Specialty Care

Specialists writing on KevinMD about their practices: what private equity does when it buys a specialty group, from dermatology roll-ups to staffing companies, and whether nurse practitioners and physician assistants belong in every specialty and on what terms. Two maintained records draw on this archive: Private equity and corporate medicine: what physicians say, in their own words and Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words.

Linking the USPSTF mammogram guidelines to their virtual colonoscopy recommendations

Kevin

Conditions and Diseases

January 7, 2010

by Mark E. Klein, MD

“I think anytime you use science to kind of fundamentally change what people are used to, I think it’s a difficult thing to grapple with.” So spoke Ned Calonge, chair of the United States Preventive Services Task Force (USPSTF) in explaining the reaction to that group’s recommendation to radically alter their previous guidelines for breast cancer screening. Regrettably the incorrect application of science, as in …

Doctors owe their patients some fiduciary responsibility

Kevin

Physician

January 7, 2010

Originally published in HCPLive.com

by Jeff Brown, MD

Fiduciary responsibility is the obligation for people entrusted with financial affairs to act in their client’s best interest, theoretically being both transparent in their dealings and accountable for them. Typically, this applies to CPAs, lawyers, financial advisers and the like. Would that it were also true for our legislators, but that’s a story for another day. To the point, physicians do not usually think …

Despite no cure, progress in the treatment of HIV/AIDS

Kevin

Conditions and Diseases

January 6, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

It’s 1984. A 20-year-old homosexual man walks into the clinic complaining of swollen glands.

It could well be a death sentence.

It is only three years since the first handful of cases of what would come to be known as acquired immune deficiency syndrome (AIDS) were described. Little is known about …

Public hospitals are the unsung jewels of our healthcare system

Danielle Ofri, MD, PhD

Physician

January 5, 2010

Public hospitals have a bad rap. They’re viewed by many as hospitals of last resort, and most patients with private insurance do anything to avoid them.

As a long-time physician in a public hospital, I’m sensitive to this reputation. I wouldn’t work in my hospital if I didn’t feel that it delivered excellent health care. I’m certainly aware that private hospitals have amenities that public hospitals can’t afford, but many of …

What’s the most popular way to diagnose a pulmonary embolism?

Kevin

Conditions and Diseases

January 4, 2010

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Emergency physicians and radiologists overwhelmingly choose computed tomography (CT) imaging to diagnose pulmonary embolism, a potentially deadly blockage of lung arteries, a new study found.

Ninety percent of radiologists and 96% of emergency physicians use CT as their first-line choice for the diagnosis of pulmonary embolism, according to a report …

How to tell a family that their loved one has died

Kevin

Patient

December 30, 2009

by Tim Noonan

When a team misses out on an opportunity to go to the Super Bowl, World Series, Final Four, or something similarly trivial, these words may be appropriate. When the person, who has been the center of your life dies, what is more insensitive than, We’re sorry for your loss?

What kind of language is that to use when providing some of the worst news we could imagine? True, we …

How to find the best cancer specialist for you

Kevin

Conditions and Diseases

December 29, 2009

by Dana Griffen

Receiving a cancer diagnosis is an upsetting experience for the patient, as well as his or her family and friends. Cancer patients are thrust into a new world with new language and new rules. Knowing where to turn and who you can trust is a huge concern.

One of the first things a cancer patient will discover is that he or she will not be treated by only one …

A cockpit checklist to improve patient safety

Kevin

Physician

December 29, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Medical teams should take a lesson from airplane crews, a new study concludes.

Medical personnel who used procedural checklists modeled after preflight checklists used by airplane crews were more likely to report safety-related incidents and feel empowered to address safety issues, according to an online report in the Dec. 21 …

A review of the latest stroke studies

Kevin

Conditions and Diseases

December 23, 2009

Originally published in HCPLive.com

by Victor G. Dostrow, MD

There are some recent developments in the world of stroke, which are interesting:

The first manuscript is an evaluation of stroke risk and the “stroke belt” (North Carolina, South Carolina, Georgia, Tennessee, Arkansas, Mississippi, or Alabama).

The authors evaluated stroke risk measured over three decade census intervals for persons aged 30 to 80, based on …

Read more…

A review of the latest stroke studies

How constant H1N1 breaking news updates may be going too far

Jeffrey Hall Dobken, MD, MPH

Conditions and Diseases

December 23, 2009

Originally posted in MedPage Today

She is 11, a fifth grader, as prepubescent as nature allows, and utterly terrified.

She hasn’t eaten normally for nearly a month, her mother reports. She sleeps poorly, reports nightmares, and cleans her hands so obsessively that she is literally bleeding raw.

Her fifth grade peer group typically does not guard its language nor govern its remarks, …

How doctors can afford to have a vacation

Kevin

Physician

December 22, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

Now this is a fun topic. I’ve always liked writing, “For a vacation” on a script pad for those stressed out patients who need to go on one. Even a weekend away, or in this economy, a “staycation.” It’s good for the soul. And it’s a good use of medical authority to help your patients.

…

How only lawyers can determine medical standard of care

Michael Kirsch, MD

Physician

December 20, 2009

by Michael Kirsch, MD

A medical malpractice case was recently filed against me.

I received the thick envelope from noble and altruistic Cleveland barristers about 6 weeks ago. Once again, I saw my name in the good company of many other physicians and our local hospital. I reviewed my medical records and felt comfortable with the care I had provided. In a medical malpractice case, quality of medical care is important, …

How doctors can show respect to patients

Danielle Ofri, MD, PhD

Patient

December 18, 2009

“Angelina Gomez,” the medical assistant hollers out to the crowded waiting room. As always, I cringe when I hear this. It sounds so harsh, so cattle-like. I know that the assistant is actually a gentle and caring person, and I understand that he uses a loud voice so that he can be heard over the general din of a large waiting room.

Nevertheless it feels horrible to me, so demeaning, like …

Best ways to get more patients for your medical practice

Kevin

Physician

December 18, 2009

Originally published in HCPLive.com

by Ed Rabinowitz

Pump up the volume. That’s what physician practices would like to do, and it has nothing to do with louder music. An increase in patient volume is the goal of virtually every practice. Even though the economy is struggling, there are still things physicians can do to increase the foot traffic passing through the practice’s corridors. And according to Drew Stevens, PhD, a practice management …

How can quitting smoking improve lung function in patients with asthma?

Kevin

Conditions and Diseases

December 18, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Asthmatic smokers who quit the habit can reverse lung damage that exacerbates their breathing difficulties, regardless of how long and how often they smoked in the past, a Dutch study found.

The lungs of asthmatics who stopped smoking were in similar condition to those of asthmatics who never smoked, based …

Explaining basic radiation therapy terms to cancer patients

Kevin

Conditions and Diseases

December 17, 2009

Originally posted in HCPLive.com

by Colleen O’Leary, RN, MSN, AOCNS

I have always been very intrigued by the various forms of radiation therapy and used to relish the day that I would take my basic oncology class to the radiation oncology department for a tour. I learned something every time. But now, with the advent of new technology and the trend for facilities to advertise that they have the biggest and best …

How an iPod Touch can make you a better doctor

Iltifat Husain, MD

Physician

December 17, 2009

There has been a great deal of commentary profiling medical applications that are useful for healthcare providers. However, there hasn’t been much talk about how mobile medical applications can enhance the doctor-patient experience and in turn help optimize your practice’s overall experience. In future posts, we’ll focus more on applications for medical providers, but this post will discuss applications centered around the physician-patient relationship.

12 most important medical advances of the decade

Dr. Charles

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 …

Read more…

12 most important medical advances of the decade

How doctors can stay up to date with current medical information

Kevin

Patient

December 14, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

With the amount of research being published in medical journals and presented at meetings, it should not be surprising when a new finding slips by a busy physician.

Nor should it be surprising, then, that some decisions about patient care might be made without benefit of the most recent evidence.

Although experts …

Some patients won’t accept a conservative approach to medical treatment

Michael Kirsch, MD

Conditions and Diseases

December 12, 2009

by Michael Kirsch, MD

Who says one person can’t make a difference? This past week, I personally set back health care reform. No, I wasn’t attending a ‘tea party’ or decrying Obamacare in a venomous letter to the editor. I single-handedly bent the health care cost curve in the wrong direction. I performed an unnecessary medical test on a hospitalized patient, which exposed her to risk and cost the system money. …

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