Dear “Robin,”
Nothing in my career in medicine has prepared me for being a friend to someone with such a terrible disease. As a doctor I dispense advice on a daily basis, but those interactions remain strangely impersonal. With you, cancer has invaded our inner circle, and we all share your shock and despair.
No one can know exactly what it feels like …
A doctor’s letter to a patient with newly diagnosed cancer
What is wrong with the state of Texas? Have they no heart? Why is it that at the time of fiscal crisis, it’s always the “little” people whose services are eliminated first?
The “little” people in this case would be babies who are either born sick or premature. The New York Times article, In Search of Cuts, Health Officials Question NICU Overuse, was shocking. The Texas state officials have …
Budget cuts to NICU admissions will have a ripple effect
Regardless of the method of reimbursement, the importance and relevance of increases in local market demand for health care services, such demand being the major economic factor that creates opportunities for business growth, is often under-appreciated by busy physician practices.
The trigger for adding a physician to a practice is typically either a response to being unable to sustain the current workload with existing personnel or a desire to proactively add …
Market demands determine whether to add physicians to a medical practice
Today, healthcare is criticized by the public as too high on technology and too low in touch. Computers take patients histories, provide differential diagnoses, and even supply educational materials to patients. A new specialty, tele-medicine, offers healthcare services to rural areas that were previously underserved or couldn’t afford the latest diagnostic technology.
A humorous story about technology occurred when a patient’s secretary called to say that her boss was too …
Patients could use more group hugs from their doctors
It will not be an ordinary table of contents. But then, the DSM-5 will not be an ordinary book.
When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders comes out in 2013, it will reflect the advances over the past two decades that have helped illuminate connections between the brain and behavior.
Functional MRI studies, for example, have provided insight into obsessive-compulsive disorder. Studies supporting a “schizophrenia spectrum” have shown …
Organizing DSM-5: The new framework of mental disorders
Whether specialists make too much money depends on whom you ask.
Policy experts
If you ask policy experts, most of whom are progressives, they will say “yes, of course, specialists make too much money.” Too many specialists making too much money spoil the national health care broth.
Just look at any other country, especially countries with government-run systems.
Specialists there make one-half of what our specialists bring home. Look at their total …
Do American medical specialists really make too much money?
by Diane Shannon, MD, MPH
Errors in communication are widely recognized as an important cause of adverse events in health care. In 2010, communication problems were the most commonly cited root cause of sentinel events, according to data reported to the Joint Commission.
In fact, communication issues were identified as a root cause of two thirds of all the sentinel …
Closing communication gaps between providers
Are you having a boy or girl? This is one of the standard questions people ask a pregnant lady. Everyone asks. It has become a kind of conversation starter. It’s not that the stranger in the grocery store really cares, but it just seems like natural thing to say. It’s part of the standard questions we ask pregnant women. How far along are you? Is there just one? When are …
Finding out the gender of your baby during pregnancy, or not
I’ve heard some physicians wonder out loud if their career has been “wasted” – either because they were on a path that wasn’t a good fit or they spent years focusing on accumulating and worrying rather than on contributing and enjoying. The question is one of personal value: Am I measuring up? And by whose metrics?
How do you measure the value of your physician career? Dollars earned? Lives saved? Honors …
What will be your legacy as a physician?
As I was getting my daily fix of ESPN recently, something a bit different than the routine scores and highlights came across my TV.
Two very talented men, both potentially bound for NFL stardom, were showcasing their talents for scouts, coaches, recruiters, and reporters – a panel of judges if you will. Although these players have certainly proved their talents in the past, these workouts will likely determine which player an …
What the physician hiring process can learn from the NFL draft
Have you noticed the recent trend against specialty physicians? Policy experts have determined that primary care needs incentives to attract medical students away from those “highly lucrative” specialties such as plastic surgery, orthopedic surgery, interventional cardiology, and neurosurgery.
Our federal government believes in equal opportunity — if you wish to become a family doctor. There are incentives sponsored …
Health reform’s prejudice against specialist physicians
Ready to learn more about nurses who work beyond the bedside? Nurses who work in the Cardiac Catheterization Lab (CCL) play an important role in cardiac care. Amy Sellers, RN blogs at Nursing Influence and graciously agreed to give us a peek at what a nurse is responsible for doing in the CCL.
Amy has worked in the Cath Lab for about 6 months now. She previously worked in cardiovascular intensive …
Nurses who work in the cardiac catheterization lab
I find that it takes more effort for me to talk patients out of doing tests than it takes to get them to submit. It doesn’t seem like it should be that way:
I need you to undergo a test where you fast for 12 hours, show up to the hospital 3 hours before the sun comes up, strip down and slide into a breezy hospital …
Talking patients out of doing tests takes effort and time
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When I was called to see the patient after a motorcycle accident I expected the worst. The patient sustained a thoracic spine injury with cord transection at T5 level as well as significant chest wall injury on the right side.
Multiple ribs were broken; some with a significant displacement. Managing patients with a significant chest wall trauma could be a nightmare. Pain control is only one of the challenges.
Read more…
Pain control in a patient with rib fractures and a spinal cord transection
by Jeffrey L. Cohen and Albert R. Meyer
Chiropractors and medical doctors (or D.O.s) have had a long and somewhat complex relationship.
Though they approach healthcare issues differently, there are many instances where they share care or even work together. Such “M.D./D.C.” relationships are legally complex, but often prove to be rewarding in many respects. Properly constructing the arrangements is critical, especially since government regulators and payers tend …
The legal issues of doctors and chiropractors working together
by Setu Mazumdar, MD
Everywhere I go I see unhappy doctors.
All everyone does is complain about rising malpractice premiums, more paperwork, declining pay, and 60 hour workweeks. This includes physicians just graduating from residency and physicians who’ve been practicing medicine for several decades.
All of those complaints are legitimate, but one question I always have in …
Physicians should blame themselves for why they are unhappy in medicine
by Greg Smith, MD
As a psychiatrist, part of my job is to listen as you tell me about symptoms that bother you every day.
If I can help you put these symptoms into a framework such as a syndrome or a disease, then we can work together on trying to figure out how to treat them. Often times in Read more…
Why cookbook medicine detracts from compassionate care
Here are the three most useful words for a doctor: “I don’t know.”
A close second would be “I’m not sure,” another three that have got me out of trouble more times than I can remember. The older I get, and more experience I have, the more useful it becomes.
Pattern recognition is essential in effective medical practice. So often patient complaints are vague and nondescript, and in the absence of physical …
The three most useful words for a doctor
Doctors who do not successfully e-prescribe 10 times for Medicare patients in the first six months of 2011 using claims-based reporting may be hit with a 1% penalty on their Medicare Part B payments for covered professional services in 2012.
The penalty will increase to 1.5% in 2013 for those who don’t e-prescribe for 25 Medicare patients during 2011.
Not yet e-prescribing?
Maybe your Read more…
E-prescribe now, or risk a Medicare penalty
To address the huge problem of errors by health professionals causing injuries and deaths to hospitalized patients, the U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius unveiled the Partnership for Patients initiative.
Secretary Sebelius referred to a recent study showing that adverse events in hospitalized patients, including those caused by human errors (i.e., preventable), occur about 10 times …
Cut hospitalizations to reduce hospital related medical errors
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