A reader informed me that Dr. Oz did a TV show recently on nosebleeds.
I took a look at the video clip and it is my opinion that some information Dr. Oz conveyed is not entirely correct. Again, I should stress that this is just my opinion and I’m sure there will be many who may feel differently.
Error #1:
Contrary to what was said on the show, ice packs do …
Teaching Dr. Oz about nosebleeds
On my drive in to work this past week I came across this:
A bus-side advertisement for a local hospital (sadly, not mine) claiming that it was “home to the city’s best transplant outcomes.” Normally I drive right by these moving billboards without paying much attention. But this time I immediately got excited, whipped out my cell phone and snapped …
How the health care industry competes for patients
An article in the Wall Street Journal, Taking Medical Jargon Out of Doctor Visits, emphasizes that the use of medical jargon leads to poor communication between physicians and patients, and consequently leads to ineffective medical care. Federal and state officials are now pushing healthcare professionals to use simpler language to communicate medical advice to patients.
I could not agree more with this mission. The gap …
Medical jargon leads to poor communication between physicians and patients
The holidays are a great opportunity to ask family members about their health history.
Learning about your family’s health history can help you answer your doctor’s medical history questions. It can even help your doctor determine if you may be at risk for an inherited cancer like breast, colorectal, ovarian, prostate or endometrial cancer, which sometimes run in the family.
Keep in mind that just a small portion of cancers – about 5 …
How to create your medical family tree
There are very few oncologic emergencies. Neoplastic epidural spinal cord compression is one of them. The delay in diagnosis and treatment is often explained by the non-specific nature of the presenting signs and symptoms.
The patient developed urinary retention a couple of weeks prior to presentation. On the morning of admission he was fully functional. Later he sat down to have a cup of coffee and boom – he couldn’t feel …
Neoplastic epidural spinal cord compression is an oncologic emergency
Here’s the scenario: on the 2nd of the month, a patient with diabetes on metformin and high blood pressure on benazepril sees her family physician for a routine follow up.
The patient’s blood pressure is elevated and the decision is made to add carvedilol to help get the blood pressure to goal. The patient’s metformin and benazepril “drop” (are renewed) at the pharmacy on the 18th of every month, a date …
Help patients synchronize their prescription drugs
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 44-year-old man is evaluated for a 2-year history of joint pain in the wrists, hands, knees, ankles, and feet. He also has a 12-year history of plaque psoriasis. His current medications include acetaminophen for joint pain, topical hydrocortisone and calcipotriene ointments, and a …
MKSAP: 44-year-old man with chronic joint pain
Whether you’re newly diagnosed with DCIS or a more advanced form of breast cancer, you’ll notice it has a big time impact. One of the things that surprised me was just how much breast cancer chews up your schedule. I had something like 38 appointments in 20 weeks, and this did not include radiation, which was not in my treatment plan.
In case you’re wondering what all those appointments were for, I had two …
How much breast cancer chews up your schedule
Patients’ gender preferences for medical care are a factor that we all know exists yet most physicians prefer to ignore it in daily practice hoping that modern medicine is gender neutral. Forty plus years ago when I started in medicine this wasn’t a consideration. Nearly all physicians were men and nurses were women. Patients simply had no choice. Male physicians felt entitled to see all comers and present day women …
Patient gender preferences for medical care
Have you ever had a cold beer after a mountain bike ride?
Oh my!
But does such indulgence put one at risk for an arrhythmia? Does alcohol exacerbate an existing arrhythmia? How much, if any, alcohol is acceptable?
These are questions I am asked frequently. And for those asking, they are very important questions.
I wish the answer was straightforward. But it is not.
Undoubtedly, excessive alcohol can precipitate an abnormal rhythm. Look no farther …
Conflicting stories on alcohol and heart disease
The psychiatrist knocks on the door of the patient’s hospital room.
Patient: “Come in.”
Psychiatrist: “Good afternoon, Mrs. Jones. I’m Dr. Moodbetter, one of the psychiatrists here. Your doctor asked me to see you. Did he say anything about this?”
Patient: “No, he didn’t! You know, I’m not nuts. I didn’t think he believed me. Great. Now he just thinks it’s all in my head.”
Psychiatrist: “Well, I don’t think he meant to imply …
Involving a psychiatrist in a patient’s care for the first time
I’m both interested in and disturbed by what some doctors have said to patients at the first consultation for tinnitus, an annoying perception of sound that comes from somewhere within their heads. Not many of these patients are referred to me – most come of their own accord for a second opinion. What they tell me their doctor said is a lesson in how not to communicate with patients, and …
Tinnitus highlights poor doctor patient communication
Dr. Ryan Flesher was working his usual shift in the emergency department that night in July of 2006. The hospital was short-staffed, per usual, and patients continued streaming through the revolving doors. Neither the people at the front desk nor the nurses saw Dr. Flesher slip quietly down the hall that night.
The following is a true story that occurred well before healthcare …
Doctors are quietly opting out of medicine
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It seems rather obvious that medical procedures should be reserved for medical indications. Why? Because almost every medical procedure, even some of the simplest, have small but real risks of complications. And risking complications can only be justified if the medical benefit outweighs the risk.
That rule applies to labor inductions, although many obstetricians have forgotten it. Induction of labor for non-medical reasons, primarily convenience, is attractive, but labor induction is …
Induction of labor should be restricted to medical indications
In our clinical years, our medical school has instituted a program in which we do learning modules along with our in hospital experience and didactics.
I was happy to see a module on empathy for my second month of surgery. The last question to be answered in this module was: “Although the studies on empathy are very consistent other authors have indicated that medical students are really not losing cognitive empathy, …
Empathy cannot be simply turned on and off
In Quality Measures and the Individual Physician, Danielle Ofri, MD, PhD questions the usefulness of feedback report cards for individual providers. She states, “Only 33% of my patients with diabetes have glycated hemoglobin levels that are at goal. Only 44% have cholesterol levels at goal. A measly 26% have blood pressure at goal. All my grades are well below my institution’s targets.”
It would be better for Dr. Ofri’s patients if …
Doctors should embrace feedback and learn from it
by Jon Meyer
Looking at the industry response to the recent study released by the Center for Studying Health System Change, Physicians Slow to E-mail Routinely with Patients – Issue Brief No. 134, it appears that a piece of the puzzle is missing. Both the study, and the analysis, put the physician at the center of the email debate. In reality, about 30% of a medical practice’s communication is from the …
Physician email implementation inertia
I am going to explain a bit about why physicians should care about online reputation management (ORM).
As the online world becomes more pervasive, reputations are increasingly built and managed on the Internet. Online Reputation Management is the process of monitoring, addressing or mitigating SERPs (search engine result pages) or mentions in online and …
Why physicians should care about online reputation management
Oncology is the area where the health care cost conundrum is coming into sharpest focus. Theoretically, who wouldn’t spend whatever it takes to cure a life-threatening disease? And yet practically the costs of new treatments are so high, and the improvements usually modest enough, that when it comes right down to it costs are becoming a real issue for patients and doctors.
An interesting article in the Journal of Clinical Oncology …
Comparative effectiveness research needs to be taught to doctors and patients
Doctors: if you’re sick, don’t go to work.
The stereotype of doctors is that they go to work, despite whatever symptoms ail them. Calling in sick places strain on colleagues. Especially in residency, where team members are expected to pick up the slack.
In a recent column, the New York Times’ Pauline Chen discusses the image of self-sacrifice that a sick doctor going to work portrays:
Hacking, febrile or racked with the …
Sick doctors who work are doing more harm to their patients than good
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