High blood pressure treatment that patients need to know

Conditions
April 21, 2010

When her gynecologist told her she had high blood pressure, Marie had a simple solution: switch doctors. After all, she had gone to him for a different problem, and this was the first time he had ever checked her blood pressure.

“He said, ‘Oh my God, you’re like a bomb waiting to explode.’ I said, ‘I didn’t come here for that, I came here for something else,’” she explained.

Two years later, …

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High blood pressure treatment that patients need to know

Radiology tests, and how to find their price

Conditions
March 30, 2010

I am often asked how we get the prices for the radiology imaging tests, such as MRI’s and mammograms, or ultrasounds. Most people assume that my day job as a doc gives me some sort of special access to this info. But that’s just not the case. Anyone can find out testing prices.

However, over the last year, those of us working at LesliesList.org have gotten more experienced and better at …

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Radiology tests, and how to find their price

When doctors can’t figure out what’s wrong with a patient

Conditions
February 10, 2010

Part one of a series.

The first patient I ever saw as a first year resident came in with a litany of complaints, not one of which I remember today except for one—he had headaches. The reason I remember he had headaches isn’t because I spent so much time discussing them but rather the opposite: at the time I knew next to nothing about headaches and somehow managed to end the …

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When doctors can’t figure out what’s wrong with a patient

How psychiatrists may be giving their patients too many drugs

Meds
January 16, 2010

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Psychiatrists who prescribe drugs for their patients today usually give more than one at a time, often with little scientific basis, researchers said.

About 60% of patients with psychiatrist office visits leading to a drug prescription received at least two medications in 2005-2006, according to government survey data analyzed by Ramin …

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How psychiatrists may be giving their patients too many drugs

Why doctors in the United States order so many CT scans and MRI tests

Conditions
January 13, 2010

It’s commonly thought that health care in the United States is heavily dependent on diagnostic testing.

But how do we compare with the rest of the world? Perhaps these graphs, courtesy of the New York Times can provide a stark illustration.

Here’s the data regarding CT scans, showing the number of tests per 1,000 people. Guess which country’s on top:

ct ... <strong srcset=Read more…

Why doctors in the United States order so many CT scans and MRI tests

Issues surrounding videotaping surgeries in the operating room

Physician
December 23, 2009

The rapid advance in digital video and still camera technology has found its way into the operating room.

There is the potential to capture and record just about every minute of every surgical procedure in some way. The newest endoscopic camera systems and operating microscopes have integrated systems to record video footage. Storing all that data is just the press of a button away.

The advantages for surgeons are obvious, like the …

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Issues surrounding videotaping surgeries in the operating room

12 most important medical advances of the decade

Physician
December 16, 2009

As the first decade of the 21st century comes to an end, it is interesting to look back and reflect on the most significant medical advances we’ve seen. I’d like to present 12 medical advances that I consider to have been the most important over the past decade, and I’d like to ask you, the wider world, to contribute in two ways:

– Add your nomination in the comment field regarding …

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12 most important medical advances of the decade

Should health care workers go to jail for medical errors?

Physician
December 11, 2009

Two years ago, I wrote about the case of Julie Thao, the Wisconsin nurse sent to prison for a medication error. I argued then that – although Julie bypassed some safety rules – she most certainly did not deserve jail time.

Along comes another case involving jail time for a medical mistake, this one featuring an Ohio pharmacist named Eric Cropp. I became aware of Eric’s case through the efforts of …

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Should health care workers go to jail for medical errors?

Seeing floaters or flashing lights can be caused by posterior vitreous or retinal detachment

Conditions
December 2, 2009

Originally posted in Insidermedicine

The eye is very similar to a camera. Both are optical systems that have lenses in the front to focus light rays onto a film. The retina is the eye’s film. It is a tissue that consists of 10 layers and is about 500 microns thick—or, half a millimeter. The main function of the retina is to trap light rays, convert them into electrical impulses, and send …

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Seeing floaters or flashing lights can be caused by posterior vitreous or retinal detachment

The joys of practicing rural emergency medicine

Physician
November 25, 2009

I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.” It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest. The natural beauty is breathtaking. Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some …

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The joys of practicing rural emergency medicine

Op-ed: Humor can be healing for both doctors and patients

Physician
November 21, 2009

A version of this op-ed, co-written with Doug Farrago, was published on October 26th, 2009 in Medscape.

It’s tough to be a doctor these days. Whether it’s listening to the difficulties of our medical colleagues as they try to best care for their patients, or engaging other health professionals about the uncertainties surrounding health reform, we’ve noticed a tense, sometimes gloomy, atmosphere among physicians.

A recent survey from the Annals of Internal …

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Op-ed: Humor can be healing for both doctors and patients

Can family doctors do safe first trimester abortions?

Conditions
November 18, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Complications from first trimester abortions performed by family practitioners are rare, and family doctors could help address abortion provider shortages across the U.S., a new study found.

Among more than 2,500 abortions performed by family physicians, abortion was successful without complications in 96.5% of patients using medications (95% CI 95.5% …

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Can family doctors do safe first trimester abortions?

Why doctors are doing so many unnecessary Pap smears

Conditions
November 17, 2009

The Wall Street Journal and other sources reported on a study from the Annals of Internal Medicine that showed that most US doctors don’t know the guidelines of how often women should get a pap smear. More importantly, doctors were doing a lot of pap smears on women who didn’t need them. In all the talk about health care reform, reducing costs by eliminating unnecessary testing has been mentioned multiple …

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Why doctors are doing so many unnecessary Pap smears

Why you should stop taking Vytorin for high cholesterol

Meds
November 16, 2009

At the American Heart Association meeting in Orlando, the results of the ARBITER 6-HALTS study were released. No Vytorin was used in the study, but I am sure that all the headlines will mention Vytorin.

The actual study published ahead of press online in the New England Journal of Medicine. Essentially, they enrolled over 200 patients from Walter Reed and Washington Adventist who had known heart disease or were at …

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Why you should stop taking Vytorin for high cholesterol

Many women report nerve-related persistent pain after breast surgery

Conditions
November 12, 2009

Originally published in Insidermedicine

Nearly half of women who undergo surgery and other treatments for breast cancer report having persistent pain in and around the treatment area a year or more later, probably because of nerve damage, according to research published in the November 10 issue of the Journal of the American Medical Association.

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Many women report nerve-related persistent pain after breast surgery

Should doctors be paid to e-mail their patients?

Physician
October 11, 2009

by Michael Kirsch, MD

This is a less controversial issue than patients ‘friending’ their doctors on Facebook, which I oppose. Although most physicians’ offices are not e-mailing with patients, perhaps they should. There are several obvious advantages.

* Decompress phone lines, which are suffocating nearly every medical practice in America.

* Relieve patients of the cruel and unusual punishment of languishing on ‘hold’ listening to elevator music or dead air.

* Allow office staff …

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Should doctors be paid to e-mail their patients?

Radiologists and communicating mammogram results to patients and their doctors

Conditions
September 24, 2009

by an anonymous radiologist

I recently read the article and comments on this link from this post, concerning radiologists, from Musings of a Dinosaur.

I was disturbed to discover the animosity with which this topic is covered. The tenor of the blog is that radiologists are greedy, self-serving and are out to erode the doctor-patient relationship. The suggestion that radiologists would schedule percutaneous breast biopsies for their financial enhancement is both …

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Radiologists and communicating mammogram results to patients and their doctors

Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

Conditions
August 26, 2009

Caster Semenya is the South African track and field star who recently was engulfed in controversy at the recently concluded World Track and Field Championships.

caster-semenya Turns out, there are some who are questioning her gender, and subsequently, tests are being conducted to see if she is really a woman.

It’s not as cut and dry as it appears.

Consider the possibility of Read more…

Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

Do patients really need their complete lab and radiology reports?

Conditions
August 21, 2009

Most prefer the bottom line, sparing them the raw data.

Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.

So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):

lab-values

Do patients really need their complete lab and radiology reports?

How soon should patients receive their test results?

Conditions
July 9, 2009

And should you assume that no news is good news?

The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent.

That’s almost a quarter of abnormal test results from that center that patients were never …

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How soon should patients receive their test results?

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