Look no further than online patient reviews to discover what is good, bad, and downright ugly about your practice. Some will say it’s important to monitor these reviews in order to improve patient care or manage your online reputation, but there’s another hidden advantage that is perhaps the most valuable of all – …
Use patient reviews to improve your Google rankings
A while back, my brother-in-law was experiencing low back pain and my sister told me that the doctor had diagnosed it as a “herniated disc.” The conversation eventually evolved into a discussion about the difference between a “herniated” disc and a “ruptured” disc. My position was that ruptured was worse; my sister’s that they were the same thing. Since inquiring minds want to know these things, I decided to look …
Shared language between doctors and patients
Four brutally honest declarations:
1. I can perfectly decide what is best for myself, my family, my patients, and my practice. I don’t need outside guidance telling me how to lead.
2. I decide what works best on my terms to practice the best medicine.
3. I will succeed and lead because I am focused on my goals just as much (if not more) than my patient’s goals.
4. My goal is to make …
Doctors need to stop being so complacent
A recent article in the Wall Street Journal is getting a lot of attention: More Doctors ‘Fire’ Vaccine Refusers. The article discussing the increasing frequency of pediatricians who are “firing” patients/families from their practices because they refuse to take recommended vaccines for fear of autism or other concerns (rampant on the internet, but all proven untrue).
It is important to note that not only should physicians be able to fire patients, …
Why doctors should be allowed to fire patients
Lately, I get the feeling that I’m doing something wrong. I’m supposed to form a partnership with my patients. My patients are supposed to be the working partner and I’m supposed to be the consulting partner.
My job as the consulting partner is to offer sagely medical advice to the boss (working partner). As a consultant, I’m supposed to help in the making of key decisions, find the appropriate tools to …
Saving patients from Internet health information
Here are some of the most common questions I encounter regarding vaccines and my answers. I’m writing this post, from a parent to a parent, because I want to equip you with accurate information to protect your child.
We give so many vaccines now and it seems like we are constantly adding more. Isn’t this too much for my child’s immune system? Isn’t it antigen overload?
The immune system is very complex, …
Answers to common vaccine questions
We have a real paradox in American healthcare. On the one hand we have exceptionally well educated and well trained providers who are committed to our care. We are the envy of the world for our biomedical research prowess, funded largely by the National Institutes of Health and conducted across the county in universities and medical schools. The pharmaceutical industry continuously brings forth life saving and disease altering medications. The …
America has a health care paradox
I have decided to spam for public health.
Phone calls, text messaging, and even apps have been shown to help improve health and sustain behavior change, even in people suffering from profound mental illness. But when it comes to using these tools for public health, there are two problems. The first is that each message (whether via phone call or text) costs money. The second is that it’s quite hard …
Using Twitter to deliver health improvement messages
One of the things I love about family medicine is that I get to care for people of all ages. I almost went into pediatrics, but the time I spend with older adults was too valuable to give up. Our elders have such great stories and knowledge to impart – it’s an honor to participate in their lives and share their experience.
Since I first realized in residency training that Medicare …
Benefits of the Medicare Adult Wellness Visit
CNN recently posted an article titled “Doctors Going Broke.” It described several cases of independent physicians who are near bankruptcy although they once were quite well off. For instance, the article detailed the case of Dr. William Pentz, a cardiologist in a small group practice, who had to borrow money last month to make payroll. He and the other cardiologists have cut their salaries in order to meet overhead. Dr. …
Surviving the new landscape of physician reimbursement
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate enormous amounts of time, at great personal sacrifice, to represent the interests of our members and their patients.
One of the things that I like least is when an ACP member (or non-member physician) caustically dismisses their efforts, usually because they disagree with some aspects of ACP policy. It …
Doctors lobby Congress to repeal the SGR
I recently wrote that “diagnosis is job number one.” In sports, there are times when two teams share the number one position. Each team competes to make it to the championship; and, ultimately, one team has to lose its top ranking.
In medicine, care and diagnosis share the number one spot, working together toward a common goal: to promote health. Some would say that, without care, the diagnosis is worthless. Certainly, …
The foundation of medicine is care
I hate running late. I prefer to arrive five minutes early for any meeting. I was that compulsive student who always turned in papers before they were due. Now I turn in conference abstracts, grant applications, and even poetry contest submissions, well before their deadlines. Unfortunately, timing is not always in my control.
I particularly hate running late in clinic. I want to see all my patients on time. It is …
Patients in the waiting room do not know why doctors are running late
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I don’t like selecting colleagues through the Match. The process was established to allow students to get the best opportunity available and I feel that our program (and our patients who rely on our trainees to provide care) is in jeopardy every year. It always turns out better than I anticipate, so I shouldn’t complain. However, we have to interview 60 prospective residents to fill our six slots so …
Advice to prospective family medicine residents
Ovarian cancer screening clearly touches a nerve.
No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease is at an advanced stage. Tests to look for the disease, such as the transvaginal ultrasound or the CA-125 blood test, are not specific enough. That leads to false positive tests that necessitate more studies that may not be …
How I approach ovarian cancer screening with patients
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively offer their patients the option to communicate with each other through email. Unlike other professionals in the United States, doctors have generally resisted the adoption of email into their practices. But according to the WSJ article, email can result in many benefits to both the doctor and patient. …
The pitfalls of email communication with patients
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Is medical ethics an important aspect of real world medical practice today? Or a quaint notion for the history books based on mom and apple pie generalisms?
For the patient and for the physician in practice, medical ethics is — or should be — a daily aspect of care. …
ACP: Medical ethics should be a daily aspect of care
There’s a great deal of planning and testing of new models of care and delivery to respond to healthcare’s ever increasing costs. We’ve all heard about Accountable Care Organizations (ACO) and medical homes. The common concern is that they become a repeat of HMOs with the accompanying misaligned incentives undermining their effectiveness. An exciting new medical home model is rapidly expanding that avoids the dreaded “gatekeeper” that was the undoing of …
How to avoid HMO gatekeeper problems in medical homes
Jack and John are identical twins but have varying interests in life. One day Jack, 43 years old, decides he has had enough of these headaches and calls his family doctor and asks what he should do. He is told that his doctor can see him in 4 days and to take some over-the-counter ibuprofen. And to go to the ER if the headaches worsen.
John, who has also been having …
Identical twins with different ideas about health care
While in residency, I took care of a toddler who was hospitalized following an anaphylactic reaction. During a diaper change at home the child suddenly developed lip swelling and severe difficulty breathing for no apparent reason. The child was urgently brought to the hospital by ambulance and initially treated in the emergency room. By the time I met her on the inpatient floor her breathing and swelling had significantly improved. …
Are physicians addressing the root causes of health problems?
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