Iron filagree enhances Melbourne

Posted on 22. Nov, 2014 by in Uncategorized

I’m breaking from health care today, with a throwback to my training as a city planner.  I’m spending several days in Melbourne, Australia, and had a chance to visit some of the old neighborhoods. We spent some time walking around Drummond Street,…

Continue Reading →

Reflections after the first cadaver lab

Posted on 22. Nov, 2014 by in Education, Medical school

“To help other people overcome their injuries.” This mantra was accompanied by flushed faces, hidden trembling hands, and nervous chuckles as the majority of my peers told the class why they decided to pursue physical therapy as a career. Soon thereafter, this adage was lost as we dived into our studies, learning every bone, muscle, […]

Continue Reading →

Medicaid is Obamacare’s sleeping giant

Posted on 22. Nov, 2014 by in Health reform, Policy

To me, Medicaid is Obamacare’s sleeping giant — the enabler of federal power and control over the health system. It is a far more powerful enabler than health exchanges, which have gotten most of the publicity. It surpasses the number of uninsured and underinsured that the exchanges have enrolled. Continue reading … Your patients are […]

Continue Reading →

Young physicians should be on Twitter. Here’s why.

Posted on 22. Nov, 2014 by in Social media, Twitter

You — a medical student, resident physician or newly-minted medical attending — are late in the game.  Sure, you appropriately hopped onto Facebook during your first few years of college, only to rightly disengage around the advent of newsfeeds and cover photos.  You passively signed up to LinkedIn last winter only to remain passively aware […]

Continue Reading →

Transforming primary care to spend extra time with patients

Posted on 22. Nov, 2014 by in Physician, Primary care

When I started my internal medicine residency, I was pretty sure I was going to rock this primary care thing. I knew the drugs for hypertension, the guidelines for diabetes management, and depression management seemed like nothing more than an algorithm. I felt buoyed by familiarity as I looked at the problem list for my first primary care patient: basically […]

Continue Reading →

The attitude when it comes to treating chronic pain

Posted on 22. Nov, 2014 by in Pain Management, Physician

Here is the attitude of ER physicians: Here are a few pills to hold you out for one or two days. Follow up with your PCP — he or she should be managing your chronic pain — not me. Now get out of my ER!” Continue reading … Your patients are rating you online: How […]

Continue Reading →

MKSAP: 40-year-old woman is evaluated for a rash

Posted on 22. Nov, 2014 by in conditions, dermatology

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old woman is evaluated for a rash on her hands that has been present for 6 weeks. This rash comes and goes throughout the year and has been present for many years, but never as severe as it is now. […]

Continue Reading →

A letter to Dr. Oz for his inbox

Posted on 21. Nov, 2014 by in Medications, OB/GYN, Physician

Dear Dr. Oz, I know the #OzsInBox question on Twitter didn’t exactly go the way you or your social media team expected.You told Sen. McCaskill when she asked you about the so-called miracles and medically baseless products that you promote on your show that you view yourself as a cheerleader, but consider #OzsInBox a wake-up call that doctors […]

Continue Reading →

What’s up with the residency programs at St. Elizabeth’s?

Posted on 21. Nov, 2014 by in Uncategorized

I’ve written about the financial difficulties leading to the closure of Quincy Medical Center and have suggested that these almost inevitably resulted from the business model employed by the private equity firm that owns this hospital system.  But…

Continue Reading →

Innovation in cardiac surgery: When doctors worked with engineers

Posted on 21. Nov, 2014 by in heart, Physician, Surgery

The term “Golden Age” seemed to permeate multiple domains in the 1950s, almost to the point of triteness. The field of cardiac surgery, however, deservedly earned the term as pioneer after pioneer introduced innovation after innovation that advanced the specialty. Walter Lillehei in Minnesotta, Wilfred Gordon Bigelow in Toronto, William Chardack in Buffalo, and Ake […]

Continue Reading →

Wake up health care: Patients Google it

Posted on 21. Nov, 2014 by in Patients, Primary care, Social media

I have to thank my colleague @SusannahFox for alerting me to this on my Twitter stream. It was a link to a Washington Post article about about a campaign to get people in Belgium to stop Googling their symptoms. Continue reading … Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. […]

Continue Reading →

Is a Google pill the only hope for cardiovascular disease detection?

Posted on 21. Nov, 2014 by in conditions, heart

Last year, Dean Dupuy, 46, an engineer at Apple, suddenly died of a heart attack while playing hockey. He experienced no warning symptoms and, with a healthy, active lifestyle, did not fit the profile of someone at risk. Too late to save him, Dupuy’s wife Victoria discovered that early coronary disease can be identified by […]

Continue Reading →

When it comes to advocacy, some doctors don’t have anything left to give

Posted on 21. Nov, 2014 by in Education, Medical school

We like to say good things; we try to make normative to our profession to do the things that should be done. Many of us are saying that physicians should be advocates for their patients and communities outside of the clinic. Sounds good right? Unfortunately, what sounds good is not always a reality on the […]

Continue Reading →

Avoid these 4 mistakes when using a computer in the exam room

Posted on 21. Nov, 2014 by in Health IT, Tech

With the growing usage of EHRs, more and more doctors are bringing their computers and tablets with them into the exam room. But just because you’re using a computer in the exam room, it doesn’t mean that you’re using it properly. Computers can be one of the most beneficial tools you use in an exam […]

Continue Reading →

Top stories in health and medicine, November 21, 2014

Posted on 21. Nov, 2014 by in Nephrology, Neurology, News, Primary care, Rheumatology

From MedPage Today: Clinical Focus in MS: Novel Approaches to Progressive Disease. Although the drug development pipeline still contains numerous products intended for patients with relapsing-remitting multiple sclerosis (RRMS), the consensus among clinicians is that relapses can be effectively squelched in nearly all RRMS patients with the dozen or so currently approved therapies. Clinical Focus in […]

Continue Reading →

Lean is not a program

Posted on 21. Nov, 2014 by in Uncategorized

Over two years ago, I wrote a post saying, You don’t “do Lean.”  Beyond suggesting that there should be a form of medical malpractice lawsuit against those consulting firms that promise hospitals that they will teach them how to “do Lean,” I summ…

Continue Reading →

Do doctors find MOC helpful? Is it important to patients?

Posted on 20. Nov, 2014 by in medical education, politics and policy

Not according to this survey.

Continue Reading →

Money for nothing: The dire straits of EHRs

Posted on 20. Nov, 2014 by in Health IT, Tech

I’ve previously written about my experience with poorly designed electronic health records and how it negatively impacts provider happiness and patient safety.  Apparently, I’m not alone in my experiences and my sentiments about this subject. Continue reading … Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. […]

Continue Reading →

Study Supports Giving Kidney Donors Priority When They Need a Kidney

Posted on 20. Nov, 2014 by in Nephrology, Organ Transplants, News,

Most former donors got a needed organ relatively quickly, researchers say

Continue Reading →

FDA Approves ‘Abuse-Resistant’ Narcotic Painkiller

Posted on 20. Nov, 2014 by in Family Medicine, Pharmacy, Dependence, Preventive Medicine, News,

Agency says it’s latest step in curbing epidemic of addiction to drugs such as Oxycontin, Vicodin

Continue Reading →

MRI Can Be Painful, Disruptive for People With Cochlear Implants

Posted on 20. Nov, 2014 by in Family Medicine, ENT, Radiology, Research, Surgery, News,

Study finds some patients had to discontinue the scan, or the hearing device was impaired by magnetic field

Continue Reading →

Abuse-Resistant Prescription Painkiller Approved

Posted on 20. Nov, 2014 by in Family Medicine, Pharmacy, Dependence, FDA Approvals,

Hysingla ER is only for chronic pain, and is formulated to resist crushing, dissolving

Continue Reading →

Severity assessment in pulmonary embolism: a need for consistency

Posted on 20. Nov, 2014 by in cardiovascular, pulmonary

As it does for many conditions, severity assessment of pulmonary embolism guides treatment. Severity assessment for PE is more important than ever these days because treatment options have multiplied. There are now many more decision points than we h…

Continue Reading →

Is it ever appropriate for us to choose the timing of our death?

Posted on 20. Nov, 2014 by in Palliative care, Physician

Human life is a gift.  Death, too, can be a gift.  Is it ever appropriate for us to choose the timing of our death? Brittany Maynard, 29, was diagnosed with a stage 4 glioblastoma, an aggressive and uniformly fatal brain tumor.  With the blessing of her family and millions of supporters around the world, she […]

Continue Reading →

Testosterone Plays Minor Role in Older Women’s Sex Lives, Study Finds

Posted on 20. Nov, 2014 by in Endocrinology, Gynecology, Reproductive Medicine, News,

Quality of relationships may have more impact on libido

Continue Reading →

Many People Who Drink a Lot Aren’t Alcoholics: CDC

Posted on 20. Nov, 2014 by in Dependence, Preventive Medicine, News,

But raising price of alcohol and limiting sales could help curb excessive drinking, researchers say

Continue Reading →

U.S. Proposes Greater Public Access to Data From Clinical Trials

Posted on 20. Nov, 2014 by in Family Medicine, Research, Preventive Medicine, News,

New rules would require even failed trials to publish summary of results

Continue Reading →

Exercise Might Not Help Some Type 2 Diabetics Control Their Blood Sugar

Posted on 20. Nov, 2014 by in Research, Diabetes, Sports Medicine, Nutrition, News,

Study suggests that about 20 percent of patients carry
‘exercise-resistant’ genes

Continue Reading →

Neuraminidase inhibitors for influenza: what does the evidence really show?

Posted on 20. Nov, 2014 by in Infectious disease

This has been the subject of controversy. Here is an evidence summary published in a recent issue of the Annals of Energency Medicine. From the article:

This Cochrane review demonstrates that oseltamivir shortens symptom duration by 21 hours in pati…

Continue Reading →

Cost of Diabetes Care Keeps Climbing, Report Shows

Posted on 20. Nov, 2014 by in Family Medicine, Nursing, Diabetes, News,

Increases also seen for prediabetes, undiagnosed diabetes care

Continue Reading →