. They were the pride and joy …
Alcohol does not discriminate when it destroys the human body
by Patrick Fitzgerald, MPH
Health advocacy organizations (HAOs) are typically organizations of prominent, trusted stakeholders who conduct campaigns to promote disease awareness, update members to new diagnostic tests and drugs, facilitate physician referrals, deliver health care services, and advocate for policies believed to be in their member’s best interest.
They range in size from national organizations with many thousands of members focused on widespread disease to smaller …
Health advocacy organizations and the lack of transparency
On January 1, the White House announced a new policy that would have paid doctors for discussing end-of-life planning during their Medicare patients’ annual wellness visit.
Under this policy, physicians would be paid to encourage their patients to establish an advance directive, which would guide medical care if the patient became incapacitated from illness, and could …
The advance directive is only a part of end of life decision making
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There are a series of medical megatrends outlined in my book The Future of Medicine – Megatrends in Healthcare that will profoundly affect health care in the coming five to fifteen years and beyond. Some are due to the explosion of basic understandings of cellular and molecular biology. Others are related to advances in engineering and computer science. Here is a very brief overview.
These are the megatrends in medical care …
Advances coming in medical science that will have a high impact
I read an interesting link via Reuters about how students have developed a smart phone application with a microscope attachment to diagnose malaria.
The article shows a picture of a child at risk somewhere in Africa.
This is a great idea, and one that can go a long way to help people who really need it. But the last word from the project’s software engineer in the article was the one that was …
When money gets involved, good medical ideas suffer
I’m a physician assistant, having graduated from PA school over thirty-six years ago. There is angst in my profession, but many PAs don’t openly voice it. I felt compelled to write to you because I still believe in my profession, and I believe in yours, as well. Sometimes I think it might be time to embrace a new belief system. …
A physician assistant writes to the doctors of America
Accountable Care Organizations (ACOs) are supposed to be provider-led (physician groups +/- hospitals) and, they are supposed to inject a new accountability, at the provider level, for the value of services delivered.
You know the old equation. Value=Quality/Cost. Those of us inside the health policy “beltway” know this mantra well. We have been talking about it for years (decades, really).
I spent almost …
An ACO must make the patient experience meaningful
When I advise students about how to choose a specialty, I suggest that they seek out advice from physicians who are at least 10 years out of residency and leading the type of life they hope to have in the future.
It is difficult, and perhaps impossible, to anticipate in your late 20s or early 30s what practicing a certain specialty will be like when you are 40, 50, or 60.
Find …
The exhaustion of emergency physicians, and its toll on patients and family
How do I get my concerns heard about the direction of my treatment?
On the surface, it seems easy. Just tell your psychiatrist what you want him to pay attention to.
On the other hand, there are many reasons why it not so simple.
How to be heard by your psychiatrist
Harold was 51 years old and needed his left arm amputated. A year ago he noticed some swelling in his forearm and went to his primary care doctor.
An MRI showed something. It was small and hard to define, hard to categorize, probably a collection of blood, but there was an outside chance it could be a sarcoma, a tumor originating from muscle …
Arm amputation from a rare sarcoma
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