When it comes to doctor- nurse interactions, when is enough, enough?Recently, I dealt with an upsetting situation involving a physician and nurse. A little background: The nurse has been working on our unit for years (since it first opened). She is very smart and savvy when it comes to nursing. She constantly gets feedback from the patients as being one of the kindest, most thorough nurses. I look up to ...
There has been so much change in medicine, physicians are leaving primary care, and new ideas are being bantered about such as patient centered medical homes (PCMH) and accountable care organizations (ACO), in an attempt to try to address the problem. To add to this strain, is the knowledge that medicine is going to have to be ready to absorb thousands of additional patients in the near future ...
This series is brought to you by MedPage Today.1. Texting May Turn Teens Off Alcohol. Being in touch with teens via text about their drinking habits may make them put down the bottle.2. 'Brain-Eating' Amoeba Kills Second Neti Pot User. Louisiana state health officials are warning patients about potential dangers of using tap water in the sinus-irrigating neti pot after two patients died of Naegleria fowleri ...
"Medical training rarely deals with helping the dying patient find peace and comfort. In fact, most physicians are uncomfortable with the entire subject. I believe it is one of the most neglected aspects of medical care. I have spent my career as a pulmonary and critical care physician, and I have cared for thousands of dying patients. In many cases, both the patients and I knew that they were dying. ...
The recently instituted 30-hour-shift work restrictions placed on medical residents have created a need for "dayfloat" services to safeguard potentially unsafe handoffs in patient care and help residents adhere to duty hour limits. The past two weeks I’ve been the dayfloat resident for the cardiology inpatient service. My job is to round with the post-call team, help them get out of the hospital on time, and then take care of their ...
In Clay Shirky's engaging book Here Comes Everybody, he describes how professionals can be blindsided by disruptive competitors. It got me thinking about medicine.Traditionally, new technologies reached medicine in a top-down direction. The invention of MRI, for example, was first introduced to hospital administrators and department chairs as a potential new diagnostic tool. Once accepted, others further down in the medical hierarchy gained exposure.This technology wasn't disruptive because it didn't ...
Our children (and grandchildren) are the future and we are responsible for their growth and development. As responsible parties, we are clearly failing.That is my interpretation of the report issued a few days ago by the Centers for Disease Control (CDC) on seven criteria known to the associate with ideal cardiovascular health as part of the National Health and Nutrition Examinination Survey. They are defined, briefly, as 1) a diet ...
I just returned home from mHealth Summit Meeting in DC which, in my opinion, is still one of the biggest and best mobile health conferences of the year. On the first day of the conference, I discussed the EndoGoddess App as a use case example of mobile health from the practicioner point of view.Sadly, the numbers of physicians in the mobile health entrepreneural space at mHealth Summit were still few and essentially ...
I took a deep breath. I had to think carefully. It's not that this was unexpected - Johns Hopkins has been anointed the country's best hospital for 21 years running by US News. But I wanted to tell the patient the truth without alienating them or failing to mention the many admirable aspects of my institution.One truth, however, cannot be denied: to call one hospital the best is not simple.Let's ...
What causes a doctor to commit suicide?A story about a radiation oncologist from Springfield, IL brought this strange case to my attention. Dr. Thomas G. Shanahan committed suicide by cutting his throat in November of 2011. He was respected in his field, having published many research papers and traveled the world helping to set up brachytherapy clinics in several countries. He also had been an acting alderman in ...
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 38-year-old woman is evaluated in the office for a 10-month history of increasingly frequent headache. The headache is often worse in the morning on awakening. She has recently started keeping a headache diary, which reveals episodes on approximately 25 days of each month. The ...
It is critical for physicians to share unusual patient diagnoses that present to clinic with routine type symptoms. In a hospital setting, these are cases for discussion and debate at Grand Rounds. In a primary care setting, we do case reviews when we can with informal sharing for the purpose of teaching and learning. The bottom line, whether in a formal academic setting, or an informal setting around the lunch ...
I remember like it was yesterday. My patient was a young blond female with two beautiful Samoan dogs. Her name was Margaret. I was only two years younger than she was. The diagnosis was poor. She was friendly when I introduced myself. And she proceeded to tell me about her health issues, how she was diagnosed and what treatment she was receiving. Marge as she wanted to be called was ...
While attending the Institute for Healthcare Improvement Annual Forum recently, my friend, Jared Conley, and I had the good fortune of finding ourselves standing a table away from Don Berwick in a relatively empty conference room. As MD/PhD in Health Policy students, we were interested in asking him a question about ACOs, so we approached him and introduced ourselves, hastily adding, "We know you’re busy, so we just have ...
Times are tough for pharmaceutical reps, with many hospitals and physician offices banning their sales visits.But, there's hope for those out of a job. Consider the physician liaison.Faced with budget cutbacks, hospitals are becoming more aggressive growing their market share. They are not only buying physician practices, they want more doctors to admit, refer to and use their ...
In the era of accountable care, you’ll notice that many hospitals and health systems are already driving towards more collaborative workflow. The integrated delivery network (IDN) is changing significantly, and for the better. But in high-acuity care areas, like the emergency department (ED), the challenge of treating patients more holistically in what is already a fast-paced environment is concerning for physicians evaluating the pay-for-performance model.In today’s ED, patients ...
This series is brought to you by MedPage Today.1. Delirium Linked to Contact Protocol. Hospitalized patients who are transferred to isolation after admission have a greater risk for developing delirium than patients who are admitted to hospitals under contact precautions.2. Risk Seen With Sleepy Docs. Despite efforts to limit working hours among healthcare providers, fatigue continues to pose hazards to staff and patients alike.3. Liberal ...
Almost four years ago now, I left my practice as an emergency medicine physician to enter the business world. However, the medical world isn’t easy to escape. I just couldn’t seem to forget some of the problems I used to face in the emergency department. So, when I had the chance to fix one of them, I took it.The most intractable problem for me was fraud, especially as it related ...
I’ve heard applying to medical schools can be a soul crushing process, but I didn’t really quite get it until I got hurled into the process myself. Although I still wouldn’t describe this as "soul crushing," it has certainly brought out a lot of insecurities in me and my accomplishments. Do they not like my stated reasons for pursuing medicine? Do my extracurricular activities seem phony and under-whelming? Is this ...
I usually cringe when I see a pharmaceutical company ad on TV. I think most pharma commercials do more harm than good. The ads scare patients out of taking medications they need.Actor: Do you have uncontrollable diarrhea? I did, and then my doctor prescribed “No-More-Poop!” Now I feel great and don’t have to worry about embarrassing accidents.Commentator: Clinical studies done at a leading university prove that “No-More-Poop” cures 99% of ...
Times are tough for pharmaceutical reps, with many hospitals and physician offices banning their sales visits. But, there's hope for those out...
Imagine that your neurosurgeon, during surgery, was talking on his cellphone using a headset. Unthinkable? Well, no. A recent article in the...
When I talk about online presence to physicians, the first question I'm often asked is, "How do I remove a negative physician...
Pediatrician Rahul Parikh has a great piece in Salon, Why doctors can’t say no. You should go read it. In the piece,...
When it comes to doctor- nurse interactions, when is enough, enough? Recently, I dealt with an upsetting situation involving a physician and...
There has been so much change in medicine, physicians are leaving primary care, and new ideas are being bantered about such as...
"Medical training rarely deals with helping the dying patient find peace and comfort. In fact, most physicians are uncomfortable with the entire...
I took a deep breath. I had to think carefully. It's not that this was unexpected - Johns Hopkins has been anointed...
The recently instituted 30-hour-shift work restrictions placed on medical residents have created a need for "dayfloat" services to safeguard potentially unsafe handoffs...
Our children (and grandchildren) are the future and we are responsible for their growth and development. As responsible parties, we are clearly...
I remember like it was yesterday. My patient was a young blond female with two beautiful Samoan dogs. Her name was Margaret....
I have not always been excited to hear patient complaints. As a younger manager I absolutely dreaded when a patient wanted to...
While attending the Institute for Healthcare Improvement Annual Forum recently, my friend, Jared Conley, and I had the good fortune of finding...
In the era of accountable care, you’ll notice that many hospitals and health systems are already driving towards more collaborative workflow. The...
A guest column by the American Medical Association, exclusive to KevinMD.com. Last month, physicians from all states and specialties came together for the American...
As we approach the end of what has been another roller-coaster year for our country, it seems an appropriate time for an...
In Clay Shirky's engaging book Here Comes Everybody, he describes how professionals can be blindsided by disruptive competitors. It got me thinking...
I just returned home from mHealth Summit Meeting in DC which, in my opinion, is still one of the biggest and best...
The term globalization loosely refers to the increasing unification of order. It has been traditionally applied to the economic sector. As the...
It can’t be ignored that dramatic transformation in our healthcare system is imminent. The economy, market forces and increasing political demands will...
Have you ever Googled yourself or your practice? Did you know that you have an ever growing online reputation? Whether you know...
The world of healthcare is inherently siloed, tethered, fragmented and prone to poor communication and collaboration. Today, healthcare workers solve their problems...
Doctor, do you Tweet? No, not really. I registered on Twitter some years ago and began but did not keep it up,...
It’s not easy trying to describe the importance of family medicine in 140 characters. Just a few months after I logged on...
