My heart is blighted like grass, and withered, for I forget to eat my bread.
–A patient’s prayer, Psalm 102
I diagnose and treat medical problems. I love doing it. Sometimes I make a big difference in someone’s life. More often, I just reassure them that they’re going to be ok. Or I give them advice about what they need to do to live healthier. But what I do has limits, and …
Some patients need absolution, not medicine
A guest column by the American Medical Association, exclusive to KevinMD.com.
As our nation’s health care system undergoes historic reforms, the American Medical Association (AMA) has embarked on a long-term strategic plan that seeks a better future for medicine – both for the physicians who make it their profession and the patients who count on us for care. Our focus is …
AMA: Prescription for the future of medicine
It’ll be no surprise to the readers of this blog that physicians’ use of Twitter and other social media has been exploding over the last couple of years. But it may surprise you to know how hard it is to really analyze that data.
Last year Dr. Katherine Chretien of the VA Medical Center in Washington, DC, published an eye-opening study in a JAMA letter. Until that …
Physician use of Twitter: Examining the data
Since the nomination of Congressman Paul Ryan as the vice presidential candidate of the Republican Party, Medicare has become front and center in the political discussions. To understand the dialogue requires an understanding of Medicare, how it works, where the money comes from, how it is spent and why there is such concern for its future costs. Here is an overview.
Medicare was designed in 1965 to serve as “major medical” …
Will Medicare as we know it persist or will it change?
I am starting a prize-linked smoking cessation program for my medical practice. Like most family docs, I constantly remind my smokers about the risks of tobacco and my ability to help them quit when ready. And like most physicians I probably have a false belief that pestering “enough” will spur action. As an unofficial student of economics and official student of public health (MPH), I should know better.
Sure, I have …
I’m paying my patients cash to quit smoking
Since the earliest days of medical school, I learned fast to bring my computer wherever I went. Not only did my laptop function as my personal entertainment center through the dullest parts of lectures, but it also proved to be a source of instantaneous and infinite medical knowledge via the click of a mouse. Four years later and here I am, one hand on the shoulder of patients whilst listening …
This generation of doctors has permanently lost their physician brains
Aspire to decency. Practice civility toward one another. Admire and emulate ethical behavior wherever you find it. Apply a rigid standard of morality to your lives; and if, periodically, you fail as you surely will, adjust your lives, not the standards.
-Ted Koppel
This week started out ordinary enough but took a quick turn when I got a message from the media director at my university that a 14 month …
Through social media, doctors now get a media spotlight
The use of computers in everyday medical practice has finally reached the tipping point.
The HITECH Act, part of the 2009 federal stimulus bill, has been the final kick in the pants that U.S. health care has long needed to make the conversion to digital. The act states that, by employing electronic health records (EHRs) in a fashion known as meaningful use, doctors are individually eligible for …
Digital medicine: Patients are stuck in the precarious middle
There’s a big discussion going on in the health tech community about a controversial keynote speech given by Vinod Khosla at the Health Innovation Summit (HIS), in which he stated that 80% of what doctors do could be replaced by machines.
If you’re a doc like me who has no idea who the heck Vinod Khosla is (he’s a venture capitalist and co-founder of Sun Microsystems), why he’d be a keynote speaker at a …
Doctors need to be part of the digital revolution
Emergency Physicians Monthly has an important debate between ACEP President David Seaberg and EP Monthly founder Mark Plaster about the “Choosing Wisely” program.
Choosing Wisely is being pushed by the ABIM Foundation as a way to get specialty societies to label certain tests as “unnecessary” or of questionable benefit.
I side with Dr. Seaberg in this argument.
I disagree with the concept some people advance …
Reduce health waste through deregulation and free market principles
As school bells ring out announcing a new school year and pigskins fly through the air announcing the arrival of a new football season, the Center for Disease Control and Prevention (“CDC”) begins its annual influenza vaccine campaign. “Flu” or influenza is a viral illness associated with fever, severe muscle aches, general malaise and respiratory symptoms. Most healthy children and adults can run a fever for 5 – 7 days …
Take your flu vaccine as soon as it is available
I have been beating the population health drum for more than 20 years, and I think the rest of the band is finally catching on to the rhythm.
From healthcare reform efforts at the very top of the heap to the healthcare industry to large and small communities, there is a heightened awareness that the physical and mental health of our diverse population is linked to our continued health and success …
Population health initiatives by the pharmaceutical industry
The latest numbers from the CDC’s National Center for Health Statistics affirm that a majority of small practices do not have an EHR. Why is that?
One big reason is because small practices don’t have the management or technical infrastructure available to prepare for and handle the biggest challenges facing medical practices today.
What are those challenges and what’s that got to do with EHR implementation? According to the Medical …
Don’t ever believe EHR uptake is slow only because it costs too much
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Republicans and Democrats don’t agree on much about Medicare, except for getting rid of the fee-for-service system for paying doctors.
“If reducing the growth of Medicare spending to sustainable rates and moving away from fee-for-service are ‘ending Medicare as we know it,’ then both parties have embraced that goal, writes former OMB Budget Director Alice Rivlin in a Daily Beast commentary.
“Paying providers on a fee-for-service basis offers incentives to …
What Republicans and Democrats can agree on about Medicare
Atul Gawande, MD, is a technophile and a believer in the checklist, and he yokes these ideologies to an attractive metaphor in his newest essay for the New Yorker. The article is worth reading in its entirety, but it can be easily paraphrased.
The Cheescake Factory, like other successful restaurant chains, has “brought chain production to complicated sit-down meals.” They’ve done it by far-reaching standardization of the best possible …
A patient is not a dish off the menu
My two oldest children recently left for semesters abroad: Michaela went to Paris, and Zack to Beijing. I have all sorts of Mommy nervousness about this, but in my heart I know they’ll be fine. They are adults now, at 21 and 20—and not just adults, but capable, responsible, great people.
I don’t know how that happened.
I know that sounds stupid. And it’s not like I have no clue at all. …
How our children turn out isn’t really up to us
Could “mommy porn” have value in the doctor’s office? Unless you live in a cave (and we physicians sometimes do), you have heard of British author E.L. James’ modern erotic 50 Shades of Grey trilogy, 30-plus million copies sold, overwhelmingly to women. The trilogy is an erotic love story about a naïve college graduate who rescues an abused billionaire – a …
Viagra for women: Prescribe 50 Shades of Grey to your female patients
I once thought that only the federal government in Washington could effect changes that would impact the cost of health care in the United States, especially with so much attention on the recent Supreme Court decision on the 2010 health care reform law. But now I think differently.
Now I believe that emboldened employers in places like Memphis can use their clout. They can influence insurers and work directly with doctors …
Align employers with doctors, hospitals and insurance companies
A colleague recently sent me a remarkable video – of Professor Lawrence Weed giving Medical Grand Rounds at Emory University in 1971. It’s fun to watch for many reasons: the packed audience composed mostly of white men in white jackets and narrow ties, the grainy black and white images a nostalgic reminder of Life Before High Def.
But the real treat is …
What EMRs are doing to our notes, and our brains
Whatever your opinion of the Affordable Care Act, you must admit that it’s good to see the American public talk about reducing health care costs, offering more efficient delivery systems, and expanding health care services to more of our nation’s people. There’s no easy (or cheap) way to provide health care to all Americans, particularly with the inefficiencies and absurdities that characterize our current health care …
Reform needs more than expanding health care coverage
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