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.

A patient dies after doctors fail to communicate in the operating room

Physician
September 10, 2009

by Jerry I. Meyers, Esq.

Communication is essential between health care providers but sometimes communication fails because of the arrogance or carelessness of the persons involved in the needed medical communication.

Several years ago, a female client about to enjoy an important anniversary was admitted to a University affiliated hospital for the purpose of having a colostomy wound debrided.

This was to be a one-day inpatient hospital procedure and was associated with little …

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A patient dies after doctors fail to communicate in the operating room

A routine brain MRI can lead to incidental findings

Conditions and Diseases
September 10, 2009

by Nancy Walsh, Contributing Writer, MedPage Today

Almost 3% of healthy, asymptomatic people who underwent MRI brain scans showed incidental abnormalities in a recent study, leading researchers to express concern about psychological and medical fallout from these increasingly popular screenings.

medpage-todayIn meta-analysis of MRI brain scans, the prevalence of neoplastic incidental findings was 0.70% (95% CI 0.47 to 0.98), while the …

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A routine brain MRI can lead to incidental findings

Do resident work-hour restrictions increase surgical complications?

Medical Education
September 8, 2009

by Chris Emery, Contributing Writer, MedPage Today

Reductions in resident physician work-hours at teaching hospitals in 2003 were associated with an increase in complications related to surgery to repair hip fractures, a new study found.

medpage-today The rates of pneumonia, hematoma, renal complications, and blood transfusions associated with hip surgery rose disproportionally at teaching hospitals compared to other hospitals after resident …

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Do resident work-hour restrictions increase surgical complications?

What Mozart can teach us about superbugs and antibiotic resistance

Conditions and Diseases
September 6, 2009

by Maya Sequeira

Composer Wolfgang Amadeus Mozart’s death in 1791 has long been a mystery, but a new study published in the Annals of Internal Medicine suggests that it was, of all things, a common strep infection that killed the maestro at the age of 35.

Researchers speculate that Mozart contracted the strep infection—easily treatable today—from a fellow musician who had been hospitalized at a crowded military hospital in Vienna. It’s not …

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What Mozart can teach us about superbugs and antibiotic resistance

The drama of using tPA in stroke within the three-hour window

Conditions and Diseases
September 6, 2009

Before telling this story, I’m going to have to lay some background for my non-medical readers.

The most obscene word in English, in my opinion, has three letters and is an acronym. It’s tPA (it stands for Tissue Plasminogen Activator).

This drug gets a lot of press as a “clotbuster.” It has the potential to break down clots and reverse a stroke. That potential, however, has a dark side. By breaking down …

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The drama of using tPA in stroke within the three-hour window

eRoentgen for the iPhone puts a radiologist by your side

Conditions and Diseases
September 5, 2009

The following is a sponsored guest post by Constantine Brocoum, a radiologist in Concord, NH. I have personally used eRoentgen, and recommend the product without reservation.

by Constantine Brocoum, MD

Like most inventions, eRoentgen was developed to respond to a need. As a practicing radiologist, I take frequent calls from primary care providers who need assistance in choosing the smartest way to diagnose their patients’ illnesses. They often need …

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eRoentgen for the iPhone puts a radiologist by your side

The ultrasound that saved a baby girl’s life

Patient
September 3, 2009

by Linda Lee, MD

Bob Hebert, in his column in The New York Times, recently wrote that, “Life in the United States is mind-bogglingly violent. But we should take particular notice of the staggering amounts of violence brought down on the nation’s women and girls each and every day for no other reason than who they are. They are attacked because they are female.”

As a family physician I can …

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The ultrasound that saved a baby girl’s life

What can health reform in the United States learn from Africa?

Health Policy
September 2, 2009

As an outside observer of the American health reform debate, I cannot help but notice the disparity of views, the fractured arguments, the protectionism and desperation. My country is in a similar struggle for health care reform, with the main difference being America is a rich nation, and we are poor by comparison. In both debates, however, I have looked for the humanitarian argument, and in many cases found it …

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What can health reform in the United States learn from Africa?

Is alternative health a form of fundamentalism?

Physician
September 1, 2009

There once was a time when all food was organic and no pesticides were used. Health problems were treated with folk wisdom and natural remedies. There was no obesity, and people got lots of exercise. And in that time gone by, the average lifespan was … 35!

That’s right. For most of human existence, according to fossil and anthropological data, the average human lifespan was 35 years. As recently as 1900, …

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Is alternative health a form of fundamentalism?

Health care reform: The uncivil war dividing America

Health Policy
August 31, 2009

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

The unfettered debate about ideas that characterizes the democratic process in the United States operates best when there is a truthful presentation of the issues, and when the process is civil and respectful. Unfortunately, the debate about health care reform has evolved to the point that it …

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Health care reform: The uncivil war dividing America

New troponin tests to better diagnose a heart attack

Conditions and Diseases
August 27, 2009

by Crystal Phend, Senior Staff Writer, MedPage Today

A generation of new, more sensitive troponin assays has improved hospitals’ ability to diagnose a heart attack to a point as early as the time of emergency department presentation, two separate studies affirmed.

medpage-today1 In one multicenter study, a sensitive troponin I assay had an early diagnostic accuracy of 96%, compared with conventional …

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New troponin tests to better diagnose a heart attack

Robert Ricketson and the surgical screwdriver medical malpractice case: The medical records revisited

Physician
August 11, 2009

Robert Ricketson is a spine surgeon who was involved in a high profile 2003 medical malpractice case in Hawaii where a surgical screwdriver was implanted into a patient’s back. This is his account of the ordeal.

by Robert Ricketson

I am writing today out of frustration and anger, as I am frankly quite tired of passively going along as my name appears year after year in malicious “medical blogs” and …

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Robert Ricketson and the surgical screwdriver medical malpractice case: The medical records revisited

Should doctors support Congress’ health reform efforts?

Health Policy
July 20, 2009

The American Medical Association recently gave unqualified support to the House health reform bill, H.R. 3200, and that is drawing the ire of some of their supporters.

To be sure, H.R. 3200 is the most left-leaning of the proposals, and there is clear ideological opposition to the so-called “public plan,” which expands the government’s role in our health care system. It’s a tremendously sensitive topic, with some expressing their outrage …

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Should doctors support Congress’ health reform efforts?

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Health Care Reform: Putting Patients First, medical bloggers at Washington, DC

Health Policy
July 20, 2009

Well, that was fun.

kevinmd This past Friday, I participated in Health Care Reform: Putting Patients First, an event put together by Better Health’s Dr. Val Jones. It was an impeccably organized gathering, and provided medical bloggers a valuable opportunity to discuss health care reform. Great timing too, given the fact that two major reform bills were introduced earlier …

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Health Care Reform: Putting Patients First, medical bloggers at Washington, DC

How did Michael Jackson die, and the medicine behind sudden cardiac death

Conditions and Diseases
June 25, 2009

Michael Jackson is dead at age 50.

I’ve received several e-mails to comment on this story, but there’s really too few details to go on. I’m sure more will emerge in the near future.

According to news reports, emergency medical services were called to his home in Los Angeles, where he was found in presumed cardiac arrest. CPR …

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How did Michael Jackson die, and the medicine behind sudden cardiac death

Maggie Mahar: Removing the hazardous waste from healthcare

Health Policy
June 8, 2009

Most of us are now familiar with the estimates that as much as one-third of our health care dollars are squandered on ineffective, often unnecessary, unproven and overpriced products and services. But which third?

The fat in our health-care system is not hanging out conveniently on the edges of the steak, waiting to be trimmed. It will take a scalpel, a keen eye, and a steady hand to remove at least …

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Maggie Mahar: Removing the hazardous waste from healthcare

5 top medical comments, June 7th 2009

Health Policy
June 7, 2009

Here are some of the more interesting comments readers have left recently.

1. David Block on the ACP’s guest column, A practice model for increasing the appeal of General Internal Medicine:
Weinberger talks about the efficiency of Care. Our commentators talk about the efficiency of Consumption. Weinberger assumes the one-on-one of two individuals, known to each other, who together negotiate the terms of personhood. Medicine is “spiritus”; no wonder he became …

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5 top medical comments, June 7th 2009

ACP: A practice model for increasing the appeal of General Internal Medicine

Physician
June 1, 2009

The following is the first in a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

Much is written and discussed these days about the importance of care coordination by a primary care physician, not only to facilitate patient-centered quality of care, but also to curb the unsustainable growth in the nation’s health care tab. Yet, we hear that the current shortage of …

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ACP: A practice model for increasing the appeal of General Internal Medicine

How much time do doctors spend on paperwork?

Physician
May 29, 2009

A common complaint is that doctors these days are spending more time doing clerical tasks.

Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do not need a medical degree to do these tasks.

Bob Doherty points to a study that gives some numbers to back up the claims. Primary care doctors spend about 3.5 …

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How much time do doctors spend on paperwork?

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