The Affordable Care Act does very little to reform the medical malpractice system.
It only allocates $50 million to various pilot projects around the country.
A recent piece in the New England Journal of Medicine provides more detail. It appears that, instead of capping non-economic damages, many of the projects have a quality …
A medical malpractice system that reduces errors and improves quality
Occasionally, you may encounter patients who you no longer wish to treat. Reasons for ending the physician-patient relationship may include chronic non-compliance, rudeness to office staff, or non-payment of bills.
While these patient behaviors can affect the interactive care-giving process, they may also identify patients with a propensity to file a claim against you. To help reduce the risk …
How to discharge a patient from your practice
by Alison Block
It’s one of my earliest memories: I’m wrestling with my brother, and I’m losing, because I’m five and he’s seven, and he’s bigger and stronger than I am. So I bite him, hard.
Instantly I know I’ve crossed some sort of line, and I employ my most primitive defense mechanism, shouting out, “He bit me! Jon bit me!” I feel shame, because I am old …
At the age of 56, Jules Levin felt pretty invincible, despite being HIV positive. He went to the gym regularly and controlled his disease well by taking his antiretroviral medicines every day.
Then he slipped one day while on vacation and broke his wrist.
He underwent an operation to insert pins in his bones and needed to wear a cast for a month, keep his arm …
Osteoporosis in patients with HIV
The desire to be touched by and connected with others is among our most primal and, until recently, our most untapped qualities.
There have always been powerful signs of it. Those of us who remember exchanging letters with distant friends and family know the palpable anticipation when a letter arrived.
Years ago I visited the senior center at Pan American Hospital in Miami, an institution beloved by the “abuelos” (grandparents), mostly elderly …
Integrating social media into everyday health care
by Graham Walker, MD
In The Hitchhiker’s Guide to the Galaxy, the Babel Fish was a fish you stuck in your ear that allowed you to understand any language spoken to you. We’re not far off.
Google recently released a new version of their (free!) Google Translate app for Android phones, featuring conversation mode, which allows you to have a back and forth …
Using Google Translate in medicine
by Ted Bacharach, MD
The physicians as a group have been accused of many things. We have been blamed for the high cost of medical care, the depersonalization of physicians and the discontinuity of medical care.
If there was any situation in which we have performed exceptionally well but not been realized by the public, it …
How the medical profession advanced women’s rights
A vaccination policy statement released by the American Academy of Pediatrics has already drawn fire from a number of anti-vaccine groups, specifically for its endorsement of vaccination against HPV infection in boys.
First, let’s examine exactly what the AAP added to its guidelines regarding the HPV4 and HPV2 vaccines: “HPV4 may be administered in a 3-dose series …
Myths about the HPV vaccine for boys
An excerpt from Finally Out: Letting Go of Living Straight, A Psychiatrist’s Own Story.
by Loren A. Olson, MD
I once cared for an aging lesbian who began to have memory problems.
She went to a neurologist who said bluntly, “Get your affairs in order. You have Alzheimer’s disease.” My patient was confused, devastated, and depressed. She asked a companion to accompany her on her return visit. This time the neurologist said, …
Isolated gay people and support from the LGBT community
Patient privacy and social media use in health care often go together when reported in mainstream media.
When physician blogs were a relatively new phenomenon several years ago, the majority of the media coverage focused on edge cases, where doctors inadvertently revealed patient information.
Only a minority of the headlines focused on the positive aspects, such as how …
Doctor reprimanded after patient privacy breached on Facebook, my take
The new healthcare reform law appears to be using the idea of improved quality to justify the enormous expense of changing the way care is delivered in the United States.
As a justification for the need for change is the reporting currently being touted as a great measure of quality. This information is gathered in many different ways and …
When quality of care becomes customer satisfaction demands
As America comes to grips with the disastrous effects of a national obesity epidemic, there’s a new feeling in the air: defeatism.
Former Carter Administration advisor Amitai Etzioni seemed to succumb to it when he wrote an article entitled “dieting gets you nowhere” for CNN recently.
In it, the liberal sociologist citied a recent nutritional study …
How obesity is a voluntary epidemic, and why we shouldn’t give up
Good primary care physicians are becoming harder and harder to find.
You may not have noticed it yet, but I predict that a year from now we’ll find it almost impossible to find primary care doctors who are willing to take on new patients – at least any primary care doctor worth seeing won’t be …
Smart patients need to establish a relationship with a primary care doctor
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Beth wrote, “I plan on having my daughter vaccinated against HPV when she’s the right age (which is what by the way?). Recently, some friends were saying they were planning to have their sons receive the vaccine as well because although males obviously don’t get cervical cancer, they can spread HPV and put their future partners …
Should the HPV vaccine be given to boys?
Two articles recently highlighted two very different areas of medicine that are quickly colliding and pointing to a new direction for health delivery.
The first, published in the Wall Street Journal, discusses the steady rise of personalized health records through companies like Google, Microsoft, and WebMD. The second, published in USA Today, examines genetic tests and the disconnect between what is available and what physicians understand about …
Personalized health records and genomic tests for patients
“See me, feel me.”
Yes, that’s right, the title of a song played at Woodstock by The Who—at sunrise of the third day, no less—is the title of my post. The song begins with those very words sung in dramatic refrain, followed by four more: Touch Me/Heal Me.
The same four imperatives succinctly describe the essence of what patients want from their doctors. But in the age of the EHR (Read more…
How an EMR emotionally disengages physicians from their patients
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 63-year-old woman is evaluated during a follow-up visit for a 4-week history of fatigue; pain in the proximal interphalangeal joints, knees, and hips; and low-grade fever.
She has not had joint swelling, chest pain, or shortness of breath. Over the past 4 years, she has …
MKSAP: 63-year-old woman with a 4 week history of fatigue
by Shanti Bansal, MD
In the cardiac catheterization lab one Tuesday morning, I encountered a situation that made me reflect on a bit of 18th-century British history.
At that time, the British government was overburdened with prisoners. A plan was hatched for sea captains to transport many of them to Australia. Due to poor conditions, up to one third died on the voyage. Politicians and clergy members …
Judicious use of complex medical procedures
At LesliesList.org we get many emails asking where an adult can get low cost vaccines.
It appears the answer is… nowhere. They don’t exist– unless you are an established patient in one of the county-funded or low-cost clinics in your metropolitan area. However, you can save a little money by comparison shopping. I think your best bet is to try one of the walk-in …
Where an adult can get low cost vaccines
In the recent Coen brothers’ remake of the 1969 movie True Grit, Mattie Ross, an intrepid 14-year-old, is determined to hunt down and kill the man who murdered her father.
To accomplish this, she hires U.S. Marshal Rooster Cogburn, (played by a mumbling Jeff Bridges) a rough, one-eyed veteran of many such quests – then announces that she plans to come along. She figures she is prepared.
After all, she and her …
True Grit and sharing decisions on health care with our doctors
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